ECSAS 2023 – Turin 26-29 July

Of Digital (Trans)formations and Medical Entanglements: On the Making of a Health Insurance Scheme in India


Sharma Smriti - University of Lucerne, Department of Social and Cultural Anthropology, Lucerne, Switzerland


15 – Hospitals in South Asia: Historical and Ethnographic Perspectives


 In recent decades, India – a country known for its under-funded and under-resourced healthcare sector has introduced health insurance schemes to address WHO’s call for UHC. These schemes aim to provide accessible and affordable healthcare to the low-income population. The newest and most widespread scheme is the Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana. The existing literature on these publicly financed health insurance schemes targeted at reducing financial risk, have highlighted their exclusionary nature, arising out of increased out of pocket expenditure. In this paper instead, I draw on twelve months of ethnographic fieldwork to analyze the processes and practices integral to the everyday management of care from within a public and private hospital in Haryana.

Taking on board new medical and digital interventions by following a ‘policy in the making’, I investigate how different actors together (intermediaries and beneficiaries) experience, navigate and adapt to them? How do these interventions facilitate or disrupt access to care and shape clinical encounters and medical treatment at hospitals? What novel strategies (e.g., tinkering with technologies) are put to use to mitigate challenges arising out of its everyday functioning? I further examine how care is divided and distributed between the public and private hospitals? What kind of roles, responsibilities and anxieties emerge from this division? What implications does it have for health reform in India?