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India

India

 

Background

India, the world’s 10th largest economy, has witnessed a decline in the incidence of poverty during the last few decades largely due to economic liberalization. But one-third of its population still remain below the poverty line subsisting on less than a dollar a day. With economic advancement has come new vulnerabilities, inequalities, and insecurities in all development areas, including health.

Research in the second half of the century established that poor are less entitled to public subsidies and more likely to financial shock owing to out of pocket expenditures on health.

The situation is understandably worse for regions like the Sundarbans in West Bengal, where poverty stricken islanders have to cope with adverse geo-climatic conditions. Against this backdrop the FHS India research initiative was launched with the guiding principle of “putting the poor first”.

 

FHS Phase 1

In the initial phase of FHS India, research was carried out to gain a systematic understanding of determinants and consequences of inequity in health, healthcare, healthcare utilization and healthcare financing. Towards the later part of the research period, FHS India focused on the Sundarbans, a chronically handicapped region of West Bengal.

For the first time, FHS India generated systematic evidence on burden of ill-health in the Sundarbans based on household surveys, chronic morbidities suffered by older adults, healthcare utilization, choice of providers, issues in access to healthcare amidst extreme geographical barriers and issues in maternal and child healthcare. Further, a preliminary understanding of the healthcare delivery mechanisms in the Sundarbans was also gathered through a systematic survey of public health facilities, semi/unskilled rural medical practitioners and charitable trusts.

One of the major focus areas of FHS I was to build up a partnership for research that will be successful in influencing health policy and service delivery mechanism in the state of West Bengal.

FHS Phase 2

Evidence-based research from the first phase identified a need for greater community exposure, learning and identification of key systemic gaps and mitigation strategies. Through audience friendly communication methods, technology use, health services provider training and a prompt, need-based support, in this phase FHS India will work to formulate a feasible and comprehensive strategy for tackling health service delivery in the Sundarbans.

For the next five years, FHS India will concentrate on research focusing on systematic understanding of the multidimensional nature of crisis in child healthcare access in delta region of the Sundarbans. However, given that child health care shares the common fundamental problems with overall primary health care system, the uptake of research is expected to significantly impact the overall system.

We are planning operational research that will be piloted to learn about and demonstrate the effectiveness of the proposed model.

A common knowledge platform will be established, which helps to establish a communication link not only between the FHS team and the stakeholders but also among the stakeholders themselves.

A Centre for Sundarban Studies will be established to operationalize the concept, which as an institutional body, will generate more resources to provide research and technical support to local stakeholders.

FHS Partners in India

News and announcements from FHS India

Recent FHS India publications

Publications

Health policy and systems research (HPSR) is a transdisciplinary field of global importance, with its own emerging standards for creating, evaluating, and utilizing knowledge, and distinguished by a particular orientation towards influencing policy and wider action to strengthen health systems. In this commentary, we argue that the ability of the HPSR field to influence real world change hinges on its becoming more people-centred. We see people-centredness as recognizing the field of enquiry as one of social construction, requiring those conducting HPSR to locate their own position in the system, and conduct and publish research in a manner that foregrounds human agency attributes and values, and is acutely attentive to policy context. 

The health situation of children in the Indian Sundarbans couldn’t be more precarious. Facing chronic malnutrition as well as a high prevalence of easily preventable but highly communicable diseases, access for children to health services in the region is complicated by the rough terrain and the winding tidal rivers of the deltaic region.The key question is, what can be done to improve the health situation of children in the Sundarbans? This briefing answers that question by outlining the several methodologies employed in the study. It then considers both the demand and supply sides for child-centred health services in the block. It concludes with recommendations for beginning to repair the fractured health system there.
FHS's 'unlocking community capabilities' (UCC) theme systematically examines how communities can be active participants in the planning, delivery, monitoring and evaluation of their health system, by identifying and mobilising individual and collective capabilities in different social, political, and institutional environments. This brief explores current activities and initial findings from the theme.
The dynamics of informal health markets in marginalised regions are relevant to policy discourse in India, but are poorly understood. The authors examine how informal health markets operate from the viewpoint of informal providers (those without any government-recognised medical degrees, otherwise known as RMPs) by drawing upon data from a household survey in 2002, a provider census in 2004 and ongoing field observations from a research site in Koppal district, Karnataka, India.
Professor Barun Kanjilal of IIHMR and the FHS India team outlines findings from the first Sundarbans Health Watch. The findings are from several in-depth studies into the health situation of children in a representative block of the Indian Sundarbans -- Patharpratima.
How Healthy are the Children of the Indian Sundarbans?\n\nIn early 2012, Future Health Systems India set out to answer this question. It undertook a study in one representative block (geographically and socially) of the Sundarbans: Patharpratima.\n\nThe key statistics presented in the following charts relate to our sample block (FHS 2012) in comparison to West Bengal (District Level Household Survey [DLHS-3] 2007-08) and Rural India overall (DLHS-3).\n\nAll findings and data can be found in the Sundarbans Health Watch Report (August 2013).