Public Health System Performance Challenges in India: A Systems Thinking Approach

29 Pages Posted: 2 Feb 2018 Last revised: 30 Jan 2021

See all articles by Amitava Dutta

Amitava Dutta

George Mason University - Department of Information Systems and Operations Management

Biju Paul Abraham

Indian Institute of Management Calcutta

Rahul Roy

Indian Institute of Management (IIM), Calcutta

Priya Seetharaman

Indian Institute of Management (IIM), Calcutta

Date Written: January 24, 2018

Abstract

Public health is a means of preventing disease and providing curative care to promote citizens’ health through organized efforts of various stakeholders. Performance challenges in public health in developing countries continue to surround access, availability and quality. The public health system in India is plagued additionally by under-investment, sub-optimal utilization of resources and failure of accountability in general. These have resulted in uneven use of curative facilities and increasing out-of-pocket expenditures intensely disfavoring economically weaker citizens. Using systems thinking approach, we identify the different constituents of public healthcare system in India and their interlinkages. We qualitatively map the underlying structure to two specific systemic behaviors – the excessive use of referrals and, the co-occurrence of overburdened tertiary care centers and the under-utilization of primary care centers. The analysis draws upon the ‘fixes that fail’ and ‘shifting the burden’ archetypes in system dynamics to argue the need for more fundamental solutions to resolve performance challenges in public healthcare system in India.

Keywords: public health, India, access quality of care, systems thinking, performance improvement

JEL Classification: I14, I18, C63

Suggested Citation

Dutta, Amitava and Paul Abraham, Biju and Roy, Rahul Kumar and Seetharaman, Priya, Public Health System Performance Challenges in India: A Systems Thinking Approach (January 24, 2018). George Mason University School of Business Research Paper No. 18-4, Available at SSRN: https://ssrn.com/abstract=3108755 or http://dx.doi.org/10.2139/ssrn.3108755

Amitava Dutta (Contact Author)

George Mason University - Department of Information Systems and Operations Management ( email )

4400 University Drive
Fairfax, VA 22030
United States
703-993-1779 (Phone)

Biju Paul Abraham

Indian Institute of Management Calcutta ( email )

Kolkata
India

Rahul Kumar Roy

Indian Institute of Management (IIM), Calcutta ( email )

Joka
Diamond Harbour Road
Kolkata, 700104
India

Priya Seetharaman

Indian Institute of Management (IIM), Calcutta ( email )

Joka
Diamond Harbour Road
Kolkata, 700104
India

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