Workstreams

Health financing is one of the key components of any health system. It serves both to enable access to healthcare services and to modify the incentives facing providers and consumers.
Problem
‘In India, most payments are made to individual service providers directly by consumers at the time that they receive the service.
This can result in: (a) poor health outcomes, (b) high exposure to financial risk with more than 5% of the population being forced to go below the poverty line afresh on this account each year, and (c) high levels of inequality.
Aim/Principle
In order to address these problems, the finance workstream expects to focus on developing pathways to address challenges related to the sources and utilization of health expenditures in a durable manner.
Key Questions
With this goal in mind, some issues the workstream intends to investigate include:
- What would be the estimated total funding needed for healthcare in India?
- How can health expenditures be increased from national and state tax-funds?
- How can the performance of government managed pools be improved?
- What is the impact and size of Commercial Health Insurance?
- How can better value from Out-of-Pocket expenditures be derived?
Get Involved
For questions on the workstream and how to get involved, please contact Hasna Ashraf (Hasna.Ashraf@Dvara.com)
Please note that these are preliminary questions that will continue to evolve based on research, input and feedback from various stakeholders. Please feel free to contact us with any suggestions or queries.
Workstream Co-Chair

Tarun Khanna
Jorge Paulo Lemann Professor, Harvard Business School; Director, The Lakshmi Mittal and Family South Asia Institute, Harvard University
Commissioners Involved

Kiran Mazumdar-Shaw
Executive Chairperson, Biocon Ltd.

Sharad Sharma
Co-founder, iSPIRT Foundation

K Sujatha Rao
Former Secretary of Health and Family Welfare, Government of India

K Srinath Reddy
President, Public Health Foundation of India

Yamini Aiyar
President and Chief Executive, Centre for Policy Research

Devi Shetty
Chairman, Narayana Hrudayalaya Limited

Atul Gupta
Assistant Professor, Department of Health Care Management, Wharton School, University of Pennsylvania.
Commission Fellows

Dr. J. Pratheeba
Health Economist at the Population Foundation of India, New Delhi.

Shruti Slaria
Policy Analyst, Swaniti Initiative

Mekhala Krishnamurthy
Associate Professor of Sociology and Anthropology at Ashoka University and a Senior Fellow at the Centre for Policy Research (CPR)

Hasna Ashraf
Research Associate with the Social Protection Initiative at Dvara Research.

Bindu Ananth
Co-founder and Chair of Dvara Trust.

Tejasvi Ravi
Lead, LGTLightstone

Neela Saldanha
Board Member of The Life You Can Save

Vivek U Padvetnaya
Vivek, Doctor

Sandhya Venkateswaran
Public Policy and Advocacy. Former Country Lead for Policy and Strategic Partnerships at the Bill and Melinda Gates foundation

Jyoti Yadav
IRS Officer
The efforts of the Commission will be underpinned by a “Citizens’ Engagement”, an unprecedented attempt to gather insights into the expectations and experiences of healthcare from Indian citizens across gender, age, reproductive stage, geographic location and social groups.
Problem
The major barriers towards achieving universal health coverage (UHC) in India include:
(a) low health coverage and financial protection; (b) inequality in access; (c) inadequate public infrastructure and financing; (d) lack of skilled human resources; and (e) lack of awareness, demand and engagement among citizens about their health entitlements.
Aim/Principle
This workstream hopes to adopt an inclusive, solutions-driven approach to promote citizens’ engagement in improving health outcomes in India and bring together diverse views on the architecture of UHC. It aims to gather the voices of both citizens who use and provide health care services in India.
Key Questions
With this goal in mind, some key issues the workstream intends to address are:
- What has been the experience of beneficiaries in seeking healthcare and how can some of the systemic challenges they face be addressed?
- Who are the different players in the provision of healthcare services? What role can they play in ensuring universal access to health services, adequate financial risk protection, high qualityof healthcare and accountability across different levels?
- What is the role of citizens, community based organizations and service providers (both public and private) in UHC? How can such roles be enabled and enhanced to achieve the objective of UHC?
- What innovative, solutions-driven platforms are available for citizens to engage with healthcare providers? How can these platforms be strengthened?
Get Involved
For questions on the workstream and how to get involved, please contact Sanghamitra Singh (Sanghamitra@populationfoundation.in)
Please note that these are preliminary questions that will continue to evolve based on research, input and feedback from various stakeholders. Please feel free to contact us with any suggestions or queries.
Workstream Co-Chair

