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The dream of universal health care demands a much larger and wider approach, engaging not just the public but also the private sector. This paper has attempted mapping the present public-private partnership scenario in India using the WHO health system functions framework, giving an insight into the nature and extent ofchallenge of the present dominant model. A systematic review methodology was adopted to identify published literature on private-public partnership in India. From an initial pool of 785 articles were identifi ed. Finally a total of 29 published articles meeting the inclusion criteria were included. The descriptive framework of Health system functions by WHO (2000), were used to analyze the data. All papers which were considered for the study were segregated based on the 4 prime health system functions: Financing; Management of non-fi nancial inputs; Health service delivery and Oversight. The literature review reveals that more than half of the papers (51.72%) selected for the study were focused on health service delivery functions and quite thin literature were available for other 3 functions, which includes fi nancing, management of non-fi nancial inputs and oversight functions as per WHO. This fi nding raise an important question if the genesis of most of the public-private partnerships is out of the inability of the public sector in reaching out to a particular target group by virtue of its geographical position or diffi culty in working with high risk groups. Considering the limitations of the present model of engagement of private and public sectors, it demands for an alternative model of engagement where the mutual strength that exists with each one of the partners, could be harnessed and complemented. An alternate model is to engage in tri-partite partnership (TPP) between the government, non-government and the corporates. [ABSTRACT FROM AUTHOR]

Public provisioning of quality health care to make available affordable and reliable health services constitutes the focal point of national health programs and policies. Signifi cant progress has been achieved over the decades during the various 5-year plan periods. The present paper discusses the changes achieved in the key areas of health over the XI 5-year plan period and further proposals for important areas under the XII 5-year plans. [ABSTRACT FROM AUTHOR]

Introduction: The state of Chhattisgarh today faces several challenges in improving the health status of its people. The on-going problems of maternal and child mortality, communicable diseases, and HIV/AIDS pandemic still need greater interventions/support from the already overburdened health systems. In addition, the public health challenges include the escalating burden of chronic noncommunicable diseases. Keeping all these things in mind a study was carried out to have an overview of the public health scenario of Chhattisgarh. Aim: This paper aims to review the different public health indicators of Chhattisgarh. Materials and Methods: This study comprised of reviewing different health indicators of Chhattisgarh adopting three different methods during the period March-April 2013. The methods were: (i) extensive online search, (ii) reviewing the related literatures from different journals and other authentic printed materials, and (iii) information collected from public health experts through e-mail, telephone, or direct interaction. Results: Out of 2.55 crore populations in the state (as per Census 2011), 78% lives in rural areas and 37% of the population is tribal. The sex ratio is 968 and the literacy rate is 65.5% in population above 7 years of age. There is a shortage of trained health care providers in Chhattisgarh. The crude birth rate is 23.5 per 1000 (population Annual Health Survey [AHS] 2011-2012). The infant mortality rate is 48 per 1000 live births (SRS 2012). Malnutrition, anemia, sickle cell hemoglobinopathy, Beta thalassemia trait, and G6 PD enzyme defi ciency are very high among the tribes of Chhattisgarh. Malaria has been a major health problem. Chhattisgarh is one of the states with annual parasite index >5 (MRC report). The other states are Rajasthan, Gujarat, Karnataka, Goa, Southern Madhya Pradesh, Jharkhand, Odisha, and Northeastern states. Conclusion: From a public health point of view, most of the health indicators are below national average and unsatisfactory. The human resources gap, poor physical infrastructure, inadequate health education and awareness, poor health-seeking behavior, and inadequate healthcare utilization compound the problem. Indicators related to health and health care delivery are outcomes of research in diverse fi elds other than the department of health. Putting them together and projecting them in a public health view point encourage others to focus on the neglected indicators/areas. However, further research is needed to have a clear database in this regard. [ABSTRACT FROM AUTHOR]

The purpose of this systematic review is firstly to critically appraise and summarize the peer-reviewed published evidence on the relationship between the caste system and risk factors for poor health status in India and secondly, to discuss the concept of the social gradient and policies that have been developed to address social inequalities of healthcare in India. Studies explored the relationship between caste membership and health-related risk factors such as mortality, health behaviors, and nutritional status. Review revealed odds of mortality; poor health behaviors and poor nutritional status were higher and in some cases were significantly higher in lower caste groups in comparison to reference groups. Odds ratios reported for mortality and poor health behaviors were significantly higher in older populations. Odds ratios reported for nutritional status and mortality were significantly higher in younger populations. Further research on the independent effects of wealth and education would broaden the scope of the social gradient health equation in India. [ABSTRACT FROM AUTHOR]

