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ORF Occasional Paper 104: Overcoming data challenges in tracking India’s health and nutrition targets
In May 2016, the Health Secretaries of the States and Union Territories of India gathered in the capital and issued “The Delhi Commitment on Sustainable Development Goals for Health”. Among others, the document acknowledged the need to invest in health data collection, analysis and research so that these can properly inform government policies and strategies necessary to address the various challenges facing India’s healthcare. Such commitment is imperative, given that the success of global SDGs over the next 15 years will largely depend on India’s performance. Measuring progress closely to ensure mid-course corrections when needed should be key to India’s health strategy. To examine the issues related to insufficient, district-level data for customised and evidence-based planning, the Observer Research Foundation organised a panel discussion in July 2016, bringing together experts in the field. This paper builds on the key themes discussed by the panel, and from these, draws policy lessons for the road ahead.
ORF Special Report: Tracking health and nutrition targets
India has made it clear that its development goals will be in alignment with the Sustainable Development Goals (SDGs), as NITI Aayog prepares the vision document for the country’s development for the 15 years beyond the Twelfth Five-Year Plan. The global success of SDGs over the next 15 years will depend, to a large extent, on India’s performance. However, India is faced with formidable challenges not only in implementing its national health and nutrition goals, but also in tracking its progress towards those targets. In July 2016 the Observer Research Foundation organised a panel discussion on the subject, titled, “Better Data for Better Health: Developing an Indian Approach on Indicators to Achieve SDGs”. This Special Report draws policy lessons built around the key themes shared during the event. A longer paper is in progress.
Sustainability and Resilience in the Indian Health System
The COVID-19 pandemic has brought to light the importance of not only improving the resilience of health systems to crises but also of ensuring their long-term sustainability. The Partnership for Health System Sustainability and Resilience (PHSSR) was established in 2020 with the goal of building more sustainable and resilient health systems around the world. One of the key objectives of PHSSR is to build knowledge, understanding, and consensus on the dimensions of health system sustainability and resilience, and how they can be improved. To achieve this goal, PHSSR focuses on seven key domains: Governance: the wide range of steering and rule-making related functions carried out by governmen...
Leprosy and inequities in India’s healthcare: Beyond the persistent rhetoric of ‘Elimination’
Even as India achieved statistical elimination of leprosy at the national level in 2005, the target continues to be part of the country’s policy documents. But what is “elimination”, to begin with? The policy documents are unclear of its operational definition, of whether it is at the national level, the state level or the district level. Despite lack of clarity, the political leadership has not failed to indulge in the rhetoric of “leprosy elimination”. In 2018, India was supposed to have achieved national level elimination—yet again. This paper argues that these declarations are devoid of any positive public health significance, and the country is a long way from eliminating le...
Financing Healthcare for All in India
40 pages AuthorsKurian, Oommen C.Publication date29 May 2015PublisherOxfam IndiaSeriesOxfam Working PapersTypeWorking paper This paper explores available evidence, contextualises and maps the debate in India around financing healthcare for all. While the focus is on healthcare in response to current policy debates, Oxfam India recognises the crucial importance of adopting a holistic approach to health, addressing factors such as nutrition and sanitation, and broader social determinants of health.
Transforming India's Approach to Cancer Care
In India, a country with a vast population and a diverse socio-economic fabric, healthcare remains fraught with challenges including disparities in access. These socio-economic disparities are deep, and they influence health outcomes. It is imperative to bridge these gaps amid the ongoing epidemiological, nutritional and demographic transitions that are bringing about massive challenges in healthcare. Cancer, for example, has emerged as a significant cause of mortality across the country. The impact of cancer in India transcends health and affects the economic and social spheres of people’s lives. A key aspect of this challenge is the financial burden borne by families dealing with the illness: According to the latest available data from 2018, out-of-pocket (OOP) expenditure accounts for over 50 percent of total health spending.[1] This financial burden is exacerbated by inequities in access to and the affordability of cancer treatment.
Weighed down by the gains: India’s twin double burdens of malnutrition and disease
Given its continent-like diversity, India’s epidemiological, nutritional, and demographic transitions are occurring in a staggered fashion, with high state-level variances. In many parts of the country, high rates of undernutrition co-exist with equally high and increasing rates of overweight and obesity. Further, the incidence of non-communicable diseases (NCDs) as a leading cause of mortality is increasing, even as the communicable, maternal, neonatal and nutritional causes (or the “Millennium Development Goals (MDG) conditions”) are coming down. Indeed, India has witnessed inconsistent progress towards the MDGs, and even in states where absolute levels of “MDG conditions” are still high, the NCD proportion is growing rapidly. The imperative is for a realignment of policy responding to fast-changing subnational realities, through greater integration between health and nutrition policy at every level of governance.
Health Equity and Inclusion in Action
In a rapidly changing world, the pursuit of health equity and inclusion remains at the forefront of countries’ goals. While progress has been made globally in recognising health equity as a pivotal element for achieving better health outcomes, there is still little discourse around genuine inclusion—ensuring that every individual, regardless of their background or circumstances, has a voice and role in their healthcare decisions. With non-communicable diseases like diabetes, cardiovascular disease, and cancer becoming increasingly prevalent, their implications extend beyond health and encompass economic consequences. Through insightful case studies, this report aims to illuminate feasible strategies that countries can adopt to ensure that healthcare is equitable and inclusive and that the influence of social determinants of health is minimised.
Punishing the Poor? A Look at Evidence and Action Regarding User Fees in Health Care
“There’s now just overwhelming evidence that those user fees actually worsened health outcomes. There’s no question about it. So did the bank get it wrong before? Yeah. I think the bank was ideological” - Dr Jim Yong Kim, World Bank Head. (2014) User fees for health care were put forward as a way to recover costs and discourage the excessive use of health services and the over- consumption of care. This did not happen. Instead, user fees punished the poor. -Dr. Margaret Chan, Director-General, WHO. (2009) The history of user fees imposed on the poor is a history of the poor being excluded from basic services. – Jeffrey Sachs, Director, Earth Institute, End of Poverty (2005) Pricing helps reduce excessive or unwarranted demand for a service and brings supply capacity more in line with willingness and ability to pay. Put differently, when a service costs money, people will think twice about demanding it. - World Bank, Financing health care in sub-Saharan Africa through user fees and insurance. (1995)
