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1. Budget Brief: National Health Mission

Author:
Avani Kapur, Ritwik Shukla, and Sharad Pandey
Publication Date:
02-2023
Content Type:
Policy Brief
Institution:
Centre for Policy Research, India
Abstract:
National Health Mission (NHM) is Government of India’s (GoI’s) largest public health programme, which aims to achieve universal access to quality healthcare. It consists of two sub-missions: ■ National Rural Health Mission (NRHM); and ■ National Urban Health Mission (NUHM). This brief uses government data to analyse: ■ NHM finances, including proposed and approved budgets, releases, and expenditures; ■ Staff and bed availability; and ■ Outcomes.
Topic:
Health, Governance, Budget, and Public Spending
Political Geography:
South Asia and India

2. Budget Brief: Ayushman Bharat

Author:
Madhur Sharma, Rahul Das, and Avani Kapur
Publication Date:
02-2023
Content Type:
Policy Brief
Institution:
Centre for Policy Research, India
Abstract:
Ayushman Bharat, under the aegis of the Ministry of Health and Family Welfare (MoHFW), was launched by Government of India (GoI) on 23 September 2018. This brief uses government data to analyse the following components of the scheme: ■ Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY); ■ Establishment of Health and Wellness Centres (HWCs); ■ Ayushman Bharat Digital Mission (ABDM); and ■ Pradhan Mantri Ayushman Bharat Health Infrastructure Mission (PM-ABHIM).
Topic:
Health, Governance, Budget, and Public Spending
Political Geography:
South Asia and India

3. FACTORING THE SMART POWER IN THE INDIA-EUROPEAN UNION ENGAGEMENTS: A SCOPING REVIEW

Author:
Nippun Gupta, Bawa Singh, Aslam Khan, and Jaspal Kaur
Publication Date:
03-2023
Content Type:
Working Paper
Institution:
Institute for Research and European Studies (IRES)
Abstract:
Power is a critical factor in several types of diplomacy. India-EU relations are a classic case of how changing geopolitics prompted diplomatic acumen. This scoping review assesses the changing relations of both partners as a manifestation of Smart Power. The dynamic relations from normative-based to pragmatic and inclusive interests based are evaluated. Their value-based relations are put under international relations theories. Their changing factors of cooperation are used to justify their smart diplomacy, where contemporary relations are less likely to be affected by multilateral interests. To solidify claims of smart power in their relations, the recent TRIPS waiver schism illuminated health diplomacy between the two regions. This health diplomacy discourse promotes smart power diplomacy between India and the EU, where new avenues of cooperation emerge despite pandemic disagreements. The article explores how hybrid power is better than soft and hard power in silos by systematically searching and selecting the existing knowledge in the contemporary context.
Topic:
Diplomacy, Health, Bilateral Relations, European Union, Soft Power, Hard Power, and Smart Power
Political Geography:
Europe, South Asia, and India

4. Community Health Workers as Rights Defenders: Exploring the Collective Identity of the Mitanins of Chhattisgarh, India

Author:
Shriyuta Abhishek and Samir Garg
Publication Date:
12-2023
Content Type:
Special Report
Institution:
Accountability Research Center (ARC), American University
Abstract:
This Working Paper discusses the Mitanin program, a state-run community health worker program in Chhattisgarh state, India. It is based on a year-long reflection and action research exercise by the implementing organization, the State Health Resource Centre (SHRC). It argues that the collective identity of these community health workers (Mitanins) is central to their work defending the social and economic rights of their community. Collective identity often plays an important role in social movements for people’s economic and political rights. However, government-funded workers rarely get involved in such movements. The authors wanted to understand whether collective identity plays a role in driving the multi-issue activism of community health workers. A composite definition of this collective identity emerged from the research. Throughout the interviews and discussions, the Mitanins described their collective identity as a sense of solidarity that all Mitanins share with the community they serve and belong to, and a feeling of sisterhood with other women and each other. It is the shared experience of being a group of empowered women with a common mission who must use their knowledge and compassion to support the people they serve. The value system underpinning their mission dictates that people should not be denied their rights. The Mitanins’ collective identity is layered; they are not merely frontline health workers, but women who care deeply about their community. They are problem-solvers, activists, and community leaders. Their collective action and collective identity as women leaders in solidarity with the community is mutually reinforcing, and has enabled them to undertake multi-issue activism and transform themselves into frontline rights defenders. The authors conducted a state-wide survey along with focus group discussions and in-depth interviews. The survey (n=558) aimed to establish what proportion of Mitanins are involved in multi-issue activism. It found that in the preceding three years, 84 percent had taken rights-based action in at least one of three domains: food security and nutrition (68 percent); healthcare (56 percent); and gender-based violence (21 percent). They refer to these actions as ‘rights-based’ because they involve negotiation and confrontation with local elites and government officials, as well as writing formal complaints to government officials. Other than rights-based actions, Mitanins also provide information to community members about their rights and entitlements to health programs, food security, and nutrition under government programs—information that is often not readily accessible to poor people in India. This paper analyzes the patterns of autonomous collective action through discussion, interviews, and the rights-based songs and slogans written by Mitanins. The authors argue that the Mitanins’ collective identity was formed due to two main factors: the program’s movement-building approach; and the degree of autonomy enjoyed by Mitanins. The movement-building approach nurtured the activist tendencies of Mitanins, and the voluntary nature of their work allowed them to retain their autonomy vis-à-vis the health system bureaucracy
Topic:
Health, Human Rights, Women, and Communal Identity
Political Geography:
South Asia and India

