Understanding India’s Health Budgets

Avani Kapur, Owen Smith, Rajesh Jha, Ritwik Shukla, Sharad Pandey
(2023)

The budget is a vital tool to support the government in executing various programs and schemes in a methodical and strategic manner. Most importantly, it is the document that informs citizens of how taxes are collected and resources are prioritised and spent — how much and on what? But the process by which the budget is prepared and the details of the budget document itself, are not easily comprehensible.

Health budgets (or budget documents in general) have traditionally been viewed as an accounting or administrative document, instead of a strategic policy document. Now, there is growing recognition that many aspects of the budgeting process are deeply embedded in India’s health system performance. Yet India’s 29 health budgets (Government of India plus 28 states) are complex, varied, and poorly understood. Thus, there is value in enhancing our collective understanding of how health budgets are formulated, executed, and evaluated; and in describing the implications of budget processes and structures for undertaking policy-relevant analysis

The main objective of this primer is to offer the reader a way to understand and interpret India’s Union and state health budgets.