Webinar Sessions
Webinar Sessions

“Randomized Regulation: The Impact of Minimum Quality Standards on Health Markets”

Dr. Jishnu Das — Randomized Regulation in the Health Sector
Abstract
Join us for a seminar featuring Dr. Jishnu Das, Professor at the McCourt School of Public Policy and the Walsh School of Foreign Service at Georgetown University. Moderated by Dr. Winnie Yip, Professor of Global Health Policy and Economics, Harvard T.H. Chan School of Public Health.
We report results from the first randomization of a regulatory reform in the health sector. The reform established minimum quality standards for patient safety, an issue that has become increasingly salient following the Ebola and COVID-19 epidemics. In our experiment, all 1348 health facilities in three Kenyan counties were classified into 273 markets, and the markets were then randomly allocated to treatment and control groups. Government inspectors visited health facilities and, depending on the results of their inspection, recommended closure or a timeline for improvements. The intervention increased compliance with patient safety measures in both public and private facilities (more so in the latter) and reallocated patients from private to public facilities without increasing out-of-pocket payments or decreasing facility use. In treated markets, improvements were equally marked throughout the quality distribution, consistent with a simple model of vertical differentiation in oligopolies. Our paper thus establishes the use of experimental techniques to study regulatory reforms and, in doing so, shows that minimum standards can improve quality across the board without adversely affecting utilization.
Biography
Jishnu Das is a Professor at the McCourt School of Public Policy and the Walsh School of Foreign Service at Georgetown University. Jishnu’s work focuses on health and education in low and middle-income countries, with an emphasis on social markets, or common, but complex, conflagrations of public and private education and health providers operating in a small geographical space.
As part of this research, he has co-developed the largest and longest-running cohort study on learning outcomes in low-income countries and has led an agenda on the measurement of healthcare quality in low-income countries. The methods he has developed are now being used by The World Bank in its Service Delivery Indicators as well as by multiple research groups in in India, Indonesia, South Africa, Kenya, Senegal and Tanzania. His research has shown how government can use information, funding and training programs to improve service delivery for the poor. His evaluations with multiple co-authors has led to the widespread adoption of a training program for informal providers (in West Bengal), health facility inspections (in Kenya) and networks for private sector providers (in India). He was also part of the team that developed India’s federal inpatient health insurance scheme, the RSBY, which reached 150 million people in 2016. Dr. Das has received the George Bereday Award from the Comparative and International Education Society, the Stockholm Challenge Award for the best ICT project in the public administration category in 2006, and the Research Academy award from the World Bank in 2017 and 2013 for research on health and education.
Webinar: Major reform efforts for India’s health system: opportunities and challenges