5. Activating Spaces, Scaling Up Voices: Community-based Monitoring and Planning of Health Services in Maharashtra, India

Author:
Abhay Shukla, Shweta Marathe, Deepali Yakkundi, Trupti Malti, and Jonathan Fox
Publication Date:
06-2023
Content Type:
Working Paper
Institution:
Accountability Research Center (ARC), American University
Abstract:
From 2007, the Indian government’s National Health Mission (NHM) supported civil society networks to carry out large-scale participatory monitoring to improve health service access and quality under the Community-based Monitoring and Planning (CBMP) program. In the state of Maharashtra, this social accountability initiative endured more than a decade and a half, despite constraints and unpredictable government funding. The CBMP program in Maharashtra supported state-wide civil society networks to enable active citizen participation in health oversight committees. It was rooted in a broad network of diverse community-based organizations and civil society organizations that work with socially excluded communities, led by Support for Advocacy and Training to Health Initiatives (SATHI). The CBMP network combined many social accountability tools into a multilevel strategy, using community assessments of health services and local meetings with clinic staff to inform problem-solving efforts at local, district, and state levels of the health system. This government-funded civil society initiative worked with local officials to convene public dialogues and to activate previously dormant official oversight bodies, animated by a parallel network of autonomous monitoring committees. This Working Paper presents SATHI’s analysis of the CBMP program’s strategy and institutional dynamics, and documents its lasting effects on two participatory oversight institutions: Village Health, Sanitation, and Nutrition Committees (VHSNCs)—part of local government, and Rogi Kalyan Samitis (Patient Welfare Committees)—part of the health system. Field research, carried out shortly before the pandemic, compared the activation of these hybrid oversight bodies in areas with and without a legacy of intensive CBMP action. Key findings include: Official participatory spaces for citizen engagement with the health system were much more active in districts where CBMP networks had intensively promoted grassroots capacity for voice. Frontline health system responsiveness to issues that could be addressed locally—identified as ‘CBMP-sensitive’—was very high. But the health system’s degree of responsiveness to problem-solving efforts decreased at higher levels. The period of intensive CBMP effort to build grassroots awareness and capacity was limited to six years. Nevertheless, that effort had lasting effects on the levels of activity of local hybrid health oversight bodies. The pandemic revealed additional evidence of the medium-term survival and institutional impact of CBMP-enabled social networks.
Topic:
Civil Society, Health, Governance, Accountability, Community, Monitoring, Planning, Monitoring, and and Evaluation (PME)
Political Geography:
South Asia and India

6. Health of nations: How Europe can fight future pandemics

Author:
Anthony Dworkin
Publication Date:
02-2022
Content Type:
Policy Brief
Institution:
European Council on Foreign Relations (ECFR)
Abstract:
As the crisis phase of covid-19 recedes, there is a chance to improve international cooperation on global health – but also a danger that competing reform proposals will lead to inaction. The EU can best support reform of pandemic preparedness and response if it takes account of the concerns of different global powers. The union should combine a push for reform of and increased funding for the WHO with support for a new fund for health emergencies, overseen by a representative group of countries. The EU should promote a new global compact on health, matching countries’ commitment to surveillance and reporting of pathogens with support for stronger healthcare systems and greater equity in the allocation of countermeasures. The EU-Africa relationship offers a chance to pioneer such an approach, but the EU will need to go further in this than it has so far. The EU should promote African vaccine manufacturing, including by pressing European pharmaceutical companies to transfer knowledge and technology to Africa.
Topic:
Health, European Union, Pandemic, and COVID-19
Political Geography:
Africa, Russia, China, Europe, India, and United States of America

7. India–East Africa: A Not So Healthy Relationship?

Author:
Isabelle Saint-Mezard and Françoise Nicolas
Publication Date:
02-2022
Content Type:
Special Report
Institution:
Institut français des relations internationales (IFRI)
Abstract:
Due to historical as well as geographical reasons, India and East Africa have long been close partners. In the recent period however, and even more so since the early 2000s, these ties have tightened as a result of combined efforts by the government of India and its business community. The presence of communities of Indian origin in several East African countries has also acted as a catalyst. East Africa is perceived as a valuable partner both by Indian authorities and by Indian private companies. Although the two types of Indian players may not explicitly coordinate their actions, their interests dovetail nicely in this particular region. The health sector sticks out as one major sector on which Indian actors focus in East Africa. It provides a striking example of the multilayered complementarity between India and East Africa, on the one hand, and between public and private Indian players’ interests on the other. However, India’s activism in the health sector is not necessarily perceived positively by the East African host countries. Despite some technology transfers and efforts by the Indian actors, be they public or private, to promote capacity-building, East African countries find themselves in a situation of dependence as a result of Indian companies exporting and producing drugs, building hospitals, improving hospital management and Information Technology (IT) infrastructure, or digitalizing healthcare. However, the major point of tension pertains to the promotion of medical tourism. Although offshore healthcare comes with many benefits, it is unlikely to be sustainable for the East African economies in the long run. Moreover, the money spent on medical tourism could arguably be used more usefully to develop local medical facilities and competence. The recent developments in the context of the pandemic have made the associated risk very clear. The challenge in the coming years will be for the two parties to find a way to better balance their relationship and set it on firmer ground – in other words, to make it healthier.
Topic:
Foreign Policy, Health, Bilateral Relations, and Partnerships
Political Geography:
Africa, South Asia, and India

