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 States

Abstract

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.