2nd September 2017
The Politics of Health: Towards Sustainable and Empowering Health Care
A Workshop organised by Sambhavanaa Institute and Health Swaraaj Group of SADED
The Indian Enigma is that India’s health indicators are among the worst in the world despite our being one of the biggest democracies and fastest growing economies. Increasing life expectancy seem to mask the poor quality of life and its health consequences. Our children and adults are more malnourished than the populations in Sub-Saharan Africa. We have a triple burden of continuing communicable diseases such as tuberculosis, malaria and pneumonia, increasing non-communicable diseases such as heart disease, cancers and environmental pollution related problems, as well as increasing injuries due to traffic accidents, social violence and suicides. And access to affordable health care is becoming more difficult. Obviously, Indian development and health policies are not in sync with health conditions of the majority. Even though health and health care are concerns of each individual, we do not seem to give them due public policy attention, either in the overall planning processes for the country or in development of health services.
In the present times, people are facing three crises related to health. One is of changing disease patterns due to rapidly changing environmental, economic, social and cultural conditions for which preventive and therapeutic measures have still to be understood and applied. The second is of the difficulties faced in availing of affordable, safe and dependable health care. The third is the dominant perspective of health knowledge and services that have led to a medicalization and commodification of health, with loss of the capacity for ‘listening to one’s body’ and being involved in decisions related to one’s own health. Thereby, the domain of health and health care have become tools of dis-empowerment at individual, community and societal levels. Government policies have led to building up of a large health services infrastructure in the country, and also contributed to creation of the crises people are facing.
Several government, academic, civil society and social movement initiatives have attempted to address these concerns. These include the Primary Health Care approach adopted internationally as part of the WHO-UNICEF’s Alma-Ata declaration in 1978 and the building of public services since the 1940s in India. In recent decades, there has been the attempt to strengthening of public services through the National Rural Health Mission, the current international approaches of Universal Health Coverage and Sustainable Development Goals, campaigns such as for the Right to Food and Right to Health.
About the Workshop:
In this program, we will examine the public policy and non-government initiatives that have attempted to work towards bottom-up, pro-people and pro-poor health care systems. They will be explored for their approach and achievements against the backdrop of the dominant political economy of healthcare. To understand what the present situation of health care is and how it can be improved from a pro-people perspective we will examine the following questions:
What all aspects affecting health are included in ‘health care’?
What affects people’s access to appropriate and quality health care?
What is ‘quality’ in health care?
What is ‘medicalisation’ and ‘commodification’ of health?
What decision-making about their health can lay people do, and what is ‘empowering’ or ‘disempowering’ for them in the context of health care?
What are the implications of these processes for designing health systems?
In order to answer these questions, we will use available data on health and the experience of attempts to improve health care. While discussing issues informed by global experience, it will focus on the Indian context.
Group Work, Interactive sessions, Presentations, Film screenings and lectures will be used to develop an understanding of the various dimensions of the politics of health and the options available for future development, will be the purpose of the course. Sessions will be structured to:
▪ Explore reasons for inequalities in health status and health care as the ‘politics of access’
▪ Understand pluralism in health knowledge as the ‘politics of knowledge’, and the processes of decision-making for health as the ‘politics of governance’, with delineation of the linkages between the three.
▪ Move towards a collective re-conceptualization of what can be the future directions for a people-centered approach to health and healthcare.
▪ Examine these issues and develop an understanding of what can be done for designing health services that are sustainable and empowering.
Who is this workshop for: Health activists, journalists dealing with health issues, early and mid-career health care providers (doctors, nurses, paramedics) or anyone interested in people oriented health policy issues, to contribute to developing a better understanding of how to empower people to deal with health problems and creating social conditions that support the same.