8. BRICS and Global Health Diplomacy in the Covid-19 Pandemic: Situating BRICS’ diplomacy within the prevailing global health governance context

Author:
Candice Moore
Publication Date:
10-2022
Content Type:
Journal Article
Journal:
Revista Brasileira de Política Internacional (RBPI)
Institution:
Instituto Brasileiro de Relações Internacionais (IBRI)
Abstract:
BRICS have been cast as a bloc with the potential to make significant changes in Global Health. The management of the Covid-19 pandemic has shown divisions in the bloc and the limits of its ability to formulate policies or even act upon previously agreed positions. This paper employs an examination of BRICS Health Ministerial declarations and an analysis of power in International Relations to reflect on BRICS’ Global Health diplomacy during the Covid-19 pandemic, covering the key questions of vaccine research and development, vaccine nationalism, and travel bans. It finds that multiple dimensions of power matter in Global Health leadership.
Topic:
Health, International Cooperation, Governance, Pandemic, COVID-19, and BRICS
Political Geography:
Africa, Russia, China, Europe, India, Asia, South Africa, Brazil, and South America

9. The Impact of the Covid-19 Pandemic on Public School Education

Author:
Accountability Initiative
Publication Date:
01-2021
Content Type:
Policy Brief
Institution:
Centre for Policy Research, India
Abstract:
This brief presents some of the key effects of the COVID-19 pandemic on India’s public school education, focussing specifically on children. It begins with a discussion of the pre-pandemic status of school education and key policy shifts over the past few years, and provides an overview of the principal issues arising from the pandemic and the resulting school closures. It then offers potential policy suggestions to address these challenges, and thereby ensuring quality education to all children.
Topic:
Education, Health, Children, and COVID-19
Political Geography:
South Asia and India

10. Dealing with Coronavirus Pandemic in the Bay of Bengal Region

Author:
Prabir De
Publication Date:
05-2021
Content Type:
Special Report
Institution:
East-West Center
Abstract:
The coronavirus has had a devastating impact on the health and economies of countries in the Bay of Bengal. India, Bangladesh, and Nepal are the region’s most affected countries in terms of COVID-19 cases and deaths, followed by Myanmar, Sri Lanka, and Thailand. It seems that Bhutan and Thailand, the least affected countries in the region, have successfully escaped the brunt of the pandemic. All these countries implemented strict lockdowns as early as March 2020, and the region’s recovery rates have been relatively high. However, the devastation from the pandemic did not reach its peak until after the lifting of lockdowns. The economic costs of the pandemic have soared and are still climbing. Today, most Bay of Bengal countries are facing a second or third wave of COVID-19 infections. India has been badly hit by a huge second Coronavirus wave, registered daily cases over 400,000 since Aril 2021. The damage being done by these additional waves is more intense than their predecessors. The Bay of Bengal countries are now looking for COVID-19 vaccines. India serves as the region’s primary producer of immunizations. Two Indian pharmaceutical companies have launched vaccines, with five more firms in the race to launch their own treatments. When vaccines are developed in India, they are easier to distribute across the region. In terms of availability, accessibility, and affordability, India’s vaccines are better suited to the needs of the region. In recent months, India has successfully supplied over 18 million doses of COVID-19 vaccines to many Bay of Bengal countries, with Thailand being a notable exception. India has also ensured more supply of the vaccines in the neighborhood.
Topic:
Economics, Health, Pandemic, and COVID-19
Political Geography:
Bangladesh, South Asia, India, Nepal, Thailand, Bhutan, and Bay of Bengal

11. Responding to COVID: a Mobility Based Surge Capacity Framework

Author:
Shamindra Nath Roy, Partha Mukhopadhyay, Jishnu Das, and Yamini Aiyar
Publication Date:
06-2021
Content Type:
Special Report
Institution:
Centre for Policy Research, India
Abstract:
It would appear, based on the experience over the past year, that at a given point in time, CoVID-19 affects a part of the country and not the whole nation. What does this imply for the sharing of resources between more affected areas and less affected areas? What does it imply for where reserves of resources need to be maintained to meet sudden surges in caseload? This note looks at these questions, by examining the spatial pattern of the epidemic over time and the nature of the resources, i.e., the extent to which their supply can be increased, the ease with which they can be moved, etc., including, where possible and necessary, the movement of patients in addition to mobile resources. Our analysis based on current transmission dynamics, points out that there are a small set of areas permanently at risk for repeat surges. These are areas where health infrastructure may need to be augmented locally. For other areas, while increases in health infrastructure would be needed, inter-district and interstate coordination can ensure that additional critical services can be made available through resource sharing. However, such a mobility-based surge capacity framework, as we have proposed, requires enabling governance structures that builds trust and facilitates coordination across district and state administrations, based on real time data analysis as well as formal institutional structures.
Topic:
Health, Infrastructure, Governance, Institutions, and COVID-19
Political Geography:
South Asia and India

