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Introduction: The healthcare delivery system of Assam faces several challenges to provide affordable, accessible and quality care services. GNRC (Guwahati Neurological Research Center) is the first super-speciality hospital to address many of these gaps by delivering integrated affordable healthcare services to the populations of Assam and other parts of North-eastern India. Description & Discussion: This paper describes the implementation of a care delivery model which provides integrated care delivery services through linking hospitals to primary healthcare services, including preventive, promotive, and curative care, along with delivering easily accessible and affordable care to the people of Assam and other parts of North-eastern India. Conclusion: The proposed model is the first innovative approach from Northeastern India, Assam, to deliver affordable, accessible and patient-centric hospital led community-based preventive, promotive, and primary, secondary, and tertiary hospital-based care. It is anticipated that GNRC's "Affordable Health Mission" will help redesign and integrate the way primary, secondary and tertiary healthcare is delivered to the population of Assam in helping patients manage their own health and reduce the numbers that needs to be admitted to secondary care and tertiary care by improving patients' independence and well-being as well as dramatically reducing the cost to the overall health system. [ABSTRACT FROM AUTHOR]

Quality health care is the essential need for all the citizens of the country. It forms the basis for equitable and sustainable economic development. India has made significant progress in basic health care over the past few decades. However, still most people do not have access to essential health care services. Health insurance is very important for every citizen, especially in India, where there is a large rural population. As everyone cannot afford private Health insurance coverage, so government must take initiatives to provide health insurance coverage to poor people. Government of India has been taking initiatives to provide financial assistance for health care costs for vulnerable and needy families. Rastriya Swasthya Bima Yojana (RSBY) was launched in the year 2008, but was not very successful. Prime Recently, Ayushman Bharat Jana Arogya Yojana (PMJAY) was launched on 23rd September 2018. It provides health insurance cover of Rs. 5 lakhs per year, per family for secondary and tertiary care hospitalization to more than 10.74 crore poor and vulnerable families. Ayushman Bharat PMJAY card holders can claim cashless services at all the empanelled hospitals or at the private hospitals (approximately 20,000 plus) those have registered to offer PMJAY. The total number of Ayushman Bharat Cards issued till 21st March 2022 are 17,86,97,235 and Hospital admissions under PMJAY as of 21st March 2022 since launch are 3,11,27,750. Ayushman Bharat PMJAY has shown a good progress since its launch. It is a successful health insurance scheme till now. This paper studies about reasons of perceived failure of Rastriya Swasthya Bima Yojana (RSBY), Introduction of Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PMJAY), its features, coverages and benefits, the factors behind the success of Ayushman Bharat PMJAY scheme, its challenges and about the future of the scheme. [ABSTRACT FROM AUTHOR]

Background: More than half of the people with Tuberculosis (TB) symptoms in India seek care from the private sector. People with TB getting treatment from private sector in India are considered to be at a higher risk for receiving suboptimal quality of care in terms of incorrect diagnosis and treatment, lack of treatment adherence support with a high loss to follow-up rate that could eventually increase their risk of drug resistance. The current study aims at documenting the approach and efforts taken by the Kerala state to partner with the private health care delivery providers for ensuring quality TB care to the people with presumed TB reaching them. Methods: A case study approach was adopted with review of all available literature followed by five Key Informant Interviews to understand the case through a primary descriptive exploration. Grounded theory approach was used to generating the single theory of the case itself that explains it. Results: Kerala state has taken a variety of interventions to ensure universal access to TB care for citizens reaching the private sector with documented improvement in the quality of TB care. Key learnings from these initiatives were (i) patients need to be at the centre of partnerships, (ii) good governance is essential for ensuring Universal Health Coverage in a mixed health system, (iii) data intelligence is required to guide partnerships, (iv) identification of the correct 'problems' is crucial for effective design of partnerships and (v) a platform for meaningful dialogue of key stakeholders is needed. Conclusion: Kerala experience demonstrated that if governments take a proactive role in engaging the private sector, in an informed and evidence-based way, they can leverage the advantages of the private sector while protecting the public health interest. [ABSTRACT FROM AUTHOR]

India is currently experiencing a demographic and epidemiological transition characterized by an aging population and an increase in chronic diseases, resulting in a greater demand for home healthcare services. Despite the critical nature and expansion of this area, home healthcare delivery in India remains under-researched. There is a dearth of information about the services, providers and organizations that offer services at home. There are various concerns in the provision of home healthcare services. These relate to accessibility and availability, information on providers, regulatory issues, standards of care, costs, safety concerns, and grievance redressal mechanisms for providers and users, which are among the topics discussed in this article. The article concludes that there is a need to recognize the "home" as a place for providing healthcare and as a "workplace" of care providers, develop standardized processes and guidelines for delivering care for different conditions at home, adopt standard human resource practices in deployment of care providers, bring transparency in the calculation of the cost of services and regulation of costs, and establish grievance redressal mechanisms for users, providers, and organizations. Further research is recommended on aspects such as user and provider perspective, training and supervision of providers, and financing, accreditation, and quality of services. [ABSTRACT FROM AUTHOR]

