Identifying Health Care Challenges in Odisha, India
Professor William C. Hsiao, Senior Faculty Scholar at the Global Health Education and Learning Incubator.
India has made significant progress improving health over the past twenty years due to a number of national- and state-level health care reforms. However, poorer states, like the state of Odisha in eastern India, continue to lag behind. In a recent article in the journal Health Systems & Reform, researchers from the India Health System Project at the Harvard T.H. Chan School of Public Health examine Odisha’s health system, including improvements from previous benchmarks, current challenges, and areas that can be targeted for reform.
Professor William C. Hsiao, Senior Faculty Scholar at the Global Health Education and Learning Incubator and K.T. Li Research Professor of Economics at the Harvard Chan School, was a coauthor on the study. Hsiao specializes in studying universal health insurance and health system reform, including sustainable financing to provide health care for poor and rural populations.
The article examines the results of 10 different surveys to obtain a comprehensive view of Odisha’s health system from the perspectives of households, patients, and providers. The study uses the Control Knob Framework to analyze how five “control knobs” in different policy areas influence three intermediate goals (access, quality, and efficiency) and three final goals (health status, financial risk protection, and citizen satisfaction).
The authors identified three key challenges in Odisha’s health system for targeted reform: poor financial risk protection, poor quality of care, and low citizen satisfaction. In their discussion, the authors highlighted several potential reasons behind these challenges, including how government insurance fails to cover outpatient and private pharmacy costs, how inadequately trained providers consistently fail to correctly diagnose and appropriately treat common ailments, and how poor, rural, or socially vulnerable groups often face inequities in services.
The authors believe that comprehensive examination of Odisha’s health system will help inform policymakers designing health care reforms in Odisha and other Indian states.
For more resources, explore our resource pack on Health Systems and Universal Health Coverage.