The IMPRI Center for Human Dignity and Development (CHDD) organized an insightful panel discussion on the theme “Population, Health, and Interim Union Budget 2024-25” as part of the IMPRI 4th Annual Series of Thematic Deliberations on Union Budget 2024-25 on February 6th, 2024.
This event gathered distinguished experts to explore the impacts of the interim budget on the multifaceted Indian economy. The session was chaired by Dr. Devinder Singh who discussed various aspects of the interim budget and its implications for public health during the panel discussion. He highlighted the close relationship between population dynamics and health, emphasising the importance of understanding population size, growth, structure, and distribution when planning health policies and programs.
Dr. Singh expressed concerns about the limited consideration of demographic factors in budgetary allocations, particularly the neglect of certain groups such as young girls, boys, and migrants. He noted the government’s commitment to setting up a high-powered committee on population growth but raised doubts about whether this initiative would adequately address the challenges.
Dr. Singh critiqued the budget’s focus on capital expenditure and support for the private sector
over public health, despite the national health policy’s target of spending 2.5% of GDP on healthcare by 2025. He highlighted the impact of COVID-19 on health budget allocations, which temporarily increased but failed to reach the aspirational target. Dr. Singh expressed disappointment that post-pandemic, health budget allocations reverted to previous levels, even decreasing in real terms.
He outlined the panel’s discussion agenda, which included assessing the budget’s responsiveness to health needs, evaluating past budget outcomes, and identifying emerging
health priorities. Dr. Singh’s remarks underscored the need for greater attention to public health in budgetary planning and allocation, emphasizing the importance of addressing demographic factors and meeting healthcare spending targets.
The next speaker for the day was Professor Sanghmitra Sheel Acharya who discussed several key points regarding population growth, demographic trends, health infrastructure, and budget allocations in her presentation. She emphasized the need to analyze population growth in conjunction with human resource development and demographic evidence. She noted a declining trend in population growth rates since the 1970s, with a faster drop between 2001 and 2011.
Dr. Acharya highlighted regional disparities in addressing population growth, with some states
faring better than others. She referenced research findings showing variations across different Indian states, particularly noting the challenges faced by large Hindi-speaking central Indian
Regarding demographic dividends, Dr. Acharya discussed the downward trend in total fertility
rates (TFR) across religious groups, indicating a shift towards smaller family sizes. She
underscored the importance of tapping into these demographic dividends and addressing
challenges related to outmigration and employment.
In terms of health sector budget allocations, Dr. Acharya noted a nominal increase that may not be sufficient to meet set goals, especially when adjusted for inflation. She discussed schemes like Ayushman Bharat and the National Health Mission, highlighting the need for improved utilization and allocation strategies.
Dr. Acharya also raised concerns about the inclusion of workers in health schemes and the
shortage of faculty in medical institutions. She questioned the effectiveness of initiatives aimed
at enhancing infrastructure and human resources, calling for a clearer roadmap for convergence across sectors to address healthcare challenges effectively.
The next speaker, Prof. Pradeep K. Panda provided an analysis of the interim budget for 2024-25, focusing on fiscal consolidation and its impact on the health sector. He highlighted the government’s aim to reduce the fiscal deficit to 5.1% of GDP while emphasizing the need for increased capital expenditure to support growth. Prof Panda criticized the low allocation to the health sector, which remains below 0.3% of GDP, noting similar trends in education spending. Despite nominal increases in health sector allocations, he pointed out discrepancies between budget estimates and actual spending, suggesting inefficiencies or capacity issues within the health system.
Prof. Panda welcomed initiatives such as expanding health coverage and addressing childhood
malnutrition but raised concerns about implementation challenges. He supported the
establishment of new medical colleges to address doctor shortages but stressed the importance of maintaining education quality. Additionally, he praised efforts to prevent cervical cancer through vaccinations for girls aged nine to 14.
Furthermore, Prof. Panda advocated for program convergence to streamline efforts and enhance implementation efficiency. He identified indirect support for the health sector through initiatives like the Production-Link Incentive (PLI) scheme and the launch of bio-manufacturing and bio-foundry programs to promote environmentally friendly alternatives.
Mr. Abhijit Mukhopadhyay’s remarks were multifaceted, covering various aspects of economic policy and budgetary allocations. Mr. Mukhopadhyay delved into the analysis of budgetary trends, particularly in the context of the pandemic’s aftermath.
He noted the deviation from fiscal deficit targets and the overarching intention of the budget to
revive the economy. Despite nominal increases in budget allocations, he highlighted concerns
regarding their adequacy, especially in light of inflationary pressures. The discrepancy between
budget estimates and actual spending, particularly in health and social welfare sectors, raised
eyebrows, with unspent allocations becoming a recurring issue.
Mr. Mukhopadhyay emphasized the importance of sustained investment in healthcare
infrastructure, particularly in rural areas, to address acute shortages of medical professionals and ensure effective utilization of resources. He also discussed demographic shifts, emphasizing the need for continuous budgetary allocations to cater to an aging population.
A central point of his discourse was the urgency of conducting a population census to inform
policy decisions accurately. He criticized the postponement of the census and urged prioritizing its completion to ensure accurate data for social welfare schemes and infrastructure planning. Outdated data hampered the effective implementation of social welfare schemes, underlining the necessity of prioritizing census efforts.
The last speaker of the day was Dr. Sachin Gupte whose remarks centered on the intersection of public health, government budget allocations, and the challenges faced in healthcare delivery. Dr. Gupte highlighted the importance of intent behind budget allocations, acknowledging the complexity of addressing diverse health needs. He praised initiatives such as including frontline workers in health insurance coverage and efforts to reduce maternal and neonatal mortality rates.
Consolidation of programs and funding for better efficiency was deemed a positive step.
Addressing the shortage of healthcare professionals, particularly at the district level, was
identified as crucial. Dr. Gupte applauded plans to upgrade district hospitals into medical
colleges, potentially increasing access to specialized care in underserved areas.
Furthermore, he acknowledged the budget’s focus on non-health determinants like climate
change, recognizing their impact on public health. Dr. Gupte acknowledged challenges in budget absorption at the state level due to a lack of skilled personnel but expressed confidence in ongoing efforts to address this issue.
In conclusion, key points highlighted during the panel discussion include the need for greater
consideration of demographic factors in budgetary allocations, challenges in meeting healthcare spending targets, disparities in healthcare infrastructure across regions, and the importance of sustained investment in healthcare to address shortages and enhance implementation efficiency.
Despite some positive initiatives, such as including frontline workers in health insurance coverage and plans to upgrade district hospitals, concerns remain regarding the adequacy of
budget allocations and the need for clearer roadmaps for convergence across sectors to address
healthcare challenges effectively.
IMPRI’s 4th Annual Series of Thematic Deliberations and Analysis of Interim Union Budget 2024-25
Watch the event at IMPRI #Web Policy Talk
Rehmat Arora is a research intern at IMPRI.