New Delhi: The government will, in its budget next month, increase the amount it plans to spend on its flagship rural health programme and will simultaneously launch a similar programme targeting the urban poor.
Rural priorities: Union health minister Ghulam Nabi Azad. PTI
According to a senior official at the ministry of health and family welfare who is involved in the budgetary process, the allocation for the National Rural Health Mission (NRHM) will be increased by 17% over 2008-09 to Rs13,930 crore; Rs50 crore will be set aside for the first-of-its-kind National Urban Health Mission; and Rs800 crore will be allocated to the Pradhan Mantri Swasthya Suraksha Yojana (PMSSY), which involves the creation of six institutions similar to the All India Institute of Medical Sciences (AIIMS) in Delhi.
The increase will see the allocation for the health sector rise to around Rs20,000 crore this year, added this person who did not want to be identified.
The details of the schemes and the amounts were independently confirmed by another health ministry official who, too, did not want to be identified.
In the interim budget, the government had made an allocation of Rs17,480 crore to the health sector as compared with the Rs17,307 crore allocated in 2008-09.
The allocation is in line with the new government’s plans for the health sector.
Soon after taking office, health minister Ghulam Nabi Azad had said that the implementation of NRHM would be his first priority. He had also said that the government would launch the National Urban Health Mission (NUHM) after its approval by the cabinet.
Azad had added that in the first phase of PMSSY, the government would look to “strengthen” the six planned AIIMS-type institutions and upgrade 13 state medical institutions.
“The new government has clearly signalled its intention—that it is going to accord very high priority to health programmes. There is a clear intent of continuing and further strengthening the NRHM,” said K. Srinath Reddy, president of the Public Health Foundation of India (PHFI).
The allocation for NRHM will be increased by 17% over 2008-09 to Rs13,930 crore; Rs50 crore will be set aside for the first-of-its-kind NUHM; and Rs800 crore will be allocated to the PMSSY, which involves the creation of six institutions similar to AIIMS. Ahmed Raza Khan / Mint
He added that though NRHM started off reasonably well, it’s too early to judge its impact.
“One of the critical problems that we envisage is going to affect this programme and many other programmes...is the human resource crisis. Not having sufficient numbers of health workers, right from doctors and nurses to community health workers....that’s going to be critical...,” Reddy added.
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Another criticism of the NRHM has been its inability to use the funds allotted.
“Health is a state subject and, hence, though the Centre disperses funds, it is upon the states to be able to utilize them optimally. That has not happened,” said a third senior official at the health ministry involved in NRHM. This official, too, did not want to be named.
Meanwhile, the government seems to have finally decided to launch NUHM, which was originally slated to be launched last year.
In January, then health minister A. Ramadoss had announced that the mission would be launched in February. However, then, too, it did not happen.
One person closely involved in creating NUHM said it may have been delayed by ministry officials who wanted to ensure that it had “political ownership”.
“They thought that if there is a new government which doesn’t identify with a scheme launched five-six months before the elections, then that would be the kiss of death for the scheme,” added this person who did not want to be identified. “So, they decided to launch it after the elections.”
NUHM aims to cover India’s 210.7 million urban residents with a special focus on the 62.5 million poor people who live in slums. The total budget for this scheme is Rs6,207.84 crore.
“There is a proposal to launch NUHM, but after a review, so that some of the missing ingredients will possibly be added. Right now, the way it is designed, it is much more of an insurance scheme for the poor... Right now, we don’t have a primary health-care infrastructure for urban areas, unlike in rural areas where at least a design exists. We need to actually ensure that our urban health care is not merely confined to an insurance mechanism, but goes beyond that,” said Reddy.
India currently spends less than 1% of its gross domestic product on health. The government plans to increase this to between 2% and 3% by 2012 through schemes such as NRHM.