Himanshu Sekhar ROUT
@utkaluniversity.ac.in
Head, Department of Analytical and Applied Economics
Utkal University
RESEARCH INTERESTS
Economics of Social Sector, Health Economics, Economics of Education, Gender, Development Economics, IPR(GI)
Scopus Publications
Scholar Citations
Scholar h-index
Scholar i10-index
Scopus Publications
N. V. Bhattacharjee, Austin E. Schumacher, Amirali Aali, Yohannes Habtegiorgis Abate, Rouzbeh Abbasgholizadeh, Mohammadreza Abbasian, M. Abbasi-Kangevari, Hedayat Abbastabar, S. ElHafeez, S. Abd-Elsalam,et al.
Pragyan Monalisa Sahoo, Himanshu Sekhar Rout, and Mihajlo Jakovljevic
Springer Science and Business Media LLC
Abstract Background Accelerated globalization especially in the late 1980s has provided opportunities for economic progress in the world of emerging economies. The BRICS nations’ economies are distinguishable from other emerging economies due to their rate of expansion and sheer size. As a result of their economic prosperity, health spending in the BRICS countries has been increasing. However, health security is still a distant dream in these countries due to low public health spending, lack of pre-paid health coverage, and heavy out-of-pocket spending. There is a need for changing the health expenditure composition to address the challenge of regressive health spending and ensure equitable access to comprehensive healthcare services. Objective Present study examined the health expenditure trend among the BRICS from 2000 to 2019 and made predictions with an emphasis on public, pre-paid, and out-of-pocket expenditures for 2035. Methods Health expenditure data for 2000–2019 were taken from the OECD iLibrary database. The exponential smoothing model in R software (ets ()) was used for forecasting. Results Except for India and Brazil, all of the BRICS countries show a long-term increase in per capita PPP health expenditure. Only India’s health expenditure is expected to decrease as a share of GDP after the completion of the SDG years. China accounts for the steepest rise in per capita expenditure until 2035, while Russia is expected to achieve the highest absolute values. Conclusion The BRICS countries have the potential to be important leaders in a variety of social policies such as health. Each BRICS country has set a national pledge to the right to health and is working on health system reforms to achieve universal health coverage (UHC). The estimations of future health expenditures by these emerging market powers should help policymakers decide how to allocate resources to achieve this goal.
Pragyan Monalisa Sahoo and Himanshu Sekhar Rout
Emerald
Purpose This paper aims to analyze the status of infrastructure, workforce and basic amenities at public health-care facilities in rural India and draw a comparison with its urban counterparts. Design/methodology/approach Rural Health Statistics data and National Sample Survey Office Report for the period 2019–10 were used to analyze lower-level public health facilities, namely, subcenters, primary health centers and community health centers (CHCs). Selected tracer indicators under World Health Organization’s (WHO) Service Availability and Readiness Assessment (SARA) mechanism such as health center density, core health workforce density and basic amenities were used to carry out the analysis. The extent of facility coverage was measured using the National Rural Health Mission (NRHM) guidelines and the proportion of facilities satisfying the Indian Public Health Standards (IPHS) was measured to assess the service provision quality in rural public health-care facilities. Findings Results indicated that the density of public health centers is higher in rural areas than in urban areas. Almost all public health-care facilities lack basic amenities in rural areas. Working positions for health specialists in CHCs barely meet the total requirement. Almost all of the public health facilities functioning in rural areas do not meet the IPHS norms. Originality/value To the best of the authors’ knowledge, the present paper is the first initiative to assess the status of rural public health-care facilities on the national level using WHO’s SARA indicators as well as NRHM and IPHS guidelines. The study is significant in terms of policy input for achieving universal health coverage in India.
The study attempted to determine the effects of soil and water conservation measures on the socio-economic status of the people in rain-fed agriculture. The findings showed that the socio-economic development index of the beneficiaries and non-beneficiaries of the Khuntapingu watershed were 0.623 and 0.426, respectively. The socio-economic development index of the beneficiaries and non-beneficiaries of the Haripur watershed were 0.404 and 0.263 respectively. The results showed the difference in the impact of the adoption of soil water conservation measures; in two different agro-climatic regions within a district, such that the impact of the Khuntapingu watershed was comparatively better than Haripur watershed. The impact of the treatment of the watersheds differs in two agro-climatic zones. It was mainly due to the difference in land topography and the difference in baseline socio-economic conditions of the people across the watersheds. So, in order to achieve good results from the treatment of the watersheds in two agro-climatic conditions, the effort and approach of the implementing agency on two different agro-climatic zones will be different as per the location. Better convergence of government schemes with empowerment for the demand-driven approach of the community institutions through the adoption and adaptation of technology of soil and conservation will have a better impact on the community. Keywords: Rain-fed agriculture, socio-economic development index, water management. JEL Codes: O13, Q15, Q25.
