Enreca Health > Research Projects > HSRE
Private Practitioners in Poor Urban Neighbourhoods in India, Indonesia and Thailand
Project start: April 1, 2004
Project end: December 31, 2008
Budget: DKK 4,000,000
Partner institutions:
Institute of Anthropology, Archaeology and Linguistics, Aarhus
University, Denmark
All India Institute of Medical Sciences (AIIMS), New Delhi, India
Center for Bioethics and Medical Humanities (CBMH), Gadjah Mada University, Jogjakarta, Indonesia
Centre for Health Equity Monitoring (CHEM), Phitsanulok
Project description:
The overall purpose of the project is to identify viable strategies for strengthening ethical practice in the private healthcare sector in poor neighbourhoods through feasible and locally acceptable control mechanisms and other possible means. While the private health care sector constitutes a large part of the health system in most countries - in India as much as 80% - very little research is carried out in this field, and little is known about the public health impact of the private sector. Studies in Thailand and elsewhere have shown that the wealthier groups of society benefit most from free services and that the poor spend large proportions of income on private health care. This is even more problematic in light of the current global policy trend to promote public-private partnerships; often, it is implicit in this drive that the quality of private services is better tan the free government services, but frequently there is little quality control in the private sector and no or insufficient research basis for such policies.
The current project seeks to understand the interface between private providers and poor urban neighbourhoods in terms of health problems, treatment outcomes, health seeking behaviour, health provider behaviour, expenditures and social and financial dynamics. Accordingly, the project seeks to combine an understanding of the patients' perspectives with an understanding of the private practitioners' and drug vendors' perspectives. Health ethics, in this connection, may be broadly understood as a consensus-based normative regulatory framework that primarily works to protect patients against iatrogenic adverse events when utilizing the health system. We believe that it will be an important achievement to provide a systematic mapping of these issues, adopting a comparative case-study for selected cities in India, Indonesia and Thailand, where a ‘case' will be constituted by a local, micro-level healthcare system (i.e., a ‘neighbourhood').
The project consists of four sub-studies, which complement each other in order to give a detailed and multi-faceted understanding of the local health systems under study:
1) Existing regulatory mechanisms, including ethical codes and legislation with direct implications for general private practitioners: desk study
2) Health systems ethics among private practitioners: ethnographic sub-study
3) Family-level treatment decision-making: qualitative interview sub-study
4) Household survey: health economics sub-study
Project team:
Associate Professor Jens Seeberg (Principal Investigator and Project Director)
Prof. Dr. Supasit Pannarunothai (Principal Investigator)
Prof. Dr. Soenarto Sastrowijoto (Principal Investigator)
Prof. Dr. Kusum Verma (Principal Investigator 1.4.2004-31.7.2005)
Prof. Dr. Chandrakant S. Pandav (Principal Investigator 1.8.2005 onwards)
Prof. dr. Laksono Trisnantoro (Co-Principal Investigator)
Dr. Sri Suparyati Soenarto (Co-Principal Investigator)
Dr. Nupur Barua (Co-Principal Investigator)
Dra. Retna Siwi Padmawati (Co-Principal Investigator)
Dr. Nur Azid Mahadinata (Co-Principal Investigator)
Dr. Angkhanporn Sornngai (Co-Principal Investigator)
Aumnoay Pirunsarn (Co-Principal Investigator)
(full list at http://www.hum.au.dk/hsre/Research_teams.html)
Contact person: Associate Professor Jens Seeberg
Read more: www.hum.au.dk/hsre
