ISSN (Print) - 0012-9976 | ISSN (Online) - 2349-8846

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Articles by Indira ChakravarthiSubscribe to Indira Chakravarthi

Corporatisation in Private Hospitals Sector in India

Transformation in the Indian private hospitals sector is examined in Maharashtra, employing qualitative interviews, witness seminars, and desk research. Findings point to significant changes: hospitals viewed as businesses to yield profits; adoption of business strategies to ensure financial viability and returns; changes in not-for-profit and small hospitals; and consequences for institutional and medical practice. Policy shifts towards greater private sector involvement in health, industry advocacy, availability of insurance, and patient expectations drive these changes towards corporatisation, which is not just about the growth of corporate hospitals; it entails structural and behavioural changes across the healthcare sector solely favouring economic goals.

COVID-19: Reinforcing the ‘Technical Fix’ and Distorting Public Health in India

The article reflects upon the possible reasons for the feeble response to the second wave of the pandemic and the consequences and limitations of the measures and policies set into motion by the state. It also looks at what lessons can be taken from history to design a feasible, scientific, humane, public health approach. 

 

Public–Private Partnerships in Healthcare

Current evidence points to the mixed performance of public–private partnerships in India and globally. A detailed study of the formulation and performance of specifi c PPPs in the healthcare sector in Bihar, Chhattisgarh and Delhi reveals that PPPs faced challenges similar to the government health system. Though they fi lled a gap in some cases, their long-term implications and sustainability need more serious assessment.

In the Name of Charity

In the context of a renewed interest in the functioning of charitable hospitals in Maharashtra, and the intention of the state charity commissioner to ensure compliance with the Indigent Patient Fund scheme, some related issues have been revisited and suggestions forwarded for modifying the scheme. Attention is drawn towards the misuse of trust hospitals and the consequences of having no ceiling on charges for close to 80% of the beds in these hospitals.

Investing in Health

The publication of “Investing in Health,” the World Bank’s highly influential 1993 World Development Report, has guided structural adjustment policies and health sector reforms in many developing countries. This study looks at how investment in health has since taken place in India with the withdrawal of the state from healthcare, transformation of healthcare into a commodity, and promotion of the private healthcare sector by the state. This has led to an unregulated industry that is aggressively seeking expansion and profits from the provision of healthcare, and attracting investments by global finance capital.

Demand-side Financing and Promotion of Maternal Health

Use of demand-side financing has become increasingly common in maternal healthcare and India has been a leading example with large-scale programmes such as the Janani Suraksha Yojana and Indira Gandhi Matritva Sahyog Yojana. This paper undertakes a systematic review of the evidence to consider how demand-side financing has been used and whether there has been any impact on maternal health service utilisation, maternal health, or other outcomes. The findings suggest that a relatively narrow focus on achieving targets has often overburdened health facilities, while inadequate referral systems and unethical practices present overwhelming barriers for women with obstetric complications. The limited evidence available also suggests that little has been done to challenge the low status of poor women at home and in the health system.

'Defective' Genes, Breast Cancer, and Preventive Mastectomy

In mid-May there appeared an article, "My Medical Choice", by Hollywood actress Angelina Jolie on her decision to minimise her risk of getting breast cancer by having a preventive double mastectomy - removal of both breasts - so that she does not have cancer. She took this decision as her BRCA genes were "faulty", which increased her risk of developing breast and ovarian cancer. She chose to write about this decision so that other women could make informed choices. The question is, did she herself have all the information? How well informed are we all really?

Repression of Workers' Struggles in Chhattisgarh

Contract workers in cement plants in Chhattisgarh, organised under the banner of the Chhattisgarh Mukti Morcha (Mazdoor Karyakarta Committee) and its affiliate union, are demanding regularisation of work, due payment of wages and other basic rights denied by the multinational companies operating in the cement industry.

Ignored Outcomes of Polio Eradication

Much of the so-called problems in the polio eradication programme in India pointed out by Rajib Dasgupta (EPW, 20 June 2009) have been known for years. At the same time, the article is silent about several critical issues. It is necessary to take cognisance of the larger political economy of immunisation instead of deluding ourselves that polio eradication is simply a matter of the "right" vaccine, the "correct" number of doses, etc.

Role of the World Health Organisation

The Alma-Ata Declaration of 1978 on Primary Health Care together with the slogan of Health for All by 2000 AD is considered one of the most significant public health initiatives of the 20th century. The 30th anniversary of the declaration provides an opportune time to revisit its history and arrive at some fresh perspectives. This article examines the role of World Health Organisation in developing countries as a directing and coordinating authority on international health, and in providing impartial, evidence-based technical information.

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