Health Care Sector in India: Some Key Issues VR Muraleedharan Dept of Humanities and Social Sciences Indian Institute of Technology Madras

Slides:



Advertisements
Similar presentations
Public-Private Partnerships in Health Keerti Bhusan Pradhan
Advertisements

HEALTH EQUITY: THE INDIAN CONTEXT Subodh S Gupta.
Maternal Health National Family Health Survey (NFHS-3)
1 Jahangir A. M. Khan PhD Health Economics and Financing Research Group CEHS, icddr,b Financial Risk Protection for Universal Health Coverage - Indicators.
Assessing the impact of a policy on universal coverage on financial risk protection, health care finance, and benefit incidence of the Thai health care.
SWADHAR AND SHORT STAY HOME SCHEMES Short Stay Home for women and girls was introduced as a social defence mechanism, by the Ministry of Social Welfare.
What is H(M)IS?. Purpose of HIS “is to produce relevant information that health system stakeholders can use for making transparent and evidence-based.
Population Problem of India Kamal singh Lecturer in Economics GCCBA-42,Chandigarh
Building the Foundations for Better Health Health Services Organization.
PREVENTION OF MATERNAL MORTALITY IN INDIA – ROLE OF IMA Dr. Vasudeva Panicker, National coordinator 1.
General people’s Committee for Health & Environement
THE STATE OF INDIA’S PUBLIC SERVICES BENCHMARKS FOR THE NEW MILLENNIUM PAC April 17, 2002.
Determinants of Poverty, Food Security & Nutrition.
National Mental Health Programme. Govt of India integrated mental health with other health services at rural level. It is being implemented since 1982.
Moving towards the goal of Universal Health Coverage (UHC) in Bangladesh Md. Ashadul Islam Director General Health Economics Unit Ministry of Health and.
Consultative Meeting on Accelerating the Attainment of MDG 5 in Kenya – August 27-28, 2014 Investing in Primary Health Care for reducing maternal & child.
Community Monitoring In the National Rural Health Mission Government of India Dr Abhijit Das Director, Centre for Health and Social Justice Member, Advisory.
National Rural Health Mission: A revolution in the health sector Subodh S Gupta Dr. Sushila Nayar School of Public Health MGIMS, Sewagram.
RNTCP: DOTS Expansion and plans for DOTS-Plus
DR. S.K CHATURVEDI UNICEF HIV/AIDS PREVENTION PROGRAMME PROGRAMME PLAN OF COOPERATION
TRANSFORMATION IN HEALTH CARE: ARE WE THERE YET? Thulani Matsebula.
Analyzing the Impact of Fiscal Policy on Poverty: Seven Stories Shanta Devarajan South Asia Region World Bank.
SAKSHAM- GFATM R-7 HIV/AIDS Counselling Programme Status of Master Trainers (Till May 2013)
Economic Growth and Democracy in India: the beginnings of a `Scissors Crisis´? Mritiunjoy Mohanty Indian Institute of Management Calcutta in Kolkata, India.
FINANCIAL OPTIONS FOR TB CONTROL IN MONGOLIA
Health Indicators Mortality indicators Morbidity indicators
Health Care In Latvia Current Situation And Challenges In the Future Ingrīda Circene Minister for Health of the Republic of Latvia Riga,
Scheme of Assistance for Working Women Hostel MINISTRY OF WOMEN AND CHILD DEVELOPMENT GOVERNMENT OF INDIA.
Conference on “Calamities: Nature or Human Action? Challenges and Responsibilities” March 05, 2014, New Delhi Rising Calamities: Impact and Challenges.
The Economics of “Fiscal Space” Shanta Devarajan World Bank.
HIV and AIDS Data Hub for Asia-Pacific 11 HIV and AIDS Data Hub for Asia-Pacific Review in slides India.
Availability Accessibility Acceptability Quality Satisfaction Continuity of care Impacts Reach and outcomes Health Sector Non-Health Sector Outputs Education.
3 August 2004 Public Health Practice III: FINANCING PUBLIC HEALTH REFORM Thomas E. Novotny MD MPH University of California San Francisco Institute for.
DR.SHRIRAM V GOSAVI HEALTH SURVEY BY NATIONAL COUNCIL OF APPLIED ECONOMIC RESEARCH.