Chandan Kumar Swain, Sourav Padhee, Umakanta Sahoo, Himanshu Sekhar Rout, and Prafulla Kumar Swain
Wiley
AbstractObjectiveTo investigate the trends and patterns of the cancer burden among the elderly in different regions of India at a subnational level.MethodsData were extracted from the Global Burden of Disease (GBD) Studies India Compare 2019. Prevalence rate, disability‐adjusted life years (DALY), and annual percentage change techniques were used to analyze data.ResultsThe three age groups with the highest prevalence of cancer were those aged 60–64 years, 65–69 years, and 70–74 years. In 2019, The prevalence of cancer among the elderly ranged from 7048.815 in Karnataka to 5743.040 in Jharkhand. Kerala has the most significant annual percentage change in the cancer prevalence rate of 0.291 between 1990 and 2019. The highest DALY rate was observed among individuals aged 80–84 years in 2019. That year, the DALY rate among the elderly was 8112.283 in India. The top five cancers with higher DALY rates among the elderly in India in 2019 were tracheal, bronchus, and lung cancer (908.473), colon and rectum cancer (752.961), stomach cancer (707.464), breast cancer (597.881), and lip and oral cavity cancer (557.637).ConclusionElderly individuals demonstrated a higher vulnerable to cancer compared to other age groups. There is a need for state‐specific government intervention to minimize the risk of cancer among the elderly due to the heterogeneity in the burden of cancer across Indian states.
Pradeep Kumar Sahoo and Himanshu Sekhar Rout
Springer Science and Business Media LLC
Chandan Kumar Swain and Himanshu Sekhar Rout
Elsevier BV
Pragyan Monalisa Sahoo, Himanshu Sekhar Rout, and Mihajlo Jakovljevic
MDPI AG
Despite economic progress, government efforts, and increased healthcare investments, health deprivation continues to persist in the countries of Brazil, Russia, India, China, and South Africa (BRICS). Hence, addressing the growing demand for health financing in a sustainable way and adopting unique approaches to healthcare provision is essential. This paper aims to review publications on the existing health financing systems in the BRICS countries, analyze the core challenges associated with health financing, and explore potential solutions for establishing a sustainable health financing system. This paper adhered to the PRISMA guidelines when conducting the keyword search and determining the criteria for article inclusion and exclusion. Relevant records were obtained from PubMed Central using nine keyword combinations. Bibliometrics analysis was carried out using R software (version 4.1.3), followed by a comprehensive manual narrative review of the records. BRICS countries experienced increased health expenditure due to aging populations, noncommunicable diseases, and medical advancements. The majority of this increased spending has come from out-of-pocket payments, which often lead to impoverishment. Due to limited fiscal capabilities, administrative difficulties, and inefficiency, providing comprehensive healthcare through public funding alone has become exceedingly difficult for these countries. Public-private partnerships are essential for achieving sustainable health financing and addressing challenges in healthcare provision.
Jyotirekha Purohit and Himanshu Sekhar Rout
Springer Science and Business Media LLC
Pradeep Kumar Sahoo, Ranjan Kumar Mohanty, and Himanshu Sekhar Rout
Springer Science and Business Media LLC
Tapasi Mohanty and Himanshu Sekhar Rout
Wiley
Pragyan Monalisa Sahoo, Himanshu Sekhar Rout, and Mihajlo Jakovljevic
Informa UK Limited
Purpose The present study assessed the awareness of the public about Biju Swasthya Kalyan Yojana (BSKY), which is a flagship public-funded health insurance scheme of the Government of Odisha. The study also identified its determinants and examined utilisation of the scheme among households in Khordha district of Odisha. Materials and Methods Primary data were collected from randomly chosen 150 households using a pretested structured questionnaire from Balipatana block of Khordha district, Odisha. Descriptive statistics and binomial logistic regression were used to substantiate the objectives. Results The study found that even though 56.70% of the sample households had heard about BSKY, procedure-specific awareness was low. State government organised BSKY health insurance camp was found to be a major source of knowledge among the sample. The regression model had an R2 of 0.414. The Chi2 value showed that the model with predictor variables was a good fit. Caste, gender, economic category, health insurance, and awareness about insurance were significant determinants of BSKY awareness. A majority (79.30%) of the sample had the scheme card with them. However, only 12.60% of the cardholders used the card and only 10.67% received benefits. Mean out-of-pocket expenditure (OOPE) faced by the beneficiaries is Rs. 15743.59. Among the beneficiaries, 53.80% financed the OOPE from their savings, 38.50% by borrowing, and 7.70% financed the OOPE by both means. Conclusion The study found that even though majority of people had heard about BSKY, they were not aware of its nature, features, and operational procedures. The trend of low benefit received and higher OOPE among the scheme beneficiaries hampers the economic health of the poor. Finally, the study highlighted the need to increase the magnitude of scheme coverage and administrative efficiency.
