Public spending key to better health care
Expenditure remains lowest globally; experts say health resources must be used optimally as there is no lack of infrastructure
NEW DELHI: Public health care in India is marred by issues ranging from lack of adequate infrastructure to human resource and ineffective use of latest technologies that can largely be attributed to low public health expenditure, experts say.
Latest government data shows that the public health expenditure remains the lowest not just globally but also among its neighbours.
In 2016, just 0.93% of India’s Gross Domestic Product (GDP) was spent on public health care in 2016. This was the second lowest among 10 South-east Asian countries. Bangladesh reported 0.42% government health spending the same year, according to data by the National Health Profile-2019 (NHP-2019) released last month.
Neighbouring countries such as Sri Lanka (1.68%), Indonesia (1.40%), Nepal (1.17) and Myanmar (1.02%) spent more than India on health care in the same year.
The figures don’t seem promising, especially considering the target India has set itself: dedicating 2.5% of the GDP to public health care by 2025.
Experts have warned that India is unlikely to achieve this target if expenditure continues to remain the same.
“If the spending is going by the same rate, both at the central and state level, then it will hover around 1.2-1.3% of the GDP. In fact, it has stayed a little over 1% for the past 10 years. It’s pretty much stagnant, so 2.5% seems unlikely,” said Dr Sakthivel Selvaraj, director, health economics and policy, Public Health Foundation of India.
In effect, low public health spend is likely to have a direct impact on government efforts to achieve Universal Health Coverage. UHC aims to make health care delivery systems accessible and affordable to all citizens.
However, some experts have also pointed out that the key is to utilise health resources optimally as the country is not entirely lacking in medical infrastructure and human resources.
“If one looks carefully, there is no shortage of medical infrastructure in the country. In fact, India has enough to provide quality secondary and tertiary level care to most of its citizens,” said Dr MC Misra, former director, All India Institute of Medical Sciences (AIIMS), Delhi.
“While government hospitals are overburdened, the bed occupancy in hospitals attached to say private medical colleges is not more than 30-40%. There is a need to rationalise the utilisation of this resource that is lying under-utilised. The government can buy facilities for people through government schemes. This way, patients will benefit a great deal,” he added.
Meanwhile, the government has maintained that the country is on the right track and is making progress steadily. “The growth in public health spending has been planned in a phased manner in India’s National Health Policy, so it will be a gradual progress. Things do not improve overnight; the government is making steady progress on most health indicators; the latest maternal mortality rate data shows close to 30% decline, which is a positive sign of movement in the right direction,” a senior health ministry official said on condition of anonymity.