12. Integrated Child Development Services

Author:
Ritwik Shukla, Sharad Pandey, and Avani Kapur
Publication Date:
02-2021
Content Type:
Policy Brief
Institution:
Centre for Policy Research, India
Abstract:
Integrated Child Development Services is Government of India’s (GoI’s) flagship programme aimed at providing basic education, health, and nutrition services for early childhood development. It has now been combined with POSHAN Abhiyaan to form Saksham Anganwadi and POSHAN 2.0. Against the backdrop of the COVID-19 pandemic, this brief uses government data to analyse: Required funds, allocations, and releases; Changes in coverage and service delivery due to the COVID-19 pandemic; Human resources; and Malnutrition status
Topic:
Education, Health, Budget, Social Services, COVID-19, and Child Development
Political Geography:
South Asia and India

13. Ayushman Bharat

Author:
Ritwik Shukla and Avani Kapur
Publication Date:
02-2021
Content Type:
Policy Brief
Institution:
Centre for Policy Research, India
Abstract:
Ayushman Bharat, under the aegis of the Ministry of Health and Family Welfare (MoHFW), was launched by Government of India (GoI) on 23 September 2018. The programme consists of two initiatives: (1) The Pradhan Mantri Jan Arogya Yojana (PMJAY); and (2) The establishment of 1.5 lakh Health and Wellness Centres (HWCs). Against the backdrop of the COVID-19 pandemic, this brief uses government data to analyse: Past trends in GoI allocations, releases, and expenditures; Eligibility and claims under PMJAY till September 2020; and Number of operational HWCs, staff in-position, and footfall.
Topic:
Health, Budget, Welfare, COVID-19, and Allocations
Political Geography:
South Asia and India

14. Experiences of Frontline Workers in Rajasthan and Himachal Pradesh during the COVID-19 Pandemic

Author:
Accountability Initiative
Publication Date:
03-2021
Content Type:
Case Study
Institution:
Centre for Policy Research, India
Abstract:
This study examines the evolving role and experiences of Frontline Workers (FLWs) during and after the nation-wide lockdown in 2020. The findings provide insights into how FLWs shouldered additional responsibilities, how they have adapted to the disruption of routine health and nutrition related services, and how they have initiated creative responses to help the system adapt to the ‘new normal’.
Topic:
Health, Public Policy, COVID-19, and Nutrition
Political Geography:
South Asia and India

15. Tracking Finances under Rashtriya Kishore Swasthya Karyakram (RKSK)

Author:
Accountability Initiative
Publication Date:
04-2021
Content Type:
Case Study
Institution:
Centre for Policy Research, India
Abstract:
The Rashtriya Kishore Swasthya Karyakram (RKSK) is an adolescent health Programme within the ambit of the National Health Mission (NHM). This study focusses on the expenditures and fund flows of RKSK in Sitapur district of Uttar Pradesh (UP). It uses a combination of quantitative and qualitative analysis.
Topic:
Health, Finance, and Accountability
Political Geography:
South Asia and India

16. Crisis from Kolkata to Kabul: COVID-19’s Impact on South Asia

Author:
Husain Haqqani and Aparna Pande
Publication Date:
05-2020
Content Type:
Special Report
Institution:
Hudson Institute
Abstract:
The world’s most populous region, South Asia, with almost 1.9 billion people living in eight countries, has so far had fewer reported infections and fatalities per capita from the novel coronavirus than projected in early models. However, the region is unlikely to escape the widespread disruption and damage felt across the globe, and its worst health-care crisis may be yet to come. In South Asia, as in other regions, the COVID-19 pandemic is testing the capacities of states to provide security and effective healthcare and to maintain essential services. It is also having an impact on fragile democratic institutions and societal bonds, in addition to putting considerable strains on the economy. [...] Following is a country-by-country report, with inputs from experts on the ground, on the coronavirus pandemic’s impact in South Asia and its human, economic, and political consequences.
Topic:
Economics, Health, Crisis Management, and COVID-19
Political Geography:
Pakistan, China, South Asia, India, Asia, and Sri Lanka

17. Reuse and Recycling of Faecal Sludge-derived Biosolids in Agriculture

Author:
Neha Agarwal, Ambarish Karunanithi, and Anju Dwivedi
Publication Date:
05-2020
Content Type:
Special Report
Institution:
Centre for Policy Research, India
Abstract:
The rapid proliferation of toilets under the Swachh Bharat Mission has necessitated the safe collection, conveyance, and treatment of faecal sludge and septage. Accordingly, the National Policy on Faecal Sludge and Septage Management (FSSM), 2017, sets the imperative for streamlining the citywide sanitation service chain. In doing so, it promotes closing of the resources loop through recycling and reuse of treated wastewater and faecal sludge-derived biosolids. The 2017 amendment to the Environment (Protection) Rules, 1986, lays down clear standards and guidance for recycling of treated wastewater. However, a regulatory lacuna concerning biosolids -whose use as a fertilizer in agriculture has been shown to enhance crop yields and reduce the burden of synthetic fertilizers - deters local action in accessing opportunities for their recycling formally. This guidance note, reviewing international biosolids regulations, is intended as an aid for policymakers and regulators at the national and state level in developing a standard for biosolids utilization in agriculture which is easy to interpret and implement, promotes their scientific and safe reuse, and ensures the protection of the health of the users, the local communities, the consumers, and the environment at large.
Topic:
Agriculture, Environment, Health, Sanitation, and Recycling
Political Geography:
South Asia and India

