Vikas Bajpai | Jawaharlal Nehru University (original) (raw)
Papers by Vikas Bajpai
Mohan Rao, Prachin Godajkar, Rama Baru, Ramila Bisht, Ritu Priya Mehrotra, Rajib Dasgupta, Sunita... more Mohan Rao, Prachin Godajkar, Rama Baru, Ramila Bisht, Ritu Priya Mehrotra, Rajib Dasgupta, Sunita Reddy and Vikas Bajpai are with the Centre for Social Medicine and Community Health, JNU, Delhi. The corresponding author is Vikas Bajpai (drvikasbajpai@gmail.com). This paper contributes to the debate on the Draft National Health Policy 2015 by analysing and critiquing some of its key recommendations within the prevailing social, economic, and political context of the country. This policy seems to suggest that strategic purchasing of curative health services from both the public and private sectors can enable India to achieve the goal of “universal healthcare.” The draft policy is based on two assumptions. One, policy interventions since the National Health Policy 2002 have been largely successful and two, there is harmony of purpose between public and private healthcare delivery systems which allows the private sector to be used for achieving public health goals. This article argues t...
Food is crucial to ensuring human well being. However, prevalence of widespread hunger and malnut... more Food is crucial to ensuring human well being. However, prevalence of widespread hunger and malnutrition in the world, especially in times when mankind has the capability to feed all the people in the world to enable them to have healthy and productive lives, obliges us to reiterate the public health importance of adequate food for ensuring human well--being. Health is perhaps the best marker of human well--being, and improved health inter--alia is reflected in longevity of human life-put simply, the ability of man to live. Talking of human health, the spectacular technological achievements of modern medical science tend to dwarf every other determinant of health in popular perception. This has tended to undermine the primary importance of food strategies in ensuring human well being. Beginning with McKewon's thesis on the modern rise of population in England and Whales, we rely on other evidence available in literature to establish the primacy of food, over and above medical ...
The health policy in the country seems to be in a limbo. The fate of the Draft National Health Po... more The health policy in the country seems to be in a limbo. The fate of the Draft National Health Policy, 2015 continues to be uncertain as it continues exist in draft stage as yet. Resultantly, there remains much confusion as to the path that the country shall adopt to achieve 'Universal Health Care' (UHC). Viewing this as an opportunity to inform policy making by drawing on the experience of countries that have already made noticeable progress towards achieving UHC, the author has conducted a desk review of the health services system of four such developing countries-Sri Lanka, Thailand, Brazil and Cuba, along with their socioeconomic coordinates and compared it with that of India. Appropriate lessons for India have been drawn from this comparison.
Global Journal of Medicine and Public Health, 2014
Non-availability of doctors willing to serve in rural areas is a big roadblock in making the rura... more Non-availability of doctors willing to serve in rural areas is a big roadblock in making the rural health services fully functional in the country to provide adequate primary and secondary level curative services to the people. Apart from many reasons like the lack of development and facilities in rural and remote areas, the main reason for the doctors' unwillingness to serve in the rural areas seems to be the fact that medical profession has become captive of the elite sections of the society. This coupled with market oriented growth of health care in the country has led to the practice of medicine being viewed as a lucrative career option for the well- to- do sections of the society rather than as a means to fulfill the more laudable social objective of health care. The government of the state of Uttrakhand in India has taken initiative to give some of the best equipped Community Health Centers (CHCs) in the state on PPP (Public Private Partnership) mode in order to provide as...
There are understandable concerns over the state of nutrition of Indians, especially the poor in ... more There are understandable concerns over the state of nutrition of Indians, especially the poor in the wake of declining daily per capita dietary energy consumption. Notwithstanding these, a section of the academia and the governments of the day have tried to explain this as ‘voluntary diversification of diets’ by Indians in favor of high value foods by compromising cereal calories. Such explanations have directly fed into contentions that estimates of malnutrition in the country are a clear overestimate resulting from application of wrong standards. This paper examines the veracity of these claims by placing reliance on established laws of changes in food consumption with changes in material conditions of life to see if the observed changes in India’s case are in accordance with these laws and thereby supportive of the claims made by the government and a section of scholars in this regard. Our investigation shows these claims are myths that are tailored to suite the convenience of th...
Correspondence to ANOOP SARAYA; ansaraya@yahoo.com INTRODUCTION Healthcare services in a country ... more Correspondence to ANOOP SARAYA; ansaraya@yahoo.com INTRODUCTION Healthcare services in a country are influenced by its socioeconomic development as well as political trends. The colonial domination by the British was largely responsible for the modernization of healthcare services in India. This influence remained even after Independence in 1947. Indian society is stratified into classes, castes and social groups based on ethnicity, race and gender. The aspirations of all these groups—often competing for a greater share—shape the developmental processes including healthcare institutions. Though policy-planners seek to reconcile these competing interests, the dominant sections corner the lion’s share of invariably limited resources. This is reflected in the way health resources are utilized and appropriated. Like competing social groups at the national level, unequal power relations exist among nations resulting in unequal distribution of international resources for healthcare. This ...
