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Union Budget 2024: How to lay the foundation for a healthy India by 2047 – Times of India

By Urvashi Prasad
Budget 2024 expectations: India has shown remarkable progress in the field of health and nutrition. Presently, over 50 crore Indians benefit from the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY), ensuring their access to healthcare. The country has established 1.73 lakh Ayushman Aarogya Mandirs (AAMs) to offer comprehensive primary healthcare services.Over the past decade, the number of medical education seats for both under- and post-graduate programmes has more than doubled. Moreover, the out-of-pocket health expenditure has decreased from 63% in 2014 to 39% in 2024.
Nevertheless, India still has a considerable distance to cover in comparison to global standards as it aims for Viksit Bharat @ 2047. The current life expectancy in India stands at 71 years, whereas it is 77 in China, 84 in Japan, and 75 in Brazil. India’s Infant Mortality Rate (IMR) is 28 per 1000 live births, contrasting with 5 in China and less than 2 in Japan. South Africa’s out-of-pocket health expenditure accounts for only about 8% of the total, in contrast to India’s 39%.
Presently, there are 10 doctors and 17 nurses and midwives per 10,000 individuals in India. In comparison, middle-income countries like China and Brazil have 17 doctors and 40 nurses and midwives per 10,000 persons, while high-income countries like the US and Australia have 39 doctors and 120 nurses and midwives per 10,000 individuals.
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Countries such as Singapore, Taiwan, and South Korea have demonstrated the potential of harnessing the demographic dividend to achieve remarkable economic growth through the implementation of progressive policies and initiatives aimed at empowering the youth in making informed health choices. The allocation of adequate funds for the health sector in the Union Budget 2024-25 is of utmost importance. According to the National Health Policy (NHP) 2017, India’s healthcare expenditure should reach 2.5% of GDP by 2024-25.
Notably, public healthcare spending in India encompasses health, family welfare, AYUSH, medical research, and water supply and sanitation. While some states have exceeded the 8% target outlined in the NHP 2017, others fall short, highlighting disparities in healthcare expenditure across states. Therefore, the central government plays a crucial role in augmenting state health expenditure to promote greater equity nationwide. Increased funding for nutrition, clean drinking water, and sanitation is also critical. The Budget 2024-25 should prioritize efforts to eradicate childhood undernutrition and anaemia among women and children.
It is vital to increase investment in the health of children and adolescents, with a particular focus on early childhood development, care, and education for children aged 0–6 years. The first 1000 days of life, from a woman’s pregnancy to her child’s second birthday, present a unique opportunity to establish the foundation for lifelong health and development. Adequate nutrition and care during this period not only impact a child’s survival but also her ability to thrive, learn, and break the cycle of poverty. Strengthening the existing 14 lakh Anganwadi Centers and providing adequate training to staff in child development and learning, could have a significant impact.
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One crucial aspect to consider is the health of students in schools. The school-age phase is a key time for the body to start storing nutrients, which aids in rapid growth. Focusing on school children is essential for India to harness the potential of its young population, who will play a vital role in the future workforce and contribute to improving the nation’s socio-economic status.
Introducing a nationwide school health initiative can ensure the overall well-being of 255 million school children and teenagers aged 6-18, with a focus on physical and mental health, nutrition, wellness, and promoting a healthy lifestyle. Creating a school environment that encourages health and nutrition through activities such as yoga, physical education, mental health support, counselling, and regular health check-ups should be a top priority.
The healthcare system’s foundation is rooted in primary healthcare, which is essential for achieving the desired health outcomes by 2047. The future well-being of citizens depends heavily on the efficient delivery of services through our AAMs. Therefore, the transformation of all AAMs must be completed by 2027. Since 2018, the primary healthcare platform has been established with 173,000 AAMs, along with the deployment of community health officers, infrastructure upgrades, telemedicine services, and provision of free drugs and diagnostics.
However, challenges related to full operationalization, coverage, quality, and continuity persist across states. The implementation of half of the package focusing on mental health, acute care, geriatric care, oral, visual, and ENT treatments, and emergency services needs to be improved. The other half of the package, which has been implemented, faces challenges with the inconsistent availability of medications and diagnostics at some AAMs. Although screenings for hypertension and diabetes have commenced, the emphasis also needs to be on treatment, follow-ups, and other services. Furthermore, cancer screening rates need to be improved, as does the training of personnel in critical areas.
Research indicates that improved health outcomes contribute to enhanced economic productivity. It is essential that Budget 2024-25 is a transformational step towards securing additional funding for healthcare, alongside enhancing the quality of health services with the existing resources.
(The author, Urvashi Prasad is Director, Office of Vice Chairman, NITI Aayog. The article has been written with research inputs from Shashvat Singh. Views expressed are personal)

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