This profile was prepared when Pralhad Malvadkar was elected to the Ashoka Fellowship in 2001.
The New Idea
Enacted in 1948, the Employee's State Insurance Scheme (ESIS) is a form of contributory health and accident insurance. Pralhad is revamping the ESIS health care system to make it more regulated, effective, and quality-driven. Through a national campaign, Pralhad is drawing together the two groups with the greatest potential to bring about reform: industrial workers who are the beneficiaries of this scheme and citizen sector organizations. He is also linking a wide range of citizen organizations to lobby for reform and to develop effective means of collaborating despite the lack of government support. One of the most radical aspects of Pralhad's work is his plan to directly involve ESIS-insured workers by organizing them into watchdog committees that monitor implementation and follow-up of specific health care services. Other measures for improving the system include creating groups of doctors who are committed to providing quality care and lobbying for legal reforms that will enable workers to demand adequate treatment. Pralhad's idea has immense potential since the scheme can be expanded to cover workers in India's large and growing informal sector as well.