The health sector reforms initially touted as the World Banks prescription and hence roundly rejected by the concerned scholars, have slowly but gradually started gaining grounds in India. Indeed, some of the reform measures adopted in a few states had preceded 1991 economic reforms. The objective of this book is to capture the various strands of reforms which had started unfolding since the late 1980s itself. Following the case study method, this volume also looks into the functioning of Rogi Kalyan Samities (RKS) and lady health volunteers, both adapted as critical components of the National Rural Health Mission (NRHM), a flagship programme of the UPA government which aims at injecting a new life to the public health care system by strengthening the health infrastructure and providing a functional link between the community and the hospitals. Not only does this volume draw on experiences of some of the states but by offering empirical evidences on some of the successful initiatives it enriches our understanding of the impact of reform measures.

New thinking about the management of public health services has stimulated a widespread movement for health sector reform across the world. This book examines the feasibility and desirability of common reforms in low income countries, based on in-depth case studies in Ghana, Zimbabwe, Sri Lanka, India and Thailand, and asks whether governments possess or can develop the capacities needed for these new and often complex roles. The book challenges conventional reform wisdom, and argues that reform approaches are needed that are more sensitive to the institutional characteristics of individual countries.

In Mexico City or Nairobi or Manila, a young girl in one part of the city is near death with measles, while, not far away, an elderly man awaits transplantation of a new kidney. How is one denied a cheap, simple, and effective remedy while another can command the most advanced technology medicine can offer? Can countries like Mexico, Kenya, or the Philippines, with limited funds and medical resources, find an affordable, effective, and fair way to balance competing health needs and demands? Such dilemmas are the focus of this insightful book in which leading international researchers bring together the latest thinking on how developing countries can reform health care. The choices these poorer countries make today will determine the pace of health improvement for vast numbers of people now and in the future. Exploring new ideas and concepts, as well as the practical experiences of nations in all parts of the world, this volume provides valuable insights and information to both generalists and specialists interested in how health care will look in the world of the twenty-first century.

"This book describes the transition in Indian healthcare system since independence and contributes to the ongoing debate within development and institutional economics on the approaches towards reform in the public health system. The institutional reform perspective focuses on examining the effective utilisation of allotted resources and improvements in delivery through decentralisation in governance by ensuring higher participation of elected governments and local communities in politics, policymaking and delivery of health services. It discusses the economic (resource) reforms to explain the relevance and expansion of state interventionism along with its influence on the health sector, accountability and allocative efficiency. The author also explores the connections between neoliberal thought and privatisation in health sector, and examines the greater role of insurance-based financing and their implications for health service access and delivery. The book offers ways to address long-standing systemic and structural problems that confront the Indian healthcare system. Based on large-scale surveys and diverse empirical data on the Indian economy, this book will be of great interest to researchers, students and teachers of health economics, governance and institutional economics, political economy, sociology, public policy, regional studies and development studies. This will be useful to policymakers, health economists, social scientists, public health experts and professionals, and government and nongovernment institutions"--

This book offers a global perspective on healthcare reform and its relationship with efforts to improve quality and safety. It looks at the ways reforms have developed in 30 countries, and specifically the impact national reform initiatives have had on the quality and safety of care. It explores how reforms drive quality and safety improvement, and equally how they act to negate such goals. Every country included in this book is involved in a reform and improvement process, but each takes place in a particular social, cultural, economic and developmental context, leading to differing emphases and varied progress. Methods for tackling common problems - financing, efficiencies, effectiveness, evidence-based practice, institutional reforms, quality improvement, and patient safety initiatives - also differ. Representatives from each nation provide a chapter to convey their own situation. The editors draw a conclusion from these numerous contributions and synthesize the themes emerging into a coherent ‘lessons learned’ summary that delivers value to the numerous stakeholders. Healthcare Reform, Quality and Safety forms a compendium of the current ‘state of the art’ in global healthcare reform. This is the first book of its type, and offers a unique opportunity for cross-fertilization of ideas to the mutual benefit of countries involved in the project. The content will be of interest to governments, policymakers, managers and leaders, clinicians, teaching academics, researchers and students.

This book provides a multi-disciplinary framework for developing and analyzing health sector reforms, based on the authors' extensive international experience. It offers practical guidance - useful to policymakers, consultants, academics, and students alike - and stresses the need to take account of each country's economic, administrative, and political circumstances. The authors explain how to design effective government interventions in five areas - financing, payment, organization, regulation, and behavior - to improve the performance and equity of health systems around the world.

This book presents the health reform experiences over the past three decades of twelve small and medium-sized nations that are not often included in international comparative studies in this field. The major conclusion of the study is that despite many similarities in policy goals, policy challenges and in the menu of policy options for countries that seek to offer universal coverage to their population, the health reforms of the nations in this book did not converge into one direction or model. However, we found several widespread policy experiences that are relevant for others, too.For example, user fees are unpopular everywhere. Governments often try to soften the consequences by exempting large groups of users, thus largely defeating the very purpose of those fees.As a second example, the introduction of new payment modes for medical care — like the shift from fee for service to case-based payment — took much longer than originally expected everywhere, and also failed to deliver their promises of improved transparency or efficiency gains A third example is that proposals are for universal coverage often ignore the challenges of implementing new financing models that elsewhere took decades if not centuries to develop.The conclusions contain both empirical findings and theoretical conclusions of interest to policy-makers and scholars of international comparison. It is accessible for academics, healthcare managers and students as well as a wider audience of readers interested in the changes in healthcare across the world.

This book is a collection of fifteen contributions that undertake a detailed analysis of seven broad dimensions of India’s economy and society. All the contributions approach the problems in their respective areas empirically, while being theoretically informed. The book begins with a section containing detailed and empirically supported chapters on the recent crisis in India’s agricultural sector and the reforms in the agricultural markets. Another section is dedicated to the issue of infrastructure financing, and new ways of financing large infrastructural projects are critically examined. Other sections are related to innovations and technology impacts on industry; international trade; health and education; labor and employment; and the very important issue of gender. The selected discussion topics are both of contemporary importance and expected to remain so for some time. Most of the chapters introduce readers to data in addition to methods of analyzing this data, to arrive at policy-oriented conclusions. The rich collection carries learnings for researchers working on a wide range of topics related to development studies, as well as for policymakers and corporate watchers.

In analysing the phenomenon of health sector reforms, this book proposes a new conceptual framework of analysis and ethnography as a methodological tool which could be used effectively in various country contexts compared to what the existing theoretical frameworks do. Thus, apart from generating new knowledge in health sector, this study has significance for policy makers across the world. When the states themselves accept the fact that increasing private participation in health care in the form of health sector reforms is happening because of deliberate state policy, they will be better positioned to take decisions which ensure effective private sector regulation and universal access to quality health care within a democratic or participatory framework of governance. Increasing privatisation of health care has also led toward citizens losing their democratic spaces with regard to decisions on universal access to quality health care. This has wider implications, not only for improved health status in general, but also about how we live in a modern society with our values of liberty, equality and justice intact. The book would be a useful guide for policy-makers, researchers, students and layman across the world.