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1.2 billion


1.27 million square miles

Capital City:

New Delhi
Out of pocket spending in India accounts for about 70% of total healthcare expenditure.

ACCESS Health began to work in India in 2006. India remains the focus of much of our work. The knowledge we have gained from our work in India informs many of our programs in other countries.

India is home to advanced innovations in healthcare delivery and technology, yet it is also the country with the highest burden of disease. The Indian government spends only one percent of its GDP on healthcare. Out of pocket spending in India is among the highest in the world, accounting for about seventy percent of total healthcare expenditure.

ACCESS Health began work in India to identify good practices in high quality and low cost healthcare. We have since expanded our work in India to support the scale up of good practices through close collaboration with governments and the private sector. Today, ACCESS Health India focuses on advancing health finance systems and understanding how these systems can improve the quality of healthcare services. The best finance and delivery systems in India can serve as models, both within the country and abroad. ACCESS Health India designs and manages programs and projects that drive domestic healthcare improvements and inspire improvements in healthcare in other countries.

Focus Areas

Healthcare Finance

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The structure of healthcare finance directly influences the behavior of healthcare providers and the quality of outcomes. By supporting strategic health financing reforms and policy implementation, our work in health financing aligns financial and non-financial incentives to ensure high quality health services are affordable and available when needed. Our programs in healthcare finance within India are broad and deep, as are our relations with a group of African and Asian countries that share improvements in healthcare finance as part of the Joint Learning Network for Universal Health Coverage.

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Healthcare Delivery Systems

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ACCESS Health is working on designing patient centered healthcare delivery systems that allow monitoring of the care continuum. The key considerations for improved healthcare delivery are access, affordability, and quality. Integrated care delivers high quality care closer to the community in both rural and urban environments. ACCESS Health is designing and implementing innovative models that can grow throughout the country.

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Quality and Process Improvement

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ACCESS Health India brings healthcare practitioners together into collaboratives to drive improvements in target areas. We have piloted successful collaboratives on neonatal care and eye care and are bringing this work to scale throughout the country.

Quality of care varies dramatically in India, both among formal and informal healthcare providers. About sixty percent of patients seeking primary care services receive unnecessary or even harmful treatment, yet many other providers are able to deliver world class services at a fraction of what that care would cost in other countries.

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As India plans to increase its public health budget, doctors, nurses, skilled community caregivers, and health workers are becoming an even more important resource. Technical and administrative skills are needed. To improve access to care and health outcomes, ACCESS Health is developing skill building programs that improve the effectiveness of the health systems. These programs span quality, primary care, public private partnerships, and health financing.

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Business Engagement

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ACCESS Health believes that sustainable change in health systems is possible through the innovative efforts of a broad cross section of partners, including government, the private sector and entrepreneurs, the not for profit sector, and education. In India, ACCESS Health works closely with entrepreneurs building innovative business models around health that will drive sustainable change in the future. ACCESS Health India also works with state governments to support effective public private partnerships in health.

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Program Areas

Maternal and Child Health

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ACCESS Health India works directly with providers to identify, share, and scale hospital processes and procedures that lead to better outcomes for mothers and their children.

In 2012, more than twenty five million infants were born in India, and about eight hundred thousand died within the first month. In addition, India reported about fifty six thousand maternal deaths in 2010. Recent health reforms have increased access to facility based maternal and newborn care without significant improvement in outcomes for mothers and infants. To improve health outcomes, these facilities must also deliver high quality care.

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Access to high quality, affordable primary care remains a challenge in much of India. The result is a high burden of disease and high out of pocket expenditures. Recent federal and state government commitments signal increasing support for a stronger primary healthcare system. ACCESS Health India supports these commitments by studying the healthcare programs and working with individual states to design and implement improvement in primary care.

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Modern Aging: inspiring and empowering entrepreneurs of all ages and backgrounds to create businesses to serve the needs of the elderly.
We are no longer active in India. Projects and resources are available in the archive.