Background: Quality of care is central to current efforts under National Rural Health Mission (NRHM) in India to sustain gains in utilization of institutional maternal and newborn care. For effective planning around institutionalizing quality improvement systems, it is important to critically evaluate India's maternal health policy and services in historical perspective. Objectives: The narrative review was conducted (i) to trace the evolution of concern with quality in maternal health in the context of health system development in India from independence (1947) to the present; and (ii) identify quality-related issues and areas for further action to improve maternal and infant survival outcomes. Materials and Methods: Peer reviewed scientifi c publications were identifi ed through systematic searches of scientifi c databases, grey literature and policy documents. Altogether 174 documents were reviewed. Prospectively designed forms extracted data on (i) health system and quality development; (ii) service performance; (iii) health and safe delivery outcomes. Results: In the fi rst four decades after independence, concerns with infrastructure expansion and vertical disease eradication programmes neglected quality of maternal healthcare in India. With growing concern for quality, strategies addressing this were incorporated in NRHM launched in 2005, including public health standards and quality assurance system in reproductive and child health services. Conclusion: Focus on quality in maternal health in India has increased in recent years, especially under NRHM, and this has helped accelerate progress in maternal and neonatal outcomes. Further action areas include the need to increase funding, match rising demand with quality services and enhance functioning of quality assurance system. [ABSTRACT FROM AUTHOR]

Introduction: The International Diabetes Federation (IDF) showed that nearly 7 crore people in India were suffering from diabetes in 2015 and this number is projected to be 12.5 crore by 2040. India's economic boom has been accompanied by a dramatic upsurge of diabetes. Globalization of unhealthy lifestyles are closing the gap between urban and rural diabetes. So it has become important to estimate the diabetes prevalence and risk factors in rural Agra, India where no community based data was available. Material and Methods: This community based cross-sectional study was carried out in rural Agra from June 2013 to 2014. The sample size was calculated to 1209. Data was collected using a structured and pre-tested questionnaire while fasting blood glucose measured with the help of Glucocard - Vital Glucometer. The data was compiled and statistically analyzed using SPSS-22 software. Results: The prevalence of Diabetes Mellitus in rural Agra was found to be 7% with a diagnostic gap of 37%. Prevalence of Diabetes was observed significantly associated with the age, occupation and socioeconomic status. Prevalence of Diabetes Mellitus was significantly more in people with higher Body mass index (13.3%), centrally obesity (10.3%) and higher Waist Hip Ratio (8.4%) than with normal BMI (4.4%), non-obese (4.2%) and normal WHR category (1.6%). On multiple logistic regression age, hypertension, BMI and WHR contribute as risk factors for developing Diabetes mellitus. Conclusion: As evident from findings diabetes is becoming common in rural population also, adding to the problem is poor awareness. Health care systems should be strengthened for early detection and effective treatment of disease. [ABSTRACT FROM AUTHOR]

Background: In the pluralistic environment of Indian healthcare financing system, community based health insurance (CBHI) holds promise to reduce the share of out of pocket (OOP) expenditure on healthcare by the households. The present study explores the extent to which the mutual model of CBHI could reach the socially and economically marginalized population along with investigating the reasons of drop-outs from the scheme in the city of Mumbai and Pune. Methods: This study used a cross sectional exploratory study method, using simple random method, conducted in slums of Mumbai and Pune. Results: The financial protection provided through health mutual fund (HMF) is still on the lower side when compared with annual OOP expenditure due to health by the household. The enrolment pattern shows that the scheme covers the marginalized people belonging to lower castes and minority community, employed in the unorganized sector. HMF is playing an important role in providing financial protection against the high frequency illness which is not covered under state sponsored schemes. Conclusion: Factors behind the members dropping out of the scheme were found to be no benefit from the scheme, inability to pay a premium, member of Employees State Insurance Scheme, unsatisfactory services from network provider and past negative experiences including claim rejection or low reimbursement. The study holds larger policy implications as there is limited study conducted to know the pattern of enrolment and exploring reasons of low rates of renewals. [ABSTRACT FROM AUTHOR]