A theory of change roadmap for universal health coverage in India
The Theory of Change (ToC) approach is one of the methodologies that the Lancet Citizens' Commission has chosen to build a roadmap to achieving Universal Healthcare (UHC) in India in the next 10 years. The work of the Citizens' Commission is organized around five workstreams: Finance, Huma...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-12-01
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| Series: | Frontiers in Public Health |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fpubh.2022.1040913/full |
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| author | Angela Chaudhuri Nilakshi Biswas Shiv Kumar Asha Jyothi Ranjani Gopinath Nachiket Mor Preethi John Thelma Narayan Mirai Chatterjee Vikram Patel Vikram Patel |
| author_facet | Angela Chaudhuri Nilakshi Biswas Shiv Kumar Asha Jyothi Ranjani Gopinath Nachiket Mor Preethi John Thelma Narayan Mirai Chatterjee Vikram Patel Vikram Patel |
| author_sort | Angela Chaudhuri |
| collection | DOAJ |
| description | The Theory of Change (ToC) approach is one of the methodologies that the Lancet Citizens' Commission has chosen to build a roadmap to achieving Universal Healthcare (UHC) in India in the next 10 years. The work of the Citizens' Commission is organized around five workstreams: Finance, Human Resources for Health (HRH), Citizens' Engagement, Governance, and Technology. Five ToC workshops were conducted, one for each workstream. Individual workshop outputs were then brought together in two cross-workstream workshops where a sectoral Theory of Change for UHC was derived. Seventy-four participants, drawn from the Commission or invited for their expertise, and representing diverse stakeholders and sectors concerned with UHC, contributed to these workshops. A reimagined healthcare system achieves (1) enhanced transparency, accountability, and responsiveness; (2) improved quality of health services; (3) accessible, comprehensive, connected, and affordable care for all; (4) equitable, people-centered and safe health services; and (5) trust in the health system. For a mixed system like India's, achieving these high ideals will require all actors, public, private and civil society, to collaborate and bring about this transformation. During the consultation, paradigm shifts emerged, which were structural or systemic assumptions that were deemed necessary for the realization of all interventions. Critical points of consensus also emerged from the workshops, such as the need for citizen-centricity, greater efficiency in the use of public finances for health care, shifting to team-based managed care, empowerment of frontline health workers, the appropriate use of technology across all phases of patient care, and moving toward an articulation of positive health and wellbeing. Critical areas of contention that remained related to the role of the private sector, especially around financing and service delivery. Few issues for further consultation and research were noted, such as payment for performance across both public and private sectors, the use of accountability metrics across both public and private sectors, and the strategies for addressing structural barriers to realizing the proposed paradigm shifts. As the ToCs were developed in expert groups, citizens' consultations and consultations with administrative leaders were recommended to refine and ground the ToC, and therefore the roadmap to realize UHC, in people's lived reality. |
| first_indexed | 2024-04-12T06:00:26Z |
| format | Article |
| id | doaj.art-75c6d743cda944e88ff4a43ef0dd5451 |
| institution | Directory Open Access Journal |
| issn | 2296-2565 |
| language | English |
| last_indexed | 2024-04-12T06:00:26Z |
| publishDate | 2022-12-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Public Health |
| spelling | doaj.art-75c6d743cda944e88ff4a43ef0dd54512022-12-22T03:45:02ZengFrontiers Media S.A.Frontiers in Public Health2296-25652022-12-011010.3389/fpubh.2022.10409131040913A theory of change roadmap for universal health coverage in IndiaAngela Chaudhuri0Nilakshi Biswas1Shiv Kumar2Asha Jyothi3Ranjani Gopinath4Nachiket Mor5Preethi John6Thelma Narayan7Mirai Chatterjee8Vikram Patel9Vikram Patel10Catalyst Group, Swasti Health Catalyst, Bangalore, IndiaCatalyst Group, Swasti Health Catalyst, Bangalore, IndiaCatalyst Group, Swasti Health Catalyst, Bangalore, IndiaCatalyst Group, Swasti Health Catalyst, Bangalore, IndiaCatalyst Group, Swasti Health Catalyst, Bangalore, IndiaThe Banyan Academy of Leadership in Mental Health, Thiruvidanthai, IndiaGlobal Business School for Health, University College London, London, United KingdomCentre for Public Health and Equity (SOCHARA), Bangalore, IndiaSelf-Employed Women's Association (SEWA), Ahmedabad, IndiaDepartment of Global Health and Social Medicine, Harvard Medical School, Boston, MA, United StatesDepartment of Global Health and Population, Harvard TH Chan School of Public Health, Boston, MA, United StatesThe Theory of Change (ToC) approach is one of the methodologies that the Lancet Citizens' Commission has chosen to build a roadmap to achieving Universal Healthcare (UHC) in India in the next 10 years. The work of the Citizens' Commission is organized around five workstreams: Finance, Human Resources for Health (HRH), Citizens' Engagement, Governance, and Technology. Five ToC workshops were conducted, one for each workstream. Individual workshop outputs were then brought together in two cross-workstream workshops where a sectoral Theory of Change for UHC was derived. Seventy-four participants, drawn from the Commission or invited for their expertise, and representing diverse stakeholders and sectors concerned with UHC, contributed to these workshops. A reimagined healthcare system achieves (1) enhanced transparency, accountability, and responsiveness; (2) improved quality of health services; (3) accessible, comprehensive, connected, and affordable care for all; (4) equitable, people-centered and safe health services; and (5) trust in the health system. For a mixed system like India's, achieving these high ideals will require all actors, public, private and civil society, to collaborate and bring about this transformation. During the consultation, paradigm shifts emerged, which were structural or systemic assumptions that were deemed necessary for the realization of all interventions. Critical points of consensus also emerged from the workshops, such as the need for citizen-centricity, greater efficiency in the use of public finances for health care, shifting to team-based managed care, empowerment of frontline health workers, the appropriate use of technology across all phases of patient care, and moving toward an articulation of positive health and wellbeing. Critical areas of contention that remained related to the role of the private sector, especially around financing and service delivery. Few issues for further consultation and research were noted, such as payment for performance across both public and private sectors, the use of accountability metrics across both public and private sectors, and the strategies for addressing structural barriers to realizing the proposed paradigm shifts. As the ToCs were developed in expert groups, citizens' consultations and consultations with administrative leaders were recommended to refine and ground the ToC, and therefore the roadmap to realize UHC, in people's lived reality.https://www.frontiersin.org/articles/10.3389/fpubh.2022.1040913/fullUniversal HealthcareTheory of ChangeCitizens' CommissionUHC roadmapnested Theory of Change |
| spellingShingle | Angela Chaudhuri Nilakshi Biswas Shiv Kumar Asha Jyothi Ranjani Gopinath Nachiket Mor Preethi John Thelma Narayan Mirai Chatterjee Vikram Patel Vikram Patel A theory of change roadmap for universal health coverage in India Frontiers in Public Health Universal Healthcare Theory of Change Citizens' Commission UHC roadmap nested Theory of Change |
| title | A theory of change roadmap for universal health coverage in India |
| title_full | A theory of change roadmap for universal health coverage in India |
| title_fullStr | A theory of change roadmap for universal health coverage in India |
| title_full_unstemmed | A theory of change roadmap for universal health coverage in India |
| title_short | A theory of change roadmap for universal health coverage in India |
| title_sort | theory of change roadmap for universal health coverage in india |
| topic | Universal Healthcare Theory of Change Citizens' Commission UHC roadmap nested Theory of Change |
| url | https://www.frontiersin.org/articles/10.3389/fpubh.2022.1040913/full |
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