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National Health Accounts Estimates

  • 02 May 2023
  • 5 min read

For Prelims: Out-of-Pocket Expenditure, WHO, Universal Health Coverage.

For Mains: National Health Accounts Estimates.

Why in News?

Recently, the Ministry of Health and Family Welfare has released the 7th National Health Accounts (NHA) Estimates for India (2019-20), which was produced by the National Health Systems Resource Centre.

  • The NHA estimates are prepared by using an accounting framework based on the internationally accepted System of Health Accounts 2011, provided by the World Health Organization (WHO).

National Health Systems Resource Centre

  • It was established in 2006-07 under the National Rural Health Mission (NRHM) of Government of India to serve as an apex body for technical assistance.
  • Its mandate is to assist in policy and strategy development in the provision and mobilization of technical assistance to the states and in capacity building for the Ministry of Health and Family Welfare (MoHFW).

What are the Key Highlights?

Health Indicators Definitions Data of Growth Trends
Out of Pocket Expenditure (OOPE)

OOPE is the money paid directly by households, at the point of receiving health care. This occurs when services are neither provided free of cost through a government health facility, nor is the individual covered under any public or private insurance or social protection scheme.

The share of OOPE in total health expenditure has declined from 62.6% in 2014-15 to 47.1% in 2019-20.
Government Health Expenditure (GHE) GHE constitutes spending under all schemes funded and managed by Union, State, and Local Governments including quasi-Governmental organizations and donors in case funds are channeled through Government organizations. health system as a low Government.

GHE’s share in the country’s total GDP increased from 1.13% (2014-15) to 1.35% (2019-20).

General Government Expenditure (GGE) This is a proportion of the share of Government expenditures towards healthcare in the General Government Expenditures and indicates Government’s priority towards healthcare. In GGE the share of health sector spending has steadily increased from 3.94% to 5.02% between 2014-15 and 2019-20.
Total Health Expenditure (THE)

THE constitutes current and capital expenditures incurred by Government and Private Sources including External funds.

In the Total Health Expenditure (THE) of the country between 2014-15 and 2019-20, the share of GHE has increased from 29% to 41.4%.

Social Security Expenditure (SSE)

It includes government-funded health insurance, medical reimbursement to government employees, and social health insurance programs.

The share of SSE on health has increased from 5.7% in 2014-15 to 9.3% in 2019-20.
Private Health Insurance Expenditures (PHIE)

PHIE constitute spending through health insurance companies where households or employers pay a premium to be covered under a specific health plan.

PHIE has increased from 3.4 % in 2013-14 to 7 % in 2019-20 estimates out of total Health Expenditure.

External/ Donor Funding for health This constitutes all funding available to the country by assistance from donors.

It has increased from 0.3 % in 2013-14 to 0.5 % in 2019-20 out of total health expenditure.

Way Forward

  • The state governments should move ahead in healthcare spending as percentage of their total budget to about 8% which is currently 4-5% for many states, adding that “this spending must be in line with the bigger picture of benefiting the citizens”.
  • It is important to persist with this trend of expenditure on primary healthcare so that promotive and preventive health, which mostly take place at primary level, can be focused upon.
  • The Fifteenth Finance Commission recommends that the public health expenditure of the Union and States should be increased together to reach 2.5% of GDP (Growth Domestic Product) by 2025.
    • Currently, 20% of the population has social and private health insurance, while the remaining 30%, known as the "missing middle," have no health insurance.

Source: PIB

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