Neglect of Public Health and Interstate Variation in Health Outcomes -Some Insights from Indian Health Sector

Abstract

The two main challenges that the Indian health sector is facing are: compared with global level
extremely low expenditure on health, leading to relatively poor health outcomes and the huge
difference of health outcomes across different States. In India, only 4% of GDP is devoted to the
health sector, the contribution of the Government expenditure is 1.1% of the GDP and the major
portion of the health expenditure is in the form of out of pocket (OOP) expenditure. This huge OOP
expenditure fuels the growth of private health care industry in India. The private health care
industry in India is valued at $40 billion and is projected to grow to $ 280 billion by 2020. Low
expenditure on health is one of the main factors responsible for poor health outcomes in India. The
IMR in India is 41.81 and it is ranked 174 among 224 countries. Besides relatively poor health
outcomes at the international level huge difference is observed across different regions within
India. On the one hand Kerala having IMR 12 is far ahead from Madhya Pradesh where IMR is 54.
Similarly percentage of women receiving full antenatal care in Tamil Nadu is 45 and in Bihar it is
only 3.