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全民数字健康:印度转向数字化医疗保健。

Digital health for all: The turn to digitized healthcare in India.

机构信息

Sociologist at the French National Centre for Scientific Research (CNRS), Centre for Studies of Social Movements (CEMS) and French Institute of Pondicherry (IFP), India.

Centre for Studies in Science Policy (CSSP), School of Social Sciences, Jawaharlal Nehru University (JNU), New Delhi, India.

出版信息

Soc Sci Med. 2023 Feb;319:114968. doi: 10.1016/j.socscimed.2022.114968. Epub 2022 Apr 15.

Abstract

In India, the use of digital technologies has become the key to the everyday operation of the welfare state in terms of accessing essential and life-sustaining entitlements. In this context, our article explores the genesis of India's digital turn in healthcare and maps the characteristics of a 'digital health for all' policy, based on empirical analysis of India's first digital-based universal health coverage programme - Rashtriya Swasthya Bima Yojana (RSBY) - with fieldwork material from the states of Jharkhand and Chhattisgarh. Being a smart-card-centred programme, RSBY marks the genesis of a digital approach to healthcare in India. The experiences of this scheme hold crucial implications for the digital healthcare landscape in India, as in the past its promoters pitched for its use to provide quality healthcare at lower cost. The technological design of the programme illustrates the construction and politics of a digitalized public-private welfare policy intended to meet the health needs of the poorest. By examining data on digital access to healthcare in the RSBY programme, as propounded and sustained by public health policies and a public-private model of governance, our article raises questions about the construction of new digital health policies and their contribution to private health markets. In doing so, it explores the key question of how digital technologies are transforming access to healthcare in India.

摘要

在印度,数字技术的应用已成为获取基本和维持生命的权益的福利国家日常运作的关键。在此背景下,我们的文章探讨了印度医疗保健数字化转型的起源,并根据对印度第一个基于数字的全民健康覆盖计划——拉什特里亚·斯瓦斯塔亚·比马·约哈纳(Rashtriya Swasthya Bima Yojana,RSBY)的实证分析,描绘了“全民数字健康”政策的特点,该计划的实地材料来自恰蒂斯加尔邦和恰尔康得邦。作为一个以智能卡为中心的计划,RSBY 标志着印度医疗保健数字化方法的起源。该计划的经验对印度的数字医疗保健领域具有重要意义,因为过去其推动者曾主张利用该计划以更低的成本提供高质量的医疗保健。该计划的技术设计说明了旨在满足最贫困人群健康需求的数字化公私福利政策的构建和政治。通过检查 RSBY 计划中关于数字获取医疗保健的数据,以及公共卫生政策和公私治理模式所主张和维持的内容,我们的文章提出了关于新数字健康政策的构建及其对私人医疗市场的贡献的问题。在这样做的过程中,它探讨了数字技术如何改变印度获取医疗保健的关键问题。

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