Overview
With a population over 1.4 billion, the health system of India has challenges and opportunities on an unprecedented scale. India is making remarkable progress towards universal health coverage with its signature health insurance plan for 40 percent of its population–the largest insurance scheme in the world–as well as innovations in digital health and primary care. Join us to hear about recent advances directly from two of India’s senior civil servants who are also pursuing graduate degrees at Harvard.
Featuring
- Praveen Gedam, MPH ’23 – “Challenges for digital health and the way forward”
Praveen is an Indian civil servant with experience of more than 20 years. Before joining Harvard, Praveen was the Additional Chief Executive Officer at the National Health Authority and in charge of two health programs of the Government of India. As the first Mission Director of an ambitious national digital health mission, he spearheaded the formulation of policies including those for digital health data management. He also led the development of a digital platform enabling interoperability among disparate systems. He also led India’s national health insurance scheme catering to >500 million citizens. Earlier in his career, Praveen led district and city governments, and departments at state and national levels, and worked extensively in the area of public health in cross-domain settings. Praveen has worked closely with various stakeholders such as political leaders, healthcare providers, international organizations, NGOs, media, and civil society. He has won several awards for his leadership and excellence in administration at the state and national levels. Praveen is MBBS from Nagpur University, India, and enjoys reading, music, and hiking. Praveen is currently a Master of Public Health student at the Harvard T.H. Chan School of Public Health and also a Fulbright scholar.
- Vipul Aggarwal, MPH ’23 – “Engaging providers under PM-JAY: issues and priorities”
Vipul is a physician turned civil servant from India with more than 20 years of work experience. Most recently he served as the administrative head of Ayushman Bharat PM-JAY, the world’s largest public funded health assurance scheme serving 540 million beneficiaries (pmjay.gov.in). In previous assignments in Gujarat, he headed the National Health Mission, which is India’s major public health program, and also headed Procurement and Supply Chain Management for the health department of the province. He has also previously served as Police Chief of several districts as well as the head of police administration of Ahmedabad City. Vipul is currently a Master of Public Health student at the Harvard T.H. Chan School of Public Health and also a Policy Fellow with the India Health Systems Reform Project.
- Moderated by Professor Michael Reich.
- With comments provided by Dr. Bijetri Bose and Elizabeth Osborn (MPH ’23), both of the India Health Systems Reform Project, to open the broader discussion.
Resources
- Watch a recording of the webinar here.
- Sponsored by the India Health Systems Reform Project of the Harvard T.H. Chan School of Public Health as part of the sixth annual Worldwide Week at Harvard by the Harvard Office of the Vice Provost for International Affairs.
Webinar: The role of private sector pharmacies in financial hardship in India: a health system analysis in the state of Odisha
Synopsis
This session held on August 24, 2022 focused on a health system analysis of the causes of high catastrophic health expenditure (CHE) in the state of Odisha in India. Odisha has the second-highest rates of CHE across India, but also has a public insurance program that covers 80% of the population and widely-used public facilities where drugs are provided free-of-charge. We designed and fielded 10 innovative surveys, including surveys of private sector pharmacies and households that captured extensive information about healthcare seeking. We find that private pharmacies fulfill an essential health system function in Odisha – providing 13% of outpatient visits and supplying the vast majority of drugs. Eliminating spending on private drugs would reduce CHE by more than half in Odisha. The public insurance program, in contrast, was not widely used and explained little variation in CHE. To reduce financial hardship in Odisha, the role currently fulfilled by private sector pharmacies must be considered alongside shortcomings in the public provision of drugs and the lack of outpatient care and drug coverage in public insurance programs.
The session concluded with a discussion of the broader approach to health systems analysis used in India Health Systems Reform Project, which emphasizes the systemic nature of the underlying causes of health system performance and the importance of the interactions between public and private actors.
Presenters
- Dr. Annie Haakenstad is an Assistant Professor at the Institute for Health Metrics and Evaluation (IHME) at the University of Washington. Annie is a faculty on the Health Systems team at IHME, where she focuses on financial risk protection, health financing, and disparities in access to health services, with a focus on reproductive and maternal health.
- Dr. Winnie Yip is Professor of the Practice of Global Health Policy and Economics in the Department of Global Health and Population at the Harvard T.H. Chan School of Public Health. Her research focuses on health system evaluations and the design and testing of innovative health system interventions to improve equitable access to efficient and good quality health care. She integrates economics, organization theory, management, and political economy to examine the use of national and state-level policy levers to produce delivery system change. She currently applies this approach to developing viable and effective models of population health based integrated delivery systems in China and India.
- Anuska Kalita is a Visiting Scientist and India Health System Specialist at the Harvard T.H. Chan School of Public Health. She has worked in the health sector for more than 16 years, in India and other countries in South Asia. Before joining Harvard, she worked with the Gates Foundation and The World Bank and was involved in designing India’s nationwide community health worker program and the National Health Policy (2017). Her research focuses on quality of care, citizens’ perceptions and satisfaction, and political economy in mixed health systems with public and private sector interactions. Anuska is currently pursuing her doctoral degree at Harvard.
Sponsors
- World Bank, Health Nutrition and Population
- Health Financing Global Solutions Group
- Joint Learning Network
- India Health Systems Reform Project of the Harvard T.H. Chan School of Public Health, for which funding from the Bill and Melinda Gates Foundation is gratefully acknowledged.
Resources
- Haakenstad, Annie, Anuska Kalita, Bijetri Bose, Jan E Cooper, and Winnie Yip. “Catastrophic Health Expenditure on Private Sector Pharmaceuticals: A Cross-Sectional Analysis from the State of Odisha, India.” Health Policy and Planning 37, no. 7 (August 3, 2022): 872–84. https://doi.org/10.1093/heapol/czac035.
Dr. Rajani Ved – Primary Health Care Reforms in India