Mitali Chinara and Himanshu Sekhar Rout
Springer Nature Singapore
Pragyan Monalisa Sahoo, Himanshu Sekhar Rout, and Mihajlo Jakovljevic
Informa UK Limited
OBJECTIVES
To conduct a comprehensive literature review on the state of population aging, healthcare financing, and provision in India.
METHODS
To obtain relevant records in the Indian context, multiple publications were searched from databases such as Scopus, ScienceDirect, Web of Science, Medline/PubMed, JSTOR, and Google Scholar using the following keywords: 'Population Ageing,' 'Population Aging,' 'Health System,' 'Demographic Dividend,' 'Non-communicable Diseases,' 'Double Burden of Diseases,' 'Health Spending,' 'Sustainable Health Financing,' and 'Health Coverage.' Data on different health indices were collected from different websites of the government of India and international organizations (e.g., World Bank, UN, WHO, and Statista).
RESULTS
As people live longer, India faces a double burden of disease, with the rising incidence of non-communicable diseases (NCDs) amidst the presence of widespread communicable diseases. The combined problem of the double burden of diseases and population aging poses a severe sustainability challenge for its healthcare financing and the entire health system. Healthcare financing based on progressive taxation and large-scale prepayment coverage is an effective solution for sustaining the health system. However, due to the prevalence of indirect taxes, India's tax system is regressive. Hence, community-based health insurance (CBHI) schemes can be a feasible solution to cover the large mass of poor working in the informal sector.
CONCLUSIONS
India needs to address the alterations in its healthcare needs and demands brought on by the advancing demographic shift. To achieve so, the country's healthcare system must be reformed to accommodate strong national policies focusing on universal access to critical care especially geriatric and palliative care.
Dipti Ray, Himanshu Sekhar Rout, and Pritee Ray
Wiley
Tapasi Mohanty and Himanshu Sekhar Rout
Wiley
Tapasi Mohanty and Himanshu Sekhar Rout
Inderscience Publishers
The objectives of the present study were to analyze nutrient consumption in the village set up of Odisha and to investigate the determinants of consumption of protein, carbohydrates, calcium and iron. various nutrients like To substantiate the objectives descriptive statistics and multiple regression were used. The consumption of cereals and vegetables was more preferred in the study area, whereas the consumption of pulses was not so popular. Per capita income has a greater influence on nutrient consumption than the other determinants. The income elasticity of calorie intake was small but statistically significant for most income levels.
The present study attempted to determine the determinants of the water conservation practices in rainfed agriculture, especially in the watershed program Keonjhar district of Odisha state in the eastern part of India. Primary data were collected by a multi-stage random sampling method. The sample size was 125 households, and information was collected by canvassing a pre-designed schedule to the head of the households through door-to-door interviews. Focus group discussions were conducted to get qualitative information. A probit binary model was applied for analysis. The factors like awareness of the farmers, participation, the share of agriculture income to the total income of the household, the slope of agricultural land, access to information were positively influenced the water conservation practice. In contrast, the caste of SC / ST household and distance of agricultural land negatively influences soil water conservation practices. The results revealed that better awareness with the active participation of people in the government program could neutralize the influence of socio-economic factors in the adoption of soil water conservation practices.
