According to Census 2011, 53 per cent of India’s population is in their reproductive age group (15- 49 years). One of five persons in our country is an adolescent (10-19 years) and every third is a young person (15-24 years).
The sheer size of the adolescent and youth population reflects the wealth of young human resource residing in the country. There is collective responsibility on the government, civil society and other stakeholders to work together to plan adequate and suitable opportunities as well as avenues to meet their needs and aspirations and address the health and well-being of this population.
At the London Summit 2012, India committed to provide family planning services to an additional 48 million new users by 2020. To fulfill our FP2020 commitments and the responsibility towards the large young population, investments in health and family planning need to be proportionately increased.
According to the FP2020 progress report 2015-16, India has only reached 7.7 million additional users, by July 2016. Three million additional users have been reached last year, in contrast to 1.5 million additional users reached, each year for the first 3 years. The accelerated efforts of the government towards universal access to family planning are also evident in its introduction of three new spacing methods of contraception in the family planning programme.
Progestin Only Pills, Centchroman and injectable contraceptive have been introduced in 2015, offering greater choice and autonomy to the users of family planning.
The issue of increasing budget allocation for Health and family planning is of utmost concern. According to World Bank figures, India spends just 1.3 per cent of its GDP on healthcare. This figure is much lower compared to BRICs countries - Brazil spends around 8.3 per cent, Russia Federation 7.1 per cent and South Africa around 8.8 per cent.
Among SAARC countries, Afghanistan spends 8.2 per cent, Maldives 13.7 per cent and Nepal 5.8 per cent. This low spending by India has been a cause for the growing inequities, insufficient access and poor quality of healthcare services.
The Twelfth Five Year Plan recommends increasing public expenditure on health to 2.5 per cent of GDP by 2017. Between 2015-16 and 2016-17, Government of India’s allocations for MOHFW increased by 13 per cent but the share of National Health Mission in MOHFW’s budget declined to 48 per cent.Trends in budget allocations indicate that percentage share to family planning has remained the same between 2013-14 and 2016-17, i.e., at 2 per cent of the total Ministry of Health and Family Welfare budget.
Further, during financial year 2015-16, 59 per cent of GOI’s fund release was primarily done in the last quarter whereas 72 per cent was released in the first two quarters in 2014- 15. This evidences staggered supply of funds for health resources and affects required investments.
Investing in health is critical for achieving the economic development goals. The health sector, which drives domestic demand for health care, has the potential of providing new jobs. The lack of skilled workforce is stark in the health sector. Increased investment will also bring down the prices of health services to the people and assist in sustaining the medium term inflation target of 4 percent.
The Population Foundation of India looks to the government to prioritise investments in health and specifically family planning in the upcoming budget announcement. Adequate and proportionate resources invested now will bear positive dividends for the country’s future.
(Author- Poonam Muttreja, Executive Director, Population Foundation of India)
