Edition 14 | October 18, 2022

Dear Friends,

We are delighted to present to you the next edition of the monthly newsletter by the Lancet Citizens' Commission on Reimagining India’s Health System. This edition focuses on a discussion on making mental health and well-being a global priority for all. It brings you an analysis on quantifying shortages and workload for various clinical and supporting resources available for health services. Further, this edition analyses the potential of telemedicine in making universal health care a reality in India, catastrophic health expenditure on private sector pharmaceuticals in Odisha and more. 

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This Month's Highlight

Make Mental Health & Well-Being for All a Global Priority

The webinar was a joint Lancet Citizens’ Commission on Reimagining India’s Health System event with Population Foundation of India (PFI)Sangath and Association for Socially Applicable Research (ASAR) and was held to mark World Mental Health Day. This year, the theme for World Mental Health Day was making mental health and well-being a global priority for all. Our distinguished panel discussed how mental health can be valued, promoted and protected; where everyone has an equal opportunity to enjoy mental health and to exercise their human rights; and where everyone can access the mental health care they need. 

News from the Commission

Are we measuring our health workforce shortage right?

The Workload Indicators of Staffing Need (WISN) is a human resources for health (HRH) management method supported by the World Health Organization (WHO) to quantify shortages and workload using data on time taken for various clinical and supporting (administrative and other) tasks and resources available, write Siddhesh Zadey, Yash Kamath, and Sharvari Mande.

Where does India stand with its human resources for health?

Recently, the Institute for Health Metrics and Evaluation (IHME) that leads the Global Burden of Diseases (GBD) studies, modeled estimates for 16 HRH cadres across 204 countries for 1990-2019 and came up with a new threshold for minimum requirement, write Madhurima Vuddemarry and Siddhesh Zadey.

Views & Opinions 

A public health emergency in slow motion

Governments and global health agencies turned a blind eye to the threat of noncommunicable diseases as they thought that these were problems of the rich countries, writes K Srinath Reddy.

Could telemedicine make universal health care a reality in India?

Universal health care means that everyone can access the health services they need without financial hardship, something most countries struggle to deliver. Digital health tools—carefully implemented—are indispensable to ensuring that this goal becomes a reality, write Parth Sharma and Siddhesh Zadey.

Reducing Her Burden: contraception as a critical step toward women’s empowerment

India having reached replacement level of fertility, the emphasis of the Family Planning Programme now is to improve maternal and child health. Along with broadening the range of accessible contraceptive options, social issues like age at marriage, age at first birth, and girls' educational attainment were given significant consideration in the strategy, write Poonam Muttreja and Andrea Wojnar.


Catastrophic health expenditure on private sector pharmaceuticals: a cross-sectional analysis from the state of Odisha, India

India has high rates of catastrophic health expenditure (CHE): 16% of Indian households incur CHE. To understand why CHE is so high, we conducted an in-depth analysis in the state of Odisha-a state with high rates of public sector facility use, reported eligibility for public insurance of 80%, and the provision of drugs for free in government-run facilities-yet with the second-highest rates of CHE across India (24%). We collected household data in 2019 representative of the state of Odisha and captured extensive information about healthcare seeking, including the facility type, its sector (private or public), how much was spent out-of-pocket, and where drugs were obtained, write Annie HaakenstadAnuska KalitaBijetri BoseJan E Cooper, and Winnie Yip.

Commission Member in Spotlight 

"India has a federal governance structure with defined jurisdictions for the Central and state governments. Given the constitutional division of responsibilities for health as a subject, the legislation, vision and financing, and delivery of healthcare services have primarily been the preserve of the state governments, albeit with periodic interventions from the Central Government. In such circumstances, effective integration and implementation of UHC provisions will be challenging, especially at the sub-national level. Greater accountability in providing and financing health services will also be a major challenge. Regulatory efforts to ensure the quality of health services constitute an ongoing challenge. Further, patient information and the protection of patient rights remains a critical challenge in the health sector, even as several laws have been enacted to protect patient rights and for grievance redressal related to medical misconduct, over-prescription of drugs and other cases of malpractices," says Sudheer Kumar Shukla, Research Fellow, Lancet Citizens' Commission

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Featured Partner

The Association of Healthcare Providers (India) works as a not-for-profit organisation and represents most healthcare providers in India. AHPI is supporting the dissemination efforts for the doctors' survey as part of the Commission work.

Help us develop a roadmap to achieve universal health coverage in India by visiting our website: https://www.citizenshealth.in/

We love hearing back from you! Please send your comments, suggestions, and contributions for these newsletters, including research highlights and published features to info@citizenshealth.in
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