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

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Understanding Government Failure in Public Health Services

High absenteeism, low quality in clinical care, low satisfaction levels with care and rampant corruption plague public health services in India. This has led to mistrust of the system and the rapid growth of private services. This paper develops an analytical framework to understand the status of healthcare in India. Drawing on a model of public sector accountability, it argues that a weak voice and low accountability is the key binding constraint to effective delivery.

Bird Flu: Public Health Implications for India

The H5N1 virus, commonly referred to as bird flu, must be viewed as a serious threat to India and all possible precautions must be taken to guard against disaster. Countries with robust public health systems are gearing up to face a H5N1 global pandemic. India's weakness in public health is, however, a cause for worry. Our defences could easily be overwhelmed by the sheer magnitude of the pandemic.

SARS: Public Health and Social Science Perspectives

SARS is unprecedented in many ways. For one, we may well be the first real epidemic of a globalised Asia. Second, it has prompted new measures put in place rapidly and with wide scope to counter the spread of the disease. How has SARS been perceived by the public and what are the social consequences of the outbreak and the responses? What can we learn about governance from the SARS outbreak? How will it impact on the planning of public health systems, much neglected in this region in the race for economic development in the era of globalisation?

Life Cycle Concerns:Ineffectively Addressed

The lifetime concerns of individuals, though a key focus of the Budget for 2003-04, are nevertheless addressed in such a way that human capital - the engine of growth - will not be accumulated in an equitable or efficient manner.

People's Health : Defining Industry Responsibility

The making of a drug policy in India has been a long and tedious odyssey through a tangled mass of opposing interests, dichotomous responsibilities, welfarist commitments and protectionist inclinations. Policy-making has been prompted nevertheless by certain notions of the role of pharmaceuticals in maintaining and enhancing the health status of people. Over the decades there has been an erosion of this focus because of intervening and often conflicting claims from industry. Periodically, committees and conventions have attempted to recover the focus.

TRIPS, Product Patents and Pharmaceuticals

Participants in the international debate on patents and pharmaceuticals have begun exploring two distinct sets of TRIPScompliant options/mechanisms that would enable patients in the developing world to access new treatments at affordable costs. The first set relates primarily to 'global' ailments, where R and D is already supported by the north, and includes options such as compulsory licensing, 'tiered' pricing and national drug price regulations. The second set of mechanisms is aimed at 'creating markets' for treatments relating to poor country-specific ailments in a manner that allows affordability without endangering incentives to future research and innovation.

Rhetoric of Evasion

When the government of India announces a new health policy after 29 years the expectation is that it will first of all define the critical issues and then proceed to elucidate a perspective which will come to grips with the major issues and construct the path to a future where the health and well-being of the people of the country are adequately cared for. The draft National Health Policy 2001 (NHP-2001) is unfortunately a short-term, myopic and blinkered wish list with no indication of where health and health care are located in the government’s list of priorities. To call this a ‘policy’ statement is a misuse of the term. Its ‘policy’ prescriptions exhibit a complete lack of understanding of both the existing state of affairs and the needs of tomorrow.... 

Government Health Services in Kerala

One of the reasons cited to justify government intervention in health care is to correct the inequities in service provision that might arise if services are provided by private sector. But in practice government decisions are taken by a few individuals and groups and these decisions might reflect their interests than that of the community. The paper examines the role government provision of health services has historically played in Kerala

Social Construction of Health

The science of health has been characterised by positivism and extreme rationalism, divested from its social and economic context. The use of social sciences is still confined in the prison of reductionism for with the increased interaction of the disciplines of medical sociology and psychology with health, there is a greater adherence to the quantitative method, nowhere more evident than the interaction of behaviourism to health. This, in turn, obfuscates both the causes of disease and ill health in a society and therefore, the quest for solutions. This study tries in its different sections to expose the handiwork of such deterministic sciences.

Curious Decision

Some things never change. In a typically nonchalant move, ignoring past debate, medical and social facts, the health ministry has recently announced plans to introduce Net En, an injectable contraceptive on a trial basis in select medical colleges around the country. This is, no doubt, is a prelude to introducing it in the public health system, a move that the health ministry has long contemplated but has hesitated to make for a variety of reasons, not least of all, the opposition to it by women's and health groups....

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