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Progressivity of Public Spending on Health care at the Sub-state Level in India: An Empirical Investigation in Tamil Nadu and Bihar

Author

Listed:
  • Datta, Pritam

    (National Institute of Public Finance and Policy)

  • Dubey, Jay Dev

    (National Institute of Public Finance and Policy)

  • Choudhury, Mita

    (National Institute of Public Finance and Policy)

Abstract

Progressivity of public spending on health is considered welfare enhancing, and is often quantified through Benefit Incidence Analysis (BIA). In India, BIA analyses have been confined to state-level aggregates, and intra-state variation in progressivity among districts have remained largely unknown due to limited availability of disaggregated data. We use multiple datasets to overcome the data constraint and undertake BIA at the district-level in the two states of Bihar and Tamil Nadu. Disaggregated information from respective state treasuries were combined with central and state samples of surveys conducted by the National Sample Survey Organization to estimate utilisation and incidence of the benefits of public spending in districts. Results highlight that several districts diverge from state-level aggregates on progressivity, and this call for targeted heath interventions at the state-level. Further, a comparison of public spending across vertical tiers of the health pyramid and utilization of health facilities in the two states provide insights on state-level effectiveness of health interventions. The study lays forward a methodological framework to undertake BIA at the district-level in India.

Suggested Citation

  • Datta, Pritam & Dubey, Jay Dev & Choudhury, Mita, 2022. "Progressivity of Public Spending on Health care at the Sub-state Level in India: An Empirical Investigation in Tamil Nadu and Bihar," Working Papers 22/375, National Institute of Public Finance and Policy.
    • Handle: RePEc:npf:wpaper:22/375
    Note: Working Paper 375, 2022
    as

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    References listed on IDEAS

    as
    1. Chakraborty, Lekha, 2022. "Covid19 and Unpaid Care Economy: Evidence on Fiscal Policy and Time Allocation in India," Working Papers 22/372, National Institute of Public Finance and Policy.
    2. Mita Choudhury & Jay Dev Dubey, 2017. "Estimating Public Spending on Health by Levels of Care for National Health Accounts: An Illustration of Use of Data on Withdrawals by Drawing and Disbursing Officers (DDOs) in India," Working Papers id:12142, eSocialSciences.
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    5. Mr. Erwin H Tiongson & Mr. Hamid R Davoodi & Sawitree S. Asawanuchit, 2003. "How Useful Are Benefit Incidence Analyses of Public Education and Health Spending," IMF Working Papers 2003/227, International Monetary Fund.
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    More about this item

    Keywords

    Health Financing ; Benefit Incidence Analysis ; Public Spending on Health ; Bihar ; Tamil Nadu ; India;
    All these keywords.

    JEL classification:

    • H2 - Public Economics - - Taxation, Subsidies, and Revenue
    • I14 - Health, Education, and Welfare - - Health - - - Health and Inequality
    • I15 - Health, Education, and Welfare - - Health - - - Health and Economic Development
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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