Background India has recently witnessed unprecedented economic growth. However, this rise in inco... more Background India has recently witnessed unprecedented economic growth. However, this rise in income has not resulted in the concurrent economic development in the country. The urban poor have been at the most disadvantage and have shown poor performance indicators in health outcomes. This paper is based on baseline assessment of knowledge and practices of selected health issue in selected slums of Ahmedabad. Methods A descriptive cross--sectional research was conducted to analyse and explore the level of awareness of hygiene and sanitation issues of slum dwellers. The data was compiled using household survey among 600 slum dwellers in two slums. From each slum, 100 households with a woman who is either pregnant at the time of the survey or who has recently delivered and 200 neighbouring households were interviewed. The non--probability snowball sampling technique was used. The data was collected with the help of structured questionnaire. Analysis There was less awareness of precur...
Background Government-sponsored health insurance schemes (GSHIS) aim to improve access to and uti... more Background Government-sponsored health insurance schemes (GSHIS) aim to improve access to and utilization of healthcare services and offer financial protection to the population. India’s Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PM-JAY) is one such GSHIS. This paper aims to understand how the processes put in place to manage hospital-based transactions, from the time a beneficiary arrives at the hospital to discharge are being implemented in PM-JAY and how to improve them to strengthen the scheme’s operation. Methods Guidelines were reviewed for the processes associated with hospital-based transactions, namely, beneficiary authentication, treatment package selection, preauthorization, discharge, and claims payments. Across 14 hospitals in Gujarat and Madhya Pradesh states, the above-mentioned processes were observed, and using a semi-structured interview guide fifty-three respondents were interviewed. The study was carried out from March 2019 to August 2019. Results Average ...
The potential accessibility of Antiretroviral (ARV) drugs at reduced cost and the emergence of la... more The potential accessibility of Antiretroviral (ARV) drugs at reduced cost and the emergence of largescale Antiretroviral Treatment (ART) programs in other developing countries, have spurred India to launch its own free antivretroviral treatment (ART) program in April 2004. While many countries worldwide have attempted costing of their national program on ART, India did not have any economic or financial estimates of how much it actually costs to run the free ART program, if all sources of spending are included. This study was undertaken with the aim of coming up with preliminary estimates of the recurrent financial cost of the ART program.
PART ONE: ADOPTING THE AIDS VACCINE IN INDIA: PROGNOSIS AND PROSPECTUS PART ONE: Adopting the AID... more PART ONE: ADOPTING THE AIDS VACCINE IN INDIA: PROGNOSIS AND PROSPECTUS PART ONE: Adopting the AIDS Vaccine in India: Progosis and Prospectus Introduction and Rationale for the Study Introduction to Selected Health Technologies Adoption of Health Technology in India A Summary of Major Findings Lessons for the Adoption of the Aids Vaccine Summary and Conclusions PART TWO: Analysis: Selected Case Studies of Adoption of Health Technologies In India Universal Immunisation Programme Hepatitis B Immunisation No-Scalpel Vasectomy Voluntary Counselling and Testing Antiretroviral Therapy in India
Introduction Prevalence of diabetes is increasing rapidly in across the world and India is no exc... more Introduction Prevalence of diabetes is increasing rapidly in across the world and India is no exception. In the year 2000, the World Health Organization (WHO) estimated that India had 32 million diabetic. One of the proven strategies to improve access to healthcare, especially in the areas that are underserved or un-served through public healthcare services, is Public–Private Partnerships (PPPs). Methodology The case study is based on the observation of the facilities and service delivery, desk review of service delivery statistics of the PHC, in-depth interviews with stakeholders. Findings It was observed that the Valam Primary health Centre (PHC) is an excellent example of locally-initiated, village-level PPP model to cater to rural population. It was quite evident from the available records that PHC is having adequate supply of strips and glucometer to perform the investigation to monitor the blood sugar level of diabetic or suspected cases, which was not available even in other ...
The National Health Policy 2017 recommended the establishment of health and wellness centres (HWC... more The National Health Policy 2017 recommended the establishment of health and wellness centres (HWC) as the primary platform to deliver comprehensive primary health care in India and emphasised that about two-thirds of the health budget of the government should be invested on primary care. In February 2018, the government announced its plan to create 150,000 HWCs under the Ayushman Bharat initiative by transforming the already existing sub-centres (SCs), primary health centres (PHCs) and urban PHCs as HWCs by 2022. The operationalisation of HWCs has been planned in a phased manner. However, for scaling up and replicability, it is imperative for the government to know how much to budget for this initiative, so that there are no interruptions in the smooth flow of services. Taking Gujarat as a case study, the study took a sample of eight HWCs for estimating the total and per-unit costs for each type of HWC. OPD footfalls were taken as an indicator for measuring output. The incremental u...
The World Trade Organization (WTO) and Trade-Related Aspects of Intellectual Property Rights (TRI... more The World Trade Organization (WTO) and Trade-Related Aspects of Intellectual Property Rights (TRIPS), which made product patents compulsory for countries to follow, meant that the entire market for generic drugs was out of bounds for manufacturing till the time the products went off-patent. The TRIPS has generated widespread discussions and debates around the costs and benefits of new patent regimes on countries such as India. This article analyses whether the post-WTO system was consistent with, and conducive to, improved public health in India. It is a first-of-its-kind effort in which the data on pharmaceutical patents applications were collected, collated, cleaned and classified according to IPC codes, to enable preliminary understanding of the nature and type of the applications. The patent applications that are filed in India are not found to be consistent with the disease burden of the country.
