Stewardship

Improving the stewardship of the entire Indian health system by supporting the Government of India’s efforts is necessary for ensuring India’s leadership role in global health. Space for fertile collaboration between stakeholders needs to be found in a win-win relationship.

While planning capacity at the central level is robust, as already indicated, specific work is probably warranted to increase the policy-making and planning capacity of some states. Emphasis will be placed on implementation and the operational translation of ideas into action. Inter-state exchange of experience with the aim of setting up effective Health Strategy and Planning, Health System Innovation Units or the like will be fostered on a voluntary basis.

Another important step in better articulating the respective roles of the Union and of states, and of the public and private segments is the 2010 “Clinical Establishments Act” and subsequent legislation which empowers authorities to require mandatory enlisting and supervision of public and private sector institutions, supported by an effective health-care quality inspectorate. Creation, management and dissemination of an electronic inventory of enlisted clinical establishments; development of standard treatment guidelines and protocols; and normative instruments for the effective implementation of the Act would be facilitated.

Improved health information/intelligence for decision-making supported by better epidemiological surveillance and policy analysis also plays a role here. WHO will support the use of internationally gained experience in measuring health systems performance, as part of a broader effort to strengthen evidence-to-policy links.

Facilitating the inclusion of national centres of expertise into a global compendium of national expertise, conducting research on emerging infections and strengthening research capacity especially in clinical trials, health economics, health financing, infectious disease modelling and other critical challenge areas is also important, as is disseminating best practices (“What works at the scale of this country?”).

Increasing the involvement of the private sector in information systems will be an option, as already seen in other countries. In fact, private business activity in India often reaches world-class levels and now the government has a crucial role in ensuring the contribution of corporations to protect the broader social good. Clearer indications are needed about where investments in infrastructure are indispensable, where acute care and chronic disease programmes against both CDs and NCDs are most needed, where human capital in the health field should learn from successful business practices, and so on. Signals abound that the vibrant private sector is willing to contribute to improving population health, be it through donations, partnerships, targeted private funding from business leaders and philanthropists or similar arrangements as attested by Pulse polio and several P-P-P (Public-Private-Partnership) projects.