Budgets for Maternal Health in India by Sona Mitra National Consultation on ‘Expanding Access and Using the Law to Ensure Sexual and Reproductive Health Rights’ was held in December’ 2015. The consultation brought together experts, activists, lawyers, health workers and students from all corners in the country, in building the understanding on the issues and the emerging challenges. Human Rights Law Network http://hrln.org

1. BUDGETS FOR MATERNAL
HEALTH IN INDIA
Sona Mitra
December, 2015
Jaipur

2. 3 MAJOR POINTS
 The overall pattern of public expenditure
to GDP ratio especially on social sectors
 The status of budgetary trends for
maternal health
 Current changes in the fiscal strategies
and resource-sharing pattern between
Centre and States and implications on
budgets for maternal health

3. PLAN AND NON-PLAN EXPENDITURE AS
SHARE OF GDP
10.5
9.3 8.9
9.7 9.6 9.6 9.3
4.9 4.3 4.1 4.0 4.5
3.7 3.3
15.4
13.6 13.1 13.7 14.2
13.3 12.6
0.0
2.0
4.0
6.0
8.0
10.0
12.0
14.0
16.0
18.0
2010-11 2011-12 2012-13 2013-14 2014-15
BE
2014-15
RE
2015-16
BE
Non-Plan Plan Total

4. SHARE OF SOCIAL SECTOR EXPENDITURE BY
SELECT UNION MINISTRIES AS SHARE OF
GDP
2.5
2.3
2.0 1.9 1.9 1.7
3.4
3.1
2.9 2.7 2.8
2.6
0.0
0.5
1.0
1.5
2.0
2.5
3.0
3.5
4.0
Share of Social
Sector Expenditure
(Excluding Food
Subsidy) as % of
GDP
Share of Social
Sector Expenditure
(Including Food
Subsidy) as % of
GDP

5. TRENDS IN BUDGETARY SPENDING ON
HEALTH AS SHARE OF GDP (IN %)
0.250.260.270.290.330.320.310.300.290.270.31
0.830.860.860.87
0.94
1.03
0.960.920.951.00
1.17
0.00
0.20
0.40
0.60
0.80
1.00
1.20
1.40
Centres’ Share Combined (Centre and states)

6. PUBLIC EXPENDITURE ON HEALTHCARE BY
CENTRE AND STATES (IN RS. CR)
0.0
20000.0
40000.0
60000.0
80000.0
100000.0
120000.0
140000.0
160000.0
States’ exp
Centre's exp

7. Nowhere near to spending 2.5
percent of GDP as
recommended by the 12th FYP

8. RECOMMENDED 12TH PLAN OUTLAY VS.
BUDGETARY ALLOCATION IN HEALTH (IN RS.
CRORE)
Departments
Recom
mende
d
Outlay
in 12th
Plan
2012
-13
2013-
14
2014-
15
(RE)
2015-
16
(BE)
Total
Allocatio
ns for
4years of
the 12th
Plan
Allocatio
n as
share of
Outlay
(%)
Dept. of Health
and Family
Welfare
268551
2513
3
27145.3 29042 29653 110973 41.3
Dept. of Ayush 10044 715 642.4 691 1214 3262.4 32.5
Dept. of Health
Research
10029 720 874.1 932 1018.2 3544.3 35.3
Dept. of Aids
Control
11394 1316 1473.1 1300 1397 5486.1 48.1
Total MOHFW
300018
2788
5
29492.5 31274 32068.2 120720 40.2

9. Major component of public
healthcare provisioning is the NHM
Expenditure on NHM as share of
GDP declining

10. EXPENDITURE BY UNION
GOVERNMENT ON NHM AS SHARE OF
GDP (IN %)
0.19 0.19 0.18
0.16
0.14 0.13
0.00
0.05
0.10
0.15
0.20
0.25
0
5000
10000
15000
20000
2010-2011
2011-12
2012-13
2013-14
2014-15
(RE)
2015-16
(BE)
Inpercent
AmountinRscrore
Total-NHM NHM as % of GDP

11. MATERNAL HEALTH ENTITLEMENTS MOSTLY
WITH MWCD AND PARTLY WITH MOHFW
Major components of maternal
health expenditure under NHM are
the NRHM_RCH_Flexipool activities
Important Maternal health
programmes within that are JSY
and JSSK.
 CSS for maternal health like ICDS,
SABLA and IGMSY are with the
MWCD

12. COMPONENT-WISE BREAK UP OF
EXPENDITURE IN NRHM, 2005-2015
RCH
Flexipool,
31.8
NRHM
Flexipool,
32.9
Infrastructu
re
Maintenanc
e, 33.7
IPPI, 3.2
NDCP, 6.5

13. COMPONENT-WISE BREAK UP OF EXPENDITURE
IN NATIONAL HEALTH MISSION, 2015-16
NRHM_RCH
flexi pool,
57.8
NUHM Flexi
pool, 7.6
Communicab
le Diseases,
6.9
NCD, 3.0
Infrastructu
re
maintenance
, 24.3
Other
services, 0.3

14. SHARE OF MATERNAL ENTITLEMENTS IN
BUDGETS OF MWCD
0.0
10.0
20.0
30.0
40.0
50.0
60.0
70.0
80.0
90.0
100.0
A 2010-2011 A 2011-2012 A 2012-13 A 2013-14 2014-15RE 2015-16BE
ICDS Rajiv Gandhi National Creche Scheme
SABLA IGMSY
National Nutrition Mission

15. EXPENDITURE ON SCHEMES RELATED TO MATERNAL
HEALTH BY UNION MINISTRY OF WOMEN AND CHILD
DEVELOPMENT (RS CRORE)
Year RGSEAG-
SABLA
IGMSY - CMB
Scheme
JSY ICDS
2010-11 329.51 116.2 1618.4 9,763
2011-12 593.75 289.8 1552.9 14,266
2012-13 503.63 82.07 1640.0 15,712
2013-14 548.33 270.0 1762.8 16,432
2014-15 R.E. 630.00 360.0 2039.8 16,520
2015-16 B.E. 10.00 438.0 N/A 8,754
Addl.
Allocations in
Union
Supplementary
Budget 2015-
16
400.00 - N/A 3,600
Total 2015-16
BE
410.00 438.0 - 12,354

16.  Reduced allocations for all programmes related to
maternal entitlements, even after the supplementary
budget additions, except IGMSY.
 Rs. 438 crores are allocated for 53 districts. It is grossly
insufficient for extending to 200 ‘high burden’ districts
as was proposed by the scheme in 2015-16.
 The cost for IGMSY to be extended to ‘high burden’ 200
districts in 2015-16, as proposed by the government
would have approximately worked out to nothing less
than at least three times the current allocation.
 A list of beneficiaries for IGMSY, as is done for JSY is
most necessary to have proper estimates for budget
allocation for IGMSY. The digitisation of list of
beneficiaries, which is in progress in many states need
to be made public.
 Maternal entitlements are a major responsibility of
MWCD, whose overall budget has been slashed
 MoHFW responsible for JSY and JSSK under NRHM
has also undergone changes in patterns of sharing
between centre and states and has faced cuts

17. Major challenge currently is to protect the
existing programmes and their adequate
allocations rather than asking for higher
allocations and better programmes for
ensuring maternal health rights for
women.

18. Thank you!
sona@cbgaindia.org
www.cbgaindia.org