Andhra Pradesh Health Sector Reform - A Narrative Case Study

Health Expenditure by Other Departments of State Government ...................................... 35
Additional State Allocations towards the Health Sector Reforms.................................... 35
CHAPTER 5: ONGOING HEALTH SECTOR REFORMS IN ANDHRA PRADESH ........ 37
HEALTH CARE DELIVERY INITIATIVES INVOLVING PRIVATE PROVIDERS................................... 37
Case Study 1: Aarogyasri Community Health Insurance Scheme....................................... 38
Case Study 2: Emergency Management and Research Institute (EMRI) ........................... 42
Case Study 3: Health Management and Research Institute (HMRI).................................. 46
MANAGEMENT INITIATIVE ‐ ANDHRA PRADESH HEALTH SECTOR REFORM PROGRAMME.. 48
Background ...................................................................................................................................... 48
Organizational Structure ............................................................................................................. 51
Goals and Strategy ........................................................................................................................ 52
Reform Initiatives of the Program ............................................................................................. 53
Beneficiaries of the Program........................................................................................................ 54
CHAPTER 6: ENABLING FACTORS AND BARRIERS TO THE REFORMS...................... 56
ENABLING FACTORS............................................................................................................................. 56
National Support for Reforms..................................................................................................... 56
Political Leadership for Reform Process .................................................................................. 56
Leadership for a multi‐sectoral response ................................................................................. 56
International Donor Support....................................................................................................... 57
Improved integration of initiatives ........................................................................................... 57
Increased emphasis on good governance................................................................................... 57
Develop capacity to deal with reforms ..................................................................................... 57
Commitment to improved involvement of community ......................................................... 58
Commitment to improved involvement of the private sector.............................................. 58
BARRIERS TO REFORMS ....................................................................................................................... 58
Remained commitment by the Government............................................................................. 59
Commitment and capacity for effective use of financial resources .................................... 59
Lack of capacity for implementation of the reforms.............................................................. 59
Insufficient attention to equity and gender.............................................................................. 59
Fiduciary Risk Assessment .......................................................................................................... 60
Negative attitudes among stakeholders towards reforms.................................................... 60
CHAPTER 7: GAPS AND OPPORTUNITIES ................................................................................ 61
DONOR SUPPORT COMING TO AN END............................................................................................. 61
To address the gap.......................................................................................................................... 61
INTERNAL AND EXTERNAL COMMUNICATION ............................................................................... 61
To Address the Gap........................................................................................................................ 62
HEALTH INFORMATION SYSTEMS..................................................................................................... 62
To Address the Gap........................................................................................................................ 64
HEALTH FINANCING............................................................................................................................ 64
To Address the Gap........................................................................................................................ 65
PROCUREMENT ..................................................................................................................................... 66
To Address the Gap........................................................................................................................ 66
HUMAN RESOURCE MANAGEMENT ................................................................................................. 67
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