Abstract

 
 Large inequities in health outcomes and treatment-seeking behaviour continue to exist in India, across households, states and residence. A few large populous states continue to contribute the most to multi-dimensional poverty, including indicators for health outcomes. A significant contributor is the high out-of-pocket spending that continues to be a key feature of India’s health sector, accompanied by one of the lowest levels of public investment on health. The COVID pandemic has brought out sharply the lack of preparedness of the country and its states to face a catastrophe of this kind. A resilient health sector can only be built by bridging the various gaps in key inputs into the sector – infrastructure, personnel, supplies and training. This investment is likely to bring down the demand for health services in the private sector and reduce spending on health services by households by making these affordable and accessible. A quantum jump in investment would also be required to offer health coverage that is truly universal in scope and coverage. Unless that happens, India would remain unprepared for the next calamity and continue with significant inequalities in health outcomes and access to services.
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