Regulating India's health services: To what end? What future?

David Peters, V. R. Muraleedharan

Research output: Contribution to journalArticle

Abstract

India has a comprehensive legal and regulatory framework and large public health delivery system which are disconnected from the realities of health care delivery and financing for most Indians. In reviewing the current bureaucratic approach to regulation, we find an extensive set of rules and procedures, though we argue it has failed in three critical ways, namely to (1) protect the interests of vulnerable groups; (2) demonstrate how health financing meets the public interests; (3) generate the trust of providers and the public. The paper reviews the state of alternative approaches to regulation of health services in India, using consumer and market based approaches, as well as multi-actor and collaborative approaches. We argue that poor regulation is a symptom of poor governance and that simply creating and enforcing the rules will continue to have limited effects. Rather than advocate for better implementation and expansion of the current bureaucratic approach, where Ministries of Health focus on their roles as inspectorate and provider, we propose that India's future health system is more likely to achieve its goals through greater attention to consumer and other market oriented approaches, and through collaborative mechanisms that enhance accountability. Civil society organizations, the media, and provider organizations can play more active parts in disclosing and using information on the use of health resources and the performance of public and private providers. The overview of the health sector would be more effective, if Indian Ministries of Health were to actively facilitate participation of these key stakeholders and the use of information.

Original languageEnglish (US)
Pages (from-to)2133-2144
Number of pages12
JournalSocial Science and Medicine
Volume66
Issue number10
DOIs
StatePublished - May 2008

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health services
Health Services
India
health service
Healthcare Financing
Health
health
Organizations
regulation
Public Opinion
ministry
Health Resources
Social Responsibility
market
regulatory framework
Public Health
accountability
public interest
civil society
Delivery of Health Care

Keywords

  • Consumer protection
  • Health financing
  • Health services
  • India
  • Regulation

ASJC Scopus subject areas

  • Economics and Econometrics
  • Public Health, Environmental and Occupational Health
  • Social Psychology
  • Development
  • Health(social science)

Cite this

Regulating India's health services : To what end? What future? / Peters, David; Muraleedharan, V. R.

In: Social Science and Medicine, Vol. 66, No. 10, 05.2008, p. 2133-2144.

Research output: Contribution to journalArticle

Peters, David ; Muraleedharan, V. R. / Regulating India's health services : To what end? What future?. In: Social Science and Medicine. 2008 ; Vol. 66, No. 10. pp. 2133-2144.
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