Maharashtra needs to increase health spending over Rs 74 bn by 2018: IIHMR

Lifestyle diseases, skill gap and urbanisation the largest reasons

Responding to rise in the Public Health Expenditure as according to the proposal made by the National Health Policy, International Institute of Health Management Research, Delhi recently held a press conference in Pune to highlight various needs, challenges and aspects influencing the government to spend on the health sector in Maharashtra.

Dr Ashok K Agarwal, Dean, IIHMR-Delhi, said, “According to the National Sample Survey Office (NSSO) the average cost of hospitalisation in India has risen from Rs 8851 to Rs 24436. The average cost of hospitalisation in Maharashtra alone is Rs 20,475 out of which 19.2 per cent people have been utilising the services of public hospitals and 80.8 per cent have been utilising the services of private hospitals. According to Ministry of Health and Family Welfare, the percentage distribution of Public Health Expenditure in Maharashtra alone is 8.7 per cent, the highest after Uttar Pradesh.”

The Budget 2015-16 announced that the total spends in India for Department of Health and Family Welfare will be Rs 29,653 crore. However, as per the Economic Survey in 2014-15, it was striking to notice that NRHM’s total outlay to enable universal access to quality health services in Maharashtra alone was Rs 561.92 crore.

Dr Agarwal also said, “According to the 2014 report of Directorate of Health Services, Government of Maharashtra, the total public health institutes in the state are 12,821. These include the PHCs and community healthcare centres. There are various medical services introduced by the NHM including a project under the name of Maharashtra emergency medical services where the total number of patients served were 1,84,390 between April to December 2014. The out-of-pocket expenditure is higher causing a burden of high health cost felt by the middle and lower income segments in the state.”

According to the PHFI findings for MoHFW, nationally the skill gap is approximately 97.9 per cent across various health workforce categories where, Maharashtra is the second largest of the states witnessing a skill gap with 5.65 lakh less paramedics. According to the Directorate of Health Services, Government of Maharashtra, the total number of attacks and deaths both sporadic and outbreaks upto December 2014-15 due to diseases such as cholera, gastro, diarrohoea, hepatitis, typhoid and leptospirosis have been 10,16,050 and 21 respectively.

To overcome these health challenges, Maharashtra’s health budget needs to be a little more ambitious to overcome the lack of public health and public health facilities. It needs to fill in the skill gaps of huge vacancies in rural hospitals and other hospitals as well as PHCs, especially doctors, specialists and nurses, overcome gross inadequacy of drug supplies in public facilities, poor maintenance of public health facilities and key equipment etc. The state should also look at investing in Healthcare IT, which is expected to increase by a CAGR of 13.4 per cent during the forecast period of 2015 to 2020.

International Institute of Health Management ResearchMaharashtraMoHFWNational Health Policy