ORCID Profile
0000-0001-6668-0107
Current Organisations
UNSW Sydney
,
George Institute for Global Health
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Publisher: Medknow
Date: 2021
Publisher: Elsevier BV
Date: 07-2023
Publisher: Research Square Platform LLC
Date: 28-10-2019
Abstract: Background: The movement for Universal Health Coverage (UHC) is gaining momentum. Health insurance is emerging as one of the favoured means to finance healthcare. The union government of India also started a health insurance scheme in 2018 in the spirit to leap towards UHC. Therefore, this study was carried out with the following objectives. To understand the coverage, distribution, and predictors of health insurance coverage in India. To examine the role of Pradhan Mantri Jan Arogya Yojana (PM-JAY) towards the goal of UHC in India. Methods: We analyzed unit-level data from the fourth round of National Family Health Survey (NFHS-4) to understand the coverage, distribution and predictors of health insurance. We categorized the health insurance schemes into four major categories based on standard categorization . The descriptive and bivariate analysis was conducted to understand the coverage and distribution and logit regression analysis was carried out to understand the predictors. Results: The overall health insurance coverage in India was around 25% out of which 22% is mandatory health insurance. Less than 2% of households reported having any voluntary health insurance. Household wealth and education of the head of households were found to be directly proportional to health insurance coverage. Overall, there was very wide inter-state and inter-class variation in health insurance coverage, which reflect a major void in the existing programmes. Conclusions: To achieve UHC in India, a definite policy direction is needed to protect those groups of citizens, who either not covered or are only partially covered from health insurance scheme. Either the PM-JAY scheme should be expanded for the larger population or an alternative health financing model is to be explored to expand the population coverage. Key-words: Health Insurance, Universal Health Coverage, India, Ayushman Bharat, Pradhan Mantri Jan Arogya Yojana, National Family Health Survey.
Publisher: Scientific Scholar
Date: 2017
Publisher: BMJ
Date: 08-2020
Publisher: Maad Rayan Publishing Company
Date: 19-03-2023
Abstract: In their paper, Tama and colleagues observe that one key challenge in a pilot, multi-component intervention to strengthen health facility regulation was the reaction from health facility owners and providers to regulatory processes. In this commentary, we propose that future research and action on health facility regulation in LMICs contexts adopt an explicit focus on addressing the role of interests and interest groups in health systems ‘hardware’ and ‘software’. Research on policy processes in LMICs consist of fewer investigations into the political economy of national or sub-national interest groups, such as physician associations or associations of health facility owners. A growing body of literature explores supply-side and demand-side interest groups, power relations within and between these stakeholders, and their advocacy approaches within LMIC health sector policy processes. We posit that such analyses will also help identify facilitators and challenges to implementation and scale-up of similar reforms to health facility regulation.
Publisher: BMJ
Date: 02-08-2023
Abstract: Burn injury is associated with significant mortality and disability. Resilient and responsive health systems are needed for optimal response and care for people who sustain burn injuries. However, the extent of health systems research (HSR) in burn care is unknown. This review aimed to systematically map the global HSR related to burn care. An evidence gap map (EGM) was developed based on the World Health Organization health systems framework. All major medical, health and injury databases were searched. A standard method was used to develop the EGM. A total of 6586 articles were screened, and the full text of 206 articles was reviewed, of which 106 met the inclusion criteria. Most included studies were cross-sectional (61%) and were conducted in hospitals (71%) with patients (48%) or healthcare providers (29%) as participants. Most studies were conducted in high-income countries, while only 13% were conducted in low-and middle-income countries, accounting for 60% of burns mortality burden globally. The most common health systems areas of focus were service delivery (53%), health workforce (33%) and technology (19%). Studies on health policy, governance and leadership were absent, and there were only 14 qualitative studies. Major evidence gaps exist for an integrated health systems response to burns care. There is an inequity between the burden of burn injuries and HSR. Strengthening research capacity will facilitate evidence-informed health systems and policy reforms to sustainably improve access to affordable, equitable and optimal burn care and outcomes.
Publisher: Elsevier BV
Date: 03-2023
Publisher: Elsevier BV
Date: 04-2016
Publisher: Elsevier BV
Date: 2021
Publisher: BMJ
Date: 09-2022
Publisher: Springer Science and Business Media LLC
Date: 16-01-2012
Publisher: Scientific Scholar
Date: 12-2014
Abstract: Background: Leprosy is mainly a chronic infectious disease caused by Mycobacterium leprae. The disease mainly affects the skin, the peripheral nerves, mucosa of the upper respiratory tract and eyes. Though the target of leprosy elimination was achieved at national level in 2006 even then a large proportion of leprosy cases reported globally still constitute from India. Aim and Objective: To study the clinico-epidemiological profile of new cases of leprosy in a rural tertiary hospital. Materials and Methods: Thirty-five newly diagnosed cases of leprosy presented in out-patient/admitted in the department of Dermatology, Venereology and Leprosy (between September 2012 and August 2013) were included in the study. Detailed history regarding leprosy, deformity, sensory loss, skin smear for AFB and histopathological examination were done in every patient. Results: The incidence was more in age group of 20 to 39 years (48.57%) and 40 to 59 years (37.14%). 68.57% were males. 48.57% cases were found to have facial deformity and ear lobe thickening was found to be pre-dominant form of facial deformity. Ulnar (88.87%) and common peroneal nerve (34.28%) were the most commonly involved nerves. The split skin smear examination was found to be positive in 27 out of 35 cases. On histopathological examination 10 patients (28.57%) were of lepromatous pole (LL), 4 (11.43%) were of indeterminate, 6 (17.14%) were of tuberculoid type (TT), 4 BT (11.4%) and 1 BL type (2.8%). Conclusions: This study helps in concluding that leprosy is still not eliminated. Active surveillance is still needed to detect the sub-clinical cases and undiagnosed cases.
