Determinants of primary healthcare in India an interstate analysis

Abstract

The state of being healthy is not only an impo1tant aspect of human development but also an indicator of economic progress. Improving the health status of the society as whole requires ensuring that each and every individual has adequate access to healthcare. In this context the present thesis attempts to identify the determinants of primary healthcare in India with a focus on healthcare pro isioning and status of health indicators among the states. The thesis attempts an inquiry into level of health status and access amono vulnerable or weaker sections of the Cgt population categorized on social and economic criteria. It also explores the significance of effective healthcare provisioning in context of importance of healthcare among individuals. The thesis also examines the health indicators of the Indian states in context of interstates variations in their performance. Finally, an attempt is made to estin1ate the effort required to scale up the primary healthcare services in the country along with financial implications of the same. The major findings of the thesis include; (i) the population weaker/vulnerable on economic criteria i.e the poorest of poor (POP), are found to be having the worst health status and access as compared to the traditionally assumed vulnerable population in social criteria i.e. SC and ST populations. (ii) The healthcare services in general are found to be income elastic in nature (Ei gt I) as individuals in general tend to spend increase proportion of their income on health. However, among the poorest of poor population healthcare services seem to be a necessity as they end up spending a significant proportion of their income of the san1e. It is, therefore, crucial to ensure effective and affordable health access to the POP population. (iii) The study of health indicators across the Indian states shows that they face significant variations and large performance gaps as compared to the best performer among them. Secondly, the analysis of effectiveness in conversion of indicators reveals.