Health Activists Express Discontent Over Rajasthan Health Budget
NEW DELHI: Jan Swasthya Abhiyan, Rajasthan has expressed discontent with the State health budget for the financial year 2018-19 and the government’s increasing inclination towards privatization of public health facilities.
In a meeting held among about 70 civil society representatives, public health experts, academicians, lawyers and Panchayati Raj Institution members from across the State, reiterated the concern that public health facilities in Rajasthan, especially preventive and primary health care services, have for long been in a state of neglect and that there is an urgent need for adequate budgets to revamp and expand existing health and nutrition related services.
The Abhiyan also expressed concern over increasing dependency of the government on health insurance scheme and public private partnership of public health facilities and cautioned that while this approach to health care may attract patients to seek treatment, but it would do little to reduce out of pocket expenditure on health or improve indicators such as maternal mortality, infant mortality, anemia, and malnutrition among others.
The Abhiyan highlighted that while the overall State health budget has shown an increase in monetary terms from Rs 10,800 crore (RE) in 2017-18 to about Rs 12,813 crore in the current budget, yet in terms of state GDP it’s not any different from the previous budget. The Abhiyan has for long been demanding that the State health budget should be increased to at least 2.5% of the state’s GDP, while it has been hovering at close to 1% since quite some years, which is grossly inadequate to deliver quality health care services to a population of Rs 7 crore.
“What is astonishing is that this fiscal year the budget for NRHM has seen a steep decline from Rs 2,158.62 crore in revised budget estimates of previous year to Rs 1,788.61 crore in the current announcements. This would certainly mean that preventive and promotive health care services in rural and deprived areas would evident huge setback’’ a statement issued said here.
The Abhiyan stated that the focus of the current budget announcements has largely been on augmenting health infrastructure by bringing about new health facilities and upgrading the existing ones, without any thought on how the government is going to meet the mammoth shortfall of human resources which for long has been an issue of grave concern.
It is still not clear as in how much budget has been allocated for Bhamashah Swasthya Bima Yojana, but there’s all probability that the budget for the scheme would receive a considerable hike, as was evident last year as well, given the very inclination of the government to expand and sustain its flagship scheme.
In 2017-18 the scheme saw an abrupt raise in its budget to Rs 1,500 crore. The current budget also categorically had a mention of establishing medical colleges and other hospitals on PPP mode. This alternately means that there’s going to be more private empanelment and more public money would be diverted to private kitty. The State has already handed over more than 100 rural and urban PHCs to private agencies to be run on PPP mode.
The Abhiyan also raised concern around malnutrition and anemia among children and women. Anaemia of more than half and lesser body mass index (BMI) of more than quarter of women in reproductive age group of the state is urgently required to be corrected. In one of its major demands Abhiyan stated that elementary education of children aged 3-6 years should be shifted from Anganwadi centres to primary schools. All government schools should have nursery section and admit children from age three onwards as is being the practice in most of the privately funded schools.
Together with this Abhiyan also emphasized that Anganwadi Centres should be engaged in Infant & Young Child Feeding (IYCF) and for dietary needs of pregnant and lactating mothers.Anganwadi centres could be turned into crèches wherever the need be. Women can leave children while going for work or spend around three hours daily with their more than six months and less than six months old child.