Strengthening Eco-system for Sustainable and Inclusive Health Financing in India

Universal Health Coverage: status, constraints, challenges and prognosis

The Impact of Road Traffic Injury: A Mixed Methods Study in North India

Injuries are a major public health problem, resulting in high health care demand and economic burden. They result in loss of disability adjusted life years (DALYs) and high out-of-pocket expenditure. However, there is little evidence on the economic burden of injuries in India. We undertook this study to report out-of-pocket expenditure and the prevalence of catastrophic health expenditure for injuries related hospitalizations in public sector hospitals in North India. Further, we also evaluate the determinants of catastrophic health expenditure. The economic impact of injuries is notably high both in terms of out-of-pocket expenditure and productivity loss. A high proportion of households experienced catastrophic expenditure and impoverishment following an injury, highlighting need for programs to prevent injuries.

Economic and Social Impact of Injury: A Pilot Study

Injuries are a serious cause of mortality and morbidity worldwide, with trauma being the leading cause of death in the first four decades of life. By contrast with the declining rates of injury seen in high-income countries, low-income and middle-income countries (LMICs) are experiencing an increase in injury rates, largely due to increased motorisation in these countries. This study assessed the extent out-of-pocket expenditure and financial risk protection from trauma care in a tertiary care hospital of India.

Evaluation of Medical Emergency Response Services in the state of Punjab

Emergency referral services (ERS) are being strengthened in India to improve access for institutional delivery. This study evaluated the publicly financed and privately delivered model of ERS in Punjab state, India, to assess its extent and pattern of utilization, impact on institutional delivery, quality and unit cost. The study finding revealed that emergency referral services in Punjab did not result in a significant change in public sector institutional deliveries. This could be due to high baseline coverage of institutional delivery and low barriers to physical access. Choice of interventions for reduction in Maternal Mortality Ratio (MMR) should be context-specific to have high value for resources spent. The ERS in Punjab needs improvement in terms of quality and reduction of cost to health system

Baseline Study to Assess the Access to Medicines Situation in India

Access to free essential medicines is a critical component of universal health coverage. However, availability of essential medicines is poor in India with more than two-third of the people having limited or no access. This has pushed up private out-of-pocket expenditure due to medicines. The states of Punjab and Haryana are in the process of institutionalizing drug procurement models to provide uninterrupted access to essential medicines free of cost in all public hospitals and health centres. Current study was undertaken to assess the availability of medicines in public sector health facilities in the 2 states. Secondly, we also ascertained the quality of storage and inventory management systems in health facilities

Cost Outcome Description of Liver-ICU Treatment in a Tertiary Care Hospital

Liver diseases contribute significantly to the health and economic burden globally. We undertook this study to assess the health system costs, out-of-pocket (OOP) expenditure and extent of financial risk protection associated with treatment of liver disorders in a tertiary care public sector hospital in India. Treatment of chronic liver disorders poses an economic challenge for both the health system and patients. There is a need to focus on prevention of liver disorders and finding ways to treat patients without exposing their households to the catastrophic effect of OOP expenditure.

Costing of primary and secondary health services in North India

With the commitment of the national government to provide universal healthcare at cheap and affordable prices in India, public healthcare services are being strengthened in India. However, there is dearth of cost data for provision of health services through public system like primary & community health centres. The aim of the current study was to bridge this gap in evidence by assessing the total annual and per capita cost of delivering the package of health services at PHC and CHC level. Secondly, we determined the per capita cost of delivering specific health services like cost per antenatal care visit, per institutional delivery, per outpatient consultation, per bed-day hospitalization etc.

Concurrent Evaluation of National Rural Health Mission

Concurrent Evaluation of National Health Mission, Haryana is a community-based household survey for assessing coverage and trends of various indicators on MCH, family planning, childhood conditions, curative care services utilisation and associated expenditure. The project also evaluates trends in coverage of indicators, quality and completeness of HMIS and coverage of universal health care in the state.

Evaluation of Medical Emergency Response Services in the state of Haryana

Various models of referral transport services have been introduced in different States in India with an aim to reduce maternal and infant mortality. Most of the research on referral transport has focussed on coverage, quality and timeliness of the service with not much information on cost and efficiency. This study was undertaken to analyse the cost of a publicly financed and managed referral transport service model in three districts of Haryana State, and to assess its cost and technical efficiency. The findings of the study revealed that the publicly delivered referral transport services in Haryana were operating at an efficient level. Increasing the demand for referral transport services among the target population represents an opportunity for further improving the efficiency of the underutilized ambulances.