Overview
Join us for a seminar featuring Dr. Rajani Ved, Director of Health at the India Office of the Bill & Melinda Gates Foundation. Moderated Dr. Winnie Yip, Professor of Global Health Policy and Economics, Harvard T.H. Chan School of Public Health.
Biography
Dr. Rajani Ved is Director, Health at the India Office of the Bill & Melinda Gates Foundation. In this role, she is responsible for developing and executing the strategy to support the foundation’s health goals in India. She is a public health physician, technical advisor and implementation specialist with nearly 30 years of experience working on community-based health services delivery, health systems strengthening and in scaling up. Her areas of expertise include the design and evaluation of large-scale health policy and programs, implementation research, and scaling up, particularly in maternal, reproductive and child health, primary health care, community health workers and civil society action. She has worked with national and state governments, research institutions, aid agencies and grassroots community organizations. At the Harvard T.H. Chan School of Public Health, Dr. Ved is a Lown Scholar.
Resources
- Watch a recording of the webinar here.
- This seminar was presented as a Brown Bag Seminar of the Department of Global Health And Population and is sponsored by the Harvard T.H. Chan School of Public Health, India Health Systems Project and the Harvard T.H. Chan School of Public Health, India Resource Center, Mumbai.
Webinar: Introduction to Political Analysis for Health Reform (Featuring Dr. Michael Reich)

Overview
This webinar introduces basic ideas of political analysis and political strategies, using examples about the politics of moving toward universal health coverage, and is presented by Prof. Michael R. Reich, Takemi Research Professor of International Health Policy, Harvard T.H. Chan School of Public Health.
Health system strengthening and the adoption of universal health coverage are both profoundly political processes. As stressed in the Flagship Approach to Health Reform, astute policy developers begin political analysis early in the policy cycle. They do not delay political analysis until after the policy has been developed. The technical work of policy development and the political work of feasibility assessment need to occur together. Political analysis and political strategies are required at each stage in the policy cycle. This introduction to political analysis focuses on conducting a stakeholder analysis and the development of political strategies, as necessary steps in managing the politics of moving toward universal coverage. Relevance to the Indian context will be discussed.
Objectives
- Introduce basic principles of applied political analysis.
- Present approaches to the assessment of political feasibility of policy reform, with a focus on stakeholder analysis and the design of political strategies.
- Introduce and demonstrate a method of applied political analysis.
Financing and Providing Basic Healthcare to Two Billion People in Low-and Lower-Income Countries for UHC