The National medical journal of India
This study examined the effect of out-of-pocket expenditure of patients on their illness and othe... more This study examined the effect of out-of-pocket expenditure of patients on their illness and other household changes impacting on their well-being, and assessed the socioeconomic status and below poverty line (BPL) card status among patients at the All India Institute of Medical Sciences, New Delhi. We did a hospital-based cross-sectional study of 374 inpatients and outpatients. Among the 374 study subjects, more than 69% of poor did not possess a BPL card. On the other hand, 5.5% of the above poverty line patients among the respondents possessed a BPL card. Of those having BPL cards, 84.4% belonged either to the lower middle, upper lower and lower socioeconomic status categories. Our data suggest that the inaccuracies in providing BPL cards limit access of the genuine poor to healthcare. In the light of national-level surveys on accessing healthcare and out-of-pocket expenditure by patients there is a case against 'targeting' in the delivery of public health services and us...
The National medical journal of India
We aimed to generate evidence on the social and economic impact of out-of-pocket expenses incurre... more We aimed to generate evidence on the social and economic impact of out-of-pocket expenses incurred by households on illness. We did a hospital-based cross-sectional study including a convenience sample of 374 inpatients and outpatients. The median illness expenditure was the same (₹62 500) for inpatients and outpatients. Of all respondents, 51.3% among the rural and 65.5% among the urban patients were employed before illness, but after illness only 24.4% among the rural and 23.4% among the urban patients remained in employment. The proportion of rural households of different socioeconomic categories that experienced decrease in expenditure on food, education and health, and those who had to sell land or cattle, and the education of whose children suffered was statistically significant. The proportion of indebted families in different socioeconomic classes was also statistically significant among both rural and urban patients. The lowest socioeconomic strata depended mostly upon the ...
Journal of Health Management, 2012
The world population recently touched seven billion and as expected, there was an outpouring of c... more The world population recently touched seven billion and as expected, there was an outpouring of concern over how burgeoning population was the biggest stumbling block for our development. There is a well-entrenched notion in the popular perception of the laity and the policy establishment that it is burgeoning population that is the biggest hindrance in the development of the country. This perception has often led to vilification of the people who are the biggest victims of the lack of development. Consequently, there has been an imposition of a population policy that concentrates only on population stabilization through family planning measures. The article builds its argument by tracing the history and ideological roots of the conventional thinking on population policy. It further relies on data regarding historical trends in population growth to establish the close relationship between development phases in human civilization and its population dynamics. Data on the relationship between population growth and availability of resources are also examined. Population policies around much of the world have privileged fertility control measures over the overall socio-economic development. The frustration engendered by such an approach has led to greater adoption of overt and covert coercion to limit population sizes. The article emphasizes the need for a more nuanced population policy. There is a need to broaden the concept of unmet need from that of a narrow techno-centric approach to include the developmental needs of the people.
Economic and Political Weekly, Jan 3, 2014
ISRN Public Health, 2013
Clinical trials industry has seen a phenomenal increase in last ten years or so, and India has em... more Clinical trials industry has seen a phenomenal increase in last ten years or so, and India has emerged as one of the foremost global destinations for clinical trials. Changed intellectual property regimen after WTO has been the prime mover of the phenomenon, and maximizing profits rather than serving any altruistic motives forms the main ideological underpinning of the rise of clinical trial industry in India. The paper examines the ideological underpinnings of the rise of clinical trials industry in the country in detail and how the ruling classes of India have tried to capitalize on this as a great economic opportunity. In the process the interests of India’s poor have been the main casualty.
The National medical journal of India
The National medical journal of India
Despite the importance of healthcare for the well-being of society, there is little public debate... more Despite the importance of healthcare for the well-being of society, there is little public debate in India on issues relating to it. The 'human capital approach' to finance healthcare largely relies on private investment in health, while the 'human development approach' envisages the State as the guarantorof preventive as well as curative care to achieve universalization of healthcare. The prevailing health indices of India and challenges in the field of public health require a human developmentapproach to healthcare. On the eve of independence, India adopted the human development approach, with the report of the Bhore Committee emphasizing the role of the State in the development and provision of healthcare. However, more recently, successive governments have moved towards the human capital approach. Instead of increasing state spending on health and expanding the public health infrastructure, the government has been relying more and more on the private sector. The ...
