India's Public Health System: How Well Does It Function at the National Level?
India has relatively poor health outcomes, despite having a well-developed administrative system, good technical skills in many fields, and an extensive network of public health institutions for research, training, and diagnostics. This suggests th...
| Main Authors: | , |
|---|---|
| Format: | Policy Research Working Paper |
| Language: | English en_US |
| Published: |
World Bank, Washington, D.C.
2013
|
| Subjects: | |
| Online Access: | http://documents.worldbank.org/curated/en/2004/11/5442345/indias-public-health-system-well-function-national-level http://hdl.handle.net/10986/14215 |
| Summary: | India has relatively poor health
outcomes, despite having a well-developed administrative
system, good technical skills in many fields, and an
extensive network of public health institutions for
research, training, and diagnostics. This suggests that the
health system may be misdirecting its efforts, or may be
poorly designed. To explore this, the authors use
instruments developed to assess the performance of public
health systems in the United States and Latin America based
on the framework of the Essential Public Health Functions,
identified as the basic functions that an effective public
health system must fulfill. The authors focus on the federal
level in India, using data obtained from senior health
officials in the central government. The data indicate that
the reported strengths of the system lie in having the
capacity to carry out most of the public health functions.
Its reported weaknesses lie in three broad areas. First, it
has overlooked some fundamental public health functions such
as public health regulations and their enforcement. Second,
deep management flaws hinder effective use of
resources-including inadequate focus on evaluation, on
assessing quality of services, on dissemination and use of
information, and on openness to learning and innovation.
Resources could also be much better used with small changes,
such as the use of incentives and challenge funds, and
greater flexibility to reassign resources as priorities and
needs change. Third, the central government functions too
much in isolation and needs to work more closely with other
key actors, especially with sub-national governments, as
well as with the private sector and with communities. The
authors conclude that with some reassessment of priorities
and better management practices, health outcomes could be
substantially improved. |
|---|