The government's share in the total health expenditure has increased from 28.6 per cent in financial year 2014 to 40.6 per cent in 2019 with a significant decline in out-of-pocket expenditure, according to the Economic Survey 2022-23.

Tabled in Parliament by Finance Minister Nirmala Sitharaman on Tuesday, the survey stated the government has also strengthened health infrastructure and prepared itself to address present and future needs.

"The share of government health expenditure in total health expenditure has increased from 28.6 per cent in the financial year 2014 to 40.6 per cent in 2019, with a concomitant decline in out-of-pocket expenditure as a percentage of total health expenditure from 64.2 per cent in 2014 to 48.2 per cent in 2019," the survey stated.

The National Health Account (NHA) for the financial year (FY) 2019 -- the latest available account -- highlights the rising importance of public healthcare and social security in ensuring universal health coverage, it said.

The NHA's estimates for FY-19 show that there has been an increase in the share of government health expenditure (GHE) in the total GDP from 1.2 per cent in FY-14 to 1.3 per cent in FY-19, the survey stated.

"Aligning with the focus on providing healthcare services to all, which comprises one of the policy recommendations of the National Health Policy-2017, the government is focusing on primary healthcare expenditure which has increased from 51.1 per cent in FY-14 to 55.2 per cent in FY-19," it stated.

This not only ensures quality services at the grassroots but also reduces the chances of ailments requiring secondary or tertiary healthcare services, the survey stated.

Between FY-14 and FY-19, the share of primary and secondary care in the government health expenditure increased from 74.4 per cent to 85.7 per cent, the survey showed.

On the other hand, the share of primary and secondary care in private health expenditure has declined from 82 per cent to 70.2 per cent during the same period, it stated.

The social security expenditure on health, which includes the social health insurance programme, government-financed health insurance schemes, and medical reimbursements made to government employees, has increased from six per cent in FY-14 to 9.6 per cent in FY-19, the survey showed.

"This is a significant increase which shows that the citizens are better equipped and better provided in terms of healthcare at their doorstep making it more accessible. Due to several such steps, out-of-pocket expenditure as a percentage of total health expenditure has declined substantially from 64.2 per cent in FY-14 to 48.2 per cent in FY-19," the survey stated.

Highlighting the progress under major government initiatives for health in FY-23, the survey stated that the intensified Mission Indradhanush 4.0 was conducted in 416 districts across 32 states and union territories, to cover children and pregnant women who missed routine immunisation due to the Covid pandemic.

Until December last year, 11 phases of Mission Indradhanush have been completed covering 701 districts across the country under which 4.5 crore children and 1.1 crore pregnant women have been vaccinated, it stated.

Resultantly, the National Family Health Survey-5 (NFHS-5) shows a 14.4 per cent increase in full immunisation coverage (FIC) from NFHS-4, and an increase in the percentage of FIC in 30 states and union territories, the survey noted.

It stated that as of January 6 this year, India has been able to administer more than 220 crore Covid vaccine doses. The economic survey said 97 per cent of eligible beneficiaries have already received at least one dose of Covid vaccine and around 90 per cent of eligible beneficiaries have received both the doses.

Vaccination for the age group 12-14 years was started on March 16 last year, followed by the precautionary dose for the age group 18-59 years starting from 10 April last year.

So far, more than 4.2 crore adolescents have been administered the first dose of the Covid vaccine and 22.4 crore precautionary doses have been administered, it stated.

The intervention in the medicinal education system since 2014 has resulted in improved recruitment of doctors and supporting staff, the survey showed. According to the National Medical Commission (NMC), 13,08,009 allopathic doctors are registered with the State Medical Councils and the NMC as on June last year.

Assuming 80 per cent availability of registered allopathic doctors and 5.7 lakh AYUSH doctors, the doctor-population ratio in the country is 1:834 against the WHO norms of 1:1000, the report mentioned.

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