332 research outputs found
Trends in Health Status and Infrastructural Support in Tamil Nadu
No full textThis paper aimed at examining the health status in Tamil Nadu and to highlight the major issues on it. The health scenario of Tamil Nadu was examined, based on certain selected health indicators and the extent of health infrastructure available in the state and its utilisation were also discussed The study observed that there is a reduction in the vital statistics such as birth rate, death rate and infant mortality rate and an increase in the life expectancy at birth in Tamil Nadu during the last three decades. These trends indicated the developments in the health status of the people and the steady progress in the health indicators. The study argued that though the demographic indicators and vital statistics indicate very high of Tamil Nadu in terms of health performance, there are several areas in which improvements are possible. To conclude, Tamil Nadu seems to have performed better compared to All India average in demographic and several health indicators. However, Tamil Nadu is capable of much higher levels of achievements with its knowledge base, administrative and institutional strength and its growth potentials.Health Status; Health Infrastructure; Health Issues; Health Scenario; Birth Rate; Death Rate; Infant Mortality; Life Expectancy; Infant Mortality; Mortality Rate;Tamil Nadu
India health system review
No full textIndia has made significant improvements in the health outcomes of its people. Life expectancy at birth increased to 69.6 years in 2020, from expected 47.7years in 1970. MMR declined from 301 to 130 per 100 000 live births between 2003 and 2014-16, and IMR declined from 68 in the year 2000 to 24 per 1000 live births in 2016. However progress is uneven across states, and demographic and epidemiological changes means, the country faces a double burden of disease and an ageing population. The top three causes of death in 2019 were ischaemic heart disease, COPD and stroke.
India has a mixed health-care delivery system. Policy recommendations in the 1940s laid the foundation for a government-funded, three-tiered public health system to deliver preventive and curative health care services. By the 1980s the private sector’s role in health began to gain prominence. Today, nearly 70% of all outpatient visits, about 58% of all inpatient episodes are provided by either for-profit or not-for-profit private providers. Quality of care, accessibility and affordability of health care services, medicines and diagnostics are a challenge. There are also differences in health outcomes between states. Several policy initiatives since the 2000s have been launched to strengthen India’s health system towards providing UHC and improving health outcomes and the Ayushman Bharat programme is attempting to tackle these issues at both hospital and outpatient settings, it is still too early to look at its impact.
The India Health System Review presents a comprehensive overview of the country’s health system. It presents key information of India’s mixed health system which demonstrates varying levels of maturity across states, and serves the needs a country with vast heterogeneity in health and development indicators, and contexts
Essays on the economic impacts of health shocks on households in low and middle income countries
No full textGiven limited evidence on economic impacts of health shocks on households in South Asia the thesis examined the issues using both cross-sectional and longitudinal household surveys from the region applying econometric analyses. The thesis found that health shocks in the form of adult deaths and major illness including non-communicable diseases and traffic injuries incurred significant out-of-pocket healthcare expenditure and reduced household labour supply and earnings in the short-run with negative consequences for child nutrition and education. The negative consequences persist in the long-run, but with lower magnitude than in the short-run. The thesis warrants policy attention for the health shocks-affected households through improved access to healthcare services and social protection benefits
Assessing the Economic Impact of HIV/AIDS on Nigerian Households: A Propensity Score Matching Approach
No full textWe assess the impact of HIV/AIDS on individuals’ health care utilization and spending in the Oyo and Plateau states of Nigeria and income foregone from work time lost. Data was from a 2004 survey of nearly 1,500 households, including 482 individuals living with HIV/AIDS. Estimating the effect of HIV is complicated by the fact that our sample of HIV positive individuals is non-random; there are selection effects, both in acquiring HIV, and in being in our sample our HIV positive people, which was based on contacts through non-governmental organizations. To overcome this selection effect, we compare HIV positive people with a control group with similar observed characteristics, using propensity score matching. The matched control group has very different health and economic outcomes than a random sample of the population indicating that our HIV sample would not have had "average" outcomes even if they had not acquired HIV. HIV is associated with significantly increased morbidity, health care utilization, public health facility use, lost work time and increased time devoted to care-giving relative to outcomes in the control group. Direct health care costs and indirect income loss per HIV positive individual were 16,569 Naira, about 32% of annual income per capita in affected households. About 40% of these costs are income losses associated with sickness and care-giving. 15% of the cost of HIV is accounted for by public subsidies on health. The largest single economic cost, representing 45% of the total economic burden of HIV, are out of pocket expenses, mainly for health care.HIV, Nigeria, Economic Impacts, Households, Direct Costs, Propensity Score
