Health Sector Reforms in Orissa

Abstract

Any health sector reform aims at improving the health status of the people by affecting the organisational structure, governance system and financing variables. The health system has to perform a number of functions in order to enable more people to avail health benefits. In this context this analyses health sector reforms, approaches and challenges faced in Orissa during the reform process. The reform effort has not made substantial improvement in rural health indicators as indicated by NFHS-III. Most of the organisational and institutional changes were introduced as a part of a donor support programme and this has not been integrated into the system. Thus the health system did not improve on a sustained basis in order to achieve health sector goals. As a part of public financing, the state has not allocated resources as per the policy stance. The fiscal crisis has also resulted in reducing share of state expenditure towards health. There was also a substantially low allocation for inputs and infrastructure which affected the service delivery in rural areas. So equity and efficiency have remained two concerns in future health sector development of the state.