Health and medical sector in India : potential reforms and problems

The main problem afflicting this sector occurs in the distribution of government health resources across states, between rural and urban areas, among different levels of health care, and between preventative and curative care programs. The total volume of resources devoted to health is not the constraint to improving health conditions in India, as India spends considerably more on health as a percentage of its GNP than most other countries in Asia. This paper finds that given the current level of resources available in the health sector in India, significant improvements in both the equity and internal efficiency of health expenditure can be achieved by better targeting of government health expenditure to poorer states that have high infant mortality rates. Currently, central government spending reinforces, rather than compensates for, inequalities in state government health spending. More importantly, improvements can be achieved by changing the current emphasis of the Indian health-care system from expensive secondary/tertiary care and medical training/research to focusing more on primary health care, communicable disease programs and integrated child nutrition and health programs. Includes bibliography. (Author abstract)