Edition 17 | January 16, 2023

Dear Friends,

We are delighted to present to you the next edition of the monthly newsletter by the Lancet Citizens' Commission on Reimagining India’s Health System. This edition discusses a theory of change roadmap for universal health coverage in India. In addition, it brings you an analysis of what India needs to do to prepare for the next health crisis, a discussion on improving the value derived by patients from out-of-pocket expenditures on health and more. 

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This Month's Highlight

A theory of change roadmap for universal health coverage in India

The Theory of Change (ToC) approach is one of the methodologies that the Lancet Citizens' Commission has chosen to build a roadmap to achieving Universal Healthcare (UHC) in India in the next 10 years. The work of the Citizens' Commission is organized around five workstreams. Five ToC workshops were conducted, one for each workstream. Individual workshop outputs were then brought together in two cross-workstream workshops where a sectoral ToC for UHC was derived. 

News from the Commission

Influenza and whooping cough (pertussis) vaccines in pregnancy

With the evidence of Delta (B.1.617.2) variant of SARS-CoV-2, (the virus that causes COVID-19), causing severe disease in pregnant women and endangering pregnancy, the Government of India in July 2021 approved and administered COVID-19 vaccines to all pregnant women as part of their standard antenatal care programme, write Tila Khan and Dipanwita Sengupta.

India’s policies should view human resources for health

India is one of the 57 countries listed as ‘countries suffering from an HRH crisis’ by the World Health Organization (WHO) in its 2006 report. Things have improved only marginally since then, write Vidhi Wadhwani & Siddhesh Zadey.

Views & Opinions 

What India needs to do to prepare for the next health crisis

India’s health system withstood an unprecedented crisis, and now it is time to consolidate, with a focus on primary health services, increasing the corps of healthcare professionals while keeping the concerns of the community at the forefront, writes K Srinath Reddy.

For booster, rely on own data

The World Health Organisation recommended a booster dose with any available vaccine following its prioritisation framework of healthcare workers, the elderly, and those with comorbidities. This recommendation was based on data which showed that after about five months after vaccination with mRNA and adenovirus vectored vaccines, there was little protection against infection. However, there continued to be lower, but good, protection from severe disease and death, writes Gagandeep Kang.

India is more than capable of riding out any new Covid wave. All it needs is to be smart

We are governed by a very capable and adaptable government, which has the unique experience of managing the world's largest pandemic that infected virtually every Indian. India did manage the Covid pandemic over the last two years much better than even developed nations and saved millions of precious lives, writes Devi Shetty.


Improving the value derived by patients from out-of-pocket expenditures on health

The webinar is a joint Lancet Citizens’ Commission on Reimagining India’s Health System event with the Population Foundation of India (PFI). While this number varies from state to state, between 50-70% of all expenditures are incurred by Indians from their own pockets when they seek healthcare services. A long-term durable solution to this problem requires state governments to increase their budgetary allocations and improve the efficiency with which these amounts are spent. For the foreseeable future, however, improving the value derived by patients from out-of-pocket expenditures will need to be a key area of focus for the Indian health system. In this panel, we hope to explore how this could best be accomplished. As a Citizens’ Commission, we invite the public to participate in the discussion, provide input and engage with the panelists. 

Register here

Commission Member in Spotlight 

"The lack of human resources for health, more in rural than urban areas, is the biggest challenge for achieving UHC in India. But it ultimately comes down to two core problems: lack of compassionate teaching and glorification of specialization. These two have led young doctors to get stuck in a rat race where they start their medical education journey in high school and end it once they are highly sub-specialized. A resource-limited primary health system can not employ these highly specialized health professionals. As these health centres need more human resources, they tend to stay the same or even worsen (if possible), forming a vicious cycle. I was fortunate to get trained by highly compassionate doctors in an institute that kept me in touch with the ground reality while turning me into a skilled health professional. A similar training program at the national level could solve these problems and help us in achieving UHC," says Parth Sharma, Junior Resident, Department of Community Medicine, Maulana Azad Medical College, Delhi

Read full interview
Featured Partner

The Swasth Alliance is a collaborative that leverages digital technologies to drive healthcare inclusion and better health outcomes. They are currently anchoring the community-led development of Health Claims Exchange: a set of common e-insurance claims exchange specifications along with a digital platform to enable this exchange. Swasth is supporting the doctors' survey as part of the Commission work.

Help us develop a roadmap to achieve universal health coverage in India by visiting our website: https://www.citizenshealth.in/

We love hearing back from you! Please send your comments, suggestions, and contributions for these newsletters, including research highlights and published features to [email protected]
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