Expanding Health Coverage for Vulnerable Groups in India
India's health sector continues to be challenged by overall low levels of public financing, entrenched accountability issues in the public delivery system, and the persistent dominance of out-of-pocket spending. In this context, this case study describes three recent initiatives introduced by t...
| Main Author: | |
|---|---|
| Format: | Working Paper |
| Language: | en_US |
| Published: |
World Bank, Washington, DC
2013
|
| Subjects: | |
| Online Access: | http://hdl.handle.net/10986/13286 |
| id |
okr-10986-13286 |
|---|---|
| recordtype |
oai_dc |
| repository_type |
Digital Repository |
| institution_category |
Foreign Institution |
| institution |
Digital Repositories |
| building |
World Bank Open Knowledge Repository |
| collection |
World Bank |
| language |
en_US |
| topic |
access to health services access to services adult mortality Adult mortality rate aged ambulatory care beds budget allocation Burden of Disease capital investments child health choice of providers communicable diseases Community Health community participation competition among insurers competition among providers contraception cost of care cost sharing decision making Delivery of Health Care delivery of health services delivery system developing countries disease control disparities in health Dissemination economic growth emergency obstetric care Employment expansion of population expenditures families Family Health family income family members Family Welfare fee-for-service Financial Management financial protection financial resources financial risks global health government departments grassroots workers Gross Domestic Product Health Activists Health Affairs health care health care delivery health care expenditure health care providers health care sector Health Care Services health care system Health Centers Health Centres health conditions Health Coverage health delivery health delivery system Health Expenditure health facilities health finance Health Financing Health Impact Health Insurance health insurance coverage health insurance industry Health Insurance Scheme Health Insurance Schemes health interventions Health Management Health Market Health Organization health outcomes Health Policy health programs health promotion health providers health sector health sector workers health service Health Service Delivery health services Health Specialist Health System health systems health workers healthcare services HIV/AIDS hospital admissions Hospital beds hospital services hospitalization hospitals human resources ill health illness Immunization impact evaluations Incidence Analysis income income countries income elasticity infant infant mortality Infant mortality rate informal payments information system inpatient care institutional mechanisms Insurance insurance companies insurance premium Insurers integration Intermediaries Lack of awareness lack of information Life expectancy Life expectancy at birth maternal mortality maternity services medical equipment Ministry of Health Ministry of Labour moral hazard morbidity mortality mother National AIDS national health National Health Policy Nurses outreach activities patient patient choice patient satisfaction patients Physician Physicians plan of action pocket payments pocket payments for health care policy decisions policy makers poor families pregnant women primary care primary health care primary health care system private health insurance private hospitals Private insurance private insurers private sector progress protection mechanisms provider payment provision of care provision of information public expenditure public expenditure on health Public Health public health care Public Health Expenditure public health interventions public health programs Public health spending public health system public hospital public hospitals public insurance public insurance schemes Public Providers Public Sector Public spending quality of care quality of life radio referral systems richer segments of society rural areas rural hospitals rural population safe blood transfusion screening service providers share of health spending social development social health insurance social insurance social sector state governments state policy Sustainable Development tuberculosis tuberculosis patients universal access vulnerability Vulnerable Groups walking workers World Health Organization |
| spellingShingle |
access to health services access to services adult mortality Adult mortality rate aged ambulatory care beds budget allocation Burden of Disease capital investments child health choice of providers communicable diseases Community Health community participation competition among insurers competition among providers contraception cost of care cost sharing decision making Delivery of Health Care delivery of health services delivery system developing countries disease control disparities in health Dissemination economic growth emergency obstetric care Employment expansion of population expenditures families Family Health family income family members Family Welfare fee-for-service Financial Management financial protection financial resources financial risks global health government departments grassroots workers Gross Domestic Product Health Activists Health Affairs health care health care delivery health care expenditure health care providers health care sector Health Care Services health care system Health Centers Health Centres health conditions Health Coverage health delivery health delivery system Health Expenditure health facilities health finance Health Financing Health Impact Health Insurance health insurance coverage health insurance industry Health Insurance Scheme Health Insurance Schemes health interventions Health Management Health Market Health Organization health outcomes Health Policy health programs health promotion health providers health sector health sector workers health service Health Service Delivery health services Health Specialist Health System health systems