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

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Healthcare Financing in India

Public and Private Healthcare and Health Insurance in India by Brijesh C Purohit, New Delhi, California, London and Singapore: Sage Publications, 2020; pp xiii + 283, ₹ 1,195 (hardcover). India Policy Finance and Policy Report: Health Matters edited by Jyotsna Jalan, Sugata Marjit and Sattwik Santra, New Delhi: Oxford University Press, 2020; pp xvi + 166, ₹ 1,495 (paperback).

Delhi’s Mohalla Clinics Hold the Potential to Significantly Improve Access to Quality Healthcare

In 2015, the Aam Aadmi Party-led Delhi government introduced “Aam Aadmi Mohalla Clinics” to provide affordable basic healthcare to marginalised sections of society at their “doorsteps.” This paper evaluates the effectiveness of the programme based on a survey of 493 respondents. We found that while AAMCs partially meet their stated objectives, several areas need urgent attention including lack of information about clinics, casteism by doctors and property owners, and availability of services.

COVID-19: Mental Healthcare without Social Justice?

Mental health is not just about absence of mental illness. It is critical that the government takes long-term economic and mental health policy measures to ensure employment, basic amenities and public health, without which mental healthcare cannot address the debilitating effects of ongoing structural violence on a majority of citizens.

Social and Systemic Determinants of Utilisation of Public Healthcare Services in Uttar Pradesh

Building on an earlier publication using the same data set plus case studies of three facilities, the reasons for the low utilisation of public health facilities in Uttar Pradesh despite the prohibitively high costs of care in the private sector are explored. The likelihood of choosing a public provider for hospitalisation care was 4.8 times higher in the poorest quintile and 3.4 times as high for women. Where access to public sector services is an issue, many go without any treatment and this could appear in the data to be a higher proportion of private sector utilisation. Inadequate facility density is one barrier to access. Facilities, which are by policy designed to offer very limited types of services—to collect user fees and prescribe drugs and diagnostics to be bought outside, and with no continuity of care between primary and secondary levels—lead to the diminishing of credibility of the public healthcare services. When services are available and there are incentives that facilitate access, like for childbirth, the choice shifts in favour of public services. Market-defined perceptions of what is good healthcare and an understaffed and demoralised workforce also contribute to poor utilisation.

Immunisation Coverage in India

This article examines the decline in coverage levels of the Routine Immunisation Programme in the better-governed states across three rounds of the District Level Household and Facility Survey. The analysis points to an urban conundrum where proximity to urban centres is a "risk factor." An understanding of peri-urbanisation processes is essential for improving outcomes and governance in urban health services and the National Urban Health Mission.

Public Health Human Resource

Public health human resources is a crucial component of any public health system. The creation of a new public health cadre would result in better public health management and workers who are able to deal with changing public health priorities.

Health Service System in India

Universalising health coverage is the current goal of the health service system in India. Tax-funded insurance for poor families is the method chosen for attaining this objective. The Rashtriya Swasthya Bima Yojana was rolled out in 2008 for households below the poverty line, enabling them to access health services in the public and private sectors. However, experience from different countries shows tax-funded insurance systems work well only in settings where public provisioning of healthcare services prevails. State-funded targeted insurance schemes do not seriously mitigate inequitable access to health services in a fundamentally private healthcare delivery market.
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