Global Health Expenditure Database (GHED) provides internationally comparable data on health spending for close to 190 countries from 2000 to 2018. The database is open access and supports the goal of Universal Health Coverage (UHC) by helping monitor the availability of resources for health and the extent to which they are used efficiently and equitably. This, in turn, helps ensure health services are available and affordable when people need them. In particular, the data published here contribute to a better understanding of:
- How much do different countries spend on health?
- How much do different actors such as government, insurance companies, households and donors contribute?
- What are the financing arrangements to pay for health?
- How much money is spent on primary health care (PHC)?
- How much money is spent on different diseases and programmes such as immunization?
- How much money is spent on the less than 5-year old population?
WHO works collaboratively with Member States and updates the database annually using available data such as health accounts studies and government expenditure records. Where necessary, modifications and estimates are made to ensure the comprehensiveness and consistency of the data across countries and years. GHED is the source of the health expenditure data republished by the World Bank and the WHO Global Health Observatory.
To mark Universal Health Coverage Day in December 2020, WHO has released new data and will soon publish the report “Global Spending on Health: Weathering the Storm”. It examines how countries were progressing towards financing UHC prior to the COVID-19 pandemic.
Before the COVID-19 pandemic, global spending on health continued to rise, albeit at a slower rate in recent years. 2018 was the first year in five years in which global spending on health grew slower than GDP. The report also shows that out-of-pocket spending continues to be a major component of health spending in low- and middle-income countries. Furthermore, this report shows that external aid, which peaked in 2014, has been increasingly directed towards lower-middle income countries. In 2018, the amount of external aid absorbed by lower-middle income countries surpassed that of low-income countries.
The report examines the potential effects on health expenditure of the COVID-19 pandemic, given its devastating impact on health and economies across the globe. The report also features dedicated chapters on lower income countries and disease/programme expenditure. The former examines health spending patterns in a subset of countries which face important macroeconomic vulnerabilities, high levels of poverty, and are lagging behind in Universal Health Coverage (UHC) indicators. In these settings, out-of-pocket spending is larger than government spending and the governments’ priority to health has been decreasing over time. The disease/programme expenditure chapter studies spending on infectious disease, NCDs, reproductive health and immunization, as well as the revenue sources for each.
28-Jan-2019: Model for malaria control
Odisha has emerged as an inspiration in the fight against malaria. In recent years it has dramatically scaled-up efforts to prevent, diagnose and treat malaria through its Durgama Anchalare Malaria Nirakaran (DAMaN) initiative, which has produced impressive results in a short span of time. In 2017, accredited social health activists (ASHAs) helped distribute approximately 11 million bed nets, which was enough to protect all the residents in areas that were at highest risk. This included residential hostels in schools. As a result of its sustained efforts, Odisha recorded a 80% decline in malaria cases and deaths in 2017.
DAMaN aims to deliver services to the most inaccessible and hardest hit people of the State. The initiative has in-built innovative strategies to combat asymptomatic malaria. DAMaN has been accorded priority in the State’s health agenda. There is financial commitment for a five-year period to sustain and build on the impact created by the initiative.
India is the only country among the 11 highest-burden countries that saw substantial progress in reducing disease burden: it saw a 24% decrease in 2017 compared to 2016. This shows that India has assumed a leadership role in advancing global efforts to end malaria. The country’s success provides hope to the other highest-burden countries to tackle malaria head-on.
India’s progress in fighting malaria is an outcome of concerted efforts to ensure that its malaria programme is country-owned and country-led, even as it is in alignment with globally accepted strategies. The turning point in India’s fight against malaria came at the East Asia Summit in 2015, when it pledged to eliminate the disease by 2030. Following this public declaration, India launched the five-year National Strategic Plan for Malaria Elimination. This marked a shift in focus from malaria “control” to “elimination”. The plan provides a roadmap to achieve the target of ending malaria in 571 districts out of India’s 678 districts by 2022.
The plan requires more than ₹10,000 crore. Adequate investment combined with coordinated action between governments, civil society and philanthropic donors is imperative to achieve this goal. Since health is a State subject, State governments across the country shoulder a special responsibility in tackling the disease.
4-Jan-2019: Adolescent Health
The Partners Forum 2018 was hosted by the Government of India from 12th to 13th December 2018 at Vigyan Bhawan in New Delhi.
The theme of the Partners Forum 2018 was “Power of Partnership” to bring different constituencies together for cross-sectoral action for women’s, children’s and adolescents’ health.
The steps taken to achieve the objectives of the Partners Forum 2018 were:
- Ministerial Conclave was organized during the Partners Forum 2018 with Health Ministers and Head of country delegations for reaffirmations of commitments by countries for accelerating momentum for women, children and adolescent health agenda.
