Health reforms and utilization of health care in three states of India: Public Health Prospects
AbstractHealth sector reforms were introduced in several states of India in 1991. The rationale was to increase choice and competition, to improve quality and access to health care Such demand-led incentives were integral to macro-economic stabilization programs world-wide during the 1990s. For a majority of the population of India, health care costs linked to commercialisation of health services were forcing households into serious debt. Using primary data on patterns of utilisation of health services (2002), this paper reports from a systematically collected empirical evidence base, to explore the preliminary impact of changes to the health sector from 1991 to 2000 in West Bengal (WB), Tamil Nadu (TN), and the hospital sector of Andhra Pradesh (AP). The overall aim is to provide historical context to the experience of reforms for poor and vulnerable groups and to understand current discourses on the health system in India, focused on “managed care” through a universal health insurance programme. We explore linkages between the past and present on disinvestment in public provision and its long-term consequences for equity of access to health care in the three states, and elsewhere in the country.
Abhiyan, J. S. 2006, Health System in India: Crisis and Alternatives Delhi, India, Booklet 2.
Bannerjee, S. Sen K (2017) Implementation and Challenges of RSBY in West Bengal: an exploratory study set in historical context, IJHPM, Wiley and Sons, Chichester, UK ( in process)
Baru, R.% Bisht, R. 2010, Health Service Inequities as Challenge to Health Security, Oxfam, India, New Delhi, India, 1V.
Basu, R. 2010, Rashtriya Swasthya Bima Yojana: Pioneering Public-Private partnership in Health Insurance, Jamia Millia University, Delhi India, Delhi, India, N/A.
Bandyopadhyay S and Sen K( 2017) Challenges of Rashtriya Swasthya Bima Yojana (RSBY): an exploratory study from West Bengal India. Int Journal of Health Planning and Management: https://doi.org/10.1002/hpm.2453.
Bhandari, L. 2010. The Impovershing Effect of Healthcare Spending in India: new methodology and findings. Economic and Political Weekly, India, XLV, (16) available from: http://www.epw.in/special-articles/impoverishing-effect-healthcare-payments-india-new-methodology-and-findings.html Accessed 1 January 2014.
Bhat, R. 2006, Finanial Health of Private Sector Hospitals in India, IIM, Ahmedabad,India, WP. 2006-01-01.
Butala, N.% Northbridge, C. 2010, Hyderabad Hospital Report, Northbridge Capital.
Chatterjee, P. 2010. India tries to break the cycle of health care debt. Bulletin of the World Health Organisation, 88, 486-487 available from: http://www.who.int/bulletin/volumes/88/7/10-020710/en/ Accessed 1 January 2014.
Dasgupta, R., Nandi, S., Kanungo, K., Nandy, M., Neog, R.,% Muruga, G. What the good doctor said:a critical examination of design issues of the RSBY through provider perspectives. Journal of Social Change 43,, 227-243. 1-1-2013. 11-12-2013.
Devarajan, S.% Shah, S. 2004. Making Public Services Work for the Poor in India. Economic and political weekly, XXXIX, (Special Issue, No.9) 907-919 available from: http://www.indiaenvironmentportal.org.in/files/services.pdf Accessed 1 January 2006.
Dilip, T. R.% Duggal, R. 2002, Incidence of Non-Fatal health Outcomes and Debt in Urban India, CEHAT, India.
Dror, D.% Vellakkal, S. 2012. Is RSBY India's Platform to Implementing Universal Hospital Insurance? Indian Journal of Medical Research, 135, (1) 56-63 available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3307185/ Accessed 1 January 2013.
Economic Research Foundation 2006, Resources for Equitable Growth, ERF, New Delhi, India.
Ergler, C., Sakdopolrak, P., Bohle, H.,% Kearns, R. 2013, "From effective cure to affective care:access barriers entitlements to health care among urban poor in Chennai, India," In Geogaphies of Development and Health, K. Luginaah, ed., Farnham,Kent, UK: Ashgate, pp. 1-26.
Ernst and Young Partners (India) 2012, Universal Health Care for India:Demystifying Financing Needs, Ernst and Young and FICCI, India, Delhi, India.
Gangoli, L., Duggal, R.,% Shukhla, A. 2005, Review of Healthcare in India, Centre for Enquiry into Allied Themes, Mumbai.
Ghosh, S. 2014. Equity in the Utilisation of Healthcare Services in India: Evidence. International Journal of Health Plannning and Management (IJHPM), Volume 2 Issue One-1(2), (2014(1)) 29-38 available from: http://ijhpm.com/?_action=articleInfo%article=2804 Accessed 2 February 2014.
Gopakumar, K.e.a. 2004. The State of India's Public Sector. Economic and political weekly, XXX1X, (9) available from: http://www.epw.in/special-articles/state-indias-public-services.html Accessed 1 January 2006.
Jacobs, e.a. 2010. From public to private and back again:sustaining a high level service during transition of management authority, a Cambodian case study. Health Policy and Planning, 25, (3) 197-2008 available from: http://www.deepdyve.com/lp/oxford-university-press/from-public-to-private-and-back-again-sustaining-a-high-service-nTxI0nLLyl Accessed 1 January 2011.
