Expenditure hurdles for NRHM - Economy and Politics

More than seven years after the government launched the National Rural Health Mission (NRHM), public health results are spotty. While allocations for health have more than tripled since 2005-06, spending on health and family welfare, as a proportion of the government’s total expenditure, has barely increased from 1.89% to 2.03% in 2010-11. This is extremely low, both in absolute terms, and compared with many other developing countries. Lack of doctors and specialists also remain a serious problem. A review of data collected by the Accountability Inititative, Centre for Policy Research, in Delhi analyses spending in public health trends. This is the last of a four-part series leading up to the Union budget due to be released on 16 March.

Slideshow

India’s expenditure on public health is extremely low compared with other developing countries

India spent only 1.4% of its GDP on public health in 2009-10, which is extremely low, both in absolute terms and compared with developing countries such as Nepal, China, Thailand, Argentina and Brazil.

Though there has been a marginal decrease in shortfall of doctors at public health centres, state-wise data is uneven.

The shortfall of doctors in PHCs decreased by six percentage points overall between March 2009 and March 2010. Uttar Pradesh, Uttarakhand and Orissa have shown some improvement, while Bihar and Gujarat have regressed.

Institutional deliveries improving across states

The proportion of institutional deliveries has increased from 57% in 2006-07 to 79% 2010-11. Kerala and Tamil Nadu were the best performing states in 2010-11, while Chhattisgarh, Uttar Pradesh and Jharkhand lagged behind.

Lack of specialists remains a serious problem across states

More than 65% of the community health centres in India do not have the required number of specialists (surgeons, paediatricians, physicians and obstetricians and gynaecologists).

The infant mortality rate has declined from 58 per 1,000 live births in 2005 to 47 in 2009, while the maternal mortality rate has declined from 254 per 100,000 live births in 2004-06 to 212 in 2007-09.