Case study of the Indian for-profit private healthcare sector: Etiological factors for poverty

Abstract

The relationship between private healthcare and poverty has generated debates amongst academics, health economists, public health specialists and policy-makers at national and international level. It is widely acknowledged that out-of-pocket (OOP) for healthcare for private healthcare directly contributes to poverty. Through this study, it has been argued that more than the private healthcare sector itself it is the dynamics surrounding the sector that is responsible for its ill-effects on poverty. A qualitative meta-analysis of secondary data and thematic analysis of primary interview data were undertaken to seek explanations for the relationship between the private healthcare sector and poverty in India. 9 studies were chosen for the qualitative meta-analysis after going through rigorous inclusion/ exclusion criteria. 6 people with long experiences in the Indian Healthcare Sector were chosen to be interviewed over the telephone. Weaknesses in governance resulting in the weakening of the public health sector; lack of regulations and risk-pooling mechanisms in the country are identified as the dynamics behind the impoverishing impacts of the for-profit private healthcare sector. Explanations for the linkages between the different dynamics are discussed. It was found that future policies should be strategically designed to accommodate poverty concerns. Existing insurance schemes need to be re-assessed to ensure better coverage of the 'really' poor people and the actual costs incurred. There is a need for stringent regulations of both public and private healthcare sector. Better political commitment to inform governance is vital to align the activities of the private sector with the wider objective of socio-economic development and poverty alleviation.