SHARE OF PRIMARY HEALTHCARE EXPENDITURE INCREASED TO 55.9% OF GOVERNMENT HEALTH EXPENDITURE (GHE) IN FY20

INFANT MORTALITY RATE DECLINES TO 28 PER LAKH LIVE BIRTHS IN 2020; MATERNAL MORTALITY RATE DECLINES TO 97 PER LAKH LIVE BIRTHS

Over the past few years, healthcare has become more affordable and accessible for the general public, as noted by the National Health Accounts (NHA) estimates, states the Economic Survey 2023-2024 tabled by the Union Minister of Finance and Corporate Affairs, Smt. Nirmala Sitharaman in Parliament today.

The Survey highlights that the latest NHA estimates (for FY20) show an increase in the share of Government Health Expenditure (GHE) in the total GDP as well as the share of GHE in Total Health Expenditure (THE).

Further, the Survey points out that over the years, the share of primary healthcare expenditure has increased from 51.3% of GHE in FY15 to 55.9% of GHE in FY20. The share of primary and secondary care in the GHE rose from 73.2% in FY15 to 85.5% in FY20. On the other hand, the share of primary and secondary care in private health expenditure has declined from 83.0% to 73.7% during the same period, which the Survey attributes to rising tertiary disease burden and utilization of Government facilities for primary healthcare.

The Survey also notes a significant increase in the social security expenditure on health, which grew from 5.7% in FY15 to 9.3% in FY20. There was also a decline in out-of-pocket expenditure (OOPE) as a percentage of Total Health Expenditure (THE) between FY15 and FY20.

Consequent to these developments, the Survey underscores improvements in key health indicators such as Infant Mortality Rate (IMR), declining from 39 per 1000 live births in 2013 to 28 per 1000 live births in 2020, and Maternal Mortality Rate (MMR) declining from 167 per lakh live births in 2014 to 97 per lakh live births in 2020.

Looking forward, the Survey recommends two trends that would be decisive for the health and disease profile of the country in the near future. First, the Survey advises the Government and the public at large to accord primacy to healthy eating and mental health. Second, with public health being a State subject, the Survey highlights the pivotal role of State and local level governance for the national programmes to reach the last mile through the ‘path of least resistance’.

Primary healthcare investment rises, improving affordability and access while social security and reduced OOPE reshape public health financing. Government health financing has shifted toward greater public investment in primary and secondary care, increasing social security funding and reducing out-of-pocket expenditure, which the Survey links to improved affordability, access, and better infant and maternal health indicators; it recommends emphasis on primary healthcare, healthy diets, mental health, and strengthened State and local governance to deliver national programmes effectively.