International Journal of Medicine and Public Health, 2011
International Journal of Medicine and Public Health, 2012
The National medical journal of India
The National medical journal of India
Indian journal of public health
Mohan Rao, Prachin Godajkar, Rama Baru, Ramila Bisht, Ritu Priya Mehrotra, Rajib Dasgupta, Sunita... more Mohan Rao, Prachin Godajkar, Rama Baru, Ramila Bisht, Ritu Priya Mehrotra, Rajib Dasgupta, Sunita Reddy and Vikas Bajpai are with the Centre for Social Medicine and Community Health, JNU, Delhi. The corresponding author is Vikas Bajpai (drvikasbajpai@gmail.com). This paper contributes to the debate on the Draft National Health Policy 2015 by analysing and critiquing some of its key recommendations within the prevailing social, economic, and political context of the country. This policy seems to suggest that strategic purchasing of curative health services from both the public and private sectors can enable India to achieve the goal of “universal healthcare.” The draft policy is based on two assumptions. One, policy interventions since the National Health Policy 2002 have been largely successful and two, there is harmony of purpose between public and private healthcare delivery systems which allows the private sector to be used for achieving public health goals. This article argues t...
Food is crucial to ensuring human well being. However, prevalence of widespread hunger and malnut... more Food is crucial to ensuring human well being. However, prevalence of widespread hunger and malnutrition in the world, especially in times when mankind has the capability to feed all the people in the world to enable them to have healthy and productive lives, obliges us to reiterate the public health importance of adequate food for ensuring human well--being. Health is perhaps the best marker of human well--being, and improved health inter--alia is reflected in longevity of human life-put simply, the ability of man to live. Talking of human health, the spectacular technological achievements of modern medical science tend to dwarf every other determinant of health in popular perception. This has tended to undermine the primary importance of food strategies in ensuring human well being. Beginning with McKewon's thesis on the modern rise of population in England and Whales, we rely on other evidence available in literature to establish the primacy of food, over and above medical ...
The health policy in the country seems to be in a limbo. The fate of the Draft National Health Po... more The health policy in the country seems to be in a limbo. The fate of the Draft National Health Policy, 2015 continues to be uncertain as it continues exist in draft stage as yet. Resultantly, there remains much confusion as to the path that the country shall adopt to achieve 'Universal Health Care' (UHC). Viewing this as an opportunity to inform policy making by drawing on the experience of countries that have already made noticeable progress towards achieving UHC, the author has conducted a desk review of the health services system of four such developing countries-Sri Lanka, Thailand, Brazil and Cuba, along with their socioeconomic coordinates and compared it with that of India. Appropriate lessons for India have been drawn from this comparison.
Global Journal of Medicine and Public Health, 2014
Non-availability of doctors willing to serve in rural areas is a big roadblock in making the rura... more Non-availability of doctors willing to serve in rural areas is a big roadblock in making the rural health services fully functional in the country to provide adequate primary and secondary level curative services to the people. Apart from many reasons like the lack of development and facilities in rural and remote areas, the main reason for the doctors' unwillingness to serve in the rural areas seems to be the fact that medical profession has become captive of the elite sections of the society. This coupled with market oriented growth of health care in the country has led to the practice of medicine being viewed as a lucrative career option for the well- to- do sections of the society rather than as a means to fulfill the more laudable social objective of health care. The government of the state of Uttrakhand in India has taken initiative to give some of the best equipped Community Health Centers (CHCs) in the state on PPP (Public Private Partnership) mode in order to provide as...
There are understandable concerns over the state of nutrition of Indians, especially the poor in ... more There are understandable concerns over the state of nutrition of Indians, especially the poor in the wake of declining daily per capita dietary energy consumption. Notwithstanding these, a section of the academia and the governments of the day have tried to explain this as ‘voluntary diversification of diets’ by Indians in favor of high value foods by compromising cereal calories. Such explanations have directly fed into contentions that estimates of malnutrition in the country are a clear overestimate resulting from application of wrong standards. This paper examines the veracity of these claims by placing reliance on established laws of changes in food consumption with changes in material conditions of life to see if the observed changes in India’s case are in accordance with these laws and thereby supportive of the claims made by the government and a section of scholars in this regard. Our investigation shows these claims are myths that are tailored to suite the convenience of th...
Correspondence to ANOOP SARAYA; ansaraya@yahoo.com INTRODUCTION Healthcare services in a country ... more Correspondence to ANOOP SARAYA; ansaraya@yahoo.com INTRODUCTION Healthcare services in a country are influenced by its socioeconomic development as well as political trends. The colonial domination by the British was largely responsible for the modernization of healthcare services in India. This influence remained even after Independence in 1947. Indian society is stratified into classes, castes and social groups based on ethnicity, race and gender. The aspirations of all these groups—often competing for a greater share—shape the developmental processes including healthcare institutions. Though policy-planners seek to reconcile these competing interests, the dominant sections corner the lion’s share of invariably limited resources. This is reflected in the way health resources are utilized and appropriated. Like competing social groups at the national level, unequal power relations exist among nations resulting in unequal distribution of international resources for healthcare. This ...
