Karnataka throws up some contradictions in health indicators that are not common: continued high incidence of maternal mortality (144 against goal of 100) despite increase in institutional births (64 per cent to 94 per cent), declining sex ratio (1,028 to 979) not only for entire population but also for children born during the last five years (922 to 910), and persistence of anaemia among children and women despite an increase in the secondary education enrolment ratios and decline in the child marriage rates. (Source: NFHS-4-2015 data.)
Karnataka needs to reconsider its dependence on health insurance as a means to provide health care, especially in view of somewhat unsatisfactory record in reaching the poorest. The goal of universal health care needs to be vigorously pursued. The rationalisation of health care facilities and upgrading the quality of services is a greater need as the number of facilities is high but the quality is suspect.
Better enforcement of bans on sex-selection practices as well as on the use of gutka is important.
‘Stop promoting alcohol’Karnataka is among very few States where consumption of alcohol has gone up. The government must stop promoting alcohol to augment revenue as it is fraught with serious consequences for the health as also wellbeing of women and families.
Health care in urban areas, particularly of migrant workers who inhabit the urban slums, needs particular attention; the design and implementation of the National Health Mission is critical in that context. Post implementation of the 14th Finance Commission’s recommendations, it is important that the State maintains expenditure on health despite reduction in the Union government’s allocation to the social sector schemes.
A plethora of new schemes have been introduced over the years, it is time to consolidate and rationalise them. It would be a good practice to place in the legislature every year third-party evaluation reports of a few schemes by rotation. In compliance with Article 371J and the State’s health policy’s (2004) acknowledgement of north Karnataka (NK) region as among the poorest, the budget must disclose allocation to the NK districts and actual expenditure in previous years.
(Srinivas Alamuru is adviser and Jyotsna Jha is director, Centre for Budget and Policy Studies.)
