Disrupting healthcare? Entrepreneurship as an "innovative" financing mechanism in India's primary care sector

Bibliographic Data

ID4588170
AuthorsSandra Bärnreuther (0000-0003-4628-8030, University of Lucerne, corresponding author)
Year2023
Volume319
Pages115314
Publication date2023-02-01
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueSocial Science & Medicine (JOURNAL)
Journal identifiersISSN: 0277-9536 • E-ISSN: 1873-5347
PublisherElsevier BV (PUBLISHER)
DOI10.1016/j.socscimed.2022.115314
PMID36127193
OpenAlexW4293660011
LanguageEN
Citations received7
References cited17

Innovation" - whether in the form of digital technologies or business models - dominates imaginaries of global health futures and is often promoted as a "solution" through which the goal of universal health coverage can be achieved. Seemingly disrupting the status quo, it offers the promise of novel and simple answers to longstanding and complex social problems. In this article, I analyze a public-private partnership between the Indian state of West Bengal and an Indian-owned social enterprise. One of its defining features is an "innovative" financing mechanism based on loans and entrepreneurship. The project employs young people from marginalized communities as health entrepreneurs, who market digital healthcare in rural areas in order to provide access to affordable and high-quality biomedical care. Although the model promises sustainable modes of financing healthcare, it shifts financial risk to low-income groups. As health workers resisted attempts to be turned into self-reliant entrepreneurs and continued to make demands on the developmental state, frictions emerged during project implementation. The question of how healthcare should be made accessible and affordable, in what manner the state should be involved in financing it, and what role innovation should play in this regard was all contested. Although an entrepreneurial business model to deliver primary care is seen as an innovative solution at a time when government expenditure in the social sector remains low and levels of un- and underemployment are high, this paper complicates prevailing claims about its disruptive powers in India and argues that its effective role for equitable social change has to be critically examined

Business · Economic growth · Economics · Entrepreneurship · Government (linguistics · Health care · Political science · Public relations · Community Development and Social Impact · Innovation and Socioeconomic Development · Microfinance and Financial Inclusion · Finance

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