ISSN (Print) - 0012-9976 | ISSN (Online) - 2349-8846

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Utilisation, Fund Flows and Public Financial Management under the National Health Mission

Since April 2014, funds for various centrally sponsored schemes, including the National Health Mission, are being transferred to implementing agencies through state treasuries. This has added an additional layer in the institutional structure for nhm fund flows. We analyse the utilisation of nhm funds in 29 states in two recent years, and the time taken for release of these funds from state treasuries to implementing agencies in three selected states: Bihar, Maharashtra, and Odisha. On average, only about 55% of funds allocated for nhm were utilised in 2015–16 and 2016–17. In Bihar and Maharashtra, this was partly due to significant delays in release of funds from state treasuries to implementing agencies. The delays were a result of complex administrative procedures associated with the release of nhm funds from state treasuries.

Compulsory Licensing of Pharmaceutical Patents in India

The trend of continued rejection of compulsory licence applications in India goes against the local generic drug manufacturers and public health safeguards incorporated in the Indian patent law. It raises serious questions about the intervening role of the state in patent monopoly to equalise the competing interests between patent holders and consumers of “public good.” This trend indicates a policy shift of the government regarding compulsory licensing.

Estimating Public Spending on Health

The use of information on withdrawals by Drawing and Disbursing Officers for improving the estimates of public spending for National Health Accounts in India is illustrated. Using information from Karnataka and Rajasthan, the study highlights the advantages of combining DDO-level information with budgetary data. The significant benefits of using DDO-level information in India have implications for better estimates of public spending and health policy design.

Delivering Essential Nutrition

In India, despite provisions for tribal development, 32% of tribal women are chronically undernourished, as opposed to 23% among those not belonging to tribal households.Large-scale surveys and routine monitoring are currently deficient in measuring the nutrition status of women, especially tribal women. This study was undertaken to analyse the reach of various health-related schemes for tribal women in Chhattisgarh, Jharkhand, and Odisha. In the light of its findings, it is recommended that all national schemes should be reviewed through a tribal lens, as tribes remain outside the ambit of most nutrition safety nets. Proven measures like strengthening tribal development nodal agencies, motivational incentives to fieldworkers and organised community involvement, need to be scaled up.

Flaws of Insurance-based Healthcare Provision

Tamil Nadu is recognised for its achievements in human development, especially in the area of healthcare. In light of the central government’s recent move to launch insurance-based targeted healthcare provision, a case is made for paying attention to building public health infrastructure based on Tamil Nadu’s experience with healthcare provisioning. The pitfalls of insurance-based provisioning and targeting, and the need to recognise regional trajectories and institutional innovations in this regard are highlighted.

AAP’s Health Policy Reforms in Delhi

Against the backdrop of a rapidly expanding privatised healthcare system, the Aam Aadmi Party government’s health policy reforms in Delhi are scrutinised.

How Equitable Will Ayushman Bharat Be?

Ayushman Bharat holds the promise to advance equity both within households as well as across social groups. However, the geographical inequities characteristic of India’s healthcare provisioning need to be overhauled first for the scheme to be more equitable.

Quality Issues in the Health Management Information System

The status of the Health Management Information System in Bihar is presented and the reasons affecting the quality of data at different levels, from the health sub-centre to the state level, are examined. The quality of HMIS data is poor because of inadequate primary records, data duplication, and other process errors.

Utilisation of Health Facilities for Childbirth and Out-of-pocket Expenditure

Using data from the household surveys on health conducted by the National Sample Survey Office between 2004 and 2014, the utilisation patterns of health facilities for childbirth and the associated
out-of-pocket expenditure are analysed. The findings reveal that the utilisation of public facilities for childbirth increased three times in rural areas and almost one and a half times in urban areas between 2004 and 2014, but that most deliveries took place in district hospitals. Also, the average medical expenditure on childbirth in government health facilities declined by 36% in rural areas and by 5% in urban areas. Considerable interstate variations in regard to oop expenditure on drugs, diagnostics and transportation were also witnessed. Though government policies to promote institutional births have improved the utilisation of public facilities and reduced the overall oop expenditure, more needs to be done for the benefits to reach the vulnerable sections, especially in urban areas.

Dissecting ‘Modicare’

Narendra Modi has been good at launching fantastic schemes, most of them being just the renaming or rehashing of the existing ones but pedalled as novel, and confidently communicated to the masses as such.

Enhancing Affordable Pharmaceutical Healthcare

The Indian intellectual property regime has often met with severe criticism from the United States as India strives to balance the need to provide affordable healthcare with a thriving market for a competitive pharmaceutical industry. In this context, the nexus between compulsory licensing, competition law and patent law merits a closer examination and it is debatable whether a strong competition law framework is indeed the way forward.

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