IndianEra > Health > India Still Far Away From Health Sustainable Goals Development 2030 Target

India’s goal to reach the Sustainable Development Goals (SDG) for health by 2030 seems like a challenge, especially with the current Health care scenario in the country.

According to the Indian Comptroller and Auditor General (CAG), India has a long way to go to achieve its target of public health spending as its primary health infrastructure is not enough and it lacks the data to track its progress in achieving its Sustainable Development Goals (SDGs) in terms of health by 2030.

These factors present a challenge to achieve the key objectives of the 2030 Agenda, added CAG in its June 2018 report.

India’s Health Ministry had said that it would increase India’s public health expenditure to 2.5 percent of its gross domestic product (GDP) by 2025.

“It has remained within a narrow band of 1.02-1.28% of GDP”, said the report.

As part of its report, the CAG covered the NITI Aayog, the Indian Health Ministry, the Statistics and Program Implementation Ministry and 14 other ministries to assess their preparedness to achieve SDGs.

The CAG also analyzed Indian state’s performance including Assam, West Bengal, Chhattisgarh, Uttar Pradesh, Haryana and Maharashtra.

The following were the findings of the CAG Report:

NITI Aayog Three Year Action Agenda

NITI Aayog

The NITI Aayog’s three-year action agenda targeted a rise in the Centre’s health budget up to NPR 1 Lakh crore by 2019-20. However, the allocations fell short.

India’s allocation in 2017-18 was INR 53,294 crore, followed by INR 56,045 crore in 2018-19 and INR 65,038 crore in 2019-20.

National Health Policy 2017

National Health Policy 2017

India’s National Health Policy 2017 created to meet SDGs suggests the increment of states health expenditures to over 8 percent of their annual budgets by 2020.

However, the states listed in the report spent between 3.29 – 5.32 percent of the period 2012-17.

National Health Mission (NHM)

National Health Mission

The NHM working to provide universal access to affordable, equitable and quality health care was conceived as crucial in reaching health targets such as:

  • Maternal Mortality Rate (MMR) – <70 deaths per 100,000 live births
  • Neonatal Mortality Rate (NMR) – <12 deaths per 1000 live births
  • Under-five Mortality Rate (U5MR) – <25 deaths per 1000 live births

Disappointingly, India recorded the following negative figures in 2017:

  • Maternal Mortality Rate (MMR) – 130 deaths per 100,000 live births
  • Neonatal Mortality Rate (NMR) – 24 deaths per 1000 live births
  • Under-five Mortality Rate (U5MR) – 39 deaths per 1000 live births

Likewise, budget allocations to the National Health Mission fell short by 13.6 percent in 2018-19 compared to the budget projections.

It was also noted that India’s neonatal mortality rate of 24 deaths per 1000 live births was higher than the global average of 18 deaths.

Additionally, India’s GDP spend of 1 percent on public health in 2015 was the second-lowest in the South-East Asian region.

State GDP Spending on Health Should Increase

GDP Spending on Health Should Increase

According to India’s National Health Policy, Indian states should increase their health spending on primary care by at least 10 percent every year to reach the 2025 target of spending 2.5 percent of GDP on health.

The policy also suggested that states should increase their health spending to over 8 percent of their annual budget by the year 2020. However, all the states under the CAG report failed to do so by 2017.

Moreover, it is reported that NHM funds provided to states were not spent for as long as five years until 2016.

Health Infrastructure Shortages

Health Infrastructure Shortages

According to data from CAG’s 2017 audit report on reproductive and child health (under the National Rural Health Mission), rural India has a shortage of the number of sub centers, primary health centers and community health centers in 28 states and UTs, about 24-38 percent.

As per the Indian Public Health Standards in 2006, each PHC with a burden of 20 deliveries per month needs at least two medical officers.

Chhattisgarh and UP had a significant shortage of human resources, according to the CAG report.

Chhattisgarh has a total of 341 doctors in PHCs, which makes up for 0.43 percent per PHC.

UP is one of the most under-performing states with a shortage of 30 percent in terms of infant and under-five mortality rankings.

Similarly, West Bengal with a population of 62 million has one PHC per 68,000 people. This is less than  half of the suggested number for one PHC – 30,000.

The population-doctor (govt. hospitals) ratio in India was 11,082:1 in 2017, compared to the WHO’s recommendation of 25 professionals per 10,000 people (25 times higher).

The NITI Aayog and the statistics ministry in consultation with the state governments had to prepare the National Indicator Framework, the backbone for monitoring of SDGs.

However, data for 137 of 306 national indicators were not available for 13 SDG goals, cited the CAG report.


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Posted by IndianEra, 22/09/2019