Health Sector Governance and Reforms in India

The background of India’s health policies, since independence, shows a systematic documentation that envisaged ambitious health governance comprising of the delivery of a public health program by the central government and primary, as well as secondary health care by the state governments. It is therefore surprising to find that none of the ambitions has been realized. The delivery of public health programme today is limited and uncoordinated, whilst primary and especially secondary care is of a poor quality and unaffordable to the bulk of the population. The health care sector has required much more intervention. Recent reforms have made some progress in addressing some of the lacunae but are still handicapped by the pervasive dominance of the private sector which severely limits the choice of policy tools available to the government. An attempt is made to assess India’s health policy reforms and argue that the policy instruments used were inconsistent with the goals it was trying to achieve.