‘Bowling alone’ while they starve together Sony Pellissery Institute of Rural Management, Anand (India)
Day 6 – Session: 3 (b) Session Title : Preparation and usefulness of (i) “Accounts at a Glance” and (i) “Combined Finance and Revenue Accounts”
Extent and Dimensions of Gender Bias in India Premananda Bharati, Manoranjan Pal and Bholanath Ghosh Indian Statistical Institute 203 BT Road, Kolkata.
CDR Analysis & Investigation Basic Course - Presentation by Ketan Computers Mobile: Website :
32 nd Review Meeting of Finance Controllers JAIPUR 2 nd -3 rd February 2012.
HUL's INITIATIVE IN RURAL DEVELOPEMENT: Hindustan Unilever Limited (HUL) and its constituent companies have been in India since Over these decades,
State-Business Relations in Indian States Siddhartha Mitra Director (Research)
CSC/ECE 517 Pre-Survey Results Fall Key / A — I have done/used this / B — I know about this / C — I want to learn about this / A — I have done/used.
Investment Climate Assessment of India 2004 Why does infrastructure and business regulation matter?: Findings from World Bank ICA 2004 Priya Basu & Taye.
PRE-BIRTH ELIMINATION OF FEMALES IN INDIA: ISSUES AND CHALLENGES DR. KANUPRIYA CHATURVEDI.
UNICEF IN INDIA NEW CHALLENGES AND CHANGING ROLE Dr. S.K. CHATURVEDI UNICEF.
Overview. Basic functions  Revenue collection  Pooling of resources  Purchasing of services.
Overview of China’s health care reform Wen Chen, Ph.D., Professor Fudan School of Public Health March 21, 2016.
CONSTRAINTS TO PRIMARY HEALTH CARE DELIVERY THE GOVERNMENT OBJECTIVES FOR DELIVERING PHC SERVICES To increase accessibility to quality health care services.
2nd African Decent Work Symposium: Yaoundé, Cameroon, 6-8 October THE SOCIAL SECURITY EXTENSION CHALLENGE: INCOME SECURITY AND HEALTH BENEFITS. Dr.
Road Map to Universal Health Coverage Dr Girdhar Gyani DG- AHPI.
Steps for the Integration of Traditional Medicine in the National Health Care Delivery System 18 TH ICASA Special Session on Traditional Medicine 1 st.
Health Care Financing Health Economic Course Series
AMBRISH DONGRE AVANI KAPUR & VIBHU TEWARY How much does India spend on Elementary Education (EE)?
Montu Bose TERI University & Arijita Dutta University of Calcutta
Population Problem of India
LIFE INSURANCE COUNCIL Press Meet on Overview of Indian life insurance industry: trends & opportunities 20th FEBRUARY, 2014 Hyderabad.
DR. S.K CHATURVEDI UNICEF
The contribution of private schools to education in India and in Uttar Pradesh NISA conference.
Current Status of Polio Cases July 2011
Social Mobilisation Network
A Presentation on Maternal Mortality Levels ( )
Current Status of Polio Cases Dec 2010
Culture 8 - National Capital Territory of Delhi Culture 6B - Goa
Current Status of Polio Cases 2009
Social Mobilisation Network
Making Healthcare a Public Good – Inverting the Political Economy
STRUCTURAL CHANGES IN INDIAN ECONOMY
STRUCTURAL CHANGES IN INDIAN ECONOMY
PRaDHAN MANTRI NATIONAL DIALYSIS PROGRAM National Health Mission
STRATEGIES AND PROGRESS
Presentation transcript:

Health Care Sector in India: Some Key Issues VR Muraleedharan Dept of Humanities and Social Sciences Indian Institute of Technology Madras

Outline The Fundamental challenge in public finance Basic Features of Indian Health Care Sector –Status of Health –Access to health care (use of health care services) –Cost of health care Distribution of Benefits of Public Spending Key Policy Questions

Fundamental Challenge in Public Finance How much should the government spend for health care? – role of government in financing and providing health care to the people How should the benefits of public spending (on healthcare) should be distributed across various socio-economic groups? Who deserves how of much of financial support for health care? Fundamental principle: A rupee spent on one person is a rupee denied to another person.

