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Begin New Search Topic Health Care Policy Political Geography India Content Type Working Paper

1. Women Left Behind

Author:
Radhika Jain and Pascaline Dupas
Publication Date:
06-2021
Content Type:
Working Paper
Institution:
Walter H. Shorenstein Asia-Pacific Research Center
Abstract:
Using administrative data on over 4 million hospital visits, we document striking gender disparities within a government health insurance program that entitles 46 million poor individuals to free hospital care in Rajasthan, India. Females account for only 33% of hospital visits among children and 43% among the elderly. These shares are lower for more expensive types of care, and far lower than sex differences in illness prevalence can explain. Almost two-thirds of non-childbirth spending is on males. We combine these data with patient survey, census, and electoral data to show that 1) the program is unable to fully offset the costs of care-seeking, which results in disparities in hospital utilization because some households are willing to allocate more resources to male than female health; 2) lowering costs does not reduce disparities, because males benefit as much as females do; and 3) long-term exposure to village-level female leaders reduces the gender gap in utilization, but effects are modest and limited to girls and young women. In the presence of gender bias, increasing access to and subsidizing social services may increase levels of female utilization but fail to address gender inequalities without actions that specifically target females.
Topic:
Gender Issues, Governance, Health Care Policy, Women, Inequality, and Health Insurance
Political Geography:
India and Asia

2. Lessons from the Covid Care Centers in West Bengal

Author:
Jishnu Das, Patrick Agte, Abhijit Chowdhury, Parthasarathi Mukherjee, and Satyarup Siddhanta
Publication Date:
12-2021
Content Type:
Working Paper
Institution:
Centre for Policy Research, India
Abstract:
With the continuing emergence of Covid-19 variants, there is underlying concern in all countries, including India, that another surge will occur in the coming months. In case of a surge like that experienced with the Delta variant, a strategy that deserves further attention for the provision of care in rural areas is the use of off-hospital sites for patients who are not severely ill. We discuss one such effort from the state of West Bengal, the lessons from which may be relevant for the management of surge cases for generalized pandemic planning. In March 2021, India experienced a large surge in Covid cases and the spike in patients led to a shortage of hospital beds and oxygen cylinders around the country. Following a notification by the Ministry of Health and Family Welfare that allowed organizations to set up care centers for the treatment of Covid-19 patients outside the hospital setting, the Liver Foundation and the Covid Care Network established eight Covid Care Centers in rural West Bengal. These centers were operational between May 2021 and September 2021, which coincided with the post-peak phase of the second Covid-19 wave in India. This report describes the project, summarizes the performance of the centers, and discusses the challenges faced during the project. We conclude that temporary facilities like the Covid Care Centers can be a viable option to provide urgent care during health emergencies.
Topic:
Health Care Policy, Crisis Management, Public Policy, and COVID-19
Political Geography:
South Asia and India

3. Modicare Post-Election: Recommendations to Enhance the Impact of Public Health Insurance on UHC Goals in India

Author:
Kalipso Chalkidou, Nishant Jain, Françoise Cluzeau, and Amanda Glassman
Publication Date:
05-2019
Content Type:
Working Paper
Institution:
Center for Global Development
Abstract:
Hailed as one of the largest publicly funded health insurance programs in the world, India’s “Modicare” has, since its launch a little more than six months ago, made universal healthcare coverage an election theme for the first time in the country’s history.[1] In this note, we describe the program, with an emphasis on its better-known secondary and tertiary care component, and offer policy recommendations to strengthen the scheme post-election to enhance its contribution to India’s vision for universal health coverage (UHC). In a country of almost 1.4 billion people that is home to one-third of global maternal deaths, where public spending for health accounts for roughly 1 percent of GDP and where 60 million people fall into poverty every year because of healthcare bills, fixing healthcare is a daunting task that will determine the world’s performance against the Sustainable Development Goals over the coming decade.
Topic:
Health, Health Care Policy, Public Health, and Health Insurance
Political Geography:
India and Asia

