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A key focus
of the Institute’s work in the area of financing has been on
financial protection schemes for the poor.
The Institute has carried out a number of studies to
estimate quantum and contribution of different sources of funds
for meeting health expenditure by people living below poverty
line, to generate an evidence base for policy. Currently the
Institute is carrying out a WHO funded study
for Government of India in three states- Orissa, MP and
Maharashtra, to plan for financial protection of the poor under
the NRHM. The study is based on primary surveys of clients of
public hospitals (PHCs, secondary hospitals and medical colleges)
and in-depth interviews of health managers, doctors and
pharmacists. The study seeks to understand the basis for consumers
incurring out of pocket expenditure on drugs, consumables and
investigations for outpatient and in-patient care in public
facilities; to study and document the nature of ailments for which
consumers incur out of pocket expenditure; and to assess and
estimate the quantum of expenditure incurred by consumers visiting
public health care facilities across different levels of care.
As part of
support to health sector reforms in
West Bengal
funded by the Indo-German Basic Health Project,
the Institute has carried out a comparative study of health
financing in developed countries that drew lessons on relevance of
European social health insurance schemes to the Indian context.
With support from the Madhya Pradesh Health department and the
Ratlam District Administration, the Institute documented the
Swablamby Swasthya Yojana (SSY) experience in Ratlam District. The
SSY, a community based health insurance experiment was launched by
the then Ratlam District Administration to find a solution for
petitions from the poor and needy seeking assistance for treatment
of serious illness. The scheme helps covered families access
government hospital services for effective treatment, by providing
drugs and therapeutics not available in the hospital. The key
distinguishing feature of the scheme is its spontaneous appearance
through the efforts of a creative district administration to meet
a felt need of people.
The Institute
was commissioned by the Ministry of Health and Family Welfare
to develop community health insurance based family health
protection plans for consideration by the government of
India
. A benefit package which included comprehensive ambulatory
primary care and access to first referral hospital services has
been developed by the Institute. The plans would mostly use
private clinics for the ambulatory care and public or nonprofit
providers for hospital services. Minimum quality of service
standard was recommended for clinics. The plans will provide
better access to public hospitals and help improve their
utilization. Nonprofit mutual health organizations are envisaged
to underwrite the health care coverage risk and administer the
plans. An income line for health and housing higher than the
poverty line has been recommended, for purposes of administration
of state financing of health insurance coverage to families.
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