Here is a reality check on how a populist policy-driven Government blinks on healthcare funding. The State which till 2011-12 was witnessing skewed funding of less allocation to more population, has taken to the course correction in 2014-15. However, the logical tweaking in 2014-15 by the Government failed to show up numerically at individual level.
Sample the skewed model. Odisha’s population in 2014-15 as projected by Census 2011 is at 43,228,228 persons and when rural areas account for a share of around 35,879,429, urban centres take a pie of 7,348,799 persons. But the State Government which till 2011-12 had allocated a mere Rs 384 crore to provide health services to a high of over 3.94 crore rural populace against Rs467 crore to a mere over 69 lakh urban populace reversed it by 2014-15 by allocating Rs1,737 crore to over 3.6 crore rural and Rs884 crore to over 73 lakh urban populace.
But when it boils down to per capita rural health spending the skewed funding then looks yawning. Rural per capita public spending on health in Odisha in 2014-15 stood at a mere around Rs484 against the urban per capita spending of Rs1,202.
What needs mentioning is among the Empowered Action Group (EAG) States, the per capita health expenditure in Odisha in 2014-15 stood at around Rs 906, which is lower than Chhattisgarh and Rajasthan but higher than Bihar, Jharkhand, MP and UP.
The net result then is for each PHC in 2014-15, the Government has spiked the allocation by mere Rs2 lakh that too under non-Plan expenditure - which means no capacity addition, only funds for upkeeping and maintenance.
The worse story is the State’s 377 Community Health Centres (CHCs) were not given a single rupee hike in 2014-15. The effect then is: saddling with high infant mortalities the State could arrange stabilisation units for newborn in only 26 of around 377 CHCs. Only 23 of 377 CHCs have four specialists and only around 42 CHCs have the X-ray machines in Odisha. Only 60 CHCs in the State have 30 beds. This looks miserable when each CHC caters to over 92,760 persons and each PHC provides healthcare services to around 27,000 people in the State. But the Government allocating Rs5 crore revived OSMSC for free-medicine scheme.
It looks ironical when the State budgeted a whopping Rs 70 crore for its populist Aahar scheme. The premier tertiary infant care centre, the SVBP Institute of Paediatrics at Cuttack that has been in the eye of infant death torrent had not given any plan allocation to augment infrastructure since 2012 - 13. It reveals the State Health Accounts. Even on non-Plan expenditure, the Institute has given a hike by mere Rs90 lakh in 2014-15. This when a decade ago WHO had asked the State to augment its tertiary childcare centres to meet the Millennium Development Goals for IMR.
District Hospitals (DHs) funding stands no better as by the year ended on March 31, 2015. The Government could hike the expenditure under non-Plan by mere Rs13 crore or Rs40 lakh per DH.