Out-of-pocket payments (OOPs) dominate the discourse on health insurance. The success of health insurance schemes is typically measured by whether such expenses decrease for the insured. Financial hardships can indeed significantly hinder access to health care. But other barriers exist within households and across social groups that can also restrict access to health care. Health insurance schemes can improve such situations and enhance access to health care. While they are well recognised for their potential to offer financial risk protection, their ability to promote equity in other ways is not as well understood. This blog draws from a recent presentation at the Fifth Global Symposium on Health Systems Research (HSR2018) to highlight how inter- and intra-household equity can be promoted through health insurance schemes for the poor. Empirical evidence from the Rashtriya Swasthya Bima Yojana (RSBY) - a state funded health insurance scheme for the poor in India – is cited to make the case.Read More
Filtering by Category: India
Worldwide, 830 women die daily from preventable causes related to pregnancy and childbirth, and unfortunately one fifth of these women reside in India (UNICEF). Maternal death accounts for highest share of Disability-Adjusted Life Year (DALY) and is more prevalent in rural areas as compared to urban ones. This is demonstrated in areas such as the Sundarbans, where geographically inaccessible terrain makes maternal health service delivery challenging. In the near absence of formal delivery care at the grassroots level, Community Delivery Centers (CDCs) bring basic obstetric care to the doorsteps of hard-to-reach regions of Indian Sundarbans.Read More
Manasee Mishra, IIHMR Kolkata and Future Health Systems, writes that if we are to truly 'leave no one behind' and achieve Universal Health Coverage (UHC), then we must recognise and respond to the compounding effects of multiple social identities that compound exclusion, discrimination and marginalisation.Read More
Forty years after the well-intentioned Alma Ata Declaration (1978), ‘Health for All’ remains a distant goal. This is particularly so for populations living in vulnerable parts of the world – conflict areas, prone to natural disasters, or geographically remote and vulnerable areas such as the Sundarbans in India. How does one, in the era of the SDGs ensure that goal #3 is achieved for the most marginalized? This blog takes us to the riverine areas of the Sundarbans in India to understand better the contextual factors which inhibit the provision, and access to health services for the people living there.
“Scaling up” is considered as a pertinent and scientific pathway recognized by academia and policy makers to reduce inequalities, to achieve the Sustainable Development Goals (SDGs), and for universal health coverage. To build upon and learn from the longstanding partnership between Bangladesh Rural Advancement Committee (BRAC), International Centre for Diarrheal Disease Research, Bangladesh (ICDDR,B), and the Institute of Development Studies (IDS), a two day conference was held on 7 -8 February in Dhaka, Bangladesh to share diverse perspectives, pathways and learnings from contextual settings to achieve successful scaling up of interventions and collaborations. The conference, in addition to throwing light on the pathways of scaling up of programs through our learnings, also acted as a potential accelerator for collaboration. This blog post shares five critical reflections from the conference mentioned below.
In India, there is a growing interest in partnership driven innovative service delivery models for providing health services to the poor. Consequently, the state and central governments in India have initiated 226 innovative programs of which 43 are through public private partnerships (PPPs). In spite of this interest in PPPs, very few programs have been scaled up to reach a wider population.On one hand, PPPs are lauded as an innovative model for service delivery and multiplicative scale-up that includes multiple actors. On the other hand, it is argued that factors such as inadequate funding, changing political context and PPP modalities like tendering and contracts limit the resources available for development and scale-up of innovations. But the fundamental question is – how can partnerships based on the premise of collaborative functioning that leverages each other’s strengths foster innovative solutions for local problems and drive them to scale?Read More
People-centeredness of a resilient health system – an illustration and few questions for the forthcoming HSR Symposium 2016
Health system and policy researchers and practitioners, civil society, academia and policy makers from around the world will gather in Vancouver, Canada for the Fourth Global Symposium on Health Systems Research (#HSR2016). The build-up to this biennial conference shows that there is considerable excitement and debate on this year’s symposium theme – Resilient and Responsive Health Systems for a changing world. Can we think of a resilient health system without it being people-centred? The answer is most certainly no.
