Seize the Moment: Now’s the time to reform rural health care in India

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The blog I have posted reflects my personal views and not those of the World Bank or its affiliates. It is unfortunate that some parties have sought to interpret what I written as the official views of the World Bank. The blog platform is intended to generate a healthy discussion. The comments that the blog attracted shows differing opinions on the subject of public and private roles in health care.

The private sector is the dominant player in the Indian health sector and most financing is out-of-pocket which in turn places a huge financial burden on the poor. However, the qualified private sector is mostly absent in distant rural and tribal areas where most Indians rely on unqualified and unregulated private providers. My statement about public delivery in India refers to these areas where residents have a limited choice - between “quacks” and often nothing at all. NRHM is the main GOI program to improve access to health care in these areas. I noted in the blog that if well-documented accountability failures of public delivery in India are not addressed, the program’s impact will be compromised and rural Indians will continue to rely on fee-for-service, unqualified providers. Recently launched government-sponsored health insurance schemes, such as RSBY, target poor Indians, offering cashless cover while allowing beneficiaries to choose among empanelled public and private providers. These schemes represent a first attempt at making both public and private providers accountable for their performance.

For more information on health in India, visit World Bank India: Health, Nutrition, and Population to learn more.


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