S V Subramanian
Professor of Population Health and Geography, Harvard Center for Population and Development Studies and Department of Social and Behavioral Sciences, Harvard T H Chan School of Public Health
Commissioners Involved

Mirai Chatterjee
Director, Social Security Team, Self-Employed Women’s Association [SEWA]

Vikram Patel
Pershing Square Professor of Global Health, Harvard Medical School; Professor, Harvard TH Chan School of Public Health; Co-founder, Sangath

Gagandeep Kang
Clinician Scientist and Professor in the Department of Gastrointestinal Sciences, Christian Medical College

Armida Fernandez
Retired Professor, Neonatology and Dean, LTMGH, Mumbai; Founder Trustee, SNEHA

Rajani Ved
Former Executive Director, National Health Systems Resource Centre

Vijay Chandru
Professor, Interdisciplinary Research, Indian Institute of Science

Leila E Caleb Varkey
Senior Advisor Reproductive Health, Centre for Catalyzing Change

Arnab Mukherji
Professor of Public Policy, Center for Public Policy, IIM Bangalore

Thelma Narayan
Director, Academics & Policy Action, SOCHARA
Commission Fellows

Sandhya Venkateswaran
Public Policy and Advocacy. Former Country Lead for Policy and Strategic Partnerships at the Bill and Melinda Gates foundation

Alok Vajpeyi
Joint Director/Head, Knowledge Management and Core Grants with Population Foundation of India.

Dipa Nag Chowdhury
Director Programmes at Population Foundation of India

Bijit Roy
Manages Secretariat of the Advisory Group on Community Action (AGCA)

Amrita Sekhar
Consultant, Division of GI Sciences, Christian Medical College, Vellore

Jacob John
Professor of Community Medicine at the Christian Medical College, Vellore

Dr. J. Pratheeba
Health Economist at the Population Foundation of India, New Delhi.
Good governance is essential to realizing India’s healthcare vision of promoting wellness, universal access, and affordable care to all Indians. This entails understanding the multiple roles and functions played by the government and a complex set of associated institutional arrangements.
Problem
The governance structures of India’s health system (public and private) have some fundamental shortcomings. These have given rise to a number of issues such as (a) the high rate of absenteeism of health care providers in government facilities; (b) poor quality of care; (c) high out of pocket expenditure; and (d) rampant corruption.
Aim/Principle
This workstream will grapple with the root causes of governance failure and seek to articulate pathways for building a robust and accountable governance framework. In order to do this, the workstream seeks to achieve a vision of universal health coverage which is equitable, affordable, and accessible to all.
Key Questions
With this aim in mind, some key areas that the workstream will focus on include:
- The architecture for regulation (public and private), such as what should be regulated, and how effective institutional structures can be built and enforced
- The federal arrangements that need to be in place, such as aligning functions across various levels of government, fiscal arrangements, and institutional dynamics
- Accountability, including understanding professional norms and ethics, devising the right incentives for performance, and creating the right trust dynamic (doctor-patient dynamics)
Get Involved
For questions on the workstream and how to get involved, please contact Sparsh Agarwal (sparsh@cprindia.org)
Please note that these are preliminary questions that will continue to evolve based on research, input and feedback from various stakeholders. Please feel free to contact us with any suggestions or queries.
Commissioners Involved

Gagandeep Kang
Clinician Scientist and Professor in the Department of Gastrointestinal Sciences, Christian Medical College

K Srinath Reddy
President, Public Health Foundation of India

Mirai Chatterjee
Director, Social Security Team, Self-Employed Women’s Association [SEWA]

Kiran Mazumdar-Shaw
Executive Chairperson, Biocon Ltd.

Arnab Mukherji
Professor of Public Policy, Center for Public Policy, IIM Bangalore

Thelma Narayan
Director, Academics & Policy Action, SOCHARA

Leila E Caleb Varkey
Senior Advisor Reproductive Health, Centre for Catalyzing Change