Publisher: Elsevier BV
Date: 06-2023
Publisher: Inishmore Laser Scientific Publishing Ltd
Date: 09-09-2020
DOI: 10.29392/001C.16633
Abstract: Significant gap exists in health research output globally, both in terms of geographic distribution and priorities. In India, wide inter-state disparity in health research output is reported and eight large states with a combined population of nearly half of India contribute to less than one-tenth of total research output. Bihar is one of the most resource-constrained states in this group with multiple health systems challenges. The objectives of this study were to understand the trend, distribution, focus, actors, and funding sources of health research on Bihar in order to propose policy recommendations. A bibliometric analysis was carried out for all PubMed indexed original research papers on health, which is either focused on Bihar or authored by an author from an organization in Bihar. Trend, author affiliation, location, theme, and funding source was analysed by review of either abstract or if required by review of the full text. A total of 982 research papers were extracted, out of which 40% was basic or clinical research and nearly 60% was public health research. There was an extraordinary surge in research output during the last decade. Clinical subjects (25 %) followed by leishmaniasis (23%) were the most common theme. Medical institutions (45%) were the biggest contributor to health research. More than 60% of papers were authored by a lead author from outside Bihar and the majority do not have a local co-author. 11 leading organizations published more than 35% of total research papers. ‘Leishmaniasis’ contributed to more than 35% of the research output by the author based in Bihar and more than 90% research output of the leading research institution in Bihar. The majority of the funded research in the last decade was supported by international agencies. The health research output from Bihar is very limited. The recent surge in research output is driven by global actors or from actors located in bigger cities and more developed states within India. To strengthen the health research systems, a specific health research policy should be formulated to steward and improve the health research ouput from Bihar.
Publisher: Forum for Medical Ethics Society
Date: 09-02-2023
Publisher: Elsevier BV
Date: 09-2021
Publisher: Medknow
Date: 2019
Publisher: Gates Open Research
Date: 2018
Publisher: Elsevier BV
Date: 03-2023
Publisher: BMJ Publishing Group Ltd
Date: 11-2022
Publisher: Springer Science and Business Media LLC
Date: 18-08-2021
DOI: 10.1186/S12960-021-00640-W
Abstract: Regulation is a critical function in the governance of health workforces. In many countries, regulatory councils for health professionals guide the development and implementation of health workforce policy, but struggle to perform their responsibilities, particularly in low- and middle-income countries (LMICs). Few studies have analyzed the influence of colonialism on modern-day regulatory policy for health workforces in LMICs. Drawing on the ex le of regulatory policy from India, the goals of this paper is to uncover and highlight the colonial legacies of persistent challenges in medical education and practice within the country, and provide lessons for regulatory policy in India and other LMICs. Drawing on peer-reviewed and gray literature, this paper explores the colonial origins of the regulation of medical education and practice in India. We describe three major aspects: (1) Evolution of the structure of the apex regulatory council for doctors—the Medical Council of India (MCI) (2) Reciprocity of medical qualifications between the MCI and the General Medical Council (GMC) in the UK following independence from Britain (3) Regulatory imbalances between doctors and other cadres, and between biomedicine and Indian systems of medicine. Challenges in medical education and professional regulation remain a major obstacle to improve the availability, retention and quality of health workers in India and many other LMICs. We conclude that the colonial origins of regulatory policy in India provide critical insight into contemporary debates regarding reform. From a policy perspective, we need to carefully interrogate why our existing policies are framed in particular ways, and consider whether that framing continues to suit our needs in the twenty-first century.
Publisher: F1000 Research Ltd
Date: 03-02-2020
DOI: 10.12688/GATESOPENRES.13109.1
Abstract: Health economics is a sub-discipline of economics that has significant relevance to public health. The academic discipline of health economics has not evolved in India till now. Since India became independent country, the public health practice in India has revolved largely around public health systems the private health system has functioned in parallel with negligible regulatory control by the government. The recent launch of a large health insurance program by the Indian government has opened the door of public resources for the private sector in health. It is envisaged that a substantial portion of public money will be erted to the private sector with little regulation. This situation will potentially change the landscape of public health care delivery in the country. With this change, the role of health economists is bound to increase, given the increased demand for economic evaluation. Ironically, there is a complete dearth of educational institutions offering specialised training in health economics in India. To fulfil this demand-supply gap, there is an urgent need to introduce the discipline of health economics at master’s level within existing university economics departments and schools of public health. Building on this foundation, academic research degrees in health economics can be evolved to fulfil future research gaps.
Publisher: Asian Development Research Institute
Date: 2019
Publisher: Asian Development Research Institute
Date: 2018
No related grants have been discovered for Vikash R. Keshri.