Objectives of Healthcare System Improve health status Provide protection against financial risks arising from illnesses – poverty reduction strategy Institute mechanisms to meet “legitimate” expectations of patients

Health Status Indicators

Per-capita spending in international dollars (PPP) Government health spending to total government spending (%) Government share of Total Expenditure (%) Health expenditure as % of GDP Births by skilled attendants Fully Immunized (%) Under-5 mortality /1000 live-births 1582<3068IMR/1000 live-births Thaila nd Sri Lank a USAChinaIndiaIndicator Health Status Indicators: India in comparison with other countries

Use of Health Care Services Dependence on Public and Private Providers:

Costs of Health Care Financial Burden of Ill-health

Two major Health Policy Challenges Reduce inequity in health status –Social and economic strata Reduce the impoverishing effects of catastrophic health expenditures

Income inequality and health status Recent Evidence Increase in Income, Education, Health Personnel exert a statistically significant negative impact on health status (IMR) But Increases in income inequality cause health status (IMR) to increase. (evidence holds good for both high income and low income countries)

Utilization of Inpatient Days in Public System: TN and Orissa (NSS 60 th Round 2004)

Utilization of Maternity Services in Public System: TN and Orissa (NSSO 60 th Round, 2004)

How Much Do Governments Spend on Health Care? And How much Should Government Spend?

Trends in Per-Capita Public Expenditure Rs. 64 ( ) Rs.184 ( ) Rs.214 ( )

All States West Bengal Uttar Pradesh Tamil Nadu Rajasthan Punjab Orissa Madhya Pradesh Maharashtra Kerala Karnataka Haryana Gujarat Bihar Assam Andhra Pradesh –921985–86States (B.E.) Share of health in revenue budget of major states (in %)

Evidently, government’s spending spent is LOW

Policy Options How should the health care system be organized? –(Financing and Provision) – Public vs Pvt sector PPP strategy?

PPP or PPM? Some Common Questions Why PPP? How to assess whether PPP works well? Conditions for PPP’s success? What is PPP?

Why PPP? : Some Familiar Answers Private sector already widely present – utilize their resources for improving public health Better delivery system – better geographical access Lack of funds in public sector to expand; will outsourcing reduce public expenditure? Peoples’ dependence on private sector and better satisfaction.

35 “Nature” of participation: examples Financial Non-Philanthropic Joint ventures Subsidies and concessions to private sector Philanthropic Contributions BGF Local Industrialists’ contributions (TN) Drugs (from MNCs – case of DEC for Filariasis ) Non-financial Philanthropic In-kind contributions Community labour for construction of PHC (TN); Non-philanthropic Health Camps by corporate hospitals

36 “Forms” of participation: examples Curative /Diagnostic Services Hiring clinical staff (OBGYN/Anesthetists/ medical officers) Blindness Control Hiring nursing staff Contracting-out of laboratory work Preventive /Promotive Services HIV-AIDS – role of NGOS TB control: role of NGOs, Hospitals, Private practitioners, Microscopy centres

37 “Forms” of participation : examples Supportive services Ambulance Catering Security Laundering Rehabilitative Mental health programme? Reconstruction of cleft formation (BGF)

Policy Justifications for PPP PPP is not an end in itself. PPP should eventually: –Reduce cost of care –Improve access to care –Improve quality of care –Reduce inequality in health status (geographic, gender, socio-economic groups)

Thank You