India’spolitical and public health leadership has led innovative schemes andtranslated the best of those into policy, and made substantial contributionsfor advancing population health.
Since the launch of the National Rural HealthMission in 2005, over 157 thousands personnel have been employed to healthsector. The Infant mortality rate (IMR) has declined from 68 to 42 per 1000live births between 2000 and 2012. The Janani Suraksha Yojana wassuccessful in ensuring delivery of more than 120 to 130 million women ingovernment facilities and more than 600 thousands new-born babies are receivingcare in neonatal care nurseries in district hospitals each year. Polio has beeneliminated from the face of the country.
This is exciting, but not enough. Eachyear, more than 40 million people, mostly in rural areas, are impoverished andrun into massive debts to access healthcare. Non-communicable diseases and injuries account for 52 per cent of deathsin India.
Burden of non-communicable diseases and resultant mortality isexpected to increase. Therefore, India’s healthcare needs radical changes. India’s healthcare challenges and poor healthindicators are widely discussed at various public health forums; but rarelyacknowledged in political discourse. For the first time in the history of Indiaall the main political parties have prioritized healthcare in their manifestos.The current government promised radical reforms in healthcare with “NationalHealth Assurance Mission (NHAM)”. Healthcare must be made a core priority forthe next decade, to enable transformation of the healthcare system, whilepromoting pro-health policies in other sectorsThe government should institutionalize UHC as a way to removebarriers to good health and expand access to quality, affordable care. In theUHC model, all citizens should be entitled to a comprehensive package ofhealthcare services, and have access to public health and accredited privatefacilities for attaining services such as diagnostics, medicine, vaccines orsurgeries as an entitlement, without having to pay at the point of use. Inmost instances, we find that it is political stability rather than politicalcompetition that is associated with improved healthcare service delivery inIndia.
The effect of turnout is mixed i.e. while its impact is positive forsome healthcare measures, it is negative for others. For effective number ofparties, we find a positive association in a majority of the cases which wouldsuggest that a broader distribution of political power has had a favourableimpact on healthcare service delivery. Importantly, these effects areheterogeneous along the conditional healthcare distribution.
Our results arerobust to heteroscedasticity and misspecification bias. We use severalrobustness checks to ensure the validity of our results. The picture that emerges from averaging out over the wholehealthcare distribution is however incomplete since the relationship betweenlocal political economic variables and healthcare provision for regions lyingat one end of the healthcare distribution, say the top quantile, may indeed bequite different from those lying at the bottom quantileIn2006, a group of American researchers led by prof. V. Navarro, have publishedan analysis through which they searched for the connection between politics andpolicies, and then, their connection to healthcare systems in Europe and NorthAmerica, between 1950 – 2000, The conclusion was that countries governed bypolitical parties of egalitarian views have the tendency to implementredistributive policies. The four political traditions were defined as: 1.
Social democratic, 2.Christian-democratic(conservative), 3. Liberal, 4.Conservative-authoritarian (dictatorships).
Thereby, countries governed by social-democratic parties during most of thestudied period, implemented policies favourable to redistribution, universalhealth coverage and social benefits for all the citizens, there were introducedsupporting policies for women health and welfare, such as unemploymentcompensation benefits for single mothers. Countries governed byChristian-democratic parties, were supporting less redistributive policies.Although these countries also promoted health policies with universal coverage,they did not implement family support policies such as homecare or childrencare. Public expenditure was noticeably lower. Countries mostly governed byliberal or conservative liberal parties did not promote universal socialservices, except for universal healthcare, which was promoted in all the abovecountries except for US, with a public expenditure of 24% of GDP for socialservices and of 5.8% of GDP for health. Countries led by dictatorships, had anunderdeveloped welfare state, with weak public transfers and poor publicservices. Average public expenditures were 14% of GDP, with 4.8% of GDP forhealth