Hindu Editorial Analysis : 21-November-2024
Recent trends in government health spending across Low-Income Countries (LICs) and Lower Middle-Income Countries (LMICs), including India, have raised concerns as nations approach the deadline for achieving the United Nations’ Sustainable Development Goals (SDGs). SDG 3, which focuses on Good Health and Well-being, aims to significantly reduce maternal mortality, child deaths, and preventable diseases, among other health challenges. However, declining health budgets are threatening the progress towards these vital goals.
SDG 3 and Health Targets
SDG 3 includes several specific targets related to health:
- SDG 3.1: Reduce maternal mortality to less than 70 per 100,000 live births.
- SDG 3.2: End preventable deaths of children under 5, aiming for a mortality rate of less than 25 per 1,000 live births.
- SDG 3.3: Eradicate epidemics like AIDS, tuberculosis, malaria, and neglected tropical diseases.
- SDG 3.4: Reduce premature deaths from non-communicable diseases (NCDs) and promote mental health.
- SDG 3.8: Achieve universal health coverage (UHC) for all.
The Decline in Health Spending
Pandemic Surge and Post-Pandemic Decline
During the COVID-19 pandemic, many countries increased health spending to manage the crisis. However, this increase was temporary, and since then, health spending has steadily declined. As a result, health spending’s share of national budgets has fallen back to pre-pandemic levels, impeding progress toward the SDGs.
- In Low-Income Countries (LICs): Health spending dropped to 5.6% of government expenditure in 2023, down from the pandemic peak.
- In Lower Middle-Income Countries (LMICs): Health spending declined to 6.5% of the budget in 2023.
Despite a modest increase in health spending per capita, the overall growth has been slow, with LICs experiencing an annual growth rate of only 0.4% from 2019 to 2023.
India’s Health Funding Challenges
India’s government health spending has also faced challenges in keeping up with the country’s health needs. The Union Budget for 2024-25 has allocated ₹90,958.63 crore for health, marking a 12.9% increase from the previous year. However, despite this increase, the share of health spending as a percentage of GDP has remained low:
- 2020-21: Government health expenditure (GHE) was 1.6% of GDP.
- 2021-22: It rose to 2.1% of GDP.
- 2023-24: GHE stood at 1.9% of GDP.
India aims to increase public health spending to 2.5% of GDP by 2025. However, post-pandemic, the share of health in the budget has fallen below 2%, which poses a significant challenge in meeting SDG 3 targets.
Strategies to Address Health Funding Gaps
To mitigate the risks associated with declining health spending, governments can adopt several strategies:
- Increase Health Spending: Prioritizing health in national budgets ensures adequate funding for essential services and programs.
- Strengthen Health Systems: Investments in healthcare infrastructure, workforce training, and medicine supply chains can improve service delivery and system resilience.
- Promote Public-Private Partnerships: Collaboration between the public and private sectors can help mobilize resources and foster innovation in healthcare.
- Leverage Technology: Using digital solutions, like telemedicine and health records, can improve access to healthcare services, especially in remote areas.
- Focus on Preventive Care: Emphasizing vaccination, health education, and early disease detection can reduce the overall burden on healthcare systems.
Key Health Initiatives in India
India has launched several key initiatives to advance the health of its citizens and meet SDG 3 targets:
- Ayushman Bharat: This initiative includes two key components:
- Pradhan Mantri Jan Arogya Yojana (PM-JAY): Provides health coverage of up to ₹5 lakh per family per year for secondary and tertiary hospital care.
- Health and Wellness Centres (HWCs): These centres offer comprehensive primary healthcare, focusing on maternal, child health, and non-communicable diseases.
- National Health Mission (NHM): Strengthens healthcare systems in both rural and urban areas.
- Poshan Abhiyaan (National Nutrition Mission): Addresses malnutrition, particularly among children, pregnant women, and lactating mothers.
- Mission Indradhanush: Aims for full immunization coverage for children and pregnant women.
- Pradhan Mantri Bhartiya Janaushadhi Pariyojana (PMBJP): Provides affordable medicines through special stores called Janaushadhi Kendras.
