Budget 2024: Empty Declarations, Insufficient Allocations For Key Schemes
Schemes aimed at women did not get the big push they needed, we find
In her hour-long Budget speech, finance minister Nirmala Sitharaman said that women are one of the four priority groups for the government, the others being farmers, young and poor people. “Their needs, their aspirations, and their welfare are our highest priority,” she said. “Their empowerment and well-being will drive the country forward.”
The interim budget, which will be valid till the elections and the formation of a new government, included major promises but a close look shows that many of these announcements were meaningless. Also, the allocations for key schemes and ministries remain dismal.
One of the major announcements was that ASHAs and Anganwadi workers and helpers would be provided health cover under the Ayushman Bharat Jan Aarogya Yojana. The health insurance scheme that provides a Rs 5 lakh cover for 120 million “poor and vulnerable” families so far covered only those ASHA and Anganwadi workers who had met the eligibility criteria for the scheme. This criteria, which varies for urban and rural pockets, is based on the socio-economic caste Census of 2011 and depends on certain kinds of deprivation and occupations.
But providing health insurance does not guarantee healthcare access.
When 43-year-old ASHA worker Usha Jadhav had a heart attack in February 2022, her Ayushman Bharat Gold Card was of no use, we reported last month. While angioplasty is covered under the Jan Arogya Yojana, Jadhav says she was told that she could not claim its benefits because she did not undergo a surgery and because the expenses did not cross Rs 2 lakh. Her husband, who works as a tractor driver, had to borrow from his employer to meet the medical expenses.
“Considering that ASHA and Aanganwadi workers come mostly from socioeconomically deprived backgrounds from rural parts of the country, they would anyway be covered by the AB-PMJAY. Assuming that this announcement leads to the coverage of all workers, previously eligible or not, how does it help if the infrastructure to seek healthcare is lacking? Neither Rs 5 lakh nor Rs 5 crore per annum makes a difference if healthcare is not accessible,” said public health physician and researcher Parth Sharma.
“The budget has been disappointing,” said Netradipa Patil, a union leader from Kolhapur, Maharashtra who works with ASHA workers. “All of us were hoping that this year, the government would increase the honorarium it gives to Rs 5,000. But no such declaration has been made. The central government honorarium has been Rs 2,000 for 5 years now.”
Vaccination For Cervical Cancer
FM Sitharaman declared that the government would “encourage” vaccination for the prevention of cervical cancer among girls in the 9 to 14 years age group.
Her statement is, however, contradicted by the government’s Press Information Bureau statement made just 18 days before the Budget – “The Union Health Ministry is yet to take a decision on the roll out of HPV vaccination in the country. It is closely monitoring the incidences of cervical cancer cases in the country and is in regular touch with states and various health departments regarding this. There have been some media reports speculating that the Union Government will launch a human papillomavirus (HPV) vaccination campaign in the second quarter of year 2024 to target girls in the 9-14 years age group. Such reports are not true.”
Parth Sharma pointed to the fact that such announcements on this vaccination are nothing new. “The HPV vaccine was introduced in India in 2008 and vaccination campaigns have been previously carried out in the states of Sikkim, Punjab, and Delhi. The central government announced the indigenous vaccine in September 2022 to prevent cervical cancer, but concrete nuanced steps for the prevention of cervical cancer are yet to be announced,” he said.
Apart from the talk about vaccination, there is not enough cervical cancer screening in India, Sharma added: “As per NFHS 5, the coverage of screening is less than 2%, despite it being a part of a national programme.”
“There is a lot of misinformation, stereotyping, and taboos around this disease. So awareness and advocacy campaigns are necessary, but there is no clarity on this on the government’s part,” said Sharma.
Funds For Critical Schemes Decline
While the overall health budget increased by 12.6%, the allocation for the largest public healthcare scheme, the National Health Mission, increased by only 1.3%. However, the National Ayush Mission – meant to push alternative health systems such as ayurveda, yoga and unani – boasted an allocation of Rs 1,200 crore, a 47% increase from revised estimates of Rs 815 crore.
Though Sitharaman said in her speech that “Upgradation of anganwadi centres under ‘Saksham Anganwadi and Poshan 2.0’ will be expedited”, the allocation for the scheme was cut by 1.5%. Moreover, this is a 40% cut in real terms when compared to allocation in 2014-15 and adjusted to inflation, found an analysis by Road Scholarz, a collective of freelance scholars and student volunteers.
Similarly, the mid-day meal scheme, which saw a 24.7% increase in allocation from 2023-24 revised estimates, got a 40% cut in real terms, as per Road Scholarz.
The education budget saw a cut of 7%, most of which has been slashed from the Department of Higher Education (17% cut). The University Grants Commission, responsible for maintaining standards of higher education and providing grants to almost 400 universities, received less than half of what it was allocated last year.
The allocation for the agriculture ministry increased by only 0.6% while allocation for 16-year-old Mahatma Gandhi National Rural Employment Guarantee Scheme (MGNREGS) remained the same. More women than men depend on the scheme that guarantees 100 days of paid work. In August 2022, women beneficiaries of the scheme had protested demanding better wages and against delayed payment of the wages.
The Jal Jeevan Mission that aims to provide tap water connection to all rural households saw an increased allocation of only 0.2%. Women in India spend almost five hours each day in water-management activities and this scheme was meant to reduce this burden.
“The worries about food have been eliminated through free ration for 80 crore people,” said Sitharaman. But the budget slashed this food subsidy by 3.3%.
The budget for direct benefit transfer of LPG subsidy saw only a 2.7% increase to Rs 1,500 crore. This is less than 5% of what the government spent on LPG subsidy in 2018-19. In 2020, the government stopped the subsidy while cylinder prices doubled since 2017. As Behanbox had reported, this price rise in LPG refills meant that women had to return to traditional, toxic stoves in the kitchen.
Two years later, the subsidy was reintroduced but only for the beneficiaries of the Pradhan Mantri Ujjwala Yojana (PMUY). The scheme, introduced in 2016, was meant to provide clean cooking fuel for rural households.
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