Articles by Rama V Baru

The report of the High Level Expert Group on Universal Health Coverage for India reaffirms the principles of universality and equity in access to healthcare and the central role public services have to play in bringing this about. However, the HLEG pays inadequate attention to regulating the deeply entrenched private health sector, which is not only embedded within an intricate and interdependent web of power relations, but also has a marked influence on policy.

This paper traces the evolution, structure and characteristics of public-private partnerships in healthcare over the last six decades. It argues that these partnerships have broken down the traditional boundaries between the market and the state, leading to the emergence of multiple actors with multiple roles and newer institutional arrangements that have redefined their role, power and authority. The fragmentation of role and authority has serious consequences for comprehensiveness, governance and accountability of health services.

Recent epidemics of gastro-enteritis in two of the poorest districts of Andhra Pradesh illustrate well why there is a need for a comprehensive broad-based public health policy which emphasises preventive and promotive care.

The World Bank's World Development Report 1993 proposes drastic changes in the direction and content of health service development. A recent seminar in Delhi raised issues regarding the report's conceptual methodological and empirical aspects.