18. Biological Risks in India: Perspectives and Analysis

Author:
Shruti Sharma
Publication Date:
12-2020
Content Type:
Working Paper
Institution:
Carnegie Endowment for International Peace
Abstract:
India faces a host of biological risk factors. Drawing lessons from the coronavirus pandemic and prior biological disasters, India’s government should pursue new safety protocols and develop new institutions to manage future biological risk. Infectious diseases such as COVID-19, the disease caused by the novel coronavirus; severe acute respiratory syndrome (SARS); Middle East respiratory syndrome (MERS); and the diseases caused by the Ebola, Nipah, and Zika viruses have exposed countries’ susceptibility to naturally occurring biological threats. Even though scientists from multiple countries concluded that the virus responsible for the coronavirus pandemic shifted naturally from an animal source to a human host,1 the international community should not ignore the possibility of pathogens escaping accidentally from research labs and threats of deliberate manipulation to create more dangerous bioweapons. India is especially vulnerable to such infections because of its geographical position, large population, low healthcare spending, minimal expenditure on research that benefits public health, weak coordination between central and state health authorities, limited involvement of private actors, poor awareness of biosecurity, and the rickety state of public health infrastructure. Most recently, COVID-19 has revealed the deep fault lines in India’s public health infrastructure, including a shortage of healthcare workers, lack of trained epidemiologists, scarcity of medical equipment, poor access to healthcare facilities in rural areas, and inefficient disease reporting and surveillance in most states. The pandemic should therefore be a wake-up call for India to assess gaps in its public health infrastructure and divert its resources toward the healthcare sector to prepare itself for both natural and man-made biological emergencies. Like any country, India faces three major biological threats: naturally occurring infections in humans or animals, or agricultural infestations; infections arising from accidental release of pathogens into the environment; and possible outbreaks caused by deliberate weaponization of dangerous pathogens that affect humans, animals, or crops. These threats—either alone or together—will force India to strengthen its capacity to detect and respond to them.
Topic:
Health, Biology, and Non-Traditional Threats
Political Geography:
South Asia and India

19. People’s Polyclinics: The Initiative of the Telugu Communist Movement.

Author:
Tricontinental: Institute for Social Research
Publication Date:
02-2020
Content Type:
Working Paper
Institution:
Tricontinental: Institute for Social Research
Abstract:
The Indian Communist movement has experimented with various forms of people’s polyclinics, which provide free or reduced-cost health care to anyone. The epicentre of this initiative has been in the Telugu-speaking region of India, where the Nellore People’s Polyclinic alone treats 1,000 patients per day at rates 40% lower than corporate hospitals and has trained over five hundred doctors who now provide health care across the region. Our Tricontinental: Institute for Social Research Dossier no. 25 focuses on the history of the polyclinics in this region.
Topic:
Communism, Health, Community, and Medicine
Political Geography:
India and Asia

20. National Health Mission

Author:
Snehal Shah, Avani Kapur, and Abhishek Andasu
Publication Date:
02-2020
Content Type:
Policy Brief
Institution:
Centre for Policy Research, India
Abstract:
he National Health Mission (NHM) is Government of India’s (GoI’s) largest public health programme. It consists of two sub-missions: National Rural Health Mission (NRHM), and National Urban Health Mission (NUHM). Using government data, this brief reports on: GoI allocations and releases; Incentives and penalties to states under conditionality framework; NHM approvals and expenditures as per programmatic components; and Outputs and outcomes.
Topic:
Government, Health, Health Care Policy, Budget, Social Policy, Public Policy, and Rural
Political Geography:
South Asia and India

21. Swachh Bharat Mission – Gramin

Author:
Avani Kapur and Sanjana Malhotra
Publication Date:
02-2020
Content Type:
Policy Brief
Institution:
Centre for Policy Research, India
Abstract:
The Swachh Bharat Mission- Gramin or SBM-G is the Government of India’s (GoI’s) flagship rural sanitation programme run by the Ministry of Jal Shakti (MJS). Using government data, this brief reports on trends for SBM-G along the following parameters: Allocations and expenditures; Physical progress of toilets built; Expenditures incurred under Information, Education, and Communication (IEC); Solid Liquid Waste Management (SLWM) activities; and Coverage and Open Defecation Free (ODF) status.
Topic:
Government, Health, Infrastructure, Budget, Social Policy, Rural, and Sanitation
Political Geography:
South Asia and India

22. Pradhan Mantri Matru Vandana Yojana & Janani Suraksha Yojana

Author:
Avani Kapur and Tenzin Yangki
Publication Date:
02-2020
Content Type:
Policy Brief
Institution:
Centre for Policy Research, India
Abstract:
This brief reports on two schemes: a) The Pradhan Mantri Matru Vandana Yojana (PMMVY), Government of India’s (GoI’s) maternity benefit scheme aimed at providing partial compensation for wage loss and improving health seeking behaviour of pregnant women and lactating mothers, and b) the Janani Suraksha Yojana (JSY) aimed at incentivising institutional and safe delivery to reduce infant and maternal mortality. Using government data, this brief reports on: Trends in allocations, releases, and utilisation; Coverage and payments; and Outputs and outcomes.
Topic:
Gender Issues, Government, Health, Health Care Policy, Budget, Women, and Social Policy
Political Geography:
South Asia and India

23. Ayushman Bharat

Author:
Ritwik Shukla and Avani Kapur
Publication Date:
02-2020
Content Type:
Policy Brief
Institution:
Centre for Policy Research, India
Abstract:
Ayushman Bharat, under the aegis of the Ministry of Health and Family Welfare (MoHFW) was launched by Government of India (GoI) on 23 September 2018. The programme consists of two initiatives: (1) The Pradhan Mantri Jan Arogya Yojana (PMJAY); and 2) The establishment of 1.5 lakh Health and Wellness Centres (HWCs). Using government data, this brief reports on the following indicators: GoI allocations and releases; Eligibility and claims under PMJAY; and Number of operational HWCs and diseases screened.
Topic:
Government, Health, Health Care Policy, and Budget
Political Geography:
South Asia and India

