Edition 18 | February 22, 2023 | |
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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 the political journey of healthcare in select Indian states. In addition, it brings you an analysis of the application of the right to health in relation to Universal Health Coverage (UHC), a discussion on how governance for health has been dealt with and shaped by the courts and more.
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The Political Journey of Healthcare in Select Indian States
Understanding India’s progress on health requires an examination of such progress across different states. While many aspects, including fiscal health, governance, institutional capacity, and others influence health progress, the political priority accorded to health by a state’s leadership remains a key driver. This paper examines the socio-political determinants of attention to health in five Indian states. The analysis surfaces four insights. One, political ideology plays a role in driving attention to health, but political legitimacy can be linked with healthcare to drive attention in the absence of an ideological driver. Two, sensitizing politicians to electorally rewarding policies elsewhere, and relevant to the state’s development journey, can motivate them to act. Three, state capacity is a key variable in the confidence to undertake reforms and the choice of reforms. Four, both the Central government and external stakeholders such as civil society can contribute to agenda setting at the state level, write Sandhya Venkateswaran, Mayank Mishra & Nikhil Iyer.
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The Right to Health and Universal Health Coverage
This paper provides a framework of analysis on the application of the right to health in relation to UHC, traversing and articulating linkages between the two, while accounting for contemporary debates and critiques of UHC.
Note: Please share your feedback on this paper with citizenhealthin@gmail.com, which can be incorporated before finalising it.
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The Judiciary – Executive Interface in areas of Health
This paper demonstrates the contours of judicial intervention in areas of health and its engagement with central and state governments on jurisdictional, financial and technical matters. In so doing, the paper indicates the ways in which governance for health has been dealt with and shaped by the courts.
Note: Please share your feedback on this paper with citizenhealthin@gmail.com, which can be incorporated before finalising it.
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Policy makers need to take mental health more seriously
In 2015, the GOI carried out a National Mental Health Survey 2015-16 to assess the prevalence of mental health in the country. The report showed mental disorders at 10.6 percent among above 18-year-olds, 16 percent among the productive age group of 30-49 year olds and lifetime morbidity affecting 150 million people with one per cent reporting high suicidal risk, writes K Sujatha Rao.
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Health budget is now Covid negative
The expanded mandate of comprehensive primary healthcare and the need to scale up the urban health component of the National Health Mission call for more funds, writes Prof K Srinath Reddy.
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Commission Members in Spotlight | |
"As a country, we are still more focused on tertiary care and less so towards primary care and the preventive and promotive aspects of healthcare. This is one area with enormous scope for improvement and rising consciousness. It may not be ‘eye-catching’, and there may not be immediate results for the effort made. But we need work on improving and making context-relevant approaches to addressing the preventive and promotive aspects," says Dr Sandra Albert, Director Indian Institute of Public Health Shillong (IIPHS) | |  |
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"There are multiple challenges that need to be addressed for achieving UHC in India. Given the significant role social determinants of health play in influencing population health, efforts should be made for multi-stakeholder engagement in designing and delivering an inclusive and pluralistic UHC-driven healthcare system. Most importantly, UHC needs a high level of political will to put health at the forefront of development," says Megha Rao, Senior Research Associate, Centre for Public Policy, IIM Bangalore
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The Indian Institute Public Health (IIPH) Shillong was established by the Public Health Foundation of India (PHFI) in collaboration with the Government of Meghalaya (GoM). The Institute aims to redress the limited institutional and systems capacity in public health in the northeast region of India. IIPH, Shillong is providing research support to the HRH and Governance workstream of the Commission. | | | | |
