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

Q. Evaluate the role of primary healthcare investment in achieving equitable health outcomes in India, with reference to recent National Health Accounts data. (15 marks, 250 words)

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.

(~248 words)

Sources: 1. Union Health Ministry Releases the National Health Accounts Estimates for India 2022-23, PIB (2026) — GHE tripling, GHE/GDP at 1.43%, OOPE decline (64.2%→43.4%), SSE rise (6%→9.9%), and primary healthcare spending doubling (₹0.5→₹1.4 lakh crore)