Instead of diminishing with the spectacular advancement of medical expertise in the country , unqualified biomedical practice in India has been strengthened by the growth of the pharmaceutical production in the twenty first century. In public health discourse, the view that the informal health practitioners have to be punished and abolished has been countered by the recommendation that they could be trained and incorporated in primary health care where public health amenities are inadequate. The quality of care provided by the informal health care practitioners has also been subject to clinical assessment based on standardized patient vignettes. Based on a sociological approach, this paper examines the time line of chronically ill patients under lived conditions to arrive at an understanding of the role of informal health practitioners in long term treatment and highlights the setbacks. This paper draws on 253 household surveys from two villages in Madhya Pradesh, in depth interviews with four unqualified practitioners in the area, twenty five unstructured interviews of chronic patients, twenty five structured interviews on the cases of untimely death and FGDs with health workers in 2021. Informal health care practitioners offer consultation cum dispensing of medicines and are the primary source of biomedical care in the remote study area without any public transport. But they are 'for profit' economic actors who are ill-equipped to handle chronic diseases. What sets them aside from the qualified private doctors in the town is their social obligation to balance their profit motive with the ethics of proximity and neighborly ties with the villagers amidst whom they reside. These features of the market and community place the informal health care practitioners at the cusp of economy and society and defy simple binaries that they are either crooks or assets. • Unqualified health practitioners provide medical care in India where none is available. • Assessing their practices, clientele and exact role is crucial to health care policy. • One point standardized patient vignettes are used to assess their quality of care. • Their treatment of chronically and severely ill patients over time also has to be examined. • They are 'for profit' economic actors, but embedded in the community. [ABSTRACT FROM AUTHOR]

World Health Organisation (WHO) defines quality care as "the extent to which health care services provided to individuals and patient populations improve desired health outcomes. In order to achieve this, health care must be safe, effective, timely, efficient, equitable and people-centred." Quality of care ensures the patient's right to assess quality health services. Health facilities often struggle to provide quality care. Improving quality of care is therefore critical if we want to reduce patient mortality. Healthcare industry can benefit greatly from Total quality management (TQM). Healthcare industry in general, and the hospital sector in particular, is going through a paradigm shift in the way total quality management (TQM) concepts are being implemented. Unlike in the past, where quality was defined from the perspective of healthcare providers, patient satisfaction has now become the central theme for every quality improvement initiative. The design, measure, improve, control (DMAIC) methodology of six sigma technique is an excellent tool for bringing in patient centric quality consciousness in the healthcare organizations.¹ The present study was undertaken to understand the gaps in service delivery related to six processes of healthcare delivery system in a tertiary care hospital of Haryana. An in depth analysis was done with the help of DMAIC methodology.2,3 The gaps in patient discharge process, call management system, ambulance management system, medical records management, patient feedback analysis, and hospital infection control system were identified, and policy recommendations for quality improvement were suggested. [ABSTRACT FROM AUTHOR]

Surgicaltraining programs across the globe have the responsibility of preparing the future generation of surgeons while promoting quality and patient safety. Surgical training differs significantly between countries, which can be based on the requirements of local accrediting bodies, different patient populations, different healthcare delivery systems and cultural and traditional patterns unique to that particular training environment. In this article, we reviewed General surgery residency training in the USA, UK, and India to identify strengths and challenges. We also highlighted salient aspects of training, including duration of the training, resident work-hours, operative opportunities, rotation and supervision, essential skill development, research activity, assessment, and regulation. [ABSTRACT FROM AUTHOR]

This article examines the political economy of health inequalities and inequities in the public health care system in India and identifies potential areas for interventions to promote equal and equitable health care for marginalized people. Drawing on the Political Economy of Health Model of Research, this article reiterates the inadequacy of policy frameworks and programs in ensuring accessible, affordable, and quality public health care services to all. We argue that for policies to be successful, policymakers should consider the diverse social registries of class, caste, religion, gender, region, ethnicity, and age, as well as their intersections. We also argue that health care policies and programs need to be: (a) dynamic and flexible, (b) intersectional and backed up by sufficient grassroots research, and (c) equitable at every stage of policy formulation, implementation, and evaluation. [ABSTRACT FROM AUTHOR]