Background India has recently witnessed unprecedented economic growth. However, this rise in inco... more Background India has recently witnessed unprecedented economic growth. However, this rise in income has not resulted in the concurrent economic development in the country. The urban poor have been at the most disadvantage and have shown poor performance indicators in health outcomes. This paper is based on baseline assessment of knowledge and practices of selected health issue in selected slums of Ahmedabad. Methods A descriptive cross--sectional research was conducted to analyse and explore the level of awareness of hygiene and sanitation issues of slum dwellers. The data was compiled using household survey among 600 slum dwellers in two slums. From each slum, 100 households with a woman who is either pregnant at the time of the survey or who has recently delivered and 200 neighbouring households were interviewed. The non--probability snowball sampling technique was used. The data was collected with the help of structured questionnaire. Analysis There was less awareness of precur...
Background Government-sponsored health insurance schemes (GSHIS) aim to improve access to and uti... more Background Government-sponsored health insurance schemes (GSHIS) aim to improve access to and utilization of healthcare services and offer financial protection to the population. India’s Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PM-JAY) is one such GSHIS. This paper aims to understand how the processes put in place to manage hospital-based transactions, from the time a beneficiary arrives at the hospital to discharge are being implemented in PM-JAY and how to improve them to strengthen the scheme’s operation. Methods Guidelines were reviewed for the processes associated with hospital-based transactions, namely, beneficiary authentication, treatment package selection, preauthorization, discharge, and claims payments. Across 14 hospitals in Gujarat and Madhya Pradesh states, the above-mentioned processes were observed, and using a semi-structured interview guide fifty-three respondents were interviewed. The study was carried out from March 2019 to August 2019. Results Average ...
The potential accessibility of Antiretroviral (ARV) drugs at reduced cost and the emergence of la... more The potential accessibility of Antiretroviral (ARV) drugs at reduced cost and the emergence of largescale Antiretroviral Treatment (ART) programs in other developing countries, have spurred India to launch its own free antivretroviral treatment (ART) program in April 2004. While many countries worldwide have attempted costing of their national program on ART, India did not have any economic or financial estimates of how much it actually costs to run the free ART program, if all sources of spending are included. This study was undertaken with the aim of coming up with preliminary estimates of the recurrent financial cost of the ART program.
PART ONE: ADOPTING THE AIDS VACCINE IN INDIA: PROGNOSIS AND PROSPECTUS PART ONE: Adopting the AID... more PART ONE: ADOPTING THE AIDS VACCINE IN INDIA: PROGNOSIS AND PROSPECTUS PART ONE: Adopting the AIDS Vaccine in India: Progosis and Prospectus Introduction and Rationale for the Study Introduction to Selected Health Technologies Adoption of Health Technology in India A Summary of Major Findings Lessons for the Adoption of the Aids Vaccine Summary and Conclusions PART TWO: Analysis: Selected Case Studies of Adoption of Health Technologies In India Universal Immunisation Programme Hepatitis B Immunisation No-Scalpel Vasectomy Voluntary Counselling and Testing Antiretroviral Therapy in India
Introduction Prevalence of diabetes is increasing rapidly in across the world and India is no exc... more Introduction Prevalence of diabetes is increasing rapidly in across the world and India is no exception. In the year 2000, the World Health Organization (WHO) estimated that India had 32 million diabetic. One of the proven strategies to improve access to healthcare, especially in the areas that are underserved or un-served through public healthcare services, is Public–Private Partnerships (PPPs). Methodology The case study is based on the observation of the facilities and service delivery, desk review of service delivery statistics of the PHC, in-depth interviews with stakeholders. Findings It was observed that the Valam Primary health Centre (PHC) is an excellent example of locally-initiated, village-level PPP model to cater to rural population. It was quite evident from the available records that PHC is having adequate supply of strips and glucometer to perform the investigation to monitor the blood sugar level of diabetic or suspected cases, which was not available even in other ...
The National Health Policy 2017 recommended the establishment of health and wellness centres (HWC... more The National Health Policy 2017 recommended the establishment of health and wellness centres (HWC) as the primary platform to deliver comprehensive primary health care in India and emphasised that about two-thirds of the health budget of the government should be invested on primary care. In February 2018, the government announced its plan to create 150,000 HWCs under the Ayushman Bharat initiative by transforming the already existing sub-centres (SCs), primary health centres (PHCs) and urban PHCs as HWCs by 2022. The operationalisation of HWCs has been planned in a phased manner. However, for scaling up and replicability, it is imperative for the government to know how much to budget for this initiative, so that there are no interruptions in the smooth flow of services. Taking Gujarat as a case study, the study took a sample of eight HWCs for estimating the total and per-unit costs for each type of HWC. OPD footfalls were taken as an indicator for measuring output. The incremental u...
The World Trade Organization (WTO) and Trade-Related Aspects of Intellectual Property Rights (TRI... more The World Trade Organization (WTO) and Trade-Related Aspects of Intellectual Property Rights (TRIPS), which made product patents compulsory for countries to follow, meant that the entire market for generic drugs was out of bounds for manufacturing till the time the products went off-patent. The TRIPS has generated widespread discussions and debates around the costs and benefits of new patent regimes on countries such as India. This article analyses whether the post-WTO system was consistent with, and conducive to, improved public health in India. It is a first-of-its-kind effort in which the data on pharmaceutical patents applications were collected, collated, cleaned and classified according to IPC codes, to enable preliminary understanding of the nature and type of the applications. The patent applications that are filed in India are not found to be consistent with the disease burden of the country.
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Papers by Mayur Trivedi