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

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Who Does a Cyclone Actually Affect? Analysing the Impacts of Major Cyclones in India

While “natural disasters” such as cyclones cause widespread and indiscriminate devastation, their impact is much worse for vulnerable communities. Such groups face the brunt of not only the cyclone but also of inefficient government planning, caste discrimination, health problems and apathy.

COVID-19 and Tribal Communities: How State Neglect Increased Marginalisation during the Pandemic

In the absence of state support and social security, the COVID-19 pandemic and lockdowns created short- and long-term hardships for already marginalised tribal communities in India.

Infant Mortality Rate

Infant mortality rate has been improving in India for a considerable time now. From 2009 to 2018, India has improved the IMR from 50 to 32. This article aims to understand the underlying improvement in the IMR at the state level and establish whether there is convergence. For this exercise, the article uses health inequality measures like standard deviation, coeffi cient of variation, rate of improvement differences, β convergence and Gini coeffi cient. The fi ndings reveal that all states show improvement in IMR over 10 years, but the rate of improvement is varying amongst state and there is no convergence amongst the states. Small states and union territories improve the IMR at a higher rate compared to that of the national improvement rate.

Regulating Reproductive Technologies

The Assisted Reproductive Technology (Regulation) Bill, 2020 was tabled in the Lok Sabha in September 2020. It was referred to the department-related Parliamentary Standing Committee on Health and Family Welfare, which submitted its 129th report on the ART Bill, 2020 on 17 March 2021. This article critically engages with the recommendations of this report.

Why India’s Vaccine Companies Are Profiteering in the Pandemic

The crisis of COVID-19 vaccines in India is a consequence of government policies dating back decades. Private foundations led by the Bill and Melinda Gates Foundation have engineered a shift in research and manufacture of essential technologies such as vaccines to private biotech labs and factories. Companies such as the Serum Institute of India and Bharat Biotech can dictate terms and prices of vaccines developed with public support because the closure of public vaccine manufacturing units over a decade ago has left the government at the mercy of the private sector.

Protection for Medical Professionals

Following the COVID-19 outbreak, when the recovery of the nation is contingent on doctors and healthcare personnel risking their lives every day, we must examine whether there is an equitable quid pro quo in terms of receiving service and providing protection. The causes of the antagonism between patients and doctors leading to violence against medical professionals are highlighted, and the efficiency of the legislations enacted for the protection of medicare professionals in India is examined. Finally, recommendations to remedy the deficiencies are provided.

Diabetes Risk Factors and Prevention Strategies

Awareness about risk factors is a prerequisite for the prevention of diabetes mellitus amongst diabetic patients. A questionnaire-based survey of diabetic patients adapted from “WHO-STEPS Surveillance” was performed during 2018 in Punjab, using descriptive statistics and multivariate logistic regression. The overall awareness level was found to be 83%, but perception and comprehension regarding risk factors and prevention strategies are still at a nascent stage. There is need for innovative awareness programmes and government campaigns on the consequences of lifestyle modification, sedentary lifestyle, and altering epidemiology of diabetes.

Healthcare Financing in India

Public and Private Healthcare and Health Insurance in India by Brijesh C Purohit, New Delhi, California, London and Singapore: Sage Publications, 2020; pp xiii + 283, ₹ 1,195 (hardcover). India Policy Finance and Policy Report: Health Matters edited by Jyotsna Jalan, Sugata Marjit and Sattwik Santra, New Delhi: Oxford University Press, 2020; pp xvi + 166, ₹ 1,495 (paperback).

Analysis of Private Healthcare Providers

India’s health system is dominated by the private sector and as a result, out-of-pocket expenditure is very high. To provide financial risk protection and avoid catastrophic health consequences, policy emphasis is on the Ayushman Bharat programme which targets to cover 50 crore people. Such a large-scale insurance scheme needs huge infrastructural and administrative support. Unincorporated private healthcare providers comprise 99% of private health providers in India, the majority of them being small scale, employing less than 10 workers and having a strong urban bias. To better promote universal health coverage, policy emphasis on better monitoring, administering regulations, transparency in system, and ensuring quality in delivery of service is needed.

Estimates of Health Insurance Coverage in India

Financing health expenditure through health insurance is currently gaining significance as a strong social policy in countries like India where public health facilities are still inadequate. An attempt to estimate the coverage of health insurance in India shows that the coverage is low and not uniform across states and union territories, despite the fact that several public-funded schemes focus on the below poverty line population. Of the various types of health insurance schemes, public-funded health insurance schemes have a dominant position. Moreover, the likelihood of health insurance coverage is relatively higher among specific social groups and in certain areas.

Too Much Care

In the context of India where public expenditure on healthcare is low, the private sector plays an important role in delivering healthcare during childbirth. An analysis of the latest round of National Family Health Survey data to estimate the differential probability of caesarean sections in private medical facilities relative to government facilities, and focusing on unplanned C-sections, reveals that the probability of an unplanned C-section is 13.5–14 percentage points higher in the private sector. These results call for a critical assessment of the role of private sector in healthcare in the context of inadequate public provision, expanding private provision and weak governance structures.

Where Is All Our Health Data Going?

Multiple initiatives going on in India regarding the collection of digital personal health data are analysed, and the question of how the data is being used is examined. While such data could facilitate healthcare and referral services, a strong and sensitive governance structure is needed to be in place to enable its optimal use and to ensure that the data is not used to further the agendas of surveillance and control.

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