 "OOPE declines, school enrolments rise as social expenditure surges: Survey")
Increase in social services expenditure (SSE) -- on the rise since 2016-17 -- has not only reduced out of pocket expenditure (OOPE) for healthcare, but has also led to better school enrolment and a slide in dropout rate, highlighted the latest Economic Survey.
The SSE as a percentage of total expenditure (TE) has increased from 23.3 per cent in the financial year 2021 (FY21) to 26.2 per cent in FY25 (Budget Estimates), growing at a compound annual growth rate (CAGR) of 15 per cent.
As part of SSE, the health expenditure grew from Rs 3.2 trillion in FY21 to Rs 6.1 trillion in FY25BE at a CAGR of 18 per cent, while expenditure on education grew at a CAGR of 12 per cent from Rs 5.8 trillion in FY21 to Rs 9.2 trillion in FY25BE.
In fact, the Economic Survey sounded confident that India is on track to achieve World Health Organisation (WHO) standards of 1 doctor for 1,000 people by 2030, with a conservative 50,000 doctors being licensed every year.
Increase in government health spending led to lower OOPE
The survey says that the increase in government health spending, with regards to health insurance and infrastructure development, has had an important implication for the reduction of financial hardship endured by households.
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With government health insurance schemes such as Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) and Central Government Health Scheme (CGHS) constituting a 5.87 per cent share in healthcare financing schemes, the share of OOPE in total health expenditure (THE) declined from 62.6 per cent to 39.4 per cent in FY22.
“AB-PMJAY has played a decisive role in the significant reductions observed in OOPE through an increase in social security and primary health expenditure, with over Rs 1.25 trillion in savings recorded,” the survey added.
India to attain WHO norm of 1 doctor per 1000 people by 2030
From a current ratio of 1 doctor available for every 1263 Indians, the survey said that the country is on track to achieve the WHO standards of 1 doctor for every 1000 people by 2030. This is considering India continues to churn out 50,000 doctors licensed every year. At the moment 1.38 million medical practitioners are available.
However, at the same time, the survey highlights that availability of doctors is more skewed towards urban areas, with urban to rural doctor density ratio at 3.8:1.
To come within the norms, the survey highlights the need to enhance the system and ensure it fully aligns with broader policy objectives. This includes sustainable and balanced medical education policy.
While the number of candidates aspiring to study MBBS have increased from around 1.6 million in 2019 to around 2.4 million in 2024, pursuing medical education in India still has problems of geographically skewed seats and affordability of courses.
The survey also pointed out that 51 per cent of all medical undergraduate (UG) seats and 49 per cent of postgraduate (PG) seats are in the southern states.
Similarly, fees for medical courses remain high at Rs 60 lakh to Rs 1 crore or more in the private sector colleges, which hold 48 per cent of MBBS seats.
Higher school enrolment, lower dropout rates
The survey also states that a rise in education expenditure has led to higher school gross enrollment ratio (GER), in line with the National Education Policy (NEP) 2020’s aim for a 100 per cent GER by 2030.
“The GER is near-universal at the primary (93 per cent) and the efforts are underway to bridge the gaps at the secondary (77.4 per cent) and higher secondary level (56.2 per cent), driving the nation closer to its vision of inclusive and equitable education for all,” the survey added.
It also highlighted a steadily declining dropout rate in recent years, standing at 1.9 per cent for primary, 5.2 per cent for upper primary, and 14.1 per cent for secondary levels.
Improvements in basic facilities and infrastructure, including medical check-ups, sanitation, and information and communication technologies (ICT) availability have been responsible for these positive developments.
The survey, however added that challenges persist, with retention rates at 85.4 per cent for primary (Class I to V), 78 per cent for elementary (Classes I to VIII), 63.8 per cent for secondary (Classes I to X), and 45.6 per cent for higher secondary (Classes I to XII).
India’s school education system serves 248 million students across 1.47 million schools with 9.8 million teachers, according to UDISE+ report for 2023-24.
The survey further talks of leveraging artificial intelligence for teachers’ professional development and providing AI-driven personal tutors for students. AI personal tutors may enhance learning with resource guidance, career counselling, and problem-solving strategies.
“The government is envisioning and developing e-learning through digital pedagogy as a long-term strategy for the education sector,” it said.