Defining, refining, and reforming the health system
If everyone in India had access to good quality health care, just imagine how different things would be. No one would have to worry about traveling long distances to a health institute or emptying out their pockets to afford medication and care; health centers would be well equipped with qualified doctors; pregnant women would be confident of giving birth to healthy babies in a safe environment; and a lot of people wouldn't have to lose their loved ones simply because they didn't have a choice. This is what reforming the health sector is all about - defining priorities, refining policies, and reforming institutions through which policies are implemented. It is the process of change involving the what, who, and how of health sector action.
The goal of reforms is for the health system to be efficient, to be of good quality where no one is discriminated against because of who they are, to raise more resources and enable the health sector and the organizations that comprise it to run efficiently and effectively on their own for a long time. All of this is geared towards improving living standards, eliminating poverty, protecting human rights, and involving people, especially those who face discrimination, in every step towards bringing positive changes to the health sector.
In India, there has been a gradual shift in the organization, structure, and delivery of health care services. Starting from the 1990s till now, reforms have focused on coordination between different sectors, involvement of Panchayati Raj Institutions in planning and monitoring health programmes, and making health services equally available to all.
In India, health sector reforms broadly cover the following areas:
- Reorganization and restructuring of the existing government health care system
- Involving communities in health service delivery and provision
- Financial reforms
- Health Management Information Systems
- Quality of care
- Public-private partnerships
National Rural Health Mission
The National Rural Health Mission (NRHM) was launched in India in 2005. The NRHM is a national programme and is the vehicle for health reforms in India.
NRHM has the following vision:-
- Implemented throughout the country with special focus on 18 states with weak public health indicators and / or weak infrastructure.
- Improve availability of and access to quality health care, especially in rural areas for poor and vulnerable communities.
- Build synergy between health and determinants of good health like nutrition, sanitation, hygiene and safe drinking water.
- Mainstream Indian systems of Medicine in the public health system.
- Increase the capacity of the health system to handle increased allocations.
- Decentralize the planning process to the community
DFID and health reforms in India
The UK government's
Department for International Development (DFID) works in close partnership with the central government in India and with state governments in Andhra Pradesh, Madhya Pradesh, Orissa, West Bengal, and Bihar. Its focus is primarily to meet the internationally agreed Millennium Development Goals by 2015. Through support for a number of nationwide health initiatives,
DFID works with the Government of India in its efforts to reduce infant, child, and maternal mortality.
In Andhra Pradesh,
DFID's involvement in the health sector includes support to the government to develop a medium-term strategy to improve the access of all people, especially the poor, to good quality health services.
In Madhya Pradesh,
DFID supports pro-poor economic and social policy reform aimed at reducing poverty.
DFID has also been involved in developing an integrated policy response and health strategy. It seeks to strengthen health planning and management at the district and lower levels to reinforce and support the processes of decentralization and a more participatory approach to development.
Currently,
DFIDs involvement in the health sector in Orissa is in assisting in reducing infant and maternal mortality by supporting better managed and more appropriately targeted health care delivery systems.
Its support in the health sector in West Bengal includes supporting the health sector strategy