Leading up to the 2021 International Health Economics Association (iHEA) Congress, we hosted “Financing and Providing Basic Healthcare to Two Billion People in Low-and Lower-Income Countries For UHC” as a pre-Congress session on July 9, 2021 from 8-10am EDT.
Background
In recent years, most nations have embraced the noble goal of universal health coverage (UHC), but unfortunately, the world has not yet identified a way around the key barrier to making it a reality in low- and lower-income countries. Absent effective means of mobilizing the financial resources to fund basic healthcare for these countries’ nearly two billion low-income residents, these people will continue to suffer inadequate access to basic healthcare and poor health. The governments of low- and lower-income countries cannot collect sufficient tax revenue to adequately fund healthcare, nor are most of them able to organize and deliver effective care at communities close to where people live. As for other sources of funds for health, donors prioritize funding for disease-specific programs, such as for HIV/AIDS, tuberculosis, malaria and programs supporting maternal and child health, but little funding is available for basic healthcare. As a result, care for everyday common diseases is neglected. Social health insurance programs can effectively mobilize funds but are limited in reach to workers employed in the formal sector, and only affluent households can afford private insurance.
This session brought together leading experts to share, discuss and debate their responses to key questions: What are potential solutions/strategies for funding AND providing basic healthcare for this neglected two billion people? What have we learned so far from different countries’ experience?
The session was moderated by Dr. Winnie Yip and included four presentations followed by a panelist discussion. Support from the Bill and Melinda Gates Foundation, India Country Office, is gratefully acknowledged.
Presenters
- Edwine Barasa, Director, Nairobi Programme, KEMRI-Wellcome Trust Research Programme
- William Hsiao, K.T. Li Professor of Economics, Emeritus, Harvard T.H. Chan School of Public Health
- Joe Kutzin, Coordinator, Health Financing Policy, World Health Organization
- Ajay Tandon, Lead Economist, The World Bank Group
Resources
Webinar: Health Systems Diagnosis (Featuring Dr. Winnie Yip)

Financing and Providing Basic Healthcare to Two Billion People in Low-and Lower-Income Countries for UHC
Leading up to the 2021 International Health Economics Association (iHEA) Congress, we hosted “Financing and Providing Basic Healthcare to Two Billion People in Low-and Lower-Income Countries For UHC” as a pre-Congress session on July 9, 2021 from 8-10am EDT.
Background
In recent years, most nations have embraced the noble goal of universal health coverage (UHC), but unfortunately, the world has not yet identified a way around the key barrier to making it a reality in low- and lower-income countries. Absent effective means of mobilizing the financial resources to fund basic healthcare for these countries’ nearly two billion low-income residents, these people will continue to suffer inadequate access to basic healthcare and poor health. The governments of low- and lower-income countries cannot collect sufficient tax revenue to adequately fund healthcare, nor are most of them able to organize and deliver effective care at communities close to where people live. As for other sources of funds for health, donors prioritize funding for disease-specific programs, such as for HIV/AIDS, tuberculosis, malaria and programs supporting maternal and child health, but little funding is available for basic healthcare. As a result, care for everyday common diseases is neglected. Social health insurance programs can effectively mobilize funds but are limited in reach to workers employed in the formal sector, and only affluent households can afford private insurance.
This session brought together leading experts to share, discuss and debate their responses to key questions: What are potential solutions/strategies for funding AND providing basic healthcare for this neglected two billion people? What have we learned so far from different countries’ experience?
The session was moderated by Dr. Winnie Yip and included four presentations followed by a panelist discussion. Support from the Bill and Melinda Gates Foundation, India Country Office, is gratefully acknowledged.
Presenters
- Edwine Barasa, Director, Nairobi Programme, KEMRI-Wellcome Trust Research Programme
- William Hsiao, K.T. Li Professor of Economics, Emeritus, Harvard T.H. Chan School of Public Health
- Joe Kutzin, Coordinator, Health Financing Policy, World Health Organization
- Ajay Tandon, Lead Economist, The World Bank Group
Resources
Webinar: Policy and Health Systems Response to COVID-19

As Principal Investigator on India Health Systems Project funded by the Bill and Melinda Gates Foundation, Dr. Yip was invited by the India Research Center Mumbai of the Harvard T.H. Chan School of Public Health to discuss the lessons learned from how various global health systems have responded to the pandemic. Dr. Yip emphasized the need for greater investment in health care delivered by the private sector in India while Mr. Alok Kumar—Advisor (Health and Nutrition), National Institution for Transforming India (NITI Aayog), the premier policy ‘Think Tank’ of the Government of India—casted a spotlight on India’s policy response to the COVID-19 outbreak.
Video of the session can be found here under Episode Five: https://www.hsph.harvard.edu/india-center/webinars/