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

National Health PolicySubscribe to National Health Policy

Decoding Ayushman Bharat

The challenges before the components of Ayushman Bharat, the (ir)rationality behind raising the insurance coverage manifold are highlighted, a political economy narrative of the changing health financing scenario is drawn, and how the design of Ayushman Bharat will feed into executing the proposed public–private partnership model in public facilities and facilitate the strategic purchasing agenda of the National Health Policy is examined. Ayushman Bharat is a step towards creating a system that would facilitate in relinquishing public funds and public institutions to already dominant private players, which will have serious implications for the healthcare delivery system in India.

‘When You Start Doing This Work, It Is Hard to Eat Dal’

In 2013, manual scavenging, or the cleaning of “dry” latrines with unprotected hands, was abolished in India. Yet, millions of dry latrines are still manually serviced by Dalit labour. The Prime Minister’s Swachh Bharat Mission has put little effort into the health and dignity of sanitation workers relative to its efforts on subsidising and encouraging latrine-building. A few days spent with the Valmiki community in Lucknow are recounted.

Measuring Catastrophic Healthcare Expenditure

Catastrophic household healthcare expenditure is a prominent policy concern. The National Health Policy 2017 takes explicit cognisance of this issue and presents an empirical formulation to examine its incidence and patterns. However, the policy needs to account for household size variations to counter an implicit bias that tilts the estimates to reflect a higher concentration of catastrophic expenditure among the rich. This concern is illustrated using health data from the 71st round of the National Sample Survey. Further, a minor modification to unravel the socio-economic gradient in catastrophic healthcare expenditure has also been discussed.

Social Choice and Political Economy of Health

The National Health Policy, 2017 can be credited for an alternative vision towards the development of the health sector in India, but it falls short of expectations on certain counts. The core idea of strategic purchasing from the private sector is relevant, but can be incompatible with the existence of a robust public sector, particularly when reforms for enhancing the competitiveness of the public sector are undermined. Thus, the NHP essentially reopens the fundamental debate regarding the role of social choice mechanisms while deciding upon policy instruments and desirable outcomes. This has profound implications for the political economy of the health sector and can unintentionally catapult health as a salient feature in electoral politics.

Draft National Health Policy 2001 - III : Mental Health: Serious Misconceptions

Policy must certainly be built on people-based principles and practices of 'holistic' health and serious consideration must be given to evolving new perspectives about mental health and the inner life that is beyond the Cartesian mind/body dichotomy. However, a 'holistic' conception of mental health is not about treating mental disorder as another type of public health issue, like kala azar or malaria. While mental health must make linkages with the public health discourse, the differences must be also recognised, articulated and debated.

Draft National Health Policy 2001 - II : Resource Generation without Planned Allocation

Unlike the health policy of 1983, this policy attempts to address the problem of poor financial allocations for health care and recommends that it be enhanced considerably. But without a detailed exercise inquiring into the present pattern of allocations, this prescription, overdue as it is, will not serve any purpose. If the additional resources are to make an impact, considerable restructuring of the health system has to be undertaken urgently.

Draft National Health Policy 2001-I : Debt Payment and Devaluing Elements of Public Health

Had the new health policy document proposed an overarching vision of how all the elements it enumerates would be put in place, it would have been a visionary document. As it stands the draft policy is riddled with contradictions and confusions. It spells a significant departure from the 1983 policy objectives of providing primary health care for all, specially the underprivileged. Instead of creatively utilising private sector to provide basic affordable health care, it all but hands over the task to the private sector, inevitably undermining existing national health programmes. By encouraging the corporate involvement in tertiary and secondary level medical care without first ensuring their access to the underprivileged, the draft denies the rights of the poor to good care.

Rhetoric of Evasion

When the government of India announces a new health policy after 29 years the expectation is that it will first of all define the critical issues and then proceed to elucidate a perspective which will come to grips with the major issues and construct the path to a future where the health and well-being of the people of the country are adequately cared for. The draft National Health Policy 2001 (NHP-2001) is unfortunately a short-term, myopic and blinkered wish list with no indication of where health and health care are located in the government’s list of priorities. To call this a ‘policy’ statement is a misuse of the term. Its ‘policy’ prescriptions exhibit a complete lack of understanding of both the existing state of affairs and the needs of tomorrow....
Back to Top