India : Private Health Services for the Poor
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World Bank, Washington, DC
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Despite India's great strides since
independence, fertility, mortality, and morbidity remain
unacceptably high. Although poverty and low levels of
education are the root causes of poor health outcomes, poor
stewardship over the health system bears some
responsibility. Although India's states exhibit a wide
variation in health outcomes, all but the best-performing
states need to focus on improving both sexual and
reproductive health care and child health care, and on
reducing communicable diseases for the poor. This paper
examines the public and private responses to this situation
detailing the reasons behind the failure of the public
sector and ways in which the private sector can be
encouraged to play a role in providing health care for the
poor in India. The paper concludes that there are three
promising areas for the private sector including; (i)
contracting out the primary health centers, (ii) social
franchising and (iii) demand-led financing. The study is
focused on what to do to improve health care for the poor,
while a series of separate background papers focus on how to
do it, and state specific issues in Andhra Pradesh, Bihar,
Karnataka, and Punjab.
Palabras clave
AGRICULTURAL ACTIVITIES, ALCOHOLISM, AMBULATORY CARE, ANTENATAL CARE, BASIC HEALTH SERVICES, BEDS, BLOOD BANKS, BURDEN OF DISEASE, CLEAN WATER, CLINICS, COMMUNICABLE DISEASES, COMMUNITY HEALTH, COMMUNITY PARTICIPATION, COST STRUCTURE, COUNSELING, DEVELOPMENT GOALS, DISEASE CONTROL, DOCTORS, EQUIPMENT, ESSENTIAL DRUGS, EXPENDITURES, FAMILY PLANNING, FEED, GENDER, HEALTH CARE, HEALTH CARE FINANCING, HEALTH CARE INSTITUTIONS, HEALTH CARE POLICY, HEALTH CARE PROVIDERS, HEALTH CARE PROVISION, HEALTH CARE SERVICES, HEALTH CARE SPENDING, HEALTH CARE SYSTEM, HEALTH CENTERS, HEALTH CHARACTERISTICS, HEALTH DATA, HEALTH EDUCATION, HEALTH FACILITIES, HEALTH INDICATORS, HEALTH INSURANCE, HEALTH INSURANCE SCHEME, HEALTH INTERVENTIONS, HEALTH MANAGEMENT, HEALTH OUTCOME INDICATORS, HEALTH OUTCOMES, HEALTH PLANS, HEALTH POLICIES, HEALTH PROGRAMS, HEALTH SECTOR, HEALTH SERVICE, HEALTH SERVICES, HEALTH STATUS, HEALTH SYSTEM, HEALTH SYSTEM PERFORMANCE, HEALTH SYSTEMS, HEALTH TARGETS, HEALTH WORKERS, HOSPITALIZATION, HOSPITALS, HOUSEHOLDS, IMMUNIZATION, IMMUNODEFICIENCY, INCOMES, INFANT MORTALITY, INFANT MORTALITY RATE, INFECTIOUS DISEASES, INFORMAL PAYMENTS, INFORMATION SYSTEM, INJURIES, INSURANCE MARKET, LEPROSY, MALARIA, MALNUTRITION, MEASLES, MEDICAL SERVICES, MEDICAL TRAINING, MEDICINES, MORBIDITY, MORTALITY, NATIONAL HEALTH, NGOS, NONGOVERNMENTAL ORGANIZATIONS, NURSING, NURSING HOMES, NUTRITION, NUTRITIONAL DEFICIENCY, PATIENT, PATIENTS, PREGNANT WOMEN, PRIMARY HEALTH CARE, PRIVATE CLINICS, PRIVATE HEALTH SERVICES, PRIVATE HOSPITALS, PRIVATE PHARMACIES, PRIVATE SECTOR, PROVISION OF HEALTH CARE, PROVISION OF SERVICES, PUBLIC HEALTH, PUBLIC HEALTH CARE, PUBLIC HEALTH SERVICES, PUBLIC HOSPITALS, PUBLIC SECTOR, PUBLIC SERVICES, PUBLIC SPENDING, RISK FACTOR, RISK GROUPS, RURAL AREAS, RURAL COMMUNITIES, SAFE WATER, STERILIZATION, WORKERS