Innovations in Delivery Platforms: A Case study of Indian Health Care Reform

Arijita Dutta, University of Calcutta, India

In tune with the global policy matrix, India introduced innovations in delivery platforms in health care in 2004-05 with launching of Performance Based Finance (PBF) to front line health workers. On the demand side incentives of conditional cash transfers were offered to women for enhanced utilization of maternal and child care. This innovation in delivery mechanism did help increasing institutional service utilization, like ante natal care, delivery care and immunization rates. However, there is something outside this too. Analysis of data of birth history of 6568 children in West Bengal, an Eastern state of India, clearly portrays increased utilization of some maternal health care services, though some un-incentivized services, like early breastfeeding and use of contraception, have stagnated. Apart from equity concerns regarding spread of the service utilization across different socio-economic strata of society, doubts have arisen about the ultimate improvement of health status among the service users. Bi variate probit regression posits, contrary to common perception and belief, 1000 more deliveries in institutions (instead of home) would result in risk of 6 more infant deaths in post reform era. However, the onus of guilt lies not on institutional delivery per se, rather the problem lies in insufficient scaling up of infrastructure, which could not match the sudden spurt in demand for utilization of services, enhanced by PBF. What the study brings out is that even if an innovation is sound in terms of medical and public health theory, it can fail in delivering the goods if it defies the simple economic logic of supply chain and demand.

About the speaker
Dr Arijita Dutta is an Associate Professor in Economics in Calcutta University. She completed her master’s degree from Jawaharlal Nehru University, New Delhi and PhD from University of Calcutta. Her research interest is Health Economics, quantitative Development Economics and Econometrics. Arijita has a number of publications in National and International Journals to her credit and has completed a number of research projects. She has been closely associated with health policy making of the state of West Bengal and has published a number of policy documents on health care in West Bengal. She has taught in a number of European Universities and is currently visiting UNU Merit, Maastricht.

Venue: Conference Rooom

Date: 24 September 2014

Time: 12:30 - 13:30  CET