Government Health Financing in India : Challenges in Achieving Ambitious Goals

The Government of India has publicly committed to a doubling or trebling of government health spending by 2012 and launched a major program, the National Rural Health Mission (NRHM), to help spend the additional funds and achieve better health outc...

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Main Authors:	Berman, Peter, Ahuja, Rajeev, Tandon, Ajay, Sparkes, Susan, Gottret, Pablo
Format:	Working Paper
Language:	English en_US
Published:	World Bank, Washington, DC 2013
Subjects:	ALLOCATIVE EFFICIENCY BASIC HEALTH CARE BLOCK GRANTS BUDGET ALLOCATION CAPITAL EXPENDITURE CARE INSTITUTIONS CHILD HEALTH COMMUNICABLE DISEASES DECENTRALIZATION DECISION MAKING DELIVERY SYSTEM DISEASE CONTROL ECONOMIC GROWTH EMPLOYMENT EXPENDITURES FAMILIES FINANCES FINANCIAL PROTECTION FORECASTS HEALTH BUDGETS HEALTH CARE HEALTH CARE DELIVERY HEALTH CARE FACILITIES HEALTH CARE SERVICES HEALTH EXPENDITURE HEALTH EXPENDITURE SHARE HEALTH EXPENDITURES HEALTH FACILITIES HEALTH FINANCING HEALTH FUNDING HEALTH INSURANCE HEALTH INSURANCE PROGRAM HEALTH OUTCOMES HEALTH PLANS HEALTH PROGRAMS HEALTH SECTOR HEALTH SERVICE HEALTH SERVICE DELIVERY HEALTH SYSTEMS HEALTH WORKERS HORIZONTAL EQUITY HUMAN DEVELOPMENT HUMAN RESOURCES IMMUNIZATION INCOME INCOME HOUSEHOLDS INCOMES INFORMATION SYSTEMS LOCAL GOVERNMENTS LOW-INCOME COUNTRIES NUTRITION PATIENT POCKET PAYMENTS POCKET PAYMENTS BY HOUSEHOLDS POCKET PAYMENTS FOR HEALTH CARE PRICE OF HEALTH CARE PRIMARY CARE PROVISION OF HEALTH CARE PUBLIC HEALTH PUBLIC HEALTH SPENDING PUBLIC INVESTMENTS PUBLIC PROVISION PUBLIC SPENDING RURAL AREAS RURAL POPULATION SHARE OF HEALTH SPENDING SUSTAINABILITY WORKERS
Online Access:	http://documents.worldbank.org/curated/en/2010/12/13843166/government-health-financing-india-challenges-achieving-ambitious-goals http://hdl.handle.net/10986/13597

