India Releases National Health Accounts (NHA) Estimates 2022–23

The Ministry of Health and Family Welfare has recently released the National Health Accounts (NHA) Estimates 2022–23 for India. The report provides a comprehensive assessment of the country’s health financing landscape, highlighting trends in public health expenditure, out-of-pocket expenditure (OOPE), and progress toward achieving Universal Health Coverage (UHC). The NHA serves as an important tool for measuring health spending patterns and evaluating the effectiveness of health policies.

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¨     The National Health Accounts (NHA) estimates provide a systematic assessment of health expenditure flows in India using the internationally accepted System of Health Accounts (SHA) 2011 framework developed by the World Health Organization (WHO).India’s NHA estimates are prepared by the National Health Systems Resource Centre (NHSRC) under the Ministry of Health and Family Welfare.

¨     The 2022–23 report is the 10th edition of the NHA estimates and captures expenditure incurred by governments, households, private insurers, firms, and external agencies on healthcare services.

¨     The report highlights a long-term increase in public health expenditure and a sustained decline in Out-of-Pocket Expenditure (OOPE), indicating improved financial protection in healthcare.

Key Highlights of NHA Estimates 2022–23

Rise in Government Health Expenditure (GHE)

¨     Government Health Expenditure (GHE) increased nearly threefold from ₹1.30 lakh crore in 2013–14 to ₹3.85 lakh crore in 2022–23.

¨     GHE as a share of GDP increased from 1.15% in 2013–14 to 1.43% in 2022–23. Under the revised GDP base year (2022–23 series), the share stands at 1.48%.

¨     GHE as a share of General Government Expenditure (GGE) rose from 3.78% to 4.89% during the same period, indicating increasing prioritisation of health in public spending.

¨     The share of GHE in Total Health Expenditure (THE) has increased by almost 15 percentage points, from 28.6% to 43.7% during the same period.

¨     In per capita terms, GHE has increased nearly 2.7 times, from ₹1,042 in 2013–14 to around ₹2,786 in 2022–23.

Decline in Out-of-Pocket Expenditure (OOPE)

¨     Out-of-Pocket Expenditure (OOPE) as a share of Total Health Expenditure (THE) declined significantly by nearly 21 percentage points from 64.2% in 2013–14 to 43.4% in 2022–23.

¨     The decline reflects expanding public provisioning of healthcare services and wider coverage under government-funded health insurance schemes such as Ayushman Bharat–PMJAY, and increased public health spending.

Increase in Social Security and Primary Healthcare Spending

¨     Social Security Expenditure (SSE) on healthcare increased from 6% to 9.9% of Total Health Expenditure between 2013–14 and 2022–23.

¨     The share of Private Health Insurance in THE has also increased, from 3.4% to 9.2%, clearly indicating improved health-seeking behaviour due to awareness and the population’s purchasing power.

¨     Government expenditure on Primary Healthcare more than doubled from around ₹0.5 lakh crore in 2013–14 to approximately ₹1.4 lakh crore in 2022–23.

¨     The report also noted an accelerated rise in public health expenditure during and after the COVID-19 pandemic period.

Significance of the Findings

¨     Progress Towards Universal Health Coverage: Rising public expenditure and declining OOPE indicate gradual progress toward Universal Health Coverage by improving financial protection against healthcare costs.

¨     Reduced Financial Burden on Households: The declining OOPE reduces the risk of catastrophic health expenditure and medical impoverishment among vulnerable households.

¨     Strengthening Public Health Systems: Increased spending on primary healthcare reflects greater policy emphasis on preventive, promotive, and community-based healthcare systems.

¨     Improved Health Financing Architecture: Rising social security expenditure indicates a gradual expansion of pooled healthcare financing mechanisms and government-supported insurance coverage.