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Governing healthcare in India: a policy capacity perspective

Governing healthcare in India: a policy capacity perspective After decades of neglect, in 2008, the Indian government launched a national health insurance programme to address the needs of the bulk of the population that could not afford healthcare. This was followed by the launch of another national programme in 2018 that further expanded insurance coverage. These schemes envision a large single-payer, insurance-based system covering about 110 million families. The central objective of this article is to assess the government’s capacity to implement these ambitious programmes. We employ the policy capacity framework developed by Wu et al. to examine the types of capacities needed to achieve desired objectives in the health sector. The central argument of the article is that there are critical capacity deficits, especially along operational dimensions. Our conclusions are generalisable to other middle-income countries currently in the process of implementing similar prospective-payment health policy reforms.Points for practitionersThis article highlights the need for governments to prioritise the capacity for implementing health policy reforms. Efforts to achieve and sustain universal healthcare are contingent not only on appropriate policy design, mobilising required resources and building political support, but also on overcoming capacity deficits in implementation. The framework presented in this article serves as a useful tool for governments to diagnose strengths and weaknesses in the specific types of capacities (analytical, operational, and political) needed for universal health coverage. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png International Review of Administrative Sciences SAGE

Governing healthcare in India: a policy capacity perspective

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References (66)

Publisher
SAGE
Copyright
© The Author(s) 2021
ISSN
0020-8523
eISSN
1461-7226
DOI
10.1177/00208523211001499
Publisher site
See Article on Publisher Site

Abstract

After decades of neglect, in 2008, the Indian government launched a national health insurance programme to address the needs of the bulk of the population that could not afford healthcare. This was followed by the launch of another national programme in 2018 that further expanded insurance coverage. These schemes envision a large single-payer, insurance-based system covering about 110 million families. The central objective of this article is to assess the government’s capacity to implement these ambitious programmes. We employ the policy capacity framework developed by Wu et al. to examine the types of capacities needed to achieve desired objectives in the health sector. The central argument of the article is that there are critical capacity deficits, especially along operational dimensions. Our conclusions are generalisable to other middle-income countries currently in the process of implementing similar prospective-payment health policy reforms.Points for practitionersThis article highlights the need for governments to prioritise the capacity for implementing health policy reforms. Efforts to achieve and sustain universal healthcare are contingent not only on appropriate policy design, mobilising required resources and building political support, but also on overcoming capacity deficits in implementation. The framework presented in this article serves as a useful tool for governments to diagnose strengths and weaknesses in the specific types of capacities (analytical, operational, and political) needed for universal health coverage.

Journal

International Review of Administrative SciencesSAGE

Published: Jun 1, 2021

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