Reproductive and child health accounts: an application to Rajasthan

This paper describes resource flows for reproductive and child health (RCH) in the health care system of Rajasthan, India, using the integrating framework of health accounts. It analyzes sources and uses of RCH funds by provider and expenditure category. The paper provides policy options for redirecting current public and private expenditures to improve RCH indicators. Comparisons of the share of government expenditure in state gross domestic product (31%), of Rajasthan state government spending as a share of total health spending (21%) and of Rajasthan state government spending as a share of reproductive and child health spending (3%) suggest that there are imbalances to correct. Even a very large increase in RCH spending by the Government of Rajasthan, an increase bringing its share of RCH total spending up to the level of its share in health spending, would add only one percentage point to the state budget. The principal result of such an increase in public RCH spending would be a substantial reduction in currently high levels of fertility and of mortality among infants, children and women of reproductive age.