Rathi A*
Department of Community Medicine, Dr. Baba Saheb Ambedkar Medical College & Hospital, New Delhi, India
Received date: 19/05/2017; Accepted date: 20/05/2017; Published date: 27/05/2017
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Importance of Health
Health is one of the biggest factors that can lead to a positive change in the economy of a country. Likewise, investing in health will lead to improved quality of patient care, diagnosis and disease prevention strategies – which will in turn lead to millions of lives saved and morbidity prevented. Each penny spent on health leads to huge return of investment and if finances are compared then investing in health is an economically sound decision. The term ‘investment’ is used instead of ‘expenditure’ as the former leads to returns in the long run. For e.g., studies have shown that one-third of the increase in income in UK can be attributed to improved health and nutrition in nineties. Right to health is the most basic fundamental right without which all other rights are worthless.
Health equity is very important as improvement in health specially when directed at the poor lead to reduction in poverty. Poor people form a large section that suffers from disease, disability and injuries so they need a bigger chunk of the budget allocated to health. Sadly in our country though lower socio-economic strata formulate the section that suffers from 80% of the disease burden, it consumes just 20% of the health resources. Due to various reasons like lack of access, lack of service quality, lack of funds, corruption, etc. public health spending is not able to cater to the needs of the poor [1,2]. The main causes of preventable deaths are TB, HIV, malaria, childhood infectious diseases, maternal and perinatal conditions, micronutrient deficiencies and tobacco related deaths. If these conditions are controlled along with enhanced family planning programs for the poor then their quality and length of life will improve and ultimately the whole country will prosper.
Need for Increasing Health Budget
About 5% of the GDP is allocated to health in our country [3] that is miniscule as compared to other fields like defense that takes up around one-fourth of the GDP. Out of this 5%, government spending of health is even lower (around 2%) [4]. The policy makers have long neglected the importance of allotting greater budget to health but they should understand that focusing on health is imperative for the overall development of a country. Majority of the funds are for RCH and communicable diseases but there are many other areas that need to be taken care of, without reducing the allocation of fund to the former.
Government in itself cannot do everything on its own and should look for partners outside like NGOs and corporates. Increased investments are needed so that more NGOs can be roped in for both research and development and service delivery. For developing a better and stronger public-private model where corporates can be held accountable for health functions also require money.
Increased amount of funds are needed to boost scientific research in biomedical and health sciences. The purview and potential of research is immense and we need to have a larger research fraternity with competent methodologies and equipment.
Our epidemiological knowledge through reporting and surveillance system needs to be greatly enhanced so that we know which part of population is suffering from what health problem and preventive and curative measures can be targeted accordingly. The surveillance need to be in sync with international agencies too so that measures can be taken to tackle impending pandemics.
Non-communicable diseases like diabetes, cardio vascular diseases, accidents, violence, mental health problems, and cancers are perils of development that India is facing. Once contributing to less than 20% of all mortality, NCDs today cause almost half of it [5]. We can no longer keep our eyes shut to this section. However all our efforts are majorly diverted towards communicable diseases till now. So we need more money for surveillance, research and curtailment strategies of NCDs too.
Any health system largely depends on capacity building and our health system is plagued with empty positions, corruptions, insufficient training and faulty recruitment strategy. So funds should be directed for trainings and redressal mechanism so that feedback can improve the services that are being provided.
Strategies for Improving Health Budget/Improving the Efficiency of Already Allocated Health Budget
Just increasing the health budget is not enough as we have witnessed in year 2014-2015 when many health departments were not able to spend the money allotted to them that ultimately lead to even lower health budget the next year. Efficiency is equally important. There are many ways through which our health budget and ultimately the health system can improve.
1. Globalization, sharing of ideas and innovation is the most important step that any developing economy can take if it wants to be at par with the developed ones. New ideas are needed that can improve our health budget and better ways are needed to spend the health budget that can happen by regularly participating in international health summits. We need to study case histories of counties that are almost at par with India in terms of GDP but have far better health outcome indicators like Sri Lanka. Such countries can be called for help for advocacy and capacity building.
2. Greater emphasis should be there on completing the targets of Millennium Development Goals like working in direction of improving maternal and child health. The pushing of targets should be avoided and they should be reached within the specified time frame.
3. Donor financing can be considered as multiple international NGOs are there like PATH, Gates foundation, GAVI that are particularly working for maternal and child health.
4. Many important vaccines like pneumococcal, IPV, HPV vaccines can be introduced in the country with the help of GAVI as India is eligible and the process of introducing these vaccines should not be delayed as the morbidity and mortality caused by these vaccine preventable diseases is humongous
5. The national commission on microeconomics in health should be given more responsibilities for formulating plans for scaling up healthcare interventions and also to device strategies so that more money can be invested in health. It should work in conjunction with the commissions of other countries and international NGOs so that percolation of innovative ideas can take place.
6. Steps should be taken to increase the efficiency of the budget that is allocated for health. Both technical and allocative efficiency need to be improved so that important health areas can be targeted and effective strategies can be made.
7. More technical people like doctors and public health experts should formulate the policies and decide the budget.
Thus a developed country is one where the people are healthy, health equity prevails and constant improvement is made in the policies and budgeting system.
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