24. Integrated Child Development Services

Author:
Avani Kapur and Ritwik Shukla
Publication Date:
02-2020
Content Type:
Policy Brief
Institution:
Centre for Policy Research, India
Abstract:
The Integrated Child Development Services is Government of India’s (GoI’s) flagship programme aimed at providing basic education, health, and nutrition services for early childhood development. This brief uses government data to analyse ICDS performance along the following parameters: Allocations, releases, and expenditures, Component-wise trends, Human and physical resources, Coverage, and Malnutrition status.
Topic:
Education, Health, Budget, Children, Food Security, and Social Policy
Political Geography:
South Asia and India

25. 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

26. 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

27. Health Care in India

Author:
Preeti Sudan
Publication Date:
04-2019
Content Type:
Research Paper
Institution:
India International Centre (IIC)
Abstract:
Our topic today, is the journey of preventive and promotive health care from a government perspective. I must say at the outset that it was always the intention of the government to have a mix of promotive and preventive health care strategies closely integrated with curative care. However, it is the curative care aspects that are most visible and this is perhaps the reason for significant investments in setting up health care facilities. In addition, people’s vocal demands for curative care, which are legitimate, led us to emphasise the curative part of health care. So the focus was tilted in favour of care provision after people fell ill, and we became the Ministry of Managing Illness. But I am glad that since last year, we are now the Ministry of Health and Wellness, and I am fortunate that I am at this very place as this paradigm shift is happening in health care. I want to also say that I’m doubly blessed, because I also got to do Beti Bachao, Beti Padhao in the Ministry of Women and Child Development, and was able to take action on discriminatory practices against women and girls in our country So I had that satisfaction as well.
Topic:
Health, Health Care Policy, and Public Health
Political Geography:
India

28. 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

29. Pradhan Mantri Matru Vandana Yojana & Janani Suraksha Yojana (PMMVY & JSY)

Author:
Ritwik Shukla and Avani Kapur
Publication Date:
07-2019
Content Type:
Policy Brief
Institution:
Centre for Policy Research, India
Abstract:
This brief reports on two maternity benefits schemes, offering conditional cash transfers to pregnant women and mothers: a) The Pradhan Mantri Matru Vandana Yojana (PMMVY), Government of India’s (GoI’s) scheme aimed at providing partial compensation for wage loss and improving health seeking behaviour of pregnant women and lactating mothers, and b) the Janani Suraksha Yojana (JSY) aimed at incentivising institutional and safe delivery for reducing infant and maternal mortality. Using government data, this brief reports on: Trends in allocations, releases, and utilisation, Coverage and payments, and Outputs and outcomes.
Topic:
Gender Issues, Government, Health, Budget, Women, and Economy
Political Geography:
South Asia and India

30. Integrated Child Development Services (ICDS)By AVANI KAPUR and RITWIK SHUKLA

Author:
Avani Kapur and Ritwik Shukla
Publication Date:
07-2019
Content Type:
Policy Brief
Institution:
Centre for Policy Research, India
Abstract:
The Integrated Child Development Services is the Government of India’s (GoI’s) flagship programme aimed at providing basic education, health, and nutrition services for early childhood development. This brief uses government data to analyse ICDS performance along the following parameters: Allocations, releases, and expenditures; Component-wise trends; Human and physical resources; Coverage, and Outcome.
Topic:
Development, Education, Government, Health, Budget, and Children
Political Geography:
South Asia, India, and Asia

31. Learning to Sustain Change: Mitanin Community Health Workers Promote Public Accountability in India

Author:
Samir Garg and Suchi Pande
Publication Date:
08-2018
Content Type:
Special Report
Institution:
Accountability Research Center (ARC), American University
Abstract:
Can community health workers (CHWs) act as agents of change in enhancing the public accountability of government, despite being state-funded actors themselves? CHW programs worldwide face challenges in achieving public accountability. They face a tension between upward accountability (to higher officials within the health system) and public accountability (to the people who access and use public health services), especially with respect to their potential to play a role as agents of public accountability (Schaaf et al. 2018). This Accountability Note illustrates how the CHW program of the Chhattisgarh state government in central India— known as Mitanin—has, over time, developed a learning strategy that permits CHWs (Mitanins) to enable sustained action on public accountability, whilst simultaneously providing health services and education, and linking communities with government healthcare services. The main proposition of this note is that this evolving learning strategy enabled state and civil society actors to design institutions and processes appropriate for accountability. Our focus is on understanding how learning has lent the program the ability to evolve ways for continuously managing the essential tensions inherent in its design, and how this has been key to developing sustainable accountability strategies. We discuss examples of how the Mitanins’ evolving learning strategy has contributed to their efforts to ensure public accountability of the health system to people who use public health services. These examples are grouped under five propositions about the roles CHWs can play in sustainable public accountability: 1. Community health workers can simultaneously act as service providers and agents of public accountability. 2. Community health workers can set agendas for advocacy on issues of accountability by building virtuous cycles of action and learning. 3. Community health workers can build countervailing power at multiple levels. 4. Community health workers can demand both rights for communities, and better working conditions for themselves. 5. ‘Action-strategists’ can create an appropriate state-civil society organization to facilitate community health workers’ action. This note offers insights from the Mitanin experience on these five ways that CHWs can build and sustain accountability, and illustrates how the program has taken a movement-building approach to public health, and thus avoided becoming a narrow technocratic intervention.
Topic:
Civil Society, Health, Accountability, Public Health, and Community Engagement
Political Geography:
South Asia and India

