How Might India’s Public Health Systems Be Strengthened?
The central government s policies, though well-intentioned, have inadvertently de-emphasized environmental health and other preventive public health services in India since the 1950s, when it was decided to amalgamate the medical and public health...
| Main Authors: | , , , |
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| Format: | Policy Research Working Paper |
| Language: | English |
| Published: |
2012
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| Subjects: | |
| Online Access: | http://www-wds.worldbank.org/external/default/main?menuPK=64187510&pagePK=64193027&piPK=64187937&theSitePK=523679&menuPK=64187510&searchMenuPK=64187283&siteName=WDS&entityID=000158349_20091125082536 http://hdl.handle.net/10986/4332 |
| Summary: | The central government s policies,
though well-intentioned, have inadvertently de-emphasized
environmental health and other preventive public health
services in India since the 1950s, when it was decided to
amalgamate the medical and public health services and to
focus public health services largely on single-issue
programs. This paper discusses how successive policy
decisions have diminished the Health Ministry s capacity for
stewardship of the nation s public health. These decisions
have introduced policies and fiscal incentives that have
inadvertently enabled states to prioritize medical services
and single-issue programs over broader public health
services, and diminished the capacity of the public health
workforce to deliver public health services. Diseases
resulting from poor environmental health conditions continue
to impose high costs even among the more affluent, and
hinder development. There are many approaches to
strengthening the public health system, and the authors
suggest one that may require relatively little modification
of existing structures and systems. They suggest
establishing a focal point in the Health Ministry for public
health stewardship, and re-vitalizing the states public
health managerial cadres as well as the grassroots public
health workers. The central government could consider
linking its fiscal support to states with phased progress in
four areas: (1) the enactment of state Public Health Acts;
(2) the establishment by states of separate public health
directorates; (3) the re-vitalization of grassroots public
health workers; and (4) health department engagement in
ensuring municipal public health. The central focal point
could provide the needed support, oversight, incentives, and
sanctions to ensure that states build robust public health
systems. These measures can do much to help governments use
public funds more effectively for protecting people s health. |
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