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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