Sustainability of Rural Health Care and NGOs in India

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Book Code: 1111018491704

Manoj Kar

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ABOUT THE BOOK

Current thinking in public health has moved beyond a mere recognition of biological and behavioural causes of ill-health and disease, to embrace an examination of interdisciplinary approaches between health, health policy and social, economic, environment & political context as determinants of health and health care sustainability. This shift reflects broad and complex analysis of relationship between human development and health holistically. By researching health and social inequalities, community responses and public policies can be better understood and necessary coherent policies can be designed to diminish inequalities and can result in better health care services and health outcomes. This book advocates on greater role for decentralised planning, involvement of People's Representative Institutions (PRIs), effectiveness in cooperative federalism in Centre-State relations and most importantly meaningful partnerships between 'Government and NGOs' as central to community participation and empowerment in Strengthening Health Systems and
Health Care benefits in achieving sustainability of Health Care in Rural India. Sustainability of non-governmental health care is studied in partnerships with their government
counterpart in one of the BIMARU State of Rajasthan. The study highlighted sustainability issues as the central theme of primary health care with the elaboration of case studies of NGOs actively engaged in donor assisted government health systems in the state. For analytical purpose, the overall working environment of NGOs in target community, policy support, management strategy and their capacities are studied. Mode of interdependence has been considered and analysed as implications for NGO-Government partnerships
for sustainability. The book concludes with policy responses for health care programmes to achieve sustainability in the context changing role of new public health in Rural India. This book will be of interest and benefit academic community, social science researchers, policy makers, public health professionals, health care administrators, NGOs, national and international development partners in hastening research issues in achieving 'Health for All' and 'Universal Health Coverage' using Primary Health Care.Current thinking in public health has moved beyond a mere recognition of biological and behavioural causes of ill-health and disease, to embrace an examination of interdisciplinary approaches between health, health policy and social, economic, environment & political context as determinants of health and health care sustainability. This shift reflects broad and complex analysis of relationship between human development and health holistically. By researching health and social inequalities, community responses and public policies can be better understood and necessary coherent policies can be designed to diminish inequalities and can result in better health care services and health outcomes. This book advocates on greater role for decentralised planning, involvement of People's Representative Institutions (PRIs), effectiveness in cooperative federalism in Centre-State relations and most importantly meaningful partnerships between 'Government and NGOs' as central to community participation and empowerment in Strengthening Health Systems and Health Care benefits in achieving sustainability of Health Care in Rural India.

Sustainability of non-governmental health care is studied in partnerships with their government counterpart in one of the BIMARU State of Rajasthan. The study highlighted sustainability issues as the central theme of primary health care with the elaboration of case studies of NGOs actively engaged in donor assisted government health systems in the state. For analytical purpose, the overall working environment of NGOs in target community, policy support, management strategy and their capacities are studied. Mode of interdependence has been considered and analysed as implications for NGO-Government partnerships for sustainability. The book concludes with policy responses for health care programmes to achieve sustainability in the context changing role of new public health in Rural India. This book will be of interest and benefit academic community, social science researchers, policy makers, public health professionals, health care administrators, NGOs, national and international development partners in hastening research issues in achieving 'Health for All' and 'Universal Health Coverage' using Primary Health Care.

ABOUT THE AUTHOR

Presently, Dr. Manoj Kar is a Professor of Public Policy and Health Governance areas in the Indian Institute of Education, Pune. He has been serving in the areas of Health Policy & Strategy Development, Health Education & Training of Health Professionals, NGOs, Rural Poverty Reduction, Malnutrition, Public Heal, HIV/AIDS, Youth Reproductive Rights, Gender issues in Health and Health Systems Development for more than 25 years.

Academically, Prof. Kar has received his M.Phil. and Ph.D. degree in “Public Health – Interdisciplinary” from the Centre for Social Medicine and Community Health, School of Social Science, Jawaharlal Nehru University, New Delhi. Sociology of health, ill-health, tribal health, human rights, health policy, health systems capacity development and research are his areas of academic interest. He has published a number of policy papers and research briefings in national and international journals and edited books. He has been nominated by WHO and recipients of East West Centre, Hawaii, USA Fellowship for 'Health Policy & Population Studies', Executive Development Programme at IIM Bangalore, Conflict Management Systems - USA, ICSSR Doctoral Fellowship and WHO-SEARO recognition for 'Extraordinary Dedication during the Emergency and Rehabilitation' in Gujarat Earthquake are worth mentioning.

He has worked as consultant to many agencies and has been professionally associated with WHOSEARO, UNAIDS-Geneva, WHO-Bangkok (Thailand), East West Centre, Hawaii (USA), UNESCO Bangkok, Indian Institute of Management-Bangalore, Indian Institute of Health Management Research-Jaipur, CARE-India, Save the Children - Australia, Ministries of Health and Family Welfare in New Delhi, Ministry of Health - Solomon Islands, Maldives, Population Foundation of India – New Delhi, Aga Khan Health Services India-Mumbai, Aga Khan Development Network-Istanbul, UNDP-Turkmenistan, UNDPUkraine, ACTIONAID-Nepal, WHO & UNAIDS in India and WHO-SPC in New Caledonia (Pacific) and Global Fund for HIV/AIDS-Geneva.

CONTENTS

Foreword ................................................................................................... 9

Acknowledgements .................................................................................. 11

Abbreviations .......................................................................................... 15

I. Introduction ............................................................................. 21

II. Issues on NGOs in Social Development .................................. 31

III. Sustainability of Development Initiatives .............................. 139

IV. Profile of Health Care and NGO Programmes in Rajasthan ........................................................................... 163

V. Designing and Planning of Present Research ......................... 197

VI. Case Study of NGO Programmes in Health ........................... 211

VII. Analysis & Discussion on Sustainability of Health Care ....... 297

VIII. Lessons Learned and Policy Implications .............................. 333

IX. Way Forward ......................................................................... 359

Bibliography .......................................................................... 367

References.............................................................................. 381

End Notes .............................................................................. 391

Annexures .............................................................................. 397

Index ...................................................................................... 409


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