id	okr-10986-13597
recordtype	oai_dc
spelling	okr-10986-135972021-04-23T14:03:08Z Government Health Financing in India : Challenges in Achieving Ambitious Goals Berman, Peter Ahuja, Rajeev Tandon, Ajay Sparkes, Susan Gottret, Pablo ALLOCATIVE EFFICIENCY BASIC HEALTH CARE BLOCK GRANTS BUDGET ALLOCATION CAPITAL EXPENDITURE CARE INSTITUTIONS CHILD HEALTH COMMUNICABLE DISEASES DECENTRALIZATION DECISION MAKING DELIVERY SYSTEM DISEASE CONTROL ECONOMIC GROWTH EMPLOYMENT EXPENDITURES FAMILIES FINANCES FINANCIAL PROTECTION FORECASTS HEALTH BUDGETS HEALTH CARE HEALTH CARE DELIVERY HEALTH CARE FACILITIES HEALTH CARE SERVICES HEALTH EXPENDITURE HEALTH EXPENDITURE SHARE HEALTH EXPENDITURES HEALTH FACILITIES HEALTH FINANCING HEALTH FUNDING HEALTH INSURANCE HEALTH INSURANCE PROGRAM HEALTH OUTCOMES HEALTH PLANS HEALTH PROGRAMS HEALTH SECTOR HEALTH SERVICE HEALTH SERVICE DELIVERY HEALTH SYSTEMS HEALTH WORKERS HORIZONTAL EQUITY HUMAN DEVELOPMENT HUMAN RESOURCES IMMUNIZATION INCOME INCOME HOUSEHOLDS INCOMES INFORMATION SYSTEMS LOCAL GOVERNMENTS LOW-INCOME COUNTRIES NUTRITION PATIENT POCKET PAYMENTS POCKET PAYMENTS BY HOUSEHOLDS POCKET PAYMENTS FOR HEALTH CARE PRICE OF HEALTH CARE PRIMARY CARE PROVISION OF HEALTH CARE PUBLIC HEALTH PUBLIC HEALTH SPENDING PUBLIC INVESTMENTS PUBLIC PROVISION PUBLIC SPENDING RURAL AREAS RURAL POPULATION SHARE OF HEALTH SPENDING SUSTAINABILITY WORKERS The Government of India has publicly committed to a doubling or trebling of government health spending by 2012 and launched a major program, the National Rural Health Mission (NRHM), to help spend the additional funds and achieve better health outcomes. This paper reviews recent data on trends in government spending and various scenarios of central and state funding to assess the feasibility of achieving these financing goals. The goal of 2 percent of Gross Domestic Product (GDP) for government health spending is unlikely to be achieved, although there is clear evidence of program growth. Much larger state-level spending is needed to accelerate overall government spending in India's federal system. In addition, there is evidence of constraints in the ability to spend significantly increased budgets in a timely way and possible state substitution of increased central funding for existing state budgets. Significantly increasing government health spending in India requires more than simply raising budgets at the central level. NRHM does show some positive effects, but the rapid gains envisaged will require greater efforts to address the shortcomings of government systems and creative approaches to India complex federal financing system. 2013-05-28T22:22:05Z 2013-05-28T22:22:05Z 2010-12 http://documents.worldbank.org/curated/en/2010/12/13843166/government-health-financing-india-challenges-achieving-ambitious-goals http://hdl.handle.net/10986/13597 English en_US Health, Nutrition and Population (HNP) discussion paper; CC BY 3.0 IGO http://creativecommons.org/licenses/by/3.0/igo/ World Bank World Bank, Washington, DC Publications & Research :: Working Paper Publications & Research South Asia India
repository_type	Digital Repository
institution_category	Foreign Institution
institution	Digital Repositories
building	World Bank Open Knowledge Repository
collection	World Bank
language	English en_US
topic	ALLOCATIVE EFFICIENCY BASIC HEALTH CARE BLOCK GRANTS BUDGET ALLOCATION CAPITAL EXPENDITURE CARE INSTITUTIONS CHILD HEALTH COMMUNICABLE DISEASES DECENTRALIZATION DECISION MAKING DELIVERY SYSTEM DISEASE CONTROL ECONOMIC GROWTH EMPLOYMENT EXPENDITURES FAMILIES FINANCES FINANCIAL PROTECTION FORECASTS HEALTH BUDGETS HEALTH CARE HEALTH CARE DELIVERY HEALTH CARE FACILITIES HEALTH CARE SERVICES HEALTH EXPENDITURE HEALTH EXPENDITURE SHARE HEALTH EXPENDITURES HEALTH FACILITIES HEALTH FINANCING HEALTH FUNDING HEALTH INSURANCE HEALTH INSURANCE PROGRAM HEALTH OUTCOMES HEALTH PLANS HEALTH PROGRAMS HEALTH SECTOR HEALTH SERVICE HEALTH SERVICE DELIVERY HEALTH SYSTEMS HEALTH WORKERS HORIZONTAL EQUITY HUMAN DEVELOPMENT HUMAN RESOURCES IMMUNIZATION INCOME INCOME HOUSEHOLDS INCOMES INFORMATION SYSTEMS LOCAL GOVERNMENTS LOW-INCOME COUNTRIES NUTRITION PATIENT POCKET PAYMENTS POCKET PAYMENTS BY HOUSEHOLDS POCKET PAYMENTS FOR HEALTH CARE PRICE OF HEALTH CARE PRIMARY CARE PROVISION OF HEALTH CARE PUBLIC HEALTH PUBLIC HEALTH SPENDING PUBLIC INVESTMENTS PUBLIC PROVISION PUBLIC SPENDING RURAL AREAS RURAL POPULATION SHARE OF HEALTH SPENDING SUSTAINABILITY WORKERS
