Financing Healthcare for All in India: Towards a Common Goal | Health Care

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This paper explores available evidence, contextualises and maps the debate in India around financing healthcare for all. While the focus is on healthcare in response to current policy debates, Oxfam India recognises the crucial importance of adopting a holistic approach to health, addressing factors such as nutrition and sanitation, and broader social determinants of health.
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  a   Financing Healthcare for all in India: Towards a Common Goal Oommen C. Kurian  b   ACKNOWLEDGEMENTS  Author: Oommen C. Kurian Inputs:  Indranil Mukhopadhyay, Anant Phadke, VR Raman, Shabareesh Pillai, Sadanand Nadkarni, Chandrakant Lahariya, Katie Malouf Bous (Oxfam International), Nicolas Mombrial (Oxfam International), Deepak Xavier(Oxfam India), Pallavi Gupta(Oxfam India), and Pooja Parvati (Oxfam India).A draft of this paper was circulated for comments and feedback at the first ever Universal Health Coverage Day commemorative event jointly organised by the World Health Organisation, Public Health Foundation of India, Rockefeller Foundation and Oxfam India. The event was held on the 12 th  December 2014 at New Delhi, India.© Oxfam India May, 2015This publication is copyright but the text may be used free of charge for the purposes of advocacy, campaigning, education, and research, provided that the source is acknowledged in full. The copyright holder requests that all such use be registered with them for impact assessment purposes. For copying in any other circumstances, permission must be secured. E-mail: policy@oxfamindia.org/ PUBLISHED BY Oxfam India: 4th and 5th Floor, Shriram Bharatiya Kala Kendra, 1, Copernicus Marg, New Delhi 110001 Tel: +91 (0) 11 4653 8000 www.oxfamindia.org Oxfam India Oxfam India, a fully independent Indian organization, is a member of an international confederation of 17 organisations. The Oxfams are rights-based organizations, which fight poverty and injustice by linking grassroots interventions, to local, national, and global policy developments.For further information please write to: policy@oxfamindia.org, or visit our website: www.oxfamindia.org. Photographs by:  Srikanth Kolari Oxfam India Working Paper Series disseminates findings of its work in progress to encourage the exchange of ideas about development issues. An objective of the series is to get the findings out quickly, even if the presentations are less than fully polished. The papers carry the names of the authors and should be cited accordingly. The findings, interpretations and conclusion expressed in this paper are entirely those of the authors. They do not necessarily represent the views of Oxfam India.  CONTENTS List of Acronyms 2Abstract 3Chapter 1: Background 5 Chapter 2: Healthcare Financing in India 9Chapter 3: Government Financed Insurance Schemes in India 15Chapter 4: The Case of Rashtriya Swasthya Bima Yojana (RSBY) 23Chapter 5: Way Forward 27 Notes 32 List of tables Table 2.1: Health Indices for India and Select Countries 9 Table 2.2: Percentage distribution of births by type of medical attention at delivery (2013) 11 List of figures Figure 2.1: Per Capita Total Public Expenditure on Health in Indian States 2009-10 12 Figure 3.1: Incurred Claims Ratio: Health Insurance Industry 20 Figure 3.2: Incurred Claims Ratio Across Insurance Categories: Public Companies 21 Figure 4.1: RSBY Hospitalisation Ratios across Oxfam’s Focus States 24  2 ACRONYMS ASHA Accredited Social Health ActivistBPL Below Poverty LineCBR Crude Birth RateCDR Crude Death RateCGHS Central Government Health Scheme CHC Community Health CentreESIS Employee State Insurance SchemeGDP Gross Domestic ProductGSDP Gross State Domestic ProductHLEG High Level Expert GroupICICI Industrial Credit and Investment Corporation of IndiaIFC International Finance CorporationILO International Labour OrganisationIMR Infant Mortality RateIRDA Insurance Regulatory and Development AuthorityJSY Janani Suraksha YojanaMMR Maternal Mortality RateMNC Multi National CorporationNAC National Advisory CouncilNCMP National Common Minimum ProgrammeNEP Net Earned PremiumNFSA National Food Security ActNHAM National Health Assurance MissionNIC National Insurance CompanyNICE National Institute for Health and Care ExcellenceNRHM National Rural Health MissionOOP Out-of-PocketPHC Primary Health CentrePHFI Public Health Foundation of IndiaPPP Public Private PartnershipRSBY Rashtriya Swasthya Bima Yojana SAP Structural Adjustment ProgrammeTFR Total Fertility RateUHC Universal Health CoverageUN United NationsUNDP United Nations Development Programme UNSDSN United Nations Sustainable Development Solutions NetworkWDR World Development ReportWHO World Health Organisation
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