Edition 16 | December 19, 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 highlights a discussion on persuading (the low-spending) state governments to focus their limited resources on areas of maximum impact. It brings you an analysis of achieving sustainable development goal targets for the health workforce and the need for it in rural areas, an analysis of the small area variation in the quality of maternal and newborn care in India and more. 

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This Month's Highlight

Persuading (the low-spending) state governments to focus their limited resources on areas of maximum impact

The webinar was a joint Lancet Citizens’ Commission on Reimagining India’s Health System event with the Population Foundation of India (PFI) and was held to mark Universal Health Coverage (UHC) Day. Our distinguished panel discussed the low expenditures by some states, which are clearly inadequate to fund UHC on their own, and the focus of the government health expenditures. 

Read Key Takeaways

News from the Commission

Achieving sustainable development goal targets for health workforce

While nurses enjoy a majority in the health workforce, they remain starkly absent from leadership roles, writes Siddhesh Zadey.

India’s policies should view human resources for health

India is one of the 57 countries listed as ‘countries suffering from an HRH crisis’ by the World Health Organization (WHO) in its 2006 report. Things have improved only marginally since then, write Vidhi Wadhwani & Siddhesh Zadey.

Rural areas need human resources for health

According to the WHO, Human Resources for Health (HRH) scarcity primarily affects low- and lower-middle-income countries like India. Since 2000, India's public health expenditure has been below the recommended 5% of the country’s GDP, write Vinayak Mishra, Gaurav Urs and Siddhesh Zadey.

Views & Opinions 

Oral health awareness is need of hour

Poor information and surveillance systems as well as low priority for public health research in oral diseases are impediments to delivering oral health programmes, writes K Srinath Reddy.

How India Can Achieve Universal Health Coverage

Even though the country's Accredited Social Health Activists (ASHA) is the world's largest community volunteer program, India's community health-care workforce tallied 1.04 million in 2020, trailing the 1.4 million health-care workers it needs, write Parth Sharma and Preethi John.


Small Area Variation in the Quality of Maternal and Newborn Care in India

In India, the district serves as the primary policy unit for implementing and allocating resources for various programs aimed at improving key developmental and health indicators. Recent evidence highlights that high-quality care for mothers and newborns is critical to reduce preventable mortality. However, the geographic variation in maternal and newborn health service quality has never been investigated, write Hwa-Young Lee, PhD; Md Juel Rana, PhD; Rockli Kim, PhD; S. V. Subramanian, PhD.

Commission Member in Spotlight 

"High out-of-pocket expenditure is obviously a barrier to achieving UHC and unless we take steps to reduce it, I don’t see how we can achieve UHC. Even within current tax-to-GDP ratios and allocations towards healthcare, we can do much better by shifting government expenditures to healthcare. This requires however, moving expenditures from other categories, which I see as a challenge. Related to this is the issue of citizen concern and demand around healthcare. Although many Indians fall into poverty each year because of catastrophic health expenditures, we really don’t see the level of electoral demand for universal health care that puts pressure on elected officials to rethink health as a priority item," says Neela Saldanha, Executive Director, Yale Research Initiative on Innovation and Scale (Y-RISE), Yale University

Read full interview
Featured Partner

Dvara Research is a policy research institution based in India. Their mission is to ensure that every household and every enterprise has complete access to suitable financial services and social security through a range of channels that enable them to use services securely and confidently. Dvara Research is providing research support to the financing workstream of the Commission.

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

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