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Raise budgetary allocation for the health sector: Muttreja

Feb 26, 2015

The Budget should make provision for increasing allocation for family planning, including an expanded choice for spacing methods of contraception, writes Poonam Muttreja.

Poonam Muttreja

New Delhi: The President on February 23, 2015 spoke about the government’s commitment to provide affordable and accessible health care to all its citizens, AYUSH, and the reduction of preventable deaths of children, for which the India Newborn Action Plan has been initiated. However, these statements do not present a clear picture of how the government plans to address major health problems faced by women and children.

The Government of India’s spending on healthcare is only 1.04% of GDP which is about 4% of total Government expenditure. Even among SAARC countries, Afghanistan spends 8.7% of its GDP on health, followed by Maldives 8.5% and Nepal 5.5%. The total expenditure share on health as percentage of GDP for Brazil, South Africa and China stand at 9.3%, 8.8% and 5.4%, respectively.

Family planning is a key investment in improving the health of women and children. An analysis of India’s recent family planning budgets reveals that the Family Welfare budget of the central government (Department of Health & Family Welfare) actually reduced by 87%, from Rs 12,278.65 crores in 2013-14 to Rs 1605.37 crores in 2014-15. Consequently, the share of Family Welfare in the total health budget of the central government reduced from 34% in 2013-14 to 4% in 2014-15. Family Planning expenditures constituted just 6% of the Reproductive Child Health (RCH) expenditure and hence 2% of the National Health Mission (NHM) expenditure in 2013-14.

India continues to witness high rates of maternal and child deaths, with an estimated 56,000 (19%) maternal deaths taking place each year from pregnancy-related causes. It has the largest number of child deaths (almost 15.8 lakh) under the age of five years in any country.

Evidence shows that access to family planning can reduce infant mortality by 10%, childhood mortality by 21% and can prevent about 2,72,000 maternal deaths worldwide per year. Lack of quality services, care and access, and the large unmet need for family planning are some of the leading causes of maternal and child deaths. Our neighbouring countries, like Bangladesh and Nepal, provide evidence that investment in family planning, and maternal and child health, contributes to positive improvement in the health and well-being of women and children.

Access to a wide range of contraceptive methods is essential to support maternal health and child survival. As high as 21.3% of eligible couples in India want to limit their family size but do not use any contraceptives, with the unmet need being higher for the limiting methods at 13.4% and spacing methods at 7.9%. Currently, there is limited choice as no new contraceptive method has been introduced in the country for decades. There is an urgent need to increase the basket of choice by increasing the availability of a wider range of contraceptives so that people can choose a method suitable for them. The addition of a new method made available to at least half the population correlates with an increase of 4-8 percentage points in total contraceptive use.

The total expenditure on family planning under the NHM is Rs 396.97 crores (2013-14). Of this, the expenditure on spacing methods is a mere Rs 5.76 crores (1.45%). Given India’s young population, the budget for spacing methods should be much higher. The Government of India has estimated that if the current unmet need for family planning could be fulfilled within the next five years, India can avert 35,000 maternal deaths and 12 lakh infant deaths. If safe abortion services are coupled with increase in family planning, the savings made to the country could be to the tune of Rs 6,500 crore.

Advocating Reproductive Choices (ARC) coalition strongly supports India’s commitment to family planning and urges the government of India to increase proportion of allocation on health, provide quality care and services and expand the basket of choice of contraceptive methods in the country.

About ARC

ARC is a coalition of like-minded civil society organizations working in the field of sexual and reproductive health since 2005. The main objective of ARC is to make concerted and sustained advocacy efforts to enhance accessibility and expand contraceptive choices. Its advocacy initiatives primarily focus on addressing the issues related to the unmet need for contraception and expanding contraceptive choices for the Indian population. Currently ARC includes 38 member organizations at the National level.

Poonam Mutreja, Executive Director, Population Foundation of India (PFI), which is the National Secretariat of the coalition group called Advocating Reproductive Choices.

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