Females in India can on average expect to live just over 60 years of a healthy life unhampered by disabling illness or injuries, the lowest healthy life expectancy among 11 countries in the World Health Organisation’s Southeast Asia region. Even when it comes to men, there are just two countries in this region, Timor-Leste and Myanmar, that are worse off in terms of healthy life expectancy.
One factor that clearly contributes to this is the fact that the mortality rate of children under five years is the highest in these same countries, Timor-Leste and Myanmar being again even worse off than India.
These sobering realities emerge from data in a recently released WHO report on the region’s progress in achieving universal health coverage and the health-related sustainable development goals.
In the countries with the best performance in the region, Sri Lanka, Thailand, and the Maldives, health expenditure as a share of total government expenditure is among the highest in the region. In contrast, the estimated share of spending on health in total government spending is the lowest in India (3.4%), Bangladesh (3%), and Myanmar (3.5).
Consequently, in these three countries, out-of-pocket expenditure, that is people spending from their own savings constitutes between 63% in India and 76% in Myanmar compared to just 11% in Thailand.
Given this situation, it comes as no surprise that Bangladesh and India also have the highest proportion of their population, 7%, and 4.2% respectively, being pushed into poverty because of having to spend on healthcare. They also have the highest proportions of people who spent more than 10% of their household’s total expenditure on healthcare, a situation that is described as catastrophic health expenditure.
Almost a quarter of the population in Bangladesh and over 17% in India are estimated to face catastrophic expenditure due to healthcare.
The report pointed out that health inequity analysis showed that some people were able to “live healthier lives and have better access to health services than others – entirely due to the conditions in which they are born, grow, live, work and age”.
It stressed the need to collect high-quality disaggregated data for monitoring health inequalities to enable the framing of appropriate policies for ensuring equitable access to and uptake of health services.