- Ayushman Bharat Digital Mission (ABDM): Facilitates a digital health ecosystem, allowing citizens to access their health records and services.
Important Points:
- SDG 3 Health Targets:
- SDG 3.1: Reduce maternal mortality to less than 70 per 100,000 live births.
- SDG 3.2: End preventable deaths of children under 5, aiming for less than 25 deaths per 1,000 live births.
- SDG 3.3: Eradicate epidemics like AIDS, tuberculosis, malaria, and neglected tropical diseases.
- SDG 3.4: Reduce premature deaths from non-communicable diseases (NCDs) and promote mental health.
- SDG 3.8: Achieve universal health coverage (UHC).
- Declining Health Spending Trends:
- During the COVID-19 pandemic, health spending increased, but it has since declined.
- In LICs, health spending as a share of government expenditure dropped to 5.6% in 2023, down from the pandemic peak.
- In LMICs, the share of health spending fell to 6.5% of the budget in 2023.
- Government health spending per capita in LICs grew at an average of 0.4% annually from 2019 to 2023.
- India’s Health Spending:
- India’s Union Budget for 2024-25 allocated ₹90,958.63 crore to health, marking a 12.9% increase from the previous year.
- However, government health expenditure (GHE) as a percentage of GDP was:
- 1.6% in 2020-21
- 2.1% in 2021-22
- 1.9% in 2023-24
- India aims to increase public health spending to 2.5% of GDP by 2025.
- Strategies to Address Health Funding Gaps:
- Increase Health Spending: Prioritize health in national budgets.
- Strengthen Health Systems: Invest in infrastructure, healthcare worker training, and supply chains.
- Promote Public-Private Partnerships: Mobilize resources and foster innovation.
- Leverage Technology: Use telemedicine and digital health records to improve access.
- Focus on Preventive Care: Emphasize vaccination and early disease detection.
- Key Health Initiatives in India:
- Ayushman Bharat: Includes PM-JAY (health coverage up to ₹5 lakh per family) and Health and Wellness Centres (HWCs).
- National Health Mission (NHM): Strengthens healthcare systems in rural and urban areas.
- Poshan Abhiyaan: Focuses on reducing malnutrition in children and mothers.
- Mission Indradhanush: Aims for full immunization coverage.
- PMBJP: Provides affordable medicines through Janaushadhi Kendras.
- Ayushman Bharat Digital Mission (ABDM): Facilitates a digital health ecosystem for easier access to healthcare services
Why In News
Recent trends in government health spending across Low-Income Countries (LICs) and Lower Middle-Income Countries (LMICs), including India, reveal worrying shifts, with many nations reducing health budgets just as they approach the critical deadline for achieving the Sustainable Development Goals (SDGs), putting progress toward key health targets at significant risk.
MCQs about Health Spending Trends in Low and Middle-Income Countries
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What is the main concern highlighted in recent trends of government health spending across Low-Income Countries (LICs) and Lower Middle-Income Countries (LMICs)?
A. Health spending has increased significantly since the pandemic.
B. Health budgets are being reduced, threatening SDG health targets.
C. Health spending has remained stable, with no significant changes.
D. Government health expenditure has shifted from primary to secondary care.
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Which of the following is a key target under SDG 3 (Good Health and Well-being)?
A. Achieve 100% literacy rates worldwide.
B. End epidemics of AIDS, tuberculosis, and malaria.
C. Eliminate poverty globally by 2030.
D. Achieve universal education for all children.
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What is India’s goal regarding government health expenditure as a percentage of GDP by 2025?
A. To decrease it to 1.5% of GDP.
B. To maintain it at 2.0% of GDP.
C. To increase it to 2.5% of GDP.
D. To increase it to 3.0% of GDP.
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Which initiative in India provides health coverage of up to ₹5 lakh per family per year for secondary and tertiary care hospitalization?
A. Ayushman Bharat Digital Mission
B. Pradhan Mantri Jan Arogya Yojana (PM-JAY)
C. National Health Mission (NHM)
D. Mission Indradhanush
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