Case Study

Taking an Ecosystems Approach: Support for Advocacy Training Initiatives’ (SATHI) Public Health Work in India

September 2016 | by Brendan Halloran, IBP (adapted from a longer study by Padmaja Nair)

The state of Maharashta is one of India’s most powerful economic engines. Yet despite India’s commitment to the principle of universal access, the state government spends less than 4 percent of its budget on health. Many social groups in Maharashta still lack access to quality healthcare and poor individuals are often forced to seek expensive private options.

Support for Advocacy and Training to Health Initiatives (SATHI) has been working to improve healthcare in Maharashta for almost 20 years. SATHI has worked with the objective of making the public health delivery system accessible and equitable to all, especially poor and marginalized people. SATHI’s work takes place along three fronts: ensuring the accountability of the public health system, establishing social control over private health systems, and promoting universal access to quality health care.

This case study documents the strategies and achievements of SATHI and its coalition partners, the impacts of CSO interventions on public health delivery and accountability, and challenges that have emerged.

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Authors

Brendan Halloran

Manager, SALT, International Budget Parnership

Brendan Halloran is International Budget Partnership’s Head of Strategy and Learning. In this role, Brendan facilitates strategy and learning processes at IBP – both the internal production of learning insights and drawing on evidence and ideas from broader research and practice in the governance space. He’s particularly interested in complex change dynamics, and how to support organizations to both navigate and strengthen their accountability ecosystems.

Prior to joining IBP in 2016, Brendan lead the learning work of the Transparency and Accountability Initiative, where he played a role in shaping and interpreting evidence about what works, as well as supporting collective learning spaces, such as the TALEARN network. Before that, Brendan spent five years living, researching and working in Guatemala, most recently as a Governance Advisor for USAID.  Brendan has a Ph.D. from Virginia Tech, and has published work in a variety of journals, think pieces, and blogs, including his own — Politics, Governance, and Development.

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