health workers healthcare services HIV/AIDS hospital admissions Hospital beds hospital services hospitalization hospitals human resources ill health illness Immunization impact evaluations Incidence Analysis income income countries income elasticity infant infant mortality Infant mortality rate informal payments information system inpatient care institutional mechanisms Insurance insurance companies insurance premium Insurers integration Intermediaries Lack of awareness lack of information Life expectancy Life expectancy at birth maternal mortality maternity services medical equipment Ministry of Health Ministry of Labour moral hazard morbidity mortality mother National AIDS national health National Health Policy Nurses outreach activities patient patient choice patient satisfaction patients Physician Physicians plan of action pocket payments pocket payments for health care policy decisions policy makers poor families pregnant women primary care primary health care primary health care system private health insurance private hospitals Private insurance private insurers private sector progress protection mechanisms provider payment provision of care provision of information public expenditure public expenditure on health Public Health public health care Public Health Expenditure public health interventions public health programs Public health spending public health system public hospital public hospitals public insurance public insurance schemes Public Providers Public Sector Public spending quality of care quality of life radio referral systems richer segments of society rural areas rural hospitals rural population safe blood transfusion screening service providers share of health spending social development social health insurance social insurance social sector state governments state policy Sustainable Development tuberculosis tuberculosis patients universal access vulnerability Vulnerable Groups walking workers World Health Organization Nagpal, Somil Expanding Health Coverage for Vulnerable Groups in India |
| geographic_facet |
South Asia India |
| relation |
UNICO Studies Series;No. 13 |
| description |
India's health sector continues to be challenged by overall low levels of public financing, entrenched accountability issues in the public delivery system, and the persistent dominance of out-of-pocket spending. In this context, this case study describes three recent initiatives introduced by the central and state governments in India, aimed at addressing some of these challenges and improving the availability of and access to health services, particularly for the poor and vulnerable groups in the country. This includes two federal schemes introduced by the Government of India-the National Rural Health Mission (NRHM) of the Ministry of Health and Family Welfare and the Rashtriya Swasthya Bima Yojana (RSBY) of the Ministry of Labor and Employment-and the Rajiv Aarogyasri scheme launched by the state government of Andhra Pradesh. The three schemes discussed in this case study were designed and implemented by different agencies almost in parallel, over the same time period, and used different financing and delivery approaches. A discussion of the mechanics and operational features of these programs has been undertaken to unravel the underlying complexities, interactions, and interdependencies of these programs within the country's health system. The remainder of this case study on India's march toward universal health coverage focuses on three recent, prominent programs, and includes a discussion on the institutional structure of these programs and their interactions within the country's health system, their mechanisms for beneficiary targeting and enrolment, the benefits packages covered by them, accompanying innovations in public financial management, and their information environment. Annex one presents an overview of the health system and health financing in India, and annex two discusses the evolutionary context of India's Government sponsored health insurance schemes. The discussion of the mechanics and operational features of these programs has been undertaken to unravel the underlying complexities, interactions, and interdependencies within these programs. The case study also aims to contribute to the ongoing debate within the Indian health sector, with opinions divided between investments in traditional input-based health spending for publicly managed health facilities versus demand-side financing, purchasing of care, and involving private providers and intermediaries in delivering services financed by public money. The case study also aims to share how the lessons learned by one program can be applicable more widely within the Indian health system and beyond |
| format |
Publications & Research :: Working Paper |
| author |
Nagpal, Somil |
| author_facet |
Nagpal, Somil |
| author_sort |
Nagpal, Somil |
| title |
Expanding Health Coverage for Vulnerable Groups in India |
| title_short |
Expanding Health Coverage for Vulnerable Groups in India |
| title_full |
Expanding Health Coverage for Vulnerable Groups in India |
| title_fullStr |
Expanding Health Coverage for Vulnerable Groups in India |
| title_full_unstemmed |
Expanding Health Coverage for Vulnerable Groups in India |
| title_sort |
expanding health coverage for vulnerable groups in india |
| publisher |
World Bank, Washington, DC |
| publishDate |
2013 |
| url |
http://hdl.handle.net/10986/13286 |
| _version_ |
1764423100835823616 |
| spelling |