sj-docx-1-chi-10.1177_17423953231153550 - Supplemental material for Morbidity and utilisation of healthcare services among people with cardiometabolic disease in three diverse regions of rural India
No full textSupplemental material, sj-docx-1-chi-10.1177_17423953231153550 for Morbidity and utilisation of healthcare services among people with cardiometabolic disease in three diverse regions of rural India by Sojib Bin Zaman, Roger G Evans, Clara K Chow, Rohina Joshi, Kavumpurathu R Thankappan, Brian Oldenburg, Ajay S Mahal, Kartik Kalyanram, Kamakshi Kartik, Michaela A Riddell, Oduru Suresh, Nihal Thomas, Gomathyamma K Mini, Pallab K Maulik, Velandai K Srikanth and Amanda G Thrift in Chronic Illness</p
Global Health
No full textBackgroundIn India, Non Communicable Diseases (NCDs) and injuries account for an estimated 62% of the total age-standardized burden of forgone Disability Adjusted Life Years (DALYs). Public and private financing of clinical services to reduce the NCD burden is a major challenge.MethodsWe used National Sample Survey Organization (NSSO) survey data from 1995-96 and 2004 covering nearly 200 thousand households to assess healthcare utilization patterns and out of pocket health spending by disease category. For this purpose, self-reported diseases and conditions were categorized into NCDs and non-NCDs. Survey data were used to assess how households financed their overall health expenditures and related this pattern to specific health conditions. We measured catastrophic spending on NCD-related hospitalization, defined as occurring when health expenditures exceeded 40% of a household's ability to pay, that is, household consumption spending less combined survival consumption expenditure; and impoverishment when per capita expenditure within the household decreased to below the poverty line once health spending was netted out.ResultsThe share of NCDs in out of pocket health expenses incurred by households increased over time, from 31.6 percent in 1995-96 to 47.3 percent in 2004. In both years, own savings and income were the most important source of financing for many health conditions, typically between 40-60 percent of all spending, whereas 30-35 percent was from borrowing. The odds of catastrophic hospitalization expenditures for cancer was nearly 170% greater and for CVD and injuries 22 percent greater than the odds due to communicable diseases. Impoverishment patterns were similar.ConclusionsOut of pocket expenses for treating NCDs rose sharply over the period from 1995-96 to 2004. When NCDs are present, the financial risks to which Indians households are exposed are significant.20121012
Needle Sharing and HIV Transmission: A Model with Markets and Purposive Behavior
No full textWithout well designed empirical studies, mathematical models are an important way to use data on needle infection for inferences about human infection. We develop a model with explicit behavioral foundations to explore an array of policy interventions related to HIV transmission among IDU. In our model, needle exchanges affect the spread of HIV in three ways: more HIV-negative IDUs use new needles instead of old ones; needles are retired after fewer uses; and the proportion of HIV-positive IDUs among users of both old and new needles rises owing to sorting effects. The first and second effects reduce the long-run incidence of HIV, while the third effect works in the opposite direction. We compare the results of our model with those of Kaplan and O'Keefe (1993) that is the foundation of many later models of HIV transmission among IDU.
Economic security arrangements in the context of population ageing in India
No full textThe rapid ageing of India's population, in conjunction with migration out of rural areas and the continued concentration of the working population in the informal sector, has highlighted the need for better economic security arrangements for the elderly. Traditional family ties that have been key to ensuring a modicum of such security are beginning to fray, and increased longevity is making care of the elderly more expensive. As a result, the elderly are at increased risk of being poor or falling into poverty. In parallel with its efforts to address this issue, the Government of India and some of the Indian states have initiated an array of programmes for providing some level of access to health care or health insurance to the great majority of Indians who lack sufficient access. Formal-sector workers have greater social security than those in the informal sector, but they only represent a small share of the workforce. Women are particularly vulnerable to economic insecurity. India's experience offers some lessons for other countries. Although there is space for private initiatives in the social security arena, it is clear that most such efforts will need to be tax-financed. The role that private providers can play is substantial, even when most funding comes from public sources, but such activity will face greater challenges as more individuals seek benefits. India has also shown that implementation can often be carried out well by states using central government funds, with a set of advantages and disadvantages that such decentralization brings. Finally, India's experience with implementation can offer guidance on issues such as targeting, the use of information technology in social security systems, and human resource management.old age risk, old age benefit, medical care, social security administration, demographic aspect, India
Will Private Health Insurance Make the Distribution of Public Health Subsidies More Equal? The Case of India
No full textThis paper assesses the impact of the entry of private players in the health insurance market on the size of the insurance market and the distribution of public health subsidies on health care provision in India. Simulation results presented in the paper suggest that the redistributive effect is small when richer groups have privileged access to public facilities. The Geneva Papers on Risk and Insurance Theory (2003) 28, 131–160. doi:10.1023/A:1026392821297
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