International Journal of Health Policy and Management

International Journal of Health Policy and Management

Is Provision of Healthcare Sufficient to Ensure Better Access? An Exploration of the Scope for Public-Private Partnership in India

Document Type : Original Article

Authors
Sabitri Dutta 1
Kaushik Lahiri 2
1 DumDum Motijheel Rabindra Mahavidyalaya, Kolkata, West Bengal, India
2 Surendranath College, Kolkata, West Bengal, India
10.15171/ijhpm.2015.77
Abstract
Background
India’s economic growth rate in recent years has been fairly impressive. But, it has been consistently failing to make considerable progress in achieving health related Millennium Development Goal (MDG) targets. Lack of coherence between provisions and utilization becomes the face of the problem. Inadequacies in outreach, access and affordability coupled with escalating healthcare costs have aggravated the problem. Here the application of PublicPrivate Partnership (PPP) model seems to have enormous potential to ease the impasse.
 
Methods
This paper tries to find the gap between the provisions and access in healthcare. The paper attempts to construct a Health Infrastructure Index (HII) and Health Attainment Index (HAI) for different states of India. Considering the presence of regional variations found in health infrastructure and attainment among the states, two states, viz. Maharashtra (MAH) and West Bengal (WB) have been chosen. Then contributions of health programs like Rashtriya Swasthya Bima Yojana (RSBY), National Rural Telemedicine Network (NRTN) and Fair Price Shops (FPS), all PPP initiatives, have been assessed for both the states by carrying out comprehensive benefit-cost analysis.
 
Results
The health infrastructure for population per unit area captures the outreach/delivery issue and the health attainment reveals the true scenario about how far the infrastructure has been accessed by the people; and the gap between the two, as the paper finds, is the root of the problem. The combined effect of RSBY and NRTN will leave both MAH and WB higher benefits in terms of  health attainment. The contributions of RSBY and NRTN have been assessed for both the states by carrying out comprehensive benefit-cost analysis. FPS comes up with immense benefits for WB. It is yet to be implemented in MAH.
 
Conclusion
The outreach and access problems arising from deficiencies in infrastructure, human resources and financial ability are expected to be well-addressed by the spread of RSBY and NRTN jointly. The FPS mechanism under PPP initiative can be an effective tool in solving affordability problem by reducing the cost of treatment.
Keywords
Health Infrastructure
Health Attainment
Public-Private Partnership (PPP)
Benefit-Cost Analysis
Subjects
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  • Received Date 08 November 2014
  • Revised Date 21 February 2015
  • Accepted Date 01 April 2015
  • First Published Date 01 July 2015
  • Published Date 01 July 2015