32. Building Regulations For Faecal Sludge Management: Review of Building Regulations From Indian States

Author:
Arkaja Singh
Publication Date:
12-2018
Content Type:
Special Report
Institution:
Centre for Policy Research, India
Abstract:
Getting approvals under the various building regulations applicable to any particular jurisdiction is often the first step in construction and development. The Report ‘Building Regulations for Faecal Sludge Management: Review of Building Regulations from Indian States’ seeks to understand how these building regulations address on-site sanitation, what kind of standards do they impose on developers, and how well do they incorporate mechanisms to enforce these standards. In this report, we look at six states: Andhra Pradesh, Odisha, Rajasthan, Tamil Nadu, Maharashtra, and Uttar Pradesh. We also look at other standards that are applicable to on-site containment of Faecal sludge, and the manner in which these standards get incorporated into the building regulations. We find that context-specific attention to On-Site Containment of Faecal Sludge is only given in very few states, at least within our sample size. Usually, Building Regulations seem to rely on already existing standards such as the National Building Code, 2016. Additionally, the inconsistencies within the bye-laws exhibit a lack of understanding on the issue of FSM, amongst the policy-makers. As Faecal Sludge Management is an issue at the interface of environment, sanitation, and public health, a lack of convergence between various departments of the government is also noticed.
Topic:
Environment, Government, Health, Regulation, and Sanitation
Political Geography:
South Asia, India, and Asia

33. Unpacking the Processes of Open Defecation Free Status in Udaipur: A case study of Udaipur, Rajasthan

Author:
Devashish Deshpande and Avani Kapur
Publication Date:
08-2018
Content Type:
Case Study
Institution:
Centre for Policy Research, India
Abstract:
This report is the culmination of a study conducted by the Accountability Initiative (AI) on Swachh Bharat Mission-Gramin in 2017 on the request of the Udaipur district administration. The study understands the outcomes, and the processes, which led to Open Defecation Free status in selected Gram Panchayats.
Topic:
Development, Health, Social Policy, Sanitation, and Services
Political Geography:
South Asia, India, and Asia

34. Infrastructure, Gender and Violence: Women and Slum Sanitation Inequalities in Delhi

Author:
Susan Esme Chaplin and Reetika Kalita
Publication Date:
10-2017
Content Type:
Special Report
Institution:
Centre for Policy Research, India
Abstract:
In Delhi, as in many other Indian cities, millions of men, women and children who live in slums and informal settlements haveto daily confront the lack of adequate sanitation facilities. These sanitation inequalities have a greater impact on the health and socioeconomic status of women and girls because of their greater social vulnerability to sexual violence; there is also the role played by biology in their need for privacy, safety and cleanliness. Men and boys, on the other hand, tend to use public urinals and open defecation (OD) sites generally more frequently, because their need for privacy during these sanitation activities is not such a cause for concern. In addition, women and girls are forced every day to risk using precarious spaces for their sanitation activities that may expose them to gender-based violence and harassment and not satisfy their biological and socio-cultural needs. These urban sanitation inequalities also negatively impact the time women have available for paid employment as well as their daily domestic responsibilities, as they have to spend each morning queuing for toilets or getting up earlier to go with other women to OD sites. For adolescent girls this can often mean being late for school, which threatens their education and future life choices. India failed to meet Millennium Development Goal No. 7 (adopted by the United Nations in 2000) relating to halving the proportion of people without access to basic sanitation. In terms of toilet usage across India, the Census 2011 found that 81 percent of urban households had a private toilet or latrine. But when it came to slum households, only 66 percent had a toilet, meaning that 34 percent had to either use a community or public toilet or resort to OD (Ministry of Housing and Urban Poverty Alleviation & National Buildings Organisations 2013, p. 60). In reality, there are an estimated 41 million urban dwellers still practising OD because of a lack of access to improved sanitation (WaterAid 2016). OD is a compulsion, not a choice, and creates particular risks and imposes a variety of harms upon women and children that men and boys do not suffer. Who or what is responsible for such socioeconomic consequences of the lack of adequate sanitation infrastructure in Indian cities which perpetuate gender inequalities? How do harms like gender-based violence impact the everyday lives of women and girls living in slums in particular? This project report examines these issues using the notion of infrastructural violence and then examines the harms and suffering caused by a lack of sanitation infrastructure in two long-established localities in Delhi: Mangolpuri and Kusumpur Pahari. Mangolpuri is a resettlement colony in the northwest region of Delhi with an estimated population of more than 350,000. It is interspersed with eight JJCs clusters of varying sizes. Kusumpur Pahari is located in the heart of south Delhi, near Jawaharlal Nehru University, and now has five blocks of JJCs and an estimated population of nearly 50,000.
Topic:
Development, Gender Issues, Health, Children, Women, Income Inequality, and Sanitation
Political Geography:
South Asia, India, and Asia