4. Engaging India: Guide to Developing Health Care Partnerships with States

Author:
Nicole Davis, Christa Twyford Gibson, and Jonathan Gonzalez-Smith
Publication Date:
08-2019
Content Type:
Working Paper
Institution:
Center for Strategic and International Studies
Abstract:
Indian states control most facets of healthcare delivery. Every state has a different set of healthcare delivery gaps and priorities. Understanding these gaps can help foreign institutions target cooperation more effectively- going to the right place with the right type of cooperation. But having a base for cooperation must be paired with an effective strategy to engage India's states. Issues such as states' political timelines, shifts in key bureaucrats, and other issues can have a major impact on potential projects. In this report, Innovations in Healthcare and CSIS lay out strategies employed by a range of international institutions with current subnational partnerships in India.
Topic:
Health, Governance, Health Care Policy, and Innovation
Political Geography:
India and Asia

5. Indian State Priorities for Health Innovation Partnerships

Author:
Nicole Davis, Christa Twyford Gibson, and Jonathan Gonzalez-Smith
Publication Date:
03-2019
Content Type:
Working Paper
Institution:
Center for Strategic and International Studies
Abstract:
Many international institutions—universities, foundations, companies, NGOs, and governments—would like to engage more deeply with the government of India to improve health outcomes. However, a lack of transparency, changing state-level priorities, and the absence of a single venue to learn about engagement opportunities holds back many potential partnerships. The Center for Strategic and International Studies (CSIS) Wadhwani Chair in U.S.-India Policy Studies and Duke University’s Innovations in Healthcare have launched the “Indian States Health Innovation Partnership” to address this information gap and encourage subnational health care cooperation between Indian government entities and external partners. The primary goal of this project is to strengthen health outcomes in India by methodically identifying which Indian states are ripe for innovative partnerships with international institutions and broadcasting these opportunities publicly to spur future partnerships. In the first phase of this project, the team developed a clearer picture of India’s state-level health care reform priorities and identified specific areas for potential partnership across four categories: capacity building, organizational delivery, financing, and specific health conditions.
Topic:
Health, Governance, Health Care Policy, Innovation, and Public Health
Political Geography:
India and Asia

6. Quality and Accountability in Healthcare Delivery: Audit Evidence from Primary Care Providers in India

Author:
Jishnu Das, Alaka Holla, Aakash Mohpal, and Karthik Muralidharan
Publication Date:
02-2015
Content Type:
Working Paper
Institution:
Centre for Policy Research, India
Abstract:
We present among the first direct evidence on the quality of healthcare in low-income settings using a unique and original set of audit studies, where standardized patients were presented to a nearly-representative sample of rural public and private primary care providers in the Indian state of Madhya Pradesh. We report three main findings. First, private providers are mostly unqualified but spent more time with patients, and completed more items on a checklist of essential history and examination items than public providers, while being no different in their diagnostic and treatment accuracy. Second, we identify the private practices of qualified public sector doctors, and show that the same doctors exert higher effort and are more likely to provide correct treatment in their private practices. Third, we find a strong positive correlation between provider effort and prices charged in the private sector, whereas we find no correlation between effort and wages in the public sector. Our results suggest that market-based accountability in the unregulated private sector may be providing better incentives for provider effort than administrative accountability in the public sector in this setting. While the overall quality of care is low in both the public and private sectors, these differences in provider effort may partly explain the dominant market share of fee-charging private providers even in the presence of a system of free public healthcare.
Topic:
Government, Health, Privatization, Health Care Policy, Social Policy, and Rural
Political Geography:
South Asia, India, and Asia

