New Publication: Comprehensive Assessment of Health System Performance in Odisha, India

India has recently implemented several major health care reforms at national and state levels, yet the nation continues to face significant challenges in achieving better health system performance. These challenges are particularly daunting in India’s poorer states, like Odisha. The first step toward overcoming these challenges is to understand their root causes. Toward this end, the Harvard T.H. Chan School of Public Health conducted a comprehensive study in Odisha based…

Publication: The relationship between decision-making autonomy and training on facility-level management performance of primary health care facilities in Odisha, India

Background Primary health care quality remains poor in many countries, despite its importance for universal health coverage. Evidence shows that better management of primary health care facilities improves service quality, and that facility managers’ autonomy and training levels can augment their management performance. In India, there is scant research in this area. Research questions include: 1) What is the effect of facility-level autonomy on management performance and is the effect…

Publication: Catastrophic Health Expenditure on Private Sector Pharmaceuticals: A Cross-Sectional Analysis from the State of Odisha, India

Drugs constitute a large component of out of pocket spending on health.

Why does out of pocket expenditure remain high in India? We assess variation in financial risk protection in Odisha, India. Our novel study is the first to investigate the in-depth role of the private sector—especially private chemist shops—in providing outpatient care and also contributing to financial hardship due to healthcare costs. Introduction India has high rates of catastrophic health expenditure (CHE): 16% of Indian households incur CHE. To understand why…

EPW: Evaluating Health Insurance Programmes – An Insurance Cascade Framework

Faculty member Dr. Sebastian Bauhoff published a piece recently in Economic and Political Weekly providing an insurance cascade as a framework to understand and assess bottlenecks in accessing public health insurance in India. An array of bottlenecks has ensured that the numerous health insurance schemes introduced over the years have failed to make any significant dent on the health sector. This article tries to assess these problems by using the…

Working Paper 4: Procurement of Medicines in Sri Lanka: A Case Study

For many decades, the nation of Sri Lanka has been providing for the health of its citizens at a level that exceeds what most other countries with similar economic situations have attained. Among other indicators, Sri Lanka has assured relatively good access to medicines while controlling prices. Sri Lanka spends about 1.6% of GDP on health, with about one-quarter of the total health budget spent on medicines. Its achievements in…

Odisha Health System Assessment: Key Findings

Context Over the past few years, India has introduced several major healthcare reforms like the National Health Mission (NHM), Pradhan Mantri Jan Aarogya Yojana (PMJAY) and the Health and Wellness Center (HWC) Programs, and the recent National Digital Health Mission (NDHM). In addition, India has implemented various state-level initiatives on health financing and healthcare delivery—all seeking to improve the health system’s performance. There have, undoubtedly, been some significant achievements, especially…

Other Research: Women’s Agency

Our team member Jan Cooper has new research to share. Abstract We propose a new method to design a short survey measure of a complex concept such as women’s agency. The approach combines mixed-methods data collection and machine learning. We select the best survey questions based on how strongly correlated they are with a “gold standard” measure of the concept derived from qualitative interviews. In our application, we measure agency…