Rajasthan government spends only Rs 904 per capita on health

Narendra Gupta, convenor of Jan Swasthya Abhiyan.File photoFile photo

Rajasthan listed as one of the States with low expenditure on health care

With the National Health Accounts Estimates 2014-15 report listing Rajasthan as one of the States with low per capita expenditure on healthcare, a health activists’ group here has demanded universal free treatment to all and an immediate halt to handing over of the government health institutions to private operators for management.

Centre’s report

The report, released by the Union Ministry of Health and Family Welfare on Tuesday, shows that the total health expenditure per capita in the State is at Rs. 2,943. Of the total spending of Rs. 21,188 crore on health in2014-15, only Rs. 6,511 crore was spent by the State government.

This calculates to the government spending only Rs. 904 per capita or 3.5% of the Gross State Domestic Product. The remaining amount was mostly borne out of pocket by the patients, the Rajasthan Jan Swasthya Abhiyan, functioning as the State chapter of People’s Health Movement, pointed out on Thursday.

Even though the infant mortality rate, maternal mortality ratio and fertility rate are high in Rajasthan, the State ironically has lesser spending per disease than the majority of other States. “The fact that the overall expenditure is one of the lowest indicates that the people themselves do not have enough resources to pay for their treatment,” said Abhiyan’s convenor Narendra Gupta.

“Gross inadequacy”

Even one-fourth of the total public health facilities in the State had not attained the Public Health Standards formulated by the Union government in 2005, said Dr. Gupta, adding that there was “gross inadequacy” of infrastructure and human resource for health.

The Jan Swasthya Abhiyan has demanded that the State government take note of the report and allocate Rs. 2,000 per capita annually for healthcare and equip all public health institutions with adequate infrastructure and human resource to attain the health standards by 2018-end.

Out-of-pocket spending

Besides, the out-of-pocket spending should be brought down to 40% or less of the total expenditure on healthcare by initiating the facility of universal free treatment to all, rather than keeping it selective.

The Abhiyan also called for an immediate halt to the State government handing over public health institutions to private operators for management and financial allocations to the latter.

Health centres require ventilator support, qualified doctors, and trained nurses to prevent infant deaths. An analysis by health activists shows per capita health expenditure in Rajasthan was one of the lowest in the country.

Infant mortality rate (IMR) in Rajasthan, according to the Sample Registration System (SRS) 2016, was 41 per 1,000 live births; in 2015, the IMR was 43.

Out of Rs 21,188 crore expenditure on health in 2014-15, the state government spent only Rs 6511 crore, said Dr Narendra Gupta, Rajasthan convener of Jan Swasthya Abhiyan. Quoting a report of National Health Accounts 2014-15, released by the union ministry of health and family welfare, he said the Rajasthan government’s per head spending on health was Rs 2,943.

The government spends 30%, and 70% of the amount spent comes from private pockets, Narendra said. “With so low spending, healthcare cannot be managed.”

The main reasons for infant deaths are birth asphyxia, low birth weight, congenital diseases, infections, and diarrhoea. Birth asphyxia is a medical condition in which newborn does not get oxygen supply during the birth process.

Dr Narendra said, “All public health institutions of the state should be equipped with infrastructure and human resources to attain Indian public health standards by the end of 2018; out-of-pocket spending should be brought down to 40%, and handing over of government health institutions to private operators for management be immediately stopped.”

JK Lone hospital superintendent Dr Ashok Gupta said, “Low birth weight and premature baby are major reasons behind newborn deaths. Management of newborns is a cost-intensive process. It requires ventilator support, qualified doctors, and trained nurses among other facilities.”

Nutrition of adolescent girls needs to be improved and childbirth age upped to reduce newborn deaths, Gupta said. “There should be space between childbirths, and deliveries should be institutionalised. Adequate infant care and emergency services, referral support and proper transport system should be ensured.”

Principal secretary, medical and health, Veenu Gupta said Chirayu programme was launched in June this year at eight districts — Barmer, Dholpur, Karauli, Jalore, Rajsamand, Sawai Madhopur, Sirohi and Udaipur — to bring down IMR.

“Newborn services were strengthened at primary and community health centres, and district hospitals.”

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