Background

Twenty-first century India faces a complex set of health policy challenges. Disparities in access to healthcare by socio-economic status, caste, gender, and geography appear to be growing. While new healthcare technologies have significantly improved standards of care, the cost of care has become prohibitively high for many, widening the gap between the rich and the poor. Further, the Indian population, as a result of urbanization, changing lifestyles, and increases in life expectancy, suffers from a wide range of adverse health outcomes: Infectious diseases and epidemics, like tuberculosis and HIV/AIDS, chronic conditions such as diabetes, coronary heart disease and mental illness, and injuries and violence. Large-scale changes in health systems are also taking place. Rapid growth in the private healthcare sector during the last two decades, combined with limited public investment in health, has contributed to increasing healthcare costs and declines in the utilization of State services. Further, serious concerns have been raised about the quality of healthcare available in India today, in the public and private sectors. Compounding these challenges is the dearth of data and analysis to guide policy development and decisions. For example, although a number of innovative experiments in healthcare financing and delivery exist, many have not been rigorously monitored and evaluated nor are there mechanisms for scaling up and managing the successes. Public health research and policy analysis is urgently needed to identify effective, replicable and sustainable approaches for health promotion and protection.