35. Odisha Urban Sanitation Policy and Strategy 2017

Author:
Centre for Policy Research
Publication Date:
12-2016
Content Type:
Special Report
Institution:
Centre for Policy Research, India
Abstract:
Over the past four years, the national policy environment and institutional response to sanitation have undergone a substantial change. The launch of the Swachh Bharat Mission (Urban) and Atal Mission for Rejuvenation and Urban Transformation (AMRUT) have catapulted sanitation into the league of priority sectors. In the backdrop of such developments, Housing and Urban Development Department under the Government of Odisha sought to revise the Urban Sanitation Strategy 2011 with the able support from the Centre for Policy Research (CPR) supported by the Bill and Melinda Gates Foundation. The revised Odisha Urban Sanitation Strategy 2017 and Odisha Urban Sanitation Policy 2017 make crucial strides towards the achievement of a Clean Odisha. The purview of the strategy has been expanded to address gaps in the entire sanitation value chain for the management of not only solid waste, but also liquid waste including faecal sludge/septage and menstrual hygiene. The revised strategy is grounded in the principles that have underpinned the Odisha government's efforts so far to provide the people with equitable and safe access to sanitation, along with establishing the most advanced sanitation infrastructure. Over the next ten years, concerned departments will work towards six objectives: (a) achieving open defecation free and (b) open discharge free urban areas; (c) effectively managing and treating solid waste; (d) ensuring that sewage, (e) septage/faecal sludge and liquid waste are safely treated and disposed; and (f) ensuring safety guidelines are followed in physical handling and management of waste. In addition, providing women and girls with safe access to menstrual hygiene has also been included as an objective in the revised strategy.
Topic:
Development, Health, Infrastructure, Governance, Public Policy, and Sanitation
Political Geography:
South Asia, India, and Asia

36. Why Are Indian Children So Short?

Author:
Seema Jayachandran and Rohini Pande
Publication Date:
04-2015
Content Type:
Working Paper
Institution:
The John F. Kennedy School of Government at Harvard University
Abstract:
India's child stunting rate is among the highest in the world, exceeding that of many poorer African countries. In this paper, we analyze data for over 174,000 Indian and Sub-Saharan African children to show that Indian firstborns are taller than African firstborns; the Indian height disadvantage emerges with the second child and then increases with birth order. This pattern persists when we compare height between siblings, and also holds for health inputs such as vaccinations. Three patterns in the data indicate that India's culture of eldest son preference plays a key role in explaining the steeper birth order gradient among Indian children and, consequently, the overall height deficit. First, the Indian firstborn height advantage only exists for sons. Second, an Indian son with an older sibling is taller than his African counterpart if and only if he is the eldest son. Third, the India-Africa height deficit is largest for daughters with no older brothers, which reflects that fact that their families are those most likely to exceed their desired fertility in order to have a son.
Topic:
Health, Poverty, Children, and International Development
Political Geography:
Africa, South Asia, and India

37. Reforming the Liability Regime for Air Pollution in India

Author:
Shibani Ghosh
Publication Date:
12-2015
Content Type:
Working Paper
Institution:
Centre for Policy Research, India
Abstract:
The recent uproar about the toxic levels of pollution in the country’s national capital region has once again brought to fore the failure of the regulatory and legal mechanisms in India to control air pollution. Despite an early legislative acknowledgment of the issues relating to air pollution, and regulatory mechanisms set up consequently, India has not been able to restrict the sharp upward trajectory of air pollution. While several issues with regard to the legal and regulatory regime governing air quality in the country deserve serious and urgent consideration, this paper focuses on one issue in particular – the liability regime for violation of air quality standards. The paper is divided into three parts. The first part discusses the relevant provisions of the law pertaining to liability - civil and criminal - for causing air pollution. The second part identifies three critical issues that have emerged in the current liability regime: (1) the Pollution Control Boards do not have the power to levy penalties; (2) criminal prosecution is not an effective solution; and (3) the National Green Tribunal Act does not provide complete relief. The third and final part of the essay proposes a way forward. It is suggested that the Pollution Control Boards need to be granted additional enforcement powers, and administrative fines for violations should be introduced, albeit with certain conditions.
Topic:
Environment, Health, Governance, Law Enforcement, Law, Reform, and Pollution
Political Geography:
South Asia, India, and Asia

38. 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

39. Physician Shortages in the Indian Public Sector

Author:
Anjali Chikersal
Publication Date:
06-2015
Content Type:
Special Report
Institution:
Centre for Policy Research, India
Abstract:
India is one of the few countries that has been estimated to have a “critical” shortage of health workers and therefore unlikely to be able to provide essential health interventions to its people (WHO 2006). The dire impacts of these shortages are evident from the fact that it has fallen short of meeting its MDG goals on several fronts. As the current discourse on Universal Health Care debates the means of expanding coverage to all citizens, the one aspect universally agreed upon is the persistent challenge that a shortage of health workforce in the public sector poses, and the pressing need to address this gap. This policy brief outlines the core issues at the root of the problem and examines the reasons for the severe shortages in the key element of this workforce, the physicians, in the Indian public sector. It then provides an overview of WHO’s Global Policy Recommendations to address this challenge and looks at the strategies that various Indian states have so far adopted. Finally, it offers a set of practical and goal oriented recommendations aimed at directly and urgently addressing the challenge in the Indian context.
Topic:
Health, Governance, Health Care Policy, Public Policy, and Public Sector
Political Geography:
South Asia and India

40. 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