Estimating financial resources for universal access to sexual reproductive health care: Evidence from two states in India

- Two states present divergent spending pattern on SRH. Total SRH expenditure in Bihar was Rs 16,779 million and Karnataka was Rs 15,825 million. Government's share in total SRH spending in Bihar was lower (59%) in comparison to Karnataka (76%).
- The per capita SRH expenditure in Karnataka was higher than Bihar.
- A large part of household spending is on curative care.
- Around 2 percent of total SRH spending is from the donor agencies.
- Improving accountability of the government needs conducting similar studies using robust sub accounting framework within NHA.

India has made insignificant progress towards achieving universal access to sexual and reproductive health (SRH). One of the key inputs for achieving universal access to SRH is financial resources. Given this, many international agencies including the UN are emphasising on monitoring the financial progress towards achieving SRH.ObjectiveTo generate evidence on spending on SRH from various sources - (government, household, international donors and NGOs) to improve the accountability of the government towards SRH goal.MethodologyAdapting a sub account framework of the NHA, this paper investigated the SRH expenditure of the two divergent states of India. The data were collected from government, households (NSSO), and foreign donors and were classified as per the International Classification of Health Accounts (ICHA).Results and DiscussionsTotal SRH expenditure is less than one percent of SGDP from all sources in each state. Among the sources, government's spending on SRH is more than household. A large part of household spending is on curative care which has implications for accessing services by the poor.In spite of data constraints, this paper presents a comprehensive analysis on SRH spending, which is critical for monitoring the commitment towards universal access to SRH. This evidence can be used for further improving data quality for RCH account in LMICs.