An Analysis of the Nexus Between Government Health Expenditure and Key Health Indicators in India: A Longitudinal Study from 2013-14 to 2021-22

Abstract

Background: India has a complex health finance system comprising public and private financing. Despite the presence of a public healthcare system, the private sector is the major contributor to the healthcare services in India. Analyzing the relationship between government health expenditure and public health outcome is crucial, witnessing a shift in public health spending in recent years. This study helps understand how health expenditure trends align with major health indicators.

Aim: This paper analyzes the correlation between Government of India’s health expenditure - measured across GDP (Gross Domestic Product), THE (Total Health Expenditure) - and the critical health indicators - neonatal, infant, child and maternal mortality rates and life expectancy at birth, over the study period 2013-14 to 2021-22. 

Methods: A longitudinal trend analysis was conducted for the period 2013-2021 using secondary published data. Health expenditure data were sourced from National Health Accounts (NHA) - India, and key health indicators were obtained from United Nations Inter-Agency Group for Child Mortality Estimation (UN-IGME) and the World Bank.

Results: The Pearson correlational model demonstrated a significant inverse relationship between public health financing and mortality. GHE as a percentage of THE shows near-perfect negative correlation with NMR (r = -0.95), IMR (r = -0.96) and U5MR (r = -0.95%). Contrariwise, OOPE as a percentage of THE showed a strong near-positive relationship against NMR (r = 0.96), IMR (r = 0.97) and U5MR (r = 0.97). Moreover, sustained rise in per capita GHE is associated with reduced MMR.  

Conclusion: The study is evident of a positive association between increased public health expenditure and improved public health indicators in India. The findings demonstrate a transition from private and OOPE spending towards increased public health investment, which strongly correlates with positive public health indicators. 

Keywords: Government Health Expenditure (GHE); Out-of-Pocket-Expenditure (OOPE); Child Mortality; Maternal Mortality