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

Articles by Sunil NandrajSubscribe to Sunil Nandraj

India’s Government Health Expenditure as the Ratio to GDP

The appropriateness of the criterion that pegs the ratio of public health expenditure to the gross domestic product—which is volatile—needs a re-examination. The targets for allocation and expenditure of financial resources for health need to be based on indicators that can be monitored.


Reconfiguring Urban Primary Healthcare

The Aam Aadmi Mohalla Clinics of the Delhi government have received national and international attention for their unique public health service delivery design. From April 2016 to March 2017 they delivered over 31 lakh free outpatient consultations at an average cost of `94 per consultation. This paper provides first-hand information and insight into how the clinics were operationalised in terms of infrastructure, human resources, laboratory services, medicines, and technology. It analyses their utilisation, financing, strengths and challenges at the operational, administrative and political level, and discusses how, in low-income settings, urban health systems can be strengthened using this model to expand primary healthcare services.


National Health Accounts Estimates

The National Health Accounts is a global tool that provides a snapshot of the flow of funds in a country’s health system by financing sources, providers of healthcare and healthcare functions. The Indian government’s Ministry of Health and Family Welfare released the NHA estimates for 2013–14 in August 2016 providing details of these expenditures by health financing schemes, providers and functions. This article comments on some of the major advances and gaps in the latest NHA estimation methodology and in the presentation of results.

NSSO 71st Round

A comment on the article "Falling Sick, Paying the Price: NSS 71st Round on Morbidity and Costs of Healthcare" (EPW, 15 August 2015) which suggests that the National Sample Survey Offi ce's 71st round on social consumption of health can be read differently.

Unregulated and Unaccountable: Private Health Providers

The recent tragedy in the super specialty hospital in Kolkata shows that West Bengal Clinical Establishment Act, 1950 was not being effectively enforced and monitored satisfactorily for ensuring the safety of patients. The situation is similar in other states as well. In this context, it is important to review existing state legislations to bring them on par with the Clinical Establishment Act of 2010 with regard to the coverage and standards to be followed.

Accreditation System for Health Facilities

In the context of weak regulatory systems, increasing demand for good quality care from the middle class and the entry of private health insurance companies, there is a need to examine mechanisms such as accreditation for improving the quality of health services.

State of Health Care in Maharashtra-A Comparative Analysis

Health indicators of Maharashtra and Punjab show that they have attained relatively high growth against the background of a high per capita income (PCI) and good economic development while Kerala shows a good development in the health sector in the context of low PCI, low level of industrialisation but relatively good infrastructural indicators. While the first pattern could be attributed to the trickling down effect of capitalist modernisation of the industrial-cum-agrarian variety in Maharashtra and of predominantly agrarian variety in Punjab, the second is rooted in socio-political, geographic and demographic particularities of Kerala. This article looks into the specifics of Maharashtra's development in health in the context of other socioeconomic indicators to examine the relationship between health sector development and capitalist growth.

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