Lok Sabha Question No. 2188 (UNSTARRED), answered on 2021-12-10
Subject: Public Health Expenditure
Ministry: HEALTH AND FAMILY WELFARE
Asked by: S. Jagathrakshakan, Thomas Chazhikadan

## GOVERNMENT OF INDIA MINISTRY OF HEALTH AND FAMILY WELFARE DEPARTMENT OF HEALTH AND FAMILY WELFARE

## LOK SABHA UNSTARRED QUESTION No. 2188 TO BE ANSWERED ON 10-12-2021

## PUBLIC HEALTH EXPENDITURE

## 2188: SHRIS. JAGATHRAKSHAKAN: SHRI THOMAS CHAZHIKADAN:

Will the Minister of HEALTH AND FAMILY WELFARE be pleased to state:

- (a) whether  as  per  the  Global  Health  expenditure  data  base,  2016  of  World  Health Organisation,  India  is  placed  at  170 th position  out  of  188  countries  in  terms  of expenditure on health and if so, the reaction of the Government thereto;
- (b) whether inadequate health infrastructure and less expenditure on health in the country during last three decades has led to difficulty in combating the COVID-19 pandemic;
- (c) if so, the efforts being made to increase the public health expenditure in the country in cooperation with the State Governments;
- (d) the  steps  taken/being  taken  by  the  Government  to  strengthen  public  health,  expand medical infrastructure, and ensure efficient delivery of health services; and
- (e) the efforts made/to be made by the Government to expand primary care substantially and ensure secondary care to all, at little or no cost?

## ANSWER

## THE MINISTER OF STATE IN THE MINISTRY OF HEALTH AND FAMILY WELFARE

## (DR. BHARATI PRAVIN PAWAR)

(a)  to  (d):  As  per  the  data  available  on  Global  Health  expenditure  data  base  (GHED)  of World  Health  Organisation,  the  rank  of  India  in  terms  of  Domestic  General  Government Health Expenditure (GGHE-D)  per  Capita  in  purchasing power  parity International Dollar(PPP Int$) has improved from 150 in the year 2016 to 147 in the year 2019.

Public  Health  &  Hospitals  is  a  State  subject  and  the  primary  responsibility  to  provide healthcare services to all the citizens of the country lies with the State Government.  With a view to strengthen the Public Health Infrastructure effectively, PM-Ayushman Bharat Health

Infrastructure Mission (PM-ABHIM) was launched by Hon'ble Prime Minister of India with a mission to develop the capacities of primary, secondary, and tertiary care health systems, strengthen existing national institutions, and create new institutions, to cater to detection and cure  of  new  and  emerging  diseases.  Ayushman  Bharat  Digital  Mission  (ABDM)  has  also been launched by Government with aim to make healthcare more accessible for citizens and enable greater efficiencies for healthcare quality and continuity of treatment.

In  addition,  some  of  the  major  initiatives  include  National  Health  Mission  (NHM), Ayushman Bharat - Health and Wellness Centres (AB-HWCs), Ayushman Bharat - Pradhan Mantri Jan ArogyaYojana(AB-PMJAY),Pradhan MantriSwasthya Suraksha Yojana (PMSSY) and upgradation of medical colleges. With the objective of delivering comprehensive  primary  health  care,  closer  to  the  homes  of  people  1.5  lakh  Health  and Wellness  Centres  (HWCs)  are  approved  to  be  set  up.    More  than  80,143,  HWCs  are functional as on 21.11.2021. AB-PMJAY is the largest health insurance scheme providing a health cover of Rs 5 lakhs per year for secondary and tertiary care to approximately 50 cr beneficiaries from poor and vulnerable families.

Essential medicines and diagnostics are provided to beneficiaries under Free Essential  Diagnostics  Service  Initiative  under  NHM.  Under  Pradhan  Mantri  National Dialysis Programme, dialysis services are provided free to patients below the poverty line (BPL). Further, under  Pradhan MantriJanaushadiPariyojana (PMBJP) quality medicines at affordable  price  are  provided  to  the  masses  through  dedicated  outlets  called  Pradhan MantriBhartiyaJanaushadi Kendra (PMBJK) across the country.

(e)  According to the National Health Accounts Estimates-2017-18, the Government health expenditure on primary and secondary care has increased from 74.4% in the year 2013-14 to 86.2% in the  year  2017-18.  The  implementation  strategy  under  NHM  has  been  to  provide financial and technical support to States / Union Territories (UTs) enabling them to provide accessible,  affordable,  accountable,  and  effective  healthcare  upto  District  Hospitals  (DHs). The National Health Policy 2017 has also advocated the provision of comprehensive primary health care in the country and recommended that allocation on primary care upto two-third or more.  Consequently,  the  existing  Sub  and  Primary  Health  Centres  are  transformed  into Health and Wellness centres to deliver Comprehensive Primary Health Care. On the basis of the health infrastructure available in the States,  15 th Finance  Commission  identified interventions  that  will  directly  lead  to  strengthening  the  primary  health  infrastructure  and facilities both in the rural and urban areas.

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