spellingShingle	ALLOCATIVE EFFICIENCY BASIC HEALTH CARE BLOCK GRANTS BUDGET ALLOCATION CAPITAL EXPENDITURE CARE INSTITUTIONS CHILD HEALTH COMMUNICABLE DISEASES DECENTRALIZATION DECISION MAKING DELIVERY SYSTEM DISEASE CONTROL ECONOMIC GROWTH EMPLOYMENT EXPENDITURES FAMILIES FINANCES FINANCIAL PROTECTION FORECASTS HEALTH BUDGETS HEALTH CARE HEALTH CARE DELIVERY HEALTH CARE FACILITIES HEALTH CARE SERVICES HEALTH EXPENDITURE HEALTH EXPENDITURE SHARE HEALTH EXPENDITURES HEALTH FACILITIES HEALTH FINANCING HEALTH FUNDING HEALTH INSURANCE HEALTH INSURANCE PROGRAM HEALTH OUTCOMES HEALTH PLANS HEALTH PROGRAMS HEALTH SECTOR HEALTH SERVICE HEALTH SERVICE DELIVERY HEALTH SYSTEMS HEALTH WORKERS HORIZONTAL EQUITY HUMAN DEVELOPMENT HUMAN RESOURCES IMMUNIZATION INCOME INCOME HOUSEHOLDS INCOMES INFORMATION SYSTEMS LOCAL GOVERNMENTS LOW-INCOME COUNTRIES NUTRITION PATIENT POCKET PAYMENTS POCKET PAYMENTS BY HOUSEHOLDS POCKET PAYMENTS FOR HEALTH CARE PRICE OF HEALTH CARE PRIMARY CARE PROVISION OF HEALTH CARE PUBLIC HEALTH PUBLIC HEALTH SPENDING PUBLIC INVESTMENTS PUBLIC PROVISION PUBLIC SPENDING RURAL AREAS RURAL POPULATION SHARE OF HEALTH SPENDING SUSTAINABILITY WORKERS Berman, Peter Ahuja, Rajeev Tandon, Ajay Sparkes, Susan Gottret, Pablo Government Health Financing in India : Challenges in Achieving Ambitious Goals
geographic_facet	South Asia India
relation	Health, Nutrition and Population (HNP) discussion paper;
description	The Government of India has publicly committed to a doubling or trebling of government health spending by 2012 and launched a major program, the National Rural Health Mission (NRHM), to help spend the additional funds and achieve better health outcomes. This paper reviews recent data on trends in government spending and various scenarios of central and state funding to assess the feasibility of achieving these financing goals. The goal of 2 percent of Gross Domestic Product (GDP) for government health spending is unlikely to be achieved, although there is clear evidence of program growth. Much larger state-level spending is needed to accelerate overall government spending in India's federal system. In addition, there is evidence of constraints in the ability to spend significantly increased budgets in a timely way and possible state substitution of increased central funding for existing state budgets. Significantly increasing government health spending in India requires more than simply raising budgets at the central level. NRHM does show some positive effects, but the rapid gains envisaged will require greater efforts to address the shortcomings of government systems and creative approaches to India complex federal financing system.
format	Publications & Research :: Working Paper
author	Berman, Peter Ahuja, Rajeev Tandon, Ajay Sparkes, Susan Gottret, Pablo
author_facet	Berman, Peter Ahuja, Rajeev Tandon, Ajay Sparkes, Susan Gottret, Pablo
author_sort	Berman, Peter
title	Government Health Financing in India : Challenges in Achieving Ambitious Goals
title_short	Government Health Financing in India : Challenges in Achieving Ambitious Goals
title_full	Government Health Financing in India : Challenges in Achieving Ambitious Goals
title_fullStr	Government Health Financing in India : Challenges in Achieving Ambitious Goals
title_full_unstemmed	Government Health Financing in India : Challenges in Achieving Ambitious Goals
title_sort	government health financing in india : challenges in achieving ambitious goals
publisher	World Bank, Washington, DC
publishDate	2013
url	http://documents.worldbank.org/curated/en/2010/12/13843166/government-health-financing-india-challenges-achieving-ambitious-goals http://hdl.handle.net/10986/13597
_version_	1764423863880384512

Government Health Financing in India : Challenges in Achieving Ambitious Goals

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