The National medical journal of India
This study examined the effect of out-of-pocket expenditure of patients on their illness and othe... more This study examined the effect of out-of-pocket expenditure of patients on their illness and other household changes impacting on their well-being, and assessed the socioeconomic status and below poverty line (BPL) card status among patients at the All India Institute of Medical Sciences, New Delhi. We did a hospital-based cross-sectional study of 374 inpatients and outpatients. Among the 374 study subjects, more than 69% of poor did not possess a BPL card. On the other hand, 5.5% of the above poverty line patients among the respondents possessed a BPL card. Of those having BPL cards, 84.4% belonged either to the lower middle, upper lower and lower socioeconomic status categories. Our data suggest that the inaccuracies in providing BPL cards limit access of the genuine poor to healthcare. In the light of national-level surveys on accessing healthcare and out-of-pocket expenditure by patients there is a case against 'targeting' in the delivery of public health services and us...
The National medical journal of India
We aimed to generate evidence on the social and economic impact of out-of-pocket expenses incurre... more We aimed to generate evidence on the social and economic impact of out-of-pocket expenses incurred by households on illness. We did a hospital-based cross-sectional study including a convenience sample of 374 inpatients and outpatients. The median illness expenditure was the same (₹62 500) for inpatients and outpatients. Of all respondents, 51.3% among the rural and 65.5% among the urban patients were employed before illness, but after illness only 24.4% among the rural and 23.4% among the urban patients remained in employment. The proportion of rural households of different socioeconomic categories that experienced decrease in expenditure on food, education and health, and those who had to sell land or cattle, and the education of whose children suffered was statistically significant. The proportion of indebted families in different socioeconomic classes was also statistically significant among both rural and urban patients. The lowest socioeconomic strata depended mostly upon the ...
Journal of Health Management, 2012
The world population recently touched seven billion and as expected, there was an outpouring of c... more The world population recently touched seven billion and as expected, there was an outpouring of concern over how burgeoning population was the biggest stumbling block for our development. There is a well-entrenched notion in the popular perception of the laity and the policy establishment that it is burgeoning population that is the biggest hindrance in the development of the country. This perception has often led to vilification of the people who are the biggest victims of the lack of development. Consequently, there has been an imposition of a population policy that concentrates only on population stabilization through family planning measures. The article builds its argument by tracing the history and ideological roots of the conventional thinking on population policy. It further relies on data regarding historical trends in population growth to establish the close relationship between development phases in human civilization and its population dynamics. Data on the relationship between population growth and availability of resources are also examined. Population policies around much of the world have privileged fertility control measures over the overall socio-economic development. The frustration engendered by such an approach has led to greater adoption of overt and covert coercion to limit population sizes. The article emphasizes the need for a more nuanced population policy. There is a need to broaden the concept of unmet need from that of a narrow techno-centric approach to include the developmental needs of the people.
Economic and Political Weekly, Jan 3, 2014
ISRN Public Health, 2013
Clinical trials industry has seen a phenomenal increase in last ten years or so, and India has em... more Clinical trials industry has seen a phenomenal increase in last ten years or so, and India has emerged as one of the foremost global destinations for clinical trials. Changed intellectual property regimen after WTO has been the prime mover of the phenomenon, and maximizing profits rather than serving any altruistic motives forms the main ideological underpinning of the rise of clinical trial industry in India. The paper examines the ideological underpinnings of the rise of clinical trials industry in the country in detail and how the ruling classes of India have tried to capitalize on this as a great economic opportunity. In the process the interests of India’s poor have been the main casualty.
The National medical journal of India
The National medical journal of India
Despite the importance of healthcare for the well-being of society, there is little public debate... more Despite the importance of healthcare for the well-being of society, there is little public debate in India on issues relating to it. The 'human capital approach' to finance healthcare largely relies on private investment in health, while the 'human development approach' envisages the State as the guarantorof preventive as well as curative care to achieve universalization of healthcare. The prevailing health indices of India and challenges in the field of public health require a human developmentapproach to healthcare. On the eve of independence, India adopted the human development approach, with the report of the Bhore Committee emphasizing the role of the State in the development and provision of healthcare. However, more recently, successive governments have moved towards the human capital approach. Instead of increasing state spending on health and expanding the public health infrastructure, the government has been relying more and more on the private sector. The ...
International Journal of Medicine and Public Health, 2011
International Journal of Medicine and Public Health, 2012
The National medical journal of India
The National medical journal of India
Indian journal of public health