Coping with economic crisis: policy development in China and India

This paper explores health policy options in response to economic crises in developing countries. The paper is based upon the premise that policy is best pursued within a broad understanding of the determinants of health of populations. To provide an empirical base for analysis, the health status and health care systems of China and India are compared. A conceptual framework on the determinants of the health status of populations is then developed, incorporating both the performance of health care systems and non-medical factors which influence health. Using the China and India experiences, the paper reviews the strengths and weaknesses of traditional tools used in the analysis of health policy. Significant policy change, it is argued, is best implemented through structural change of several health care system components simultaneously. Health policy analysis, it is further argued, must consider the broader political economy of the society. Moreover, there remain many imperfectly understood sociocultural aspects of behaviour which enable some families to produce good health despite economic constraints. The paper concludes that economic crisis presents an opportunity for a structural review of a society's health systems. Health policy options in response to economic crisis cannot be confined to the health care sector. Rather, health policy should be viewed as only one, perhaps important, element of a package of socioeconomic policy options. Critical to policy choices are reliable information on the condition of the poor and high political priority to minimize the adverse impact of economic crisis on the health, nutrition and social welfare of disadvantaged groups