The Challenge of Additionality: The Impact of Central Grants for Primary Healthcare on State-Level Spending on Primary Healthcare in India

Publish Year: 1398
نوع سند: مقاله ژورنالی
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JR_HPM-8-6_003

تاریخ نمایه سازی: 18 مرداد 1403

Abstract:

BackgroundIn planning for universal health coverage, many countries have been examining their fiscal decentralization policies with the goal of increasing efficiency and equity via “additionalities.” The concept of “additionality,” when the government of a lower administrative level increases the funding allocated to a particular issue when extra funds are present, is often used in these contexts. Although the definition of “additionality” can be used more broadly, for the purposes of this paper we focus narrowly on the additional allocation of primary healthcare expenditures. This paper explores this idea by examining the impact of central level primary healthcare expenditure, on individual state level contributions to primary healthcare expenditure within ۱۶ Indian states between ۲۰۰۵ and ۲۰۱۳. MethodsIn examining ۵ main variables, we compared differences between government expenditures, contributions, and revenues for Empowered Action Group (EAG) states, and non-EAG states. EAG states are normally larger states that have weaker public health infrastructure and hence qualify for additional funding. Finally, using a model that captured the quantity of central level primary healthcare expenditure distributions to these states, we measured its impact on each state’s own contributions to primary healthcare spending. ResultsOur results show that, at the state level, growth in per capita central level primary healthcare expenditure has increased by ۱۱۰% from ۲۰۰۵-۲۰۱۳, while state’s own contributions to primary healthcare expenditure per capita increased by ۳۲%. Further analyses show that a ۱% change disbursement from the central level leads to a -۰.۱۳۲%, although not significant, change by states in their own expenditure. The effect for wealthier states is -۰.۱۵۱% and significant and for poorer states the effect is smaller at -۰.۰۹۶% and not significant. ConclusionThis analysis suggests that increases in central level primary healthcare expenditure to states have an inverse relationship with primary healthcare expenditures by the state level. Furthermore, this effect is more pronounced in wealthier Indian states. This finding has policy implications on India’s decision to increase block grants to states in place of targeted program expenditures.

Authors

Diana M. Bowser

The Heller School for Social Policy and Management, Brandeis University, Waltham, MA, USA

Rajesh Jha

Independent Consultant, Delhi, India

Manjiri Bhawalkar

Health Financing Team, The Global Fund to Fight AIDS, Tuberculosis and Malaria, Geneva, Switzerland

Peter Berman

Department of Global Health and Population, International Health Systems Program, Harvard School of Public Health, Boston, MA, USA

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  • Bossert T. Analyzing the decentralization of health systems in developing ...
  • McIntyre D, Brijlal V, Nkosi M. The South African Reforms ...
  • Samadi AH, Keshtkaran A, Kavosi Z, Vahedi S. The Effect ...
  • Marchildon GP, Bossert TJ. Federalism and Decentralization in Health Care: ...
  • Mukherjee A, Glassman A, Mahbub R. India’s states increase health ...
  • Mukherjee A. Fiscal Devolution and Health Financing Reform: Lessons for ...
  • Bossert TJ, Bowser DM, Amenyah JK. Is decentralization good for ...
  • Costa-Font J, Pons-Novell J. Public health expenditure and spatial interactions ...
  • Ferrario C, Zanardi A. Fiscal decentralization in the Italian NHS: ...
  • Torbica A, Fattore G. The "Essential Levels of Care" in ...
  • Knight B. Endogenous federal grants and crowd-out of state government ...
  • Garg CC, Evans DB, Dmytraczenko T, Izazola-Licea JA, Tangcharoensathien V, ...
  • Liang LL, Mirelman AJ. Why do some countries spend more ...
  • Martinez Alvarez M, Borghi J, Acharya A, Vassall A. Is ...
  • Jamison DT, Summers LH, Alleyne G, et al. Global health ...
  • Wickremasinghe D, Gautham M, Umar N, Berhanu D, Schellenberg J, ...
  • Farag M, NandaKumar AK, Wallack S, Hodgkin D, Gaumer G, ...
  • Karan A, Yip W, Mahal A. Extending health insurance to ...
  • Stigler FL, Macinko J, Pettigrew LM, Kumar R, van Weel ...
  • Global Health Expenditure Database. World Health Organization website. http://apps.who.int/nha/database/ViewData/Indicators/en. Published ...
  • Indian Public Health Standards (IPHS). Guidelines for Primary Health Centres. ...
  • Sekhar TV. Public Health and Panchayati Raj Institutions in Karnataka. ...
  • ۲۳Power to the States: Making fiscal transfers work for better ...
  • Rao MG, Choudhury M. Health Care Financing Reforms in India. ...
  • Bhawan N. National Rural Health Mission: Meeting people’s health needs ...
  • Government of India. Abridged Life Tables ۲۰۱۰-۲۰۱۴ ...
  • Office of Registrar General, India. Special Bulletin on Maternal Mortality ...
  • Nandan D. National rural health mission: turning into reality. Indian ...
  • World Bank. Official exchange rate (LCU per US, period average). ...
  • Berman P, Bhawalkar M, Jha R. Government financing of health ...
  • Hooda SK. Changing Pattern of Public Expenditure on Health in ...
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