Designing Regional Health Systems in India: A Case Study of Himachal Pradesh

Designing health systems is a complex challenge. It is made all the more complex in a large and diverse country like India because of the extent and magnitude of variations in it. An attempt is made in this note to carefully study the Indian State of Himachal Pradesh as a case study and to develop a health systems design for it by carefully analyzing its health status, stage of development, and its local geography. The note finds that the State has a number of choices in front of it and if it carefully makes them at this stage over a five to ten year period of time it can aspire to build a first-world health system with health outcomes comparable to the Nordic countries. And, since improved health systems, particularly UHC focussed health systems, are very labour intensive, they should also be seen by the State as being one of the engines of growth in addition to being a means to provide improved healthcare. And, even as the States seeks to reconfigure its health system over the longer-term, it can achieve reductions in unmanaged hypertension, diabetes, and hyperglycaemia very quickly by the use of simple first line drugs, leading to enormous gains in productivity in the short-term while contributing to a reduction in the burden of disease in the medium to long-term.