ISSN (Print) - 0012-9976 | ISSN (Online) - 2349-8846

Healthcare in IndiaSubscribe to Healthcare in India

Birth Pangs

In June 2018, a small survey of the Pradhan Mantri Matru Vandana Yojana in two blocks of Jharkhand—Manika in Latehar district and Khunti in Khunti district—examined the status of the scheme and the problems faced by women at the time of pregnancy and delivery, such as health expenditure, inadequate nutrition, and loss of income. The findings call for better implementation of the scheme, as well as make a case for maternity benefits to be raised to a minimum of ₹6,000 per child for all pregnancies and not just for the first living child.

Role of the Private Sector in Escalating Medical Inflation

​ The dominance of the private sector as the provider of healthcare induces inflationary pressure on the household budget and potentially on the government health budget through the insurance route. Analysing 75th round NSS data, it is found that treatment costs in private commercial hospitals as well as in private charitable hospitals are manifold compared to public facilities.

Revisiting Open Defecation

Since October 2014, the Government of India has worked towards the goal of eliminating open defecation by 2019 through the Swachh Bharat Mission. In June 2014, the results of a survey of rural sanitation behaviour in North India were first reported. The results from a late 2018 survey that revisited households from the 2014 survey in four states—Bihar, Madhya Pradesh, Rajasthan, and Uttar Pradesh—are presented. Although rural latrine ownership increased considerably over this period, open defecation remains very common in these four states. There is substantial heterogeneity across states in what the sbm did and how. These outcomes suggest the need for a transparent, fact-based public dialogue about the sbm, its costs and benefits, and its accomplishments and means.

Gamechanger or a Trojan Horse?

The Maternity Benefit Act, 1961, a key legislation in India that enables women to transcend the public–private dichotomy and stake their claim for productive participation in the labour force, saw major amendments in 2017. Four aspects of the amendments—increased maternity leave, maternity leave for adoption and surrogacy, provision of crèche, and paternity leave—are juxtaposed with feminist and constitutional principles as well as ground-level realities and practices. An increase in maternity benefits in law with a neglect of paternity leave and benefits is a lopsided approach that further reinforces gendered division of labour and care work as the domain of women. The social responsibility of employers is emphasised, and a deeper engagement of the state with the policy of parental benefits is advocated.

Making Rural Healthcare System Responsive to Domestic Violence: Notes from Patan in Gujarat

Domestic violence affects more than one-third of the women population in India, causing physical, mental, and psychological trauma to the survivors. While there have been specific interventions in urban India to combat gender violence, rural India is still in want of such initiatives. Against such a backdrop, the Society for Women’s Action and Training Initiatives has devised a novel initiative to tackle domestic violence in rural Patan district of Gujarat by collaborating with the existing healthcare system. Since 2012, it has been able to offer counselling, mediation, relief, and legal recourse to the victims of violence.

Health Insurance in Private Hospitals

Private hospitals are expected to play a key role in the implementation of government-sponsored health insurance schemes in India. Examining the availability and spread of private hospitals in the country and an analysis of their empanelment in government-sponsored health insurance schemes reveal that in low-income states of the country, empanelment of private hospitals by insurance companies is low and concentrated in a few pockets. This may indicate differences in entry conditions or low willingness of private hospitals to participate in these schemes, which has implications for the access to healthcare and insurance for the poor.

The Injustice of Child Mortality

A Shot of Justice: Priority-Setting for Addressing Child Mortality b y Ali Mehdi, New Delhi: Oxford University Press, 2019; pp xxiv + 247, ₹995

Women’s Education and Fertility in the Hindi Heartland

Using evidences from the Sample Registration System and the third and fourth rounds of the National Family Health Survey, this article shows that the fertility rate continues to be high in the Hindi heartland of the country, and that too among educated women. It also proposes some plausible hypotheses in this regard, which would require validation through further research.

National Medical Commission Act, 2019

The relevance, provisions and the implications of the National Medical Commission Act, 2019 for the future of medical education and health practice in the country are examined here. This act is a step towards improving governance and introducing reforms with the potential to create an enabling environment, and facilitate standardisation in processes and transparency in the functioning of the health sector.

Changing Wealth Inequalities in Child Nutrition in Indian States

How have wealth inequalities in child nutrition changed in the major states of India between the last two rounds of the National Family Health Survey? The temporal change in the likelihood of child stunting in the poorest quintile of households vis-à-vis the richer quintiles is examined. Alternative measures of wealth inequality in child nutrition, based on the ranking of the households’ wealth scores (namely the concentration index and the extended concentration index), are also used to see how the magnitudes have changed. The poorly performing states have not only retained the last ranks in terms of average stunting, but have also faltered in the reduction of stunting during the decade under study. In three of these states, the improvement in child stunting has disfavoured the poor by all measures. Comparing the concentration index and the extended concentration index for the two rounds, it is found that inequality in stunting has increased in all the states excluding Uttarakhand. This calls for immediate policy attention, since children from the poorest households in the backward states seem to suffer from the dual burden of the state effect and the class effect.

Dementia and the Challenges of Caregiving: A Personal Account

Dementia, an incurable and neurodegenerative brain disease, affects millions of elderly in India, and remains a hidden epidemic. However, little is being done by the government to enable individuals affected by the disease to live with dignity and respect in the society.

National Medical Commission Act

The National Medical Commission Act, passed by Parliament in July 2019, has been billed by the government as the “biggest reform” in the medical profession and a “pro-poor legislation” that shall make quality medical care more accessible to the people. Paradoxically enough, the act ran into severe resistance from the very profession whose lot it was supposed to improve. An examination of some of the provisions of the act in light of these developments makes us think that the act may well be a case of the cure being worse than the malady itself. There is a need for the resistance against this act to be revived.

Pages

Back to Top