Note4Students
From UPSC perspective, the following things are important :
Prelims level: Centrally Sponsored initiatives related to the Health sector;
Mains level: Health Infrastructure and Funding in India;
Why in the News?
Realizing the full potential of Union Budget 2024-25 health allocations depends on State-level factors, as states share costs and handle the implementation of Centrally Sponsored Schemes (CSS).
About the two major Centrally Sponsored initiatives
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Issue of Low Fund Utilization and Faculty Shortage:
- Poor Fund Absorption in PM-ABHIM: Fund absorption has been poor, with only 29% used in 2022-23. The reasons are – complex execution structures, reliance on health grants from the 15th FC (only 45% utilized), and delays in construction due to rigid procedures.
- Low Fund Utilization in HRHME: Utilization of funds in educational infrastructure was only around 25% of the budget estimates in both 2022-23 and 2023-24.
- Shortage of teaching faculty: There is a significant shortage of teaching faculty in newly established medical institutions, with over 40% vacancies reported in 11 of the 18 All India Institutes of Medical Sciences.
- For example, in Uttar Pradesh, 30% of teaching faculty positions were vacant in 2022 for government medical colleges established between 2019-21.
- Lack of specialist positions: The shortage of specialists affects the establishment and upgrading of medical colleges and district hospitals, with more than a third of sanctioned specialist positions in urban CHCs and two-thirds in rural CHCs remaining vacant as of March 2022.
How can states work on Fiscal space? (Way forward)
- Enhanced Budget Planning and Allocation: States should prioritize and allocate funds efficiently for health infrastructure and recurring costs.
- Strengthening Revenue Generation: States can explore increasing their own revenue sources through improved tax collection, introducing new revenue streams, or enhancing public-private partnerships.
- Optimizing Expenditure Management: Implementing better financial management practices, such as cost control measures, transparent procurement processes, and efficient use of existing resources, can help in managing and maximizing the impact of budget allocations for health infrastructure and services.
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