Shifts in public health budget allocation and disparities among major Indian States

Since India's economic liberalization in 1991, government spending on infrastructure and public health services—which aims to promote fair access—has changed significantly. Due to disparities in budgetary resources and policy priorities, Indian states exhibit significant variability in their spending patterns as primary healthcare providers. With a focus on interstate inequalities, equity concerns, and the impact of public funding on health outcomes, this study examines changing public health budget trends in 15 key states over the post-reform era. It examines changes in budgetary allotments, per capita expenditures, and the ratio of revenue to capital expenditures using state-level data. The results show unequal progress, with wealthier states in a better position to support health services and infrastructure while poorer states must contend with competing demands for growth and budgetary limits. Essentially, the main challenge facing post-reform India is not only increasing overall public health spending but also allocating it fairly among states in order to promote a stronger, healthier nation. For consistent growth in the health sector, policy recommendations emphasize more fiscal devolution, targeted expenditures, and strong institutions.