Health Investments to Reduce Health Inequities in India: Do We Need More Evidence?

I. Gupta, A. Ranjan
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Abstract

    Large inequities in health outcomes and treatment-seeking behaviour continue to exist in India, across households, states and residence. A few large populous states continue to contribute the most to multi-dimensional poverty, including indicators for health outcomes. A significant contributor is the high out-of-pocket spending that continues to be a key feature of India’s health sector, accompanied by one of the lowest levels of public investment on health. The COVID pandemic has brought out sharply the lack of preparedness of the country and its states to face a catastrophe of this kind. A resilient health sector can only be built by bridging the various gaps in key inputs into the sector – infrastructure, personnel, supplies and training. This investment is likely to bring down the demand for health services in the private sector and reduce spending on health services by households by making these affordable and accessible. A quantum jump in investment would also be required to offer health coverage that is truly universal in scope and coverage. Unless that happens, India would remain unprepared for the next calamity and continue with significant inequalities in health outcomes and access to services.
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减少印度卫生不平等的卫生投资:我们需要更多证据吗?
印度的家庭、州和居民在健康结果和寻求治疗行为方面仍然存在巨大的不平等。少数几个人口大国继续对多层面贫困做出最大贡献,包括健康结果指标。一个重要的因素是高自付支出,这仍然是印度卫生部门的一个关键特征,同时也是卫生公共投资水平最低的部门之一。新冠肺炎疫情严重表明,该国及其各州缺乏应对此类灾难的准备。只有在基础设施、人员、物资和培训等关键投入方面弥补各种差距,才能建立一个有韧性的卫生部门。这项投资可能会降低私营部门对医疗服务的需求,并通过使这些服务负担得起和可获得来减少家庭在医疗服务上的支出。还需要大幅增加投资,才能提供范围和覆盖范围真正普遍的医疗保险。除非发生这种情况,否则印度将对下一场灾难毫无准备,并在健康结果和获得服务方面继续存在严重的不平等。
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