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AFRICAN JOURNAL OF HEALTH ECONOMICS - Volume 6 Issue 2, December 2017

Pages: 26-37
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Inequality in Health Care Sector in India: A case Study of Health Facility, Human
Resources for Health and Amenities Distribution at the District level in Four Indian


Category: Review & Research


Across nations, National Health Policies, including that of India, have emphasised a
preference for equitable health care facilities. Keeping these emphases on equity in mind we
explored four Indian states using sub-state level (or district level) data. We applied mainly,
three well established indicators, namely Gini coefficient and Thiel’s T and L indices to
gauge magnitudes of inequity. Using individual state level aggregate data, we compared our
results between two periods for the same state which included one high income and another
low income Indian state. Also we compared across four states, namely, Punjab, Karnataka,
Madhya Pradesh and West Bengal using the most recent information available for the year.
Our results indicate that government investment in three tier health facilities expansion
comprising of primary, secondary and tertiary level care, has indeed resulted in low
inequities in terms of health facilities availability and distribution. However, private health
facilities or certain specific public health facilities did not seem to be much equitable
particularly at the sub-state level. The focus of our results are on availability as it relates to
geographical distribution and did not indicate equitable utilisation of health care facilities or
health care outcomes at the district levels.

Keywords: Gini Coefficient, Inequality National Health, Theil Entropy