Masterarbeit, 2019
65 Seiten, Note: 7
CHAPTER 1 BACKGROUND INFORMATION
1.1. GEOGRAPHY:
1.2. GOVERNANCE AND ADMINISTRATION:
1.3. POPULATION:
1.4. NATIONAL CURRENCY:
CHAPTER 2 PROBLEM STATEMENT, JUSTIFICATION, AND OBJECTIVES
2.1. PROBLEM STATEMENT:
2.2. JUSTIFICATION:
2.3. OBJECTIVES:
2.4. METHODOLOGY:
2.5. SEARCH STRATEGY:
2.6. EXCLUSION CRITERIA:
2.7. FRAMEWORK:
2.8. KEYWORDS:
2.9. LIMITATIONS:
CHAPTER 3 STUDY RESULTS FINDINGS
3.1. GROSS DOMESTIC PRODUCT (GDP) GROWTH RATES:
3.2. ACTORS INVOLVED IN STEWARDSHIP FUNCTIONS:
3.3. HEALTHCARE SYSTEM, SERVICE DELIVERY AND INFRASTRUCTURE:
3.4. HUMAN RESOURCES FOR HEALTH:
3.5. LEGAL AND REGULATORY FRAMEWORK FOR HEALTH FINANCING:
3.6. KEY ACTORS IN HEALTH FINANCING:
3.7. HEALTH EXPENDITURE IN INDIA:
3.8. RESOURCE COLLECTION:
3.9. POOLING:
3.10. PURCHASING:
CHAPTER 4 DISCUSSION:
CHAPTER 5 CONCLUSION AND RECOMMENDATION:
This thesis examines the systemic bottlenecks within India’s health financing functions—specifically resource collection, pooling, and purchasing—to understand why the current mechanisms fail to provide equitable health care access without causing financial hardship to households.
3.1. GROSS DOMESTIC PRODUCT (GDP) GROWTH RATES:
Indian is the seventh-large economy in the world in terms of GDP(26). In 2018 estimated GDP of India was 2.7 trillion international united state dollars (INR 187.7 million) with the annual growth rate of 6.9% (27). However, by looking at per-capita GDP in terms of purchasing power parity, India ranks 119 among the countries in the world and is even below then neighboring countries like Bhutan and Sri Lanka(28). In comparison to the annual growth rate of GDP, per capita, the annual growth rate is 5.8%(28).
3.2. ACTORS INVOLVED IN STEWARDSHIP FUNCTIONS:
By the mandate of the constitution of India article 47, the state government is accountable for offering health care services as per the guidelines of Indian public health standards(5). However, governance and administration of the healthcare system in India are provided by both union and state government as per the seventh Indian constitutional schedule(29) (5). For instance, Union government is responsible for national disease-specific programs (National AIDS Control Programme, Revised National Tuberculosis Programme, National Non-Communicable Disease Programme, Janani Shishu Suraksha Karyakram, National Health Mission to mention a few) aimed to stop and control communicable and non communicable diseases, enhancing maternity and child health. However, maintaining public health, hospitals, sanitation, nutrition is the duty of state government.
CHAPTER 1 BACKGROUND INFORMATION: Provides an overview of India's demographic, geographical, and administrative structure, including the federal governance model of the healthcare system.
CHAPTER 2 PROBLEM STATEMENT, JUSTIFICATION, AND OBJECTIVES: Defines the research gap regarding financial accessibility in India and outlines the methodology and framework used to analyze health financing bottlenecks.
CHAPTER 3 STUDY RESULTS FINDINGS: Presents an in-depth analysis of India’s economic growth, the roles of key actors in health stewardship, current expenditure levels, and the performance of resource collection, pooling, and purchasing mechanisms.
CHAPTER 4 DISCUSSION: Synthesizes findings on public health spending, the impact of OOP expenditures, and the limitations of existing health insurance schemes in providing adequate financial protection.
CHAPTER 5 CONCLUSION AND RECOMMENDATION: Concludes the study by proposing policy shifts, including increased public health spending, capacity building for state governments, and the integration of health insurance into a unified national policy.
Health Financing, India, Out-of-pocket payments, Universal Health Coverage, Health Insurance, Resource Collection, Pooling, Purchasing, Fiscal Space, Health Inequity, Public Spending, Financial Accessibility, Catastrophic Expenditure, Healthcare Infrastructure, Stewardship.
The research fundamentally analyzes the bottlenecks within India's health financing system that prevent affordable access to quality healthcare for its citizens.
Central themes include the evaluation of health financing functions, the burden of out-of-pocket expenditure, the role of government health insurance schemes, and the influence of public spending on healthcare outcomes.
The study aims to perform a detailed analysis of the existing health financing mechanisms to identify bottlenecks affecting financial accessibility and to provide actionable recommendations for stakeholders.
The study utilizes a literature review and a desk study, analyzing secondary data from the National Health Account, National Family Health Survey, and relevant policy reports, guided by the OASIS analytical framework.
The main section evaluates health financing functions—specifically resource collection, pooling, and purchasing—through the lens of India's current economic status, regulatory framework, and healthcare infrastructure performance.
The work characterizes the Indian health context using terms such as out-of-pocket payments, health equity, health insurance fragmentation, and fiscal space for health, all critical to understanding the current healthcare burden.
The OASIS framework is used as a diagnostic tool to systematically identify the strengths and weaknesses of health financing functions, with a specific focus on achieving financial accessibility as a gateway to universal health coverage.
The author identifies that while schemes like RSBY aim to cover the poor, they suffer from issues such as corruption, voluntary enrollment limitations, and fragmented service coverage, which reduce their overall impact on providing financial protection.
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