Communitization of Health: Reflections from IIHMR – FHS on climate health research to policy at the SOCHARA meet, Bangalore
In April 2016, FHS IIHMR presented their research on ‘Climate, Society and Health - Research to policy’ at a workshop in Bangalore, India examining complexities, at both the macro and micro level, of ensuring that climate health research informs polity. The workshop - which was attended by academics, post graduate students and civil society members with thematic expertise in agriculture, climate, food security and child rights - was being conducted to mark the silver jubilee celebrations of SOCHARA - an NGO committed to a community health approach to addressing public health problems.Read More
We set out to leave for Ghoramara - one of the islands of the Sagar block of the Indian Sundarbans in the southern part of West Bengal - as a part of the IIHMR University – FHS study on climatic uncertainties and child health. As I sat in the bottom deck of the ferry travelling the hour long journey from Kakdwip to Ghoramara, I began to read the documents shared by the Panchayat on the island. The island, home to a population of 5000 people, is surrounded by rivers from all corners. It has no primary health facility but a sub-centre and ten anganwadi centres. It is popularly called the sinking island because the rising sea levels due to global warming and climatic events had leached a major portion of the island in the last few decades. A report by Centre for Science and Environment stated that over 25 years, Ghoramara’s land mass has been eaten away by the advancing sea – from 9 sq km to just about 4.7 sq km. I wondered what it meant for people living all their lives in a village and watching it gradually leach out.Read More
How can Rural Medical Practitioners (RMPs) improve health service delivery in the hard-to-reach areas in the Sundarbans? IIHMR Researcher, Rittika Bramhachari explores how incorporating RMPs can help India to reach Universal Health Coverage.Read More
How can the use of photos help to influence decision-makers? Shibaji Bose, FHS PIRU Officer at IIHMR blogs about how women in the Indian Sundarbans used Photovoice - a visual action research technique - to demonstrate to decision makers the challenges that they face in gaining access to health services.Read More
FHS Researcher Upasona Ghosh writes an article for The International Health Policies (IHP) network on how climate negotiations happen on a global scale, but also in local settings around the world, including in the 'beautiful forest' - the Sundarbans.Read More
On 27 April 2015, the Indian Institute of Health Management Research (IIHMR) University (FHS partner) and Welthungerhilfe, with technical inputs from UNICEF, co-hosted a consultation meeting in Kolkata to address the challenges and barriers to the adoption of a sustainable multi-sectoral approach to combat child undernutrition in the Indian state of West Bengal. This blog outlines the key messages, outcomes and actions from the meeting.Read More
Debjani Barman is a recipient of a RinGs’ small research grant. Within this blog post she discusses how she became interested in gender, care seeking, and health service delivery, and what led her to develop this project.Read More
Future Health Systems and Africa Hub partners will be participating at the ResUp MeetUp Symposium and Training Exchange in Nairobi from 9 to 12 February 2015, which will bring together members of the ResUp MeetUp community to share learning and best practice, and build capacity for research uptakeRead More
This post was written by Upasona Ghosh, Senior Research Officer at the Indian Institute of Health Management Research and originally appeared on Eldis. It is one of two case studies published on Eldis to mark the World Health Organization conference on health and climate, which tookplace in Geneva from 27-29 August.Read More
Is the health system response out of sync with the demands of the islanders in the Indian Sundarbans?
Five years ago, a mid-summer nightmare named Aila crashed on the Sundarbans with murderous fury and wreaked destruction beyond repair. On May 25, 2009 the tropical cyclone hit the Sundarbans in India and Bangladesh with a wind speed of 110 km/hr. Over 8,000 people went missing and more than a million were rendered homeless in the two countries. In India about 300 people were killed in Sagar Island alone in the Indian Sundarbans. Figures can scarcely do justice to record the number of homes destroyed, lives lost and livelihoods decimated.
There was a localised health system collapse in the immediate aftermath of Aila – a fact attested by the islanders loudly and by the state health policy makers privately.Read More