Soni Devi, 28, recently lost her newborn daughter to an “unexplained illness”. Uneducated, and married to a daily-wager, Devi is little aware of the treatment options for a healthy pregnancy and for post-pregnancy complications—medicines, regular health check-ups and the need to vaccinate a newborn for various illnesses.
As her family struggled to make ends meet in Uttar Pradesh, Devi relocated to Jaipur to work in a handloom factory. For thousands of people like Soni who are forced to migrate to urban areas for financial stability, the onus is on the government to allocate funds for social sector spending, such as healthcare, education and women’s issues, in the upcoming budget on 1 February.
The recent deaths of over 100 children in Kota, Rajasthan, were due to the lack of basic facilities, and the increasing need for India to raise its spending on social sectors to harness the benefits of the demographic bulge.
Prioritizing social sector reforms
Public health experts said without improving living conditions and basic facilities, the United Nations’ sustainable development goal (SDGs) targets can’t be achieved. “For meeting SDGs, India needs to step up public funding for ensuring successful implementation of the National Health Policy (2017). To reach the stated goal of 2.5% of GDP (gross domestic product), as public financing for health by 2025 from the present 1%, Union budgets from now on have to allocate more funds for health in every annual budget,” said K. Srinath Reddy, president, Public Health Foundation of India (PHFI).
Though, in recent years, India’s health budget has been growing, it is still below the desired level. In 2019-20, ₹64,559 crore was allocated for healthcare, an increase from ₹55,959 crore (revised estimate) in 2018-19 and ₹48,853 crore in the previous fiscal year.
Vikram Thaploo, chief executive, telehealth, Apollo Hospitals Enterprise Ltd, said despite the fiscal tight rope, the government “should ensure that due attention is accorded to improve accessibility to health-care”. “Studies have indicated that social spending has a significant co-relation with improved aggregate welfare in low- and middle-income countries. More specifically, social spending has a direct impact on improving human development indices,” he added.
India ranks 130 among 189 countries in human development index (HDI), shows a UN report. HDI is a composite index assessing progress in three basic factors —health as measured by life expectancy at birth, knowledge measured by the mean years of education, and standard of living measured by per-capita gross national income.
Educationists also said India has made significant progress on access to education, but its quality remains a concern. “School education is certainly important for improving human development index, but it cannot be seen in isolation. Research funding should be given due attention in the budget not because it shall improve higher education, but because it also shall fix the broken school system by offering good teachers. In a changing employment environment, the education system no more looks like a pyramid but a pipe-like structure and demands equal attention across the education supply-chain,” said S.S. Mantha, former chairman of the All India Council for Technical Education.
Mantha said he was hopeful that the budget will focus on Bharat and bring renewed focus on women’s health and education. India spends less than 4% of its GDP on education and the demand is to expand it to over 6%.
Experts said that the focus must also be on gender-sensitivity, making its impact assessment mandatory, considering that women, constituting 48% of India’s population, have historically lagged behind men in terms of social indicators. “Women have not been the centre of many schemes and, in the absence of any gender impact assessment, it is very difficult to conclude how women are getting benefitted. This needs rectification,” said Ranjana Kumari, director, Centre for Social Research.
A section of experts said the Swachh Bharat Abhiyan and access to potable water have raised hopes of more allocations for issues directly benefitting rural India. “Treatment facilities for sludge and solid waste; capacity building initiatives; emphasis on research and innovation, and behaviour change, could be a few measures for which the upcoming budget may consider allocations,” said Ashwajit Singh, managing director, IPE Global, an international development consultancy. “The social stock exchange (SSE) could be linked to CSR funding (to raise funds.”
Come 1 February, the Centre’s priorities for social sector reforms will be revealed, and whether it considers using the SSE to raise capital through an electronic fund-raising platform.
