National rural health mission and the interstate variations in public healthcare spending in India: A study of the Indian North-Eastern states

Background/Objectives: The North-Eastern region of India comprised of eight states of which seven states come under small states and special category states. The region has a very large rural population which is highly agrarian in nature. The performances of the states in many of the health indicators have been better than most of big Indian states yet the status of health infrastructure and health accessibility in the region are still a grave concern. The study aims to find the interstate variations before and after the implementation of National Rural Health Mission (NRHM) Act of 2005, on the public health expenditure in the North-Eastern states. Methodology: The data on public health expenditure has been obtained from the State Finance Reports of the Reserve Bank of India (RBI), on population from the office of the Registrar General & Census Commission of India and the Gross State Domestic Product (GSDP) from the Directorate of Economics and Statistics of respective state governments, Central Statistics Office. The study is of twenty-six years, 1990-91 to 2015-16. The study uses the coefficient of variation to determine the extent of interstate variations. Findings: The study found that the interstate variation in public healthcare expenditure with all the eight states in the region is on a decline. Further, the study found that post NRHM, the states have equalised their proportion of health spending. Novelty/Improvement: There have been no studies to compare the interstate disparity in public health expenditure in the North-Eastern states before and after the implementation of NRHM in recent years. Keywords: Public health expenditure; interstate variations; National rural health mission; North Eastern States; India