7. Repurposing Global Polio Eradication's Tool Kit

Author:
Nellie Bristol
Publication Date:
09-2014
Content Type:
Working Paper
Institution:
Center for Strategic and International Studies
Abstract:
The Global Polio Eradication Initiative (GPEI), a 26 year, $11 billion drive to eradicate poliovirus worldwide, is one of the largest public health initiatives ever. It is led by national governments together with the World Health Organization (WHO), the United Nations Children's Fund (UNICEF), the U.S. Centers for Disease Control and Prevention (CDC), Rotary International, and the Bill Melinda Gates Foundation. Involving a variety of partners from NGOs to universities and foundations and engaging millions of health workers and volunteers, the GPEI has provided billions of polio vaccine doses around the world. While it recently has faced new outbreaks and international spread of poliovirus, the GPEI has reduced the annual number of polio cases globally by more than 99 percent.
Topic:
Health, World Health Organization, and Health Care Policy
Political Geography:
India and United Nations

8. HIV/AIDS Intervention Packages in Five Countries: A Review of Budget Data

Author:
Amanda Glassman, Denizhan Duran, Rachel Silverman, and Victoria Fan
Publication Date:
10-2013
Content Type:
Working Paper
Institution:
Center for Global Development
Abstract:
More than ever, global health funding agencies must get better value for money from their investment portfolios; to do so, each agency must know the interventions it supports and the sub-populations targeted by those interventions in each country.
Topic:
Foreign Policy, Development, Economics, Health, Humanitarian Aid, and Health Care Policy
Political Geography:
India, Philippines, Ethiopia, and Nigeria

9. State Health Insurance and Out-of-Pocket Health Expenditures in Andhra Pradesh, India

Author:
Victoria Fan, Anup Karan, and Ajay Mahal
Publication Date:
06-2012
Content Type:
Working Paper
Institution:
Center for Global Development
Abstract:
In 2007, the state of Andhra Pradesh in southern India began rolling out the Aarogyasri health insurance to reduce catastrophic health expenditures in households “below the poverty line.” We exploit variation in program roll-out over time and districts to evaluate the impacts of the scheme using difference-in-differences. Our results suggest that, within the first year of implementation, Phase I of Aarogyasri significantly reduced out-of-pocket inpatient expenditures and, to a lesser extent, outpatient expenditures. These results are robust to checks using quantile regression and matching methods. No clear effects on catastrophic health expenditures or medical impoverishment are seen. Aarogyasri is not benefiting scheduled caste and scheduled tribe households as much as the rest of the population.
Topic:
Health, Poverty, and Health Care Policy
Political Geography:
India, Asia, and Andhra Pradesh

10. New Approaches to Global Health Cooperation: Perspectives from Brazil

Author:
Katherine E. Bliss, Paulo Buss, and Felix Rosenberg
Publication Date:
09-2012
Content Type:
Working Paper
Institution:
Center for Strategic and International Studies
Abstract:
On November 7, 2011, the Global Health Policy Center of the Center for Strategic and International Studies (CSIS) in Washington, D.C., in partnership with the Fiocruz Center for Global Health (CRIS) in Rio de Janeiro, Brazil, hosted a seminar entitled “New Approaches to Global Health Cooperation.” The event, which took place in Rio de Janeiro, assembled health policy researchers and practitioners from Brazil, Europe, the United States, and sub - Saharan Africa to examine emerging practices in global health co operation. Issues considered included the factors driving greater international engagement on public health challenges, the growing trend of trilateral cooperation, and the role of the BRICS (Brazil, Russia, India, China, and South Africa) and South - South activities in expanding international cooperation on global health. Over the course of the day - long meeting, speakers and audience members examined the reasons for the overall expansion of funding and programming for overseas global health activities durin g the past decade; considered the factors that underpin Brazil's increasing focus on global health as an area of bilateral and multilateral outreach; reviewed the characteristics of successful trilateral cooperation efforts; and debated the future of multi country engagement on health.
Topic:
Development, Emerging Markets, Health, and Health Care Policy
Political Geography:
Africa, Russia, United States, China, Europe, Washington, India, South Africa, Brazil, and Latin America