Leone, T., James, K.,% Padmadas, S. 2012. The burden of maternal healthcare expenditure in India:a multilevel analysis of national data. Maternal and Child Health Journal, 17, (9) 1622-1630 available from: http://link.springer.com/article/10.1007%2Fs10995-012-1174-9 Accessed 2 February 2014.
Levesque, J.-F., Haddad, S., Narayana, D.,% Fournier, P. 2006. Outpatient care utlization in urban kerala, India. Health Policy and Planning, 21, (4) 289-301 available from: http://heapol.oxfordjournals.org/content/21/4/289.full Accessed 26 February 2014.
Liu, X., Hotchkiss, D.,% Bose, S. 2014. The effectiveness of contracting out primary health care services in developing countries: a review of the evidence. Health Policy and Planning, 23, (1) 1-13 available from: http://heapol.oxfordjournals.org/content/23/1/1.full Accessed 1 January 2008.
Ministry of Labour and Empoyment of the Government of India. RSBY. 1-1-2014. New Delhi, Ministry of Labour and Employment. 1-1-2014.
Ref Type: Online Source
Mohanty, S.% Srivastava, A. 2013. Out of pocket expenditure on institutional deliver in India. Health Policy and Planning, 28, (3) 247-262 available from: http://heapol.oxfordjournals.org/content/28/3/247.abstract Accessed 1 February 2014.
Mondal, S. 2013. Health care services in India: a few questions on equity. Scientific Research, 5, (No.1) 53-61 available from: http://dx.doi.org/10.4236/health.2013.51008 Accessed 1 January 2014.
Narayana, K. 2003. Changing Health Care System. Economic and political weekly, 38, (22-29 March) 1230-1241 available from: http://www.jstor.org/discover/10.2307/4413374?uid=2%uid=4%sid=21103606586857 Accessed 1 February 2012.
Newbrander, W. 1997. Private Sector Growth in Asia: Introduction New York, John Wiley and Sons.
Nigam, R. Inequality in India: Income, access to healthcare and education. Infoexchange January2005[News and Features], 1-4. 1-1-2005. 1-1-2010.
Pollock, A. 2004. NHS PLC: The Privatisation of our Health Care London, Verso Books.
Pollock, A.% Price, D. 2002. Market Forces in Public Health. The Lancet, 359, (9315) 1363-1364Accessed 1 January 2009.
Qadeer, I. 2013. Universal Health Care: the trojan horse of neo liberal policy. Social Change, 43, (2) 149-164 available from: http://sch.sagepub.com/content/43/2/149.full.pdf+html Accessed 1 January 2014.
Qadeer, I., Sen, K.,% Nayar, K. R. 2001, "Introduction.," In Public Health and the Poverty of Reforms, First ed. New Delhi, India: Sage Publications, pp. 27-36.
Rao, P. 2012. The Private Health Sector in India: A Framework for Improving the Quality of Care. ASCI Journal of Management, 41, (2) 14-39 available from: http://journal.asci.org.in/Vol.41(2011-12)/41_2_phrao.pdf Accessed 1 February 2014.
Selvaraj, S.% karam, A. 2012. Why Publicly financed health insurance schemes in are ineffective in providing financial risk protection- Special Article. Economic and political weekly, XLV11, (11) 60-68 available from: http://uhc-india.org/uploads/HI_EPW.pdf Accessed 1 January 2013.
Sen, K and Gupta, S(2017) “Being Poor: Challenges of Implementing Rashriya, Swasthya Bima Yojana in West Bengal- masking poverty and entitlement”. Social Change, Council for Social Development, Sage India ( in press)
Sen, K. 2003, "Introduction: Restructuring health services - public subsidy of private provision," In Restructuring health services: Changing contexts and comparative perspectives, K. Sen, ed., New York, U.S.A.: Zed Books, p. 17.
Sen, K.% Koivusalo, M. 1998. Health care reforms and development countries: a critical overview. Int J Health Plann Management, 13, (3) 199-215Accessed 9 January 2009.
Shahrawat, R.% Rao, K. 2012. Insured yet vulnerable:out-of-pocket payments and India's poor. Health Policy and Planning, 27, (3) 213-221 available from: http://www.ncbi.nlm.nih.gov/pubmed/21486910 Accessed 1 February 2014.
Srinivasan, S. 2005, Health: Background% Perspective, “Infochange”, Mumbai, India. On line.
Thakur, H (2016) Study of Enrolment and Utilization of Rashtriya Swasthya Bima Yojana (India’s National Health Insurance Programme) in Maharashtra. Front. Public Health. Vol.3. issue 282. Pp.1-13
The Economist 2010, Health Insurance: Clear Diagnosis, uncertain remedy, The Economist, London, United Kingdom.
Unger, J.-P., De Paepe, P., Ghilbert, P., Soors, W.,% Green, A. 2006, Integrated care: a fresh perspective for international health policies in low and middle-income countries 6.
Yeravedkar, R., Yeravedkar, G., Tutakne, M., hatia, N.,% uralidhar, T. 2013. Strengthening of primary health care:key to dleiver inclusive health care. Indian Journal of Public heatlh, 57, (2) 59-64Accessed 1 January 2014