- The 12 success case studies from different countries were disseminated during the Partners Forum 2018 on various themes. From India, Intensified Mission Indradhanush was one of the 12 case studies presented during the event.
- India adaptations of Global Health Strategy for Women’s, Children’s and Adolescents’ Health; and Guidelines on Midwifery services in India were released during the event.
- Partners Forum Communique was released with commitments from different constituencies to work together on issues related to women, children and adolescent health.
- Government of India organized “Market Place” during the event for showcasing innovations and best practices from State governments on the theme of Reproductive, Maternal, Neonatal, Child and Adolescent Health.
- The Partners Forum 2018 was attended by over 1500 participants with 600 participants from different countries. The participants included Health Ministers from various countries, partner organizations, Civil Society organizations, Academics, State representatives and Youth representatives.
The issues discussed during the event were on following topics:
- Political Leadership with focus on women’s political leadership, financing, high quality healthcare, young people, Violence Against Women, Universal Health Coverage.
- Multi-sectoral collaboration for Early Childhood Development, Adolescent Health, Sexual and Reproductive Health Rights, Empowerment, Humanitarian & Fragile setting, Quality, Equity and Dignity.
- Discussion on Financial Accountability, Social accountability, Private sector accountability, Parliamentarians’ Role, and Accountability in humanitarian setting.
- Sessions on People centered Partnerships, Harnessing Partnerships, Partnership for Maternal and Child Health in challenging contexts, Sustainable financing and Digital innovations for Women, Children and Adolescent Health.
- The Partners’ Forum was co-organized by the Partnership for Maternal, Newborn and Child Health and the Government of India. The Government of India contributed Rs. 2.5 crores for hosting the event.
Health being a State subject. Government of India provides financial and technical assistance to States/ UTs based on the proposals in their Annual Programme Implementation Plans (APIP) under National Health Mission (NHM). Various initiatives under National Health Mission (NHM) to improve maternal, child and adolescent health in the country during last 3 years and current year are given below:
Steps being taken to improve Maternal and Child Health:-
- Janani Suraksha Yojana (JSY), a demand promotion and conditional cash transfer scheme to encourage institutional deliveries.
- Janani Shishu Suraksha Karyakram (JSSK) aims to eliminate out-of-pocket expenses for pregnant women and for treatment of sick neonates.
- Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA) to provide fixed-day assured comprehensive and quality antenatal care universally to all pregnant women on 9th of every month.
- LaQshya - Labor room Quality improvement Initiative for improving quality of care around birth and ensure respectful maternity care.
- Maternal and Child Health (MCH) Wings are being established at high caseload facilities to improve quality of care.
- Maternal Death Surveillance and Response (MDSR) at facilities and in community to take corrective action for averting maternal deaths.
- Operationalization of Comprehensive Abortion Care Services and services for Reproductive Tract Infections and Sexually Transmitted Infections (RTI/STI) at health facilities.
- Capacity building of MBBS doctors in Anaesthesia (LSAS) and Obstetric Care including C-section (EmOC) skills and establishment of Skill Labs to enhance quality of training.
- Mother and Child Tracking System (MCTS) and Mother and Child Tracking Facilitation Centre (MCTFC) to monitor timely and quality ANC services, JSY benefit, Immunization etc.
- Dissemination of Operational guidelines for Universal screening of Gestational Diabetes Mellitus, screening for hypothyroidism for high risk pregnancy, calcium supplementation and de-worming during pregnancy.
- Under Anemia Mukt Bharat (Intensified National Iron Plus Initiative), iron and folic acid supplementation is provided across life stages for pregnant and lactating women, children and adolescent girls.
- Establishment of Special Newborn Care Units (SNCU), Newborn Stabilization Units (NBSU) and Kangaroo Mother Care (KMC) units for care of sick and small babies.
- Home Based Newborn Care (HBNC) and Home Based Care of Young Children (HBYC) by ASHAs to improve child rearing practices.
- Early initiation and exclusive breastfeeding and appropriate Infant and Young Child Feeding (IYCF) practices are being promoted in convergence with Ministry of Women and Child Development. Mass media campaigns and capacity building of health care providers under Mothers’ Absolute Affection (MAA) programme for improving breastfeeding practices.
- Universal Immunization Programme (UIP) is being supported to provide vaccination to children against various life threatening diseases.
- Government has launched Mission Indradhanush to reach the target of 90% Full Immunization Coverage through covering unvaccinated and partially vaccinated children and pregnant women in pockets of low immunization coverage in hard-to-reach areas.
- Rashtriya Bal Swasthya Karyakram (RBSK) for screening and early detection of birth defects, diseases, deficiencies, development delays and early intervention services all children in the 0-18 years age group.
