The Politics of Health in India
The Politics of Health in India by Roger Jeffery, University of California Press (1988)
Public health services in India have received an almost universally hostile press. They are held to share some of the blame for India's continuing high levels of disease and premature death. In this study, Roger Jeffery provides the first detailed account of Indian health services since 1947. His work revises accepted views and contributes to the development of theoretical approaches that are badly needed if we are to understand the processes of change in the health services of developing countries.
The author carefully outlines the status of health and health services in India before independence. After considering the legacy of British rule, he assesses patterns of health expenditure , the education of health personnel, and the operations of health institutions after 1947. The politics of health in India and the impact of the international economy form the context of his study. He argues that health services are only loosely connected to the patterns of class domination in India. This has allowed them flexibility and autonomy to deal with the major health needs of the mass of the Indian population as well as serve the Indian elite.
Examining the patterns of development, the author concludes that Indian health services, in spite of their considerable limitations, are more closely geared to Indian health needs than are those of many other developing countries where a powerful medical profession has been encouraged by international aid to devote resources to hospitals and medical colleges. In India, health planners have been supported by international agencies in a rather different agenda - maintaining substantial, though flawed, preventive campaigns, training for paramedical workers and improved water supply and sanitation.
Reforms since 1970 have continued this tradition, but the limitations of the existing system and the constraints on the likely success of the reforms, suggest that the Indian health system will remain less adequate than it could be. "Health For All" in India by the year 2000 may be an unattainable goal.