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Hard-cover • 2019
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Healthcare for India’s Poor
The Health Insurance Way
About the Book
<div style="font-size: 13px;"> <p>In 2018, the Government of India announced Ayushman Bharat, a flagship initiative for delivery of healthcare services to India’s poor. Ayushman Bharat consists of two major components - the National Health Protection scheme or PMJAY (Pradhan Mantri Jan Arogya Yojana) and Health and Wellness Centers. </p> <p>The National Health Protection Scheme or Pradhan Mantri Jan Arogya Yojna (PM-JAY) is planned as the world’s largest health insurance scheme covering approximately 500 million poor and vulnerable people - about 40% of India’s population. Critical to the success of PM-JAY, however, is the previous experience of Rashtriya Swasthya Bima Yojna (RSBY), a social health Insurance scheme based on a Public Private Partnership (PPP) framework that covered below poverty line families. </p> <p>This book is based on a study of the RSBY aimed at understanding the provision, availability and use of health services under Public-Private Partnership contracts and the factors that influence such services. It intends to share with policy-makers several insights from RSBY that may be useful for other health care schemes for the poor and vulnerable. </p> <p>With the current focus on Universal Health Care as its backdrop, the book focuses on contract design and looks at the incentive structures created by division of roles, responsibilities and relationships within the contracts. It also examines the regulatory and political environment, and the institutional capacity to deliver quality services. </p> <p>In doing so it compares the provision of healthcare services across public and private providers for the insured and uninsured beneficiaries. This is done to understand the accessibility, availability and utilisation patterns of health care services for those below the poverty line.</p> </div>
Praise for this book
Contracting private providers is not so unusual across the world; however it is very unusual to use private insurance intermediaries in an almost entirely publicly financed scheme to provide improved access to health care. In this context, this book sheds valuable light on how the PPP in RSBY was structured, and what its implications were for the availability of hospital services and their use by beneficiaries enrolled in RSBY, and how Ayushman Bharat can build on those experiences.
Prof Anne Mills
Professor of Health Economics and Policy
London School of Hygiene and Tropical Medicine
India took a bold step towards UHC by implementing Ayushman Bharat in 2018. Sonalini’s book carefully examines valuable lessons from RSBY for Ayushman Bharat. These are lessons also for many low and middle income countries moving towards UHC, apropos strategic purchasing, effective financial protection for the poor, coordination between primary care and hospital-based care.
Prof Soonman Kwon
Seoul National University
This book captures the rich experience of the Health Insurance Scheme called Rashtriya Swasthya Bima Yojana (RSBY) which was implemented in several states across India. India’s experiments with social health insurance schemes could emerge as models for delivering sustainable healthcare in low income countries.
Prof C. Rangarajan
Chairman, Madras School of Economics &
Former Governor, Reserve Bank of India
About the Author(s) / Editor(s)
Sonalini Khetrapal is a Social Sector Specialist in the Asian Development Bank in Manila, Philippines.
Sonalini is an Indian National and holds a PhD degree from the Department of Health Economics and Policy, the London School of Hygiene and Tropical Medicine, UK on the provision of health services in a social health Insurance scheme under Public-Private Partnership contracts. An engineering major from Cornell University, She received her post graduate degree from Columbia University, USA, focused on Health Policy and Management.
As part of South Asia department in ADB Manila, Sonalini is currently leading the Health Systems Strengthening Project in Bhutan and is the co-lead for National Urban Health project in India.
Before joining ADB, she worked with the World Bank, Washington where she was engaged in the Basic Health Services Project in Ethiopia and co-led work on the Integration of Health Systems in Bangladesh and Philippines.
She has also worked as the project coordinator for the Bureau of Tobacco Control in the Department of Health and Mental Hygiene, New York, USA.
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