Evaluate the role of primary healthcare investment in achieving equitable health outcomes in India, with reference to recent National Health Accounts data.

The National Health Accounts (NHA) Estimates 2022-23 reveal that government spending on primary healthcare has more than doubled — from ₹0.5 lakh crore to ₹1.4 lakh crore over a decade — signalling a decisive shift toward the foundation of an equitable health system [1].

How primary healthcare drives equity

• Financial protection: Government Health Expenditure tripled (₹1.30 to ₹3.85 lakh crore), coinciding with Out-of-Pocket Expenditure falling from 64.2% to 43.4% of total spending — shielding poor households from catastrophic costs [1].
• Rising social security: Social Security Expenditure on health rose from 6% to 9.9%, reflecting risk-pooling that benefits the vulnerable [1].
• Access at the doorstep: Primary care investment (Health & Wellness Centres) brings preventive and diagnostic services to underserved rural and tribal areas, narrowing spatial inequity.
• Cost-effectiveness: Every rupee in primary care averts costlier tertiary treatment, freeing resources for wider coverage.

Limits to the equity claim

• GHE remains only 1.43% of GDP — far below the National Health Policy 2017 target of 2.5% — capping the scale of protection [1].
• OOPE at 43.4% is still high; the poorest continue to face impoverishing expenses.
• Inter-state disparities in absorptive capacity and quality mean spending does not translate uniformly into outcomes.

Thus, primary healthcare investment is a necessary but insufficient lever for equity. Scaling public spending toward the 2.5% GDP goal, strengthening Health & Wellness Centres, and targeting laggard states can convert this fiscal momentum into truly universal health coverage, advancing SDG-3.