- Nutrition Rehabilitation Centres (NRCs) at public health facilities to manage children with Severe Acute Malnutrition (SAM) admitted with medical complications.
- National Deworming Days (NDDs) are being organised in the country to de-worm children aged 1-19 years using platforms such as AWCs and Schools by administering Albendazole tablets.
- Intensified Diarrhoea Control Fortnight (IDCF) is being observed across the country since 2014 for childhood diarrhoea control by promotion of ORS and zinc for treatment of childhood diarrhoea and creating community awareness on personal and community hygiene practices.
- IEC/BCC activities with focus on ANC, institutional delivery, nutrition, immunization etc.
Steps being taken to improve to improve Adolescent Health:-
- The Government is implementing Rashtriya Kishor Swasthya Karyakram(RKSK) under NHM to improve health of adolescents in the country. Rashtriya Kishor Swasthya Karyakram includes following interventions: Weekly Iron and Folic acid Supplementation (WIFS) programme to provide weekly Iron and Folic Acid tablets to in-school boys and girls and out-of-school girls and biannual anti-helminthic Albendazole tablets for prevention of iron and folic acid deficiency anaemia covering government, government aided and municipal schools and Anganwadi centres.
- School Health Program under Ayushman Bharat to strengthen health promotion and disease prevention interventions for school children.
- Scheme for Promotion of Menstrual Hygiene for rural adolescent girls to increase awareness and hygienic practices among adolescent girls related to Menstrual Hygiene.
- Peer educators in the community are conducting participatory sessions on adolescent health issues.
- Adolescent Health Day (AHD) is being organized in community for reaching out to adolescents and their parents/care givers and community leaders.
- Adolescent Friendly Health Clinics (AFHCs) at Government health facilities with Medical Officers, ANMs and Counselors trained in Adolescent Friendly Health Services for adequate and appropriate care to adolescents.
11-Dec-2018: PM Modi to inaugurate Partners’ Forum 2018
The Prime Minister, Shri Narendra Modi, will inaugurate the fourth Partners’ Forum on 12th December at New Delhi. The Government of India, in association with the Partnership for Maternal, Newborn and Child Health (PMNCH), is hosting a two-day international conference on 12th and 13th December 2018, bringing together about 1500 participants from across 85 countries to improve the health and well-being of women, children and adolescents. The invited countries have been selected from across all regions and income levels and include countries that are currently chairing key global and regional bodies (e.g. G7, G20, BRICS, etc.).
This is the fourth in a series of global high-level multi-country, multi-stakeholder events aimed at sustaining global momentum for issues related to health of women, children and adolescents.
Partners’ Forum is a global health partnership launched in September 2005 to accelerate efforts to reduce child and maternal mortality, improve adolescent, child, newborn and maternal health. This partnership is an alliance of more than 1,000 plus members, across 10 constituencies in 92 countries: academic, research and teaching institutions; donors and foundations; health care professionals; multilateral agencies; non-governmental organizations; partner countries; global financing mechanisms and the private sector.
The previous chapters were held in Johannesburg, South Africa (2014), New Delhi, India (2010) and Dar es Salaam, Tanzania (2007). This is the second time India is hosting the Partners’ Forum.
PMNCH's mission is to support the global health community to work successfully towards achieving the Sustainable Development Goals (SDGs), particularly the health related SDGs as articulated in the Strategy for Women’s Children’s and Adolescents’ Health in support of ‘Every Woman Every Child’ (EWEC) movement.
The programme of the Partners’ Forum will be framed around the objectives of the Global Strategy of Survive – Thrive – Transform. The programme will include four high-level plenaries that will focus on political leadership, multi-sectoral action, accountability and power of partnership. Each high-level plenary will be followed by six concurrent sessions that provide the opportunity for more detailed discussions to on Forum’s key themes.
The Forum will also present and explore the findings of the 12 Success Factors case studies that showcase how countries are collaborating across sectors to improve women’s, children’s and adolescents’ health. The case studies will be published in a special Partners’ Forum edition of the BMJ (originally called British Medical Journal) and disseminated widely.
The Partners’ Forum will showcase learning from across six regions: Africa, Eastern Mediterranean, Europe, Americas, South East Asia and Western Pacific on six thematic areas:
- Early Childhood Development (Germany & Chile);
- Adolescent Health and Well-Being (USA & Indonesia);
- Quality, Equity and Dignity (QED) in Services (India & Cambodia);
- From India, Intensified Mission Indradhanush has been selected as one of the case studies under QED theme.
- Sexual and Reproductive Health (Malawi & Malaysia) and;
- Empowerment of Women, Girls and Communities (South Africa & Guatemala); and in Humanitarian and Fragile Settings (Sierra Leone & Afghanistan).