okr-10986-132862021-04-23T14:03:07Z Expanding Health Coverage for Vulnerable Groups in India Nagpal, Somil access to health services access to services adult mortality Adult mortality rate aged ambulatory care beds budget allocation Burden of Disease capital investments child health choice of providers communicable diseases Community Health community participation competition among insurers competition among providers contraception cost of care cost sharing decision making Delivery of Health Care delivery of health services delivery system developing countries disease control disparities in health Dissemination economic growth emergency obstetric care Employment expansion of population expenditures families Family Health family income family members Family Welfare fee-for-service Financial Management financial protection financial resources financial risks global health government departments grassroots workers Gross Domestic Product Health Activists Health Affairs health care health care delivery health care expenditure health care providers health care sector Health Care Services health care system Health Centers Health Centres health conditions Health Coverage health delivery health delivery system Health Expenditure health facilities health finance Health Financing Health Impact Health Insurance health insurance coverage health insurance industry Health Insurance Scheme Health Insurance Schemes health interventions Health Management Health Market Health Organization health outcomes Health Policy health programs health promotion health providers health sector health sector workers health service Health Service Delivery health services Health Specialist Health System health systems health workers healthcare services HIV/AIDS hospital admissions Hospital beds hospital services hospitalization hospitals human resources ill health illness Immunization impact evaluations Incidence Analysis income income countries income elasticity infant infant mortality Infant mortality rate informal payments information system inpatient care institutional mechanisms Insurance insurance companies insurance premium Insurers integration Intermediaries Lack of awareness lack of information Life expectancy Life expectancy at birth maternal mortality maternity services medical equipment Ministry of Health Ministry of Labour moral hazard morbidity mortality mother National AIDS national health National Health Policy Nurses outreach activities patient patient choice patient satisfaction patients Physician Physicians plan of action pocket payments pocket payments for health care policy decisions policy makers poor families pregnant women primary care primary health care primary health care system private health insurance private hospitals Private insurance private insurers private sector progress protection mechanisms provider payment provision of care provision of information public expenditure public expenditure on health Public Health public health care Public Health Expenditure public health interventions public health programs Public health spending public health system public hospital public hospitals public insurance public insurance schemes Public Providers Public Sector Public spending quality of care quality of life radio referral systems richer segments of society rural areas rural hospitals rural population safe blood transfusion screening service providers share of health spending social development social health insurance social insurance social sector state governments state policy Sustainable Development tuberculosis tuberculosis patients universal access vulnerability Vulnerable Groups walking workers World Health Organization India's health sector continues to be challenged by overall low levels of public financing, entrenched accountability issues in the public delivery system, and the persistent dominance of out-of-pocket spending. In this context, this case study describes three recent initiatives introduced by the central and state governments in India, aimed at addressing some of these challenges and improving the availability of and access to health services, particularly for the poor and vulnerable groups in the country. This includes two federal schemes introduced by the Government of India-the National Rural Health Mission (NRHM) of the Ministry of Health and Family Welfare and the Rashtriya Swasthya Bima Yojana (RSBY) of the Ministry of Labor and Employment-and the Rajiv Aarogyasri scheme launched by the state government of Andhra Pradesh. The three schemes discussed in this case study were designed and implemented by different agencies almost in parallel, over the same time period, and used different financing and delivery approaches. A discussion of the mechanics and operational features of these programs has been undertaken to unravel the underlying complexities, interactions, and interdependencies of these programs within the country's health system. The remainder of this case study on India's march toward universal health coverage focuses on three recent, prominent programs, and includes a discussion on the institutional structure of these programs and their interactions within the country's health system, their mechanisms for beneficiary targeting and enrolment, the benefits packages covered by them, accompanying innovations in public financial management, and their information environment. Annex one presents an overview of the health system and health financing in India, and annex two discusses the evolutionary context of India's Government sponsored health insurance schemes. The discussion of the mechanics and operational features of these programs has been undertaken to unravel the underlying complexities, interactions, and interdependencies within these programs. The case study also aims to contribute to the ongoing debate within the Indian health sector, with opinions divided between investments in traditional input-based health spending for publicly managed health facilities versus demand-side financing, purchasing of care, and involving private providers and intermediaries in delivering services financed by public money. The case study also aims to share how the lessons learned by one program can be applicable more widely within the Indian health system and beyond 2013-05-02T17:53:10Z 2013-05-02T17:53:10Z 2013-01 http://hdl.handle.net/10986/13286 en_US UNICO Studies Series;No. 13 CC BY 3.0 IGO http://creativecommons.org/licenses/by/3.0/igo World Bank World Bank, Washington, DC Publications & Research :: Working Paper Publications & Research South Asia India |