Performance of community health insurance in India: findings from empirical studies

Contemporary Universal Health Coverage in India - The Case of Federal State of Odisha (Orissa)

Purpose

The present study assessed the awareness of the public about Biju Swasthya Kalyan Yojana (BSKY), which is a flagship public-funded health insurance scheme of the Government of Odisha. The study also identified its determinants and examined utilisation of the scheme among households in Khordha district of Odisha.

Materials and Methods

Primary data were collected from randomly chosen 150 households using a pretested structured questionnaire from Balipatana block of Khordha district, Odisha. Descriptive statistics and binomial logistic regression were used to substantiate the objectives.

Results

The study found that even though 56.70% of the sample households had heard about BSKY, procedure-specific awareness was low. State government organised BSKY health insurance camp was found to be a major source of knowledge among the sample. The regression model had an R² of 0.414. The Chi² value showed that the model with predictor variables was a good fit. Caste, gender, economic category, health insurance, and awareness about insurance were significant determinants of BSKY awareness. A majority (79.30%) of the sample had the scheme card with them. However, only 12.60% of the cardholders used the card and only 10.67% received benefits. Mean out-of-pocket expenditure (OOPE) faced by the beneficiaries is Rs. 15743.59. Among the beneficiaries, 53.80% financed the OOPE from their savings, 38.50% by borrowing, and 7.70% financed the OOPE by both means.

Conclusion

The study found that even though majority of people had heard about BSKY, they were not aware of its nature, features, and operational procedures. The trend of low benefit received and higher OOPE among the scheme beneficiaries hampers the economic health of the poor. Finally, the study highlighted the need to increase the magnitude of scheme coverage and administrative efficiency.

Engagement of non-governmental organisations in moving towards universal health coverage: a scoping review

BACKGROUND

Developing essential health services through non-governmental organisations (NGOs) is an important strategy for progressing towards Universal Health Coverage (UHC), especially in low- and middle-income countries. It is crucial to understand NGOs' role in reaching UHC and the best way to engage them.

OBJECTIVE

This study reviewed the role of NGOs and their engagement strategies in progress toward UHC.

METHOD

We systematically reviewed studies from five databases (PubMed, Web of Science (ISI), ProQuest, EMBASE and Scopus) that investigated NGOs interventions in public health-related activities. The quality of the selected studies was assessed using the mixed methods appraisal tool. PRISMA reporting guidelines were followed.

FINDINGS

Seventy-eight studies met the eligibility criteria. NGOs main activities related to service and population coverage and used different strategies to progress towards UHC. To ensure services coverage, NGOs provided adequate and competent human resources, necessary health equipment and facilities, and provided public health and health care services strategies. To achieve population coverage, they provided services to vulnerable groups through community participation. Most studies were conducted in middle-income countries. Overall, the quality of the reported evidence was good. The main funding sources of NGOs were self-financing and grants from the government, international organisations, and donors.

CONCLUSION

NGOs can play a significant role in the country's progress towards UHC along with the government and other key health players. The government should use strategies and interventions in supporting NGOs, accelerating their movement toward UHC.

Indian medical graduates in New Zealand: does anyone win?

Medical migration has become a global phenomenon, partly led by easier air travel, economic factors and the expansion of medical technology. New Zealand has gradually evolved from being 'bicultural' to a multicultural, multitextured society. The movement of the Indian people, particularly Indian physicians, will be the focus of this paper. In the last three decades, migration eligibility in New Zealand has changed from countries of origin or ability to speak English, to profession and skills. Despite struggling with its own issues, New Zealand has proven to be a preferred destination for Indian medical graduates (IMGs). India is widely recognised as the largest 'donor country' for doctors, many of whom go on to establish themselves as leaders and prominent figures in their field. This migration involves three parties: India as a donor country, New Zealand as a recipient country and IMGs as the drivers of this process. Factors behind this growing phenomenon are examined and recommendations are made so that all three parties can benefit from it.