Highlighting the importance of health sector and addressing the budgetary allocation associated with it #IMPRI Center for Human Dignity and Development (CHDD), IMPRI Impact and Policy Research Institute, New Delhi organized a panel discussion on “Population, Health, and Union Budget 2022-23” under the series The State of Population and Development – #PopulationAndDevelopment on February 4th, 2022.
The distinguished panel included Sandeep Chachra, Executive Director, ActionAid India; Prof Sanghmitra Sheel Acharya, Professor, Centre of Social Medicine and Community Health, Jawaharlal Nehru University (JNU), New Delhi; Dr Shoba Suri, Senior Fellow, Health Initiative, Observer Research Foundation (ORF), New Delhi; Urvashi Prasad, Director, Development Monitoring and Evaluation Office (DMEO), NITI Aayog; Prof Pradeep K. Panda, Professor and Dean, School of Public Health, Asian Institute of Public Health (AIPH) University, Bhubaneswar. Devender Singh, Global Studies Programme, University of Freiburg, Germany; Visiting Senior Fellow, IMPRI was the chair for the event.
Devender Singh started the discussion by addressing health as a very important aspect in the union budget. He termed the budget as a vision document as it incorporates long term plans and priorities of the country. He highlights this discussion as a medium to learn more about the objectives or targets achieved or what could be done for the future.
Overview of Budget Allocation
Prof Sanghmitra Sheel Acharya began by addressing the Covid-19 situation and its impact on budget allocation for the health sector. She highlighted the absence of “Emergency Response Fund” despite being aware of pandemic and its future possible mutations. She stated this year’s vision for the budget as being too optimistic and there has been a static budget allocation towards the education and health sector. Despite health being the worst hit during pandemic the allocation given is very minimal and there is lack of generation of data and its proper use, especially related to covid, mortality or vaccine.
Prof Acharya stressed upon few issues pertaining to health sector i.e. the need for holistic infrastructure development in health sector, vacancies in institutes without health personnel for long term, not enough recognition given to the frontline workforce, burdened working women, clarity in care for elderly and mental health patients and highlighted social disparity in access to health care. She suggested focusing on students and teachers as well while considering mental health, nutritional access to weaker sections of society and wider availability of data related to health.
Challenges and Expectations from Union Budget 2022-23
Sandeep Chachra started the discussion by appreciating and welcoming the government’s decision on emphasising mental health and introduction of the National Digital Database which would help in the long run. Listing some challenges he mentioned that the health sector cannot be viewed in isolation of other sectors. Sandeep Chachra discussed the deep impact covid brought in for the informal sector and the “trickle down approach” as a method for increased well-being. He highlighted Private Consumption data as one of the most important indicators for well-being of people and mentioned how the ability of people to spend on health decreased due to lack of additional support from government. He stated the requirement of long-term planning in consideration with covid as there has been no provision or planning for booster dose vaccination. Another issue highlighted by Sandeep Chachra was the “outstanding health crises” with respect to women and children. He mentioned the lack of attention given to increased levels of anemia in women and children and suggested the need to factor in the social diversity of India as a priority for the pending issues. Sandeep Chachra suggested the importance of occupational health and safety of workforces in budget planning and called for due recognition to be given to frontline workers, sanitation workers besides ensuring dignified wages.
Focus on Women and Children in Health Sector
Dr Shoba Suri stated the need for multi-sector planning and vision for allocation while considering the ground level reality. Focusing on women and children she stated this budget as disappointing and mentioned the adequate need for nutrition and investment for women. There is a need to strengthen and implement the health services, Anganwadi services and benefits for the poor. She also went on to discuss the lack of allocation in various women centric schemes. She emphasised enough on considering economic reality and ground level conditions while laying the budget.
Furthermore, she discussed about insufficient Gender Budgeting, due recognition given to health personnel, lack of basic sanitation services for Anganwadi’s, no indication of Public Distribution System and neglecting adolescent children. She suggested the need for “holistic and realistic budget.”
Urvashi Prasad began by stating public health and related areas as a big challenge in allocation. She stressed upon the recent digital push and stated that it can’t substitute real health services and needed to look in detail for implementation and impact of budgetary allocation. Further, she emphasised the relationship between centre and state in addressing the gap, allocation and implementation in the social sector. We need to have a systematic outlook within the government. Talking about Outcome Budget there is a shift in mindset required of what we achieve tangibly and re-orienting ourselves for the next budget.
Detailed Analysis through data
Prof Pradeep K. Panda welcomed the introduction of various social determinants in the recent budget like – provision of tap water, provision for housing, digital classroom and school etc. An important point mentioned by him was the sharp reduction in overall share of health expenditure as a share of total government expenditure in the health sector and further discussed few data estimates related to health sector. He also stated the absence of priority by the government in the public health sector and presence of stagnant allocation in the health sector. He emphasised the requirement of ways and strategies to handle the digital divide and factor in diversity of India while execution, focus on quality of health care and strengthen primary healthcare.
Devender Singh concluded the discussion on Population, Heath Sector and Union Budget 2022-23 by stating this as a “non-pandemic budget in pandemic times.” He mentioned the increase in budget allocation for the health sector marginal and not sufficient. Despite pandemic we see slashing in vaccination budget and reduction in budget related to nutrition. Post pandemic it seems the government is solely focused on reviving the economy through a ‘trickle down approach’.
YouTube Video: #PopulationAndDevelopment | E2 | Population, Health, and Union Budget 2022-23 | Panel Discussion
Acknowledgement: Sunishtha Yadav is a research intern at IMPRI.