Sapna Desai
Associate, Population Council
Commission Fellows

Mekhala Krishnamurthy
Associate Professor of Sociology and Anthropology at Ashoka University and a Senior Fellow at the Centre for Policy Research (CPR)
Human Resources for health are integral to high performing, equitable and quality health systems and require policy considerations related to numbers, distribution, skills, motivation and performance of the healthcare workforce.
Problem
The challenges in ensuring adequate human resources in healthcare are multidimensional. These include: (a) absolute shortages, skewed distribution, and the failure of human resource planning and policy to take migration into account; (b) mismatch between disease profile and competencies; (c) centralized planning; (d) variable quality of pre/in-service training and mentoring in public and private sectors; (e) varying levels of emphasis placed on specialists, generalists and non-physician health workers; and (f) growing mistrust between providers and citizens.
Aim/Principle
The guiding principle of this workstream is to ensure that all people regardless of location, income, class, and gender have access to a skilled health worker or service provider who is adequately equipped, motivated, supervised, treated with dignity and remunerated adequately.
Key Questions
With this aim in mind, some key areas the workstream will investigate include:
- Human resource policy, planning and processes to estimate the needs and composition of workforce based on changing demography and disease burden
- Organizational, regulatory and institutional capacities required to build competencies of health workers and service providers
- Leveraging India’s plural health systems to deliver effective health care
Get Involved
For questions on the workstream and how to get involved, please contact Amrita Sekhar (amrita.sekhar@gmail.com)
Please note that these are preliminary questions that will continue to evolve based on research, input and feedback from various stakeholders. Please feel free to contact us with any suggestions or queries.
Commissioners Involved

Gagandeep Kang
Clinician Scientist and Professor in the Department of Gastrointestinal Sciences, Christian Medical College

Armida Fernandez
Retired Professor, Neonatology and Dean, LTMGH, Mumbai; Founder Trustee, SNEHA

Vikram Patel
Pershing Square Professor of Global Health, Harvard Medical School; Professor, Harvard TH Chan School of Public Health; Co-founder, Sangath

Bhushan Patwardhan
Distinguished Professor, Savitribai Phule Pune University;

Leila E Caleb Varkey
Senior Advisor Reproductive Health, Centre for Catalyzing Change

Thelma Narayan
Director, Academics & Policy Action, SOCHARA

Sapna Desai
Associate, Population Council
Commission Fellows

Amrita Sekhar
Consultant, Division of GI Sciences, Christian Medical College, Vellore

Sarika Chaturvedi
Scientist, Dr D Y Patil University, Pune
The use of diverse technologies will be vital in helping India leapfrog into an advanced healthcare system that fulfils the vision of promoting wellness, universal access, and affordable care to all Indians.
Problem
The main obstacles to effective universal healthcare in India include (a) availability of service, particularly in smaller cities and rural India; (b) affordability of care, especially for the economically disadvantaged; (c) quality of care; (d) continuum of care; and (e) individual empowerment. The designed technological framework and healthcare architecture will have to be citizen-centric and take into account language barriers, needs of rural citizens, and behavioural inertia against change.
Aim/Principle
The technology workstream aims to propose new ways of using technology so as to transform every stage of the healthcare journey and make it more accessible, empowering and effective.
Key Questions
With this goal in mind, some questions that the workstream intends to investigate include:
- How can we deploy technology to make services more affordable and accessible to even the most economically disadvantaged?
- How can technology be used to empower patients and enable them to identify what is in their best interest, reducing the push for generalized solutions across the system?
- How can stakeholders in the healthcare industry, especially healthcare providers, be enabled to elevate their healthcare outcomes using cutting-edge technology?
- How can technology help bridge the large gap we see in the availability of services and human resources, particularly in smaller cities and rural areas?
Get Involved
For questions on the workstream and how to get involved, please contact Divya Mohan, (dsmohan25@gmail.com)
Please note that these are preliminary questions that will continue to evolve based on research, input and feedback from various stakeholders. Please feel free to contact us with any suggestions or queries.
Commissioners Involved

Kiran Mazumdar-Shaw
Executive Chairperson, Biocon Ltd.

Tarun Khanna
Jorge Paulo Lemann Professor, Harvard Business School; Director, The Lakshmi Mittal and Family South Asia Institute, Harvard University

Nachiket Mor
Visiting Scientist, The Banyan Academy of Leadership in Mental Health

S V Subramanian
Professor of Population Health and Geography, Harvard University

Bhushan Patwardhan
Distinguished Professor, Savitribai Phule Pune University;

Vijay Chandru
Professor, Interdisciplinary Research, Indian Institute of Science

Atul Gupta
Assistant Professor, Department of Health Care Management, Wharton School, University of Pennsylvania.
Commission Fellows

Divya Mohan
PhD student, Health Economics, University of Aberdeen

Dr. Ajay Bakshi
Neurosurgeon, Neuroscientist, McKinsey consultant and ex-CEO of Max Healthcare, Manipal Hospitals and India Operations of IHH/Parkway Hospitals

Dr. Renuka Garg
General physician