Budget 2018: Despite making strides in improving life expectancy at birth, the Economic Survey noted, child and maternal malnutrition remained a challenge causing health loss in the country. However, the disease burden — such as diarrhoea, lower respiratory infections, and other common infections manifested due to malnutrition — has dropped in the country. Life expectancy at birth has improved by around 10 years between 1990 and 2015. The government meanwhile in the current financial year has widened the scope of several existing programmes apart from initiating new ones to improve all round development of women and children. Some of the schemes include Integrated Child Development Services, Pradhan Mantri Matru Vandana Yojana, National Nutrition Mission and Pradhan Mantri Ujjwala Yojana. The other key health risks faced by citizens include air pollution, dietary risks, high blood pressure and diabetes, the Survey noted. In addition, “limited affordability and access to quality medical services are among the major challenges contributing to delayed or inappropriate responses to disease control and patient management”, said the Survey. The government has, however, taken various steps to regulate prices of drugs and diagnostics such as supporting states through National Free Diagnostic Service Initiative and National Free Drug Initiative under the National Health Mission.
Nevertheless, the out of pocket expenditure (OoPE) on health by households is as high as 62% which adversely affects the poorer sections and widens inequalities. As per National Health Accounts 2014-15, the government healthcare providers accounted for around 23% of the Current Health Expenditure while the share of private hospitals and clinics was higher at 31%. Expenditure on diagnostics (including medicines and diagnostic tests) by households is about 10% of the total OoPE during 2013-14, the Survey said, citing the findings of household health expenditure survey. The annual document further pointed out at a wide difference in average prices of diagnostic tests across the country with the price ranges varying substantial. “There is a need to prioritise standardisation of rates by devising appropriate quality assurance framework and regulatory mechanism,” noted the Survey.
India has committed to meet the targets set under the Sustainable Development Goals-3 and ensuring health for all will be crucial in achieving those targets.
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The Survey also emphasized on the urgency to enact Clinical Establishments (Registration and Regulation) Act, 2010 and notified the Clinical Establishments (Central Government) Rules, 2012 by all states and Union Territories to regulate the clinical establishments across the country. At present, only 10 states and Union Territories adhere to the guidelines.