Q. Why in
News/Context -The Ministry of Health and
Family Welfare has released the 7th National Health
Accounts (NHA) Estimates for India (2019-20)(Source - PIB, Ministry
of Health and Family Welfare website)
Q. What are National Health Account (NHA) estimates?
· The NHA estimates are prepared by using an
accounting framework based on the internationally accepted standard of System
of Health Accounts, 2011, developed by
the World Health Organization (WHO).
· The National Health Account (NHA) estimates
for India 2019-20 is the seventh
consecutive NHA estimates report prepared by NHSRC, designated as National
Health Accounts Technical Secretariat (NHATS) in 2014 by the Union Health
Ministry.
Q. What
are the findings and key highlights?
· Share of Out-of-Pocket
Expenditure (OOPE) in Total Health Expenditure declines from 62.6% in
2014-15 to 47.1% in 2019-20. The continuous decline in the OOPE in the overall
health spending show progress towards ensuring financial protection and
Universal Health Coverage for citizens.
· In General
Government Expenditure (GGE), the share of health sector spending has
steadily increased from 3.94% to 5.02% between 2014-15 and 2019-20. This
clearly indicates that healthcare has been the priority for public investment
in the country.
· Share of Government Health Expenditure in Total Health Expenditure increases from
29% (2014-15) to 41.4% (2019-20)
· Government Health Expenditure’s share in country’s total GDP increases
from 1.13% (2014-15) to 1.35% (2019-20)
· The share
of Social Security Expenditure (SSE) on
healthcare has increased from 5.7% in 2014-15 to 9.3% in 2019-20. This
increase in social security has a direct impact on reducing out-of-pocket
payments.
· Private
Health Insurance Expenditures (PHIE) increased from 3.4 %
in 2013-14 to 7 % in 2019-20 estimates out of total Health Expenditure.
·
Per
capita Government spending on healthcare doubles.
|
Definitions for your understanding (Important for Prelims) ·
Out-of-pocket expenditure 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. ·
Total health expenditure (THE)constitutes
current and capital expenditures incurred by the government and private
sources, including external funds.THE as a percentage of GDP indicates health
spending relative to the country’s economic development. THE per capita
indicates health expenditure per person in the country. ·
Government Health Expenditure (GHE)as a
percent of THE 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. ·
Social Security Expenditure (SSE)include finances
allocated by the Government towards payment of premiums or budget allocation
for Union and State Government financed health insurance schemes (PMJAY, RSBY
and other State-specific health insurance schemes), employee benefit schemes,
or any reimbursements made to Government employees for healthcare purposes
and Social Health Insurance scheme expenditures. This indicates the extent of
pooled funds available for specific categories of the population. ·
Private Health Insurance Expenditures as a
percent of THE:Private health insurance expenditures constitute
spending through health insurance companies where households or employers pay
a premium to be covered under a specific health plan. This indicates the
extent to which there are voluntary prepayments plans to provide financial
protection. |
***Healthcare Schemes in India that you Must know***
Public Health is a State subject; hence, the responsibility of
providing medical assistance to patients of all income group is of respective
State/ UT Governments. However, National
Health Mission (NHM) – a flagship programme of the Ministry with its two
Sub-Missions, National Rural Health Mission (NRHM) and National Urban Health
Mission (NUHM), supports States /UTs to strengthen their health care
systems so as to provide universal access to equitable, affordable and quality health care services.
