K. V. Ramani and Dileep Mavalankar
Health and Socio-economic developments are so closely intertwined that is impossible to achieve one without the other. While the economic development in India has been gaining momentum over the last decade, our health system is at crossroads today. Even though Government initiatives in public health have recorded some noteworthy successes over time, the Indian health system is ranked 118 among 191 WHO member countries on overall health performance. Building Health Systems that are responsive to community needs, particularly for the poor, requires politically difficult and administratively demanding choices. Health is a priority goal in its own right, as well as a central input into economic development and poverty reduction. Health sector is complex with multiple goals, multiple products, and different beneficiaries. India is well placed now to develop a uniquely Indian set of health sector reforms to enable the health system in meeting the increasing expectations of its users and staff. Managerial challenges are many to ensure availability, access, affordability, and equity in delivering health services to meet the community needs efficiently and effectively. In this working paper, we describe the status of our health system, discuss critical areas of management concerns, suggest a few health sector reform measures, and conclude by identifying the roles and responsibilities of various stakeholders for building health systems that are responsive to the community needs, particularly for the poor.
