Health's share of government expenditure drops from 8% to 5.1%
Morung Express News
Dimapur | November 15
Nagaland's Government Health Expenditure (GHE) declined by 29.1% in 2023–24, following a in the preceding financial year, according to the National Health Accounts (NHA) Estimates for India 2023–24 released on November 15.
The State's GHE fell to Rs 917 crore in 2023–24 from Rs 1,294 crore in 2022–23, a reduction of Rs 377 crore.
Per capita government health expenditure also declined from Rs 6,470 to Rs 4,585 during the period, a decrease of Rs 1,885 per person.
Thus, the per capita GHE or average government health spending for each person in Nagaland fell from Rs 6,470 in 2022–23 to Rs 4,585 in 2023–24, a decline by Rs 1,885 per person.
The decline was also reflected in health spending as a proportion of the State's overall economy and government expenditure.
GHE as a percentage of Gross State Domestic Product (GSDP) fell from 3.6% in 2022–23 to 2.3% in 2023–24, while its share of General Government Expenditure (GGE) dropped from 8% to 5.1%, the lowest rate in India.
Sharp reversal
The reduction comes even as Nagaland's overall government expenditure and economy expanded during the period.
GGE increased from Rs 16,115 crore in 2022–23 to Rs 17,942 crore in 2023–24, while GSDP rose from Rs 35,629 crore to Rs 39,809 crore.
Against this growth, government health expenditure moved in the opposite direction, declining by nearly a third.
The latest figures also mark a reversal of the increase recorded over the preceding years.
Nagaland's GHE stood at Rs 615 crore in 2017–18, with per capita expenditure of Rs 3,075.
It increased gradually to Rs 636 crore in 2018–19, Rs 683 crore in 2019–20 and Rs 737 crore in 2020–21.
Expenditure rose more sharply to Rs 1,098 crore in 2021–22 and further to Rs 1,294 crore in 2022–23, when per capita GHE reached Rs 6,470.
The latter was the highest recorded in the seven-year period covered by the available estimates.
The increase in expenditure was accompanied by a rise in its relative share. GHE as a proportion of GSDP increased from 2.4% in 2020–21 to 3.4% in 2021–22 and 3.6% in 2022–23. Its share of GGE similarly rose from 5.8% to 8% over the same period, remaining at 8% in 2022–23.
However, both indicators registered a marked decline in 2023–24. The 5.1% share of GGE was the lowest recorded in the seven-year period, tied with 2018–19, while the 2.3% share of GSDP was tied with 2019–20 for the lowest.
Despite the latest decline, the nominal GHE of Rs 917 crore in 2023–24 remained higher than the expenditure recorded in each of the four financial years between 2017–18 and 2020–21.
Among the eight North-East states, Nagaland's per capita GHE of Rs 4,585 in 2023–24 was higher than Assam (Rs 2,282) and Tripura (Rs 3,360), but lower than Manipur (Rs 5,507), Meghalaya (Rs 7,533), Arunachal Pradesh (Rs 8,885), Mizoram (Rs 9,320) and Sikkim (Rs 16,026).
Nagaland also recorded the lowest proportion of government expenditure allocated to health among the eight NE states. GHE accounted for 5.1% of GGE, compared to 10.7% in Meghalaya, 10.2% in Sikkim, 10% in Manipur, 7.7% in Mizoram, 7.1% in Assam, 6.4% in Tripura and 6.1% in Arunachal Pradesh.
In terms of GHE as a share of GSDP, Nagaland's 2.3% was among the lowest in the region, equal to Sikkim.
The corresponding proportions were 4.7% in Arunachal Pradesh, 4.2% in Meghalaya, 3.8% in Manipur, 2.8% in Mizoram, 1.7% in Tripura and 1.4% in Assam.
National outlook
At the national level, GHE more than tripled from Rs 1.30 lakh crore in 2013–14 to Rs 4.14 lakh crore in 2023–24, according to the Union Ministry of Health and Family Welfare.
Per capita government health expenditure also increased from Rs 1,042 to Rs 2,959 over the decade.
The NHA estimates further showed a decline in the share of household Out-of-Pocket Expenditure (OOPE) in Total Health Expenditure (THE) from 64.2% in 2013–14 to 42.7% in 2023–24, a reduction of 21.5 percentage points. The share also declined from 43.4% in 2022–23 to 42.7% in 2023–24.
The Government's share in THE increased by 14.9 percentage points over the decade, while Social Security Expenditure on Health rose from 6% to 11% of THE. Government expenditure on primary healthcare also reached approximately Rs 1.53 lakh crore in 2023–24, according to the Ministry.
The NHA report does not provide state-specific estimates of THE, household OOPE or Social Security Expenditure on Health for Nagaland. It attributed the limitation to insufficient sample sizes for small states and North-East states to generate statistically significant estimates for certain expenditure components derived from sample surveys.
Nagaland: Government Health Financing Indicators
(2017–18 to 2023–24)
Indicator | 2017–18 | 2018–19 | 2019–20 | 2020–21 | 2021–22 | 2022–23 | 2023–24 |
GHE as % of GSDP | 2.5 | 2.4 | 2.3 | 2.4 | 3.4 | 3.6 | 2.3 |
GHE as % of GGE | 5.4 | 5.1 | 5.3 | 5.8 | 8.0 | 8.0 | 5.1 |
Per capita GHE (Rs) | 3,075 | 3,180 | 3,415 | 3,685 | 5,490 | 6,470 | 4,585 |
Government Health Expenditure (Rs crore) | 615 | 636 | 683 | 737 | 1,098 | 1,294 | 917 |
Population (crore) | 0.2 | 0.2 | 0.2 | 0.2 | 0.2 | 0.2 | 0.2 |
GSDP (Rs crore) | 24,492 | 26,527 | 29,716 | 31,221 | 31,913 | 35,629 | 39,809 |
General Government Expenditure (Rs crore) | 11,466 | 12,516 | 12,843 | 12,724 | 13,711 | 16,115 | 17,942 |
Source: National Health Accounts Estimates (various years), Ministry of Health and Family Welfare.
Government Health Financing indicators in North-East (2023-24)
State | GHE (Rs cr) | Per capita GHE (Rs) | GHE/GSDP | GHE/GGE |
Sikkim | 1,109 | 16,026 | 2.3% | 10.2% |
Mizoram | 932 | 9,320 | 2.8% | 7.7% |
Arunachal Pradesh | 1,777 | 8,885 | 4.7% | 6.1% |
Meghalaya | 2,260 | 7,533 | 4.2% | 10.7% |
Manipur | 1,652 | 5,507 | 3.8% | 10.0% |
Nagaland | 917 | 4,585 | 2.3% | 5.1% |
Tripura | 1,344 | 3,360 | 1.7% | 6.4% |
Assam | 8,214 | 2,282 | 1.4% | 7.1% |
Source: National Health Accounts Estimates, Ministry of Health and Family Welfare.