The schemes launched under NHM are available free of cost to all income groups visiting in Public Health
Facilities at sub district and district level are given below:
Reproductive,
Maternal, Neonatal, Child and Adolescent health
- JananiShishuSurakshaKaryakaram
(JSSK)
- RashtriyaKishorSwasthyaKaryakram(RKSK)
- RashtriyaBalSwasthyaKaryakram
(RBSK)
- Universal
ImmunisationProgramme
- Mission
Indradhanush (MI)
- JananiSurakshaYojana
(JSY)
- Pradhan
MantriSurakshitMatritvaAbhiyan (PMSMA)
- NavjaatShishuSurakshaKaryakram
(NSSK)
- National
Programme for Family planning
- LaQshya’
programme (Labour Room Quality Improvement Initiative)
National Nutritional
Programmes
- National
Iodine Deficiency Disorders Control Programme
- MAA
(Mothers’ Absolute Affection) Programme for Infant and Young Child Feeding
- National
Programme for Prevention and Control of Fluorosis (NPPCF)
- National
Iron Plus Initiative for Anaemia Control
Communicable diseases
- Integrated
Disease Surveillance Programme (IDSP)
- Revised
National Tuberculosis Control Programme (RNTCP)
- National
Leprosy Eradication Programme (NLEP)
- National
Vector Borne Disease Control Programme (NVBDCP)
- National
AIDS Control Programme (NACP)
- Pulse
Polio Programme
- National
Viral Hepatitis Control Program (NVHCP)
- National
Rabies Control Programme
- National
Programme on Containment of Anti-Microbial Resistance (AMR)
Non-communicable
diseases
- National
Tobacco Control Programme(NTCP)
- National
Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular
Diseases & Stroke (NPCDCS)
- National
Programme for Control Treatment of Occupational Diseases
- National
Programme for Prevention and Control of Deafness (NPPCD)
- National
Mental Health Programme
- National
Programme for Control of Blindness & Visual Impairment (NPCB&VI)
- Pradhan
Mantri National Dialysis Programme (PMNDP)
- National
Programme for the Health Care for the Elderly (NPHCE)
- National
Programme for Prevention & Management of Burn Injuries (NPPMBI)
- National
Oral Health programme
Other major initiatives include JananiShishuSurakshaKaryakram (JSSK) (under which free drugs, free
diagnostics, free blood and diet, free transport from home to institution,
between facilities in case of a referral and drop back home is provided), RashtriyaBalSwasthyaKaryakram (RBSK)
(which provides newborn and child health screening and early interventions
services free of cost for birth defects, diseases, deficiencies and
developmental delays to improve the quality of survival), implementation of Free Drugs and Free Diagnostics Service
Initiatives and PM National Dialysis Programme.
Ayushman Bharat
Programme-
· It
provides for holistic and integrated health care and is the principal vehicle
for achieving Universal Health Coverage (UHC).
· AB-PMJAY
provides health coverage of up to Rs 5.00
lakh per family per year to 10.74 crore poor, deprived families as per
Socio Economic Caste Census (SECC) database
· It’s
Health and Wellness Centre component (AB-HWC) provides essential primary and
community health services such as maternal, neonatal and child health services
including immunization and nutrition, thus fostering human capital development
during children’s critical early years. These centres also provide services to
prevent and manage common NCDs and major communicable diseases.
· The
other component, AB-Pradhan Mantri Jan
ArogyaYojana (AB-PMJAY) provides free and cashless care to about 500
million poor and deprived people for secondary and tertiary hospitalization
care.
· To
enhance the facilities for tertiary care of cancer, Strengthening of Tertiary
Care for Cancer Scheme is being implemented to support setting up of State
Cancer Institutes (SCI) and Tertiary Care Cancer Centres (TCCC) in different
parts of the country. Oncology in its various aspects has focus in case of new
AIIMS and many upgraded institutions under Pradhan MantriSwasthyaSurakshaYojna
(PMSSY).
· Financial
assistance to patients living below poverty line for life threatening diseases
under the schemes such as RashtriyaArogyaNidhi
(RAN), Health Minister’s Cancer Patient Fund (HMCPF) and Health Minister’s
Discretionary Grant (HMDG) is also provided.
· Affordable Medicines
and Reliable Implants for Treatment (AMRIT) Deendayal outlets have been opened
with an objective to make available drugs and implants for Cardiovascular
Diseases (CVDs), Cancer and Diabetes at discounted prices to the patients.
Automatically
included households (based on fulfilling any of the 5 parameters of inclusion):
a.
Households
without shelter.
b.
Destitute,
living on alms.
c.
Manual
scavenger families.
d.
Primitive
tribal groups.
e.
legally
released bonded labour
