This PhD project will be based at the University of Melbourne with an initial stay of 18-24 months at University of Toronto.
Meaningful and inclusive progress hinges on the availability and access to health for all. The World Health Organisation contends that Universal Health Coverage (UHC) is achieved when “all people and communities can use the promotive, preventive, curative, rehabilitative and palliative health services they need, of sufficient quality to be effective, while also ensuring that the use of these services does not expose the users to financial hardship”. To be able to achieve UHC health systems need to be such that they can deliver truly responsive healthcare to all – particularly to those most vulnerable and marginalised in a society.
Subsidized public healthcare facilities that were originally intended to be a major source of health-related financial risk protection for the poor in India have suffered from low resource allocations over several decades, resulting in low quality of care, rural-urban differentials in healthcare access and high levels of out of pocket spending on private care. One major policy response has been the introduction, by central and state governments of India, of multiple subsidized health insurance programs for inpatient care, often focusing on the poor. The most prominent example of these schemes is the PM-JAY, launched by the central government in 2018; but programs of varying generosity in benefits packages and population eligibility criteria have also been introduced by several state governments in the last two decades.
A systematic assessment of the targeting efficacy of these programs has not yet been undertaken, nor the associated implications for equity explored. The project proposes a comparative assessment of the benefits provided under the programs in different states, the criteria used for determining eligibility, and implementation strategies used. Using a mix of household survey data and qualitative research, the project also intends to take a deep dive into public insurance schemes in two states to assess how program design, implementation and household characteristics influence access to benefits. Of particular interest for this project are poor populations’ access and eligibility to benefits under varying program and eligibility design.
A/Prof Beverley Essue (University of Toronto)