Susanta Kumar Barik and Himanshu Sekhar Rout
Emerald
Purpose Owing to the rising costs and shrinking budgets; inefficiency can be observed in the financing and delivery of health service both in the private and public sectors, which is not only causing organizations to reconsider their management patterns but also to use new strategies to achieve competitive merits in the current world of business. Outsourcing is one of the best alternates. The purpose of this paper is to study: the nature and magnitude of outsourcing of health-care services in a Smart City of Eastern India; the motives behind outsourcing: and the factors affecting outsourcing decisions. Design/methodology/approach The study was conducted in Bhubaneswar, a Smart City of Eastern India and capital of Odisha State. Data relating to the outsourcing of health-care services were collected from 40 hospitals (each having a minimum of 10 beds) through a structured schedule. Descriptive statistics were calculated through Statistical Package for Social Science to substantiate the objectives. Findings Most of the clinical services were outsourced by small hospitals, while a significant portion of non-clinical services were outsourced by large and medium hospitals. Reduction in cost and better management control were the major driving forces of outsourcing. Loss of control over service providers and quality of measurement were considered as the main disadvantages in the decision-making process of not outsourcing the services by hospitals. Originality/value The study is the first-ever survey based on empirical evidence about the state of facilities management services outsourced in public and private hospitals in Odisha, India. The paper concluded that the effect of outsourcing did not synchronize successfully as shown in international literature.
Babita Panda and Himanshu Sekhar Rout
SAGE Publications
This study estimates whether Rashtriya Swasthya Bima Yojana (RSBY) protects beneficiaries from out-of-pocket health expenditure arising at the time of illness and points out obstacles that the beneficiaries face. This article uses data of 100 beneficiaries selected through simple random sampling from the beneficiaries list that were collected from the district headquarter hospital of Mayurbhanj District, Odisha, India. This study highlights that only 8.4 per cent beneficiaries access their full healthcare services from the scheme. More than 50 per cent are forced to spend from their own pocket even though they have sum assured. The beneficiaries face problems like lack of awareness, no proper enrolment procedure, no cooperative hospital staff, limited assured money sanctioned per day, only inpatient care services, an unhygienic atmosphere in the hospital, long distance to the empanelled hospital and exploitation among health service providers. Awareness may be created among insured. The behaviour of healthcare providers may be turned friendly. Immediate attention may be provided by help desk counters to the beneficiaries. The sum assured amount may be increased. The detailed receipt of hospital expenditure may be supplied to the insured at the time of discharge.
Subba Lakshmi Tirukoti and Himanshu Sekhar Rout
SAGE Publications
Building health systems that are responsive to community needs particularly for the poor is essential. In view of the growing divergence both between and within the states, disaggregated studies are necessary for identification of the critical areas calling for policy intervention. In this connection, the article is an attempt to analyse the performance of healthcare system of Andhra Pradesh (AP) at district level by focusing on technical efficiency. The study is based on secondary data. Stochastic frontier model has been used for analysis. The results show that the efficiency of the public health delivery system remains low. Not all the districts with lower infant mortality rate (IMR) have efficient health systems. The disparities across districts in terms of availability of hospitals and primary health centres have an adverse impact on improving IMR in AP. Overcoming these disparities within the health system may lead to improvement of public health system at district level in AP. Further, reduction in IMR may be possible at a faster pace in the state if such efforts are coupled with steps to promote literacy particularly female literacy. This could make them empowered to demand for adequate health infrastructure and ensure better utilization of it in poorly performing districts.
Himanshu Sekhar Rout
SAGE Publications
Socially constructed gender has significant influence on the health and Household Health Expenditures (HHE). From the gender and health literatures, three things are clear: most of the studies are macro in nature and based on secondary data; there is lack of research on the issues of gender and health, and out of whatever researches exist, most focus on the female sex; and as health conditions are localised, there is a need for research on the micro aspects of gender and health. In this connection, the present article is a modest attempt to study the gender bias (or unbais) in the HHE based on primary data collected from four districts of Odisha, India, by adopting multi-stage random sampling method. To substantiate the gender bias (or unbais) in health expenditure, multiple regression analysis is used and descriptive statistics are estimated. The result shows that there is a significant difference between the average male and female HHE in rural, urban and combined areas but not in tribal areas. A comparative study of influence of gender on HHE in rural and urban areas shows that the influence of male on the average HHE in rural areas is more than in urban areas whereas the influence of female on it is higher in urban areas. But a comparative study of influence of gender on HHE in rural, urban and tribal areas shows that the influence of male and female on the average HEE is more in tribal areas than rural and urban areas. To reduce the gender disparity in HHE long-term and sustained improvements in women’s and men’s health is required. This may be brought out through expansion of education and economic opportunities among men and women. Moreover, a strong mental and attitudinal change in both men and women is essential.