India Philanthropy Report 2014 by Bain and Dasra says lack of funds will lead to more deaths of children

By 2025, India will need an incremental $12 billion over and above public health expenditure to meet its 2035 health objectives for women and children. Photo: AFP

Mumbai: India’s child mortality rate may worsen despite the government’s efforts to lower it because of a dearth of funding, according to the India Philanthropy Report 2014 by business consulting company Bain and Co. and Dasra, a philanthropic foundation, to be released on Friday.

The lack of a comprehensive ecosystem of public, private and philanthropic stakeholders to help close the gaps in reproductive, maternal, new-born, child and adolescent (RMNCH+A) health are also critical hurdles, said the report.

With a child mortality rate of 63 deaths per 1,000 live births, as of 2011, a target of 19 deaths per 1,000 live births can be achieved by 2035, the report said. “But if we don’t act now, instead of in 20-25 years, we may not reach our goal until 2055,” the report warned.

India has recorded a significant improvement in women and children’s health over the last 15-20 years. Maternal and infant mortality rates, the number of underweight children, child marriages and the total fertility rate have all declined. Several areas of concern still remain, including a high rate of anaemia among mothers and children.

The Bain-Dasra report said that by 2025, India will need an incremental $12 billion over and above public health expenditure to meet its 2035 health objectives for women and children, including slashing the maternal mortality rate by 60% and the child mortality rate by more than 70%.

Doubling the current share of contributions to health through mandated corporate social responsibility (CSR) spending and donations by high networth individuals (HNIs) can garner an extra $2.7 billion, the report said.

But multilateral and bilateral agencies are unlikely to increase their current annual grants of about $700 million. This leaves a shortage of nearly $8.6 billion to reach the $12 billion in funding needed by 2025, which will need to come from private foreign donors, such as the Bill and Melinda Gates Foundation and the Michael and Susan Dell Foundation.

The report said that in addition to strengthening health systems and scaling up healthcare programmes and services, private global philanthropy will be critical in catalysing the development of a vibrant healthcare ecosystem and enhancing India’s health delivery and support systems.

“When it comes to philanthropic capital, the pool is still developing. We are far from where we need to be. The coordination is not there for philanthropists to invest as much as they would like to, and that is why philanthropy is not at a large scale here,” said Arpan Sheth, a partner at Bain and the main author of the report.

According to Sheth, to bolster the confidence of philanthropists, India needs a larger set of non-governmental organizations (NGOs) with the scale and managerial expertise to facilitate the use of capital at the ground level.

“In the next 10-12 years, it is absolutely crucial for non-state actors to work with the public and private sector to help bridge the gap to reach transformational outcomes. Here, the expanding role of philanthropists and mandated CSR will be crucial,” said Smarinita Shetty, director at Dasra.

The report said the current coverage of 30 health-focused NGOs per 100,000 women will need to increase to 125 per 100,000 if India is to achieve outcomes similar to the success it won in the battle against HIV/AIDS or polio.

“Enhancing government training programmes to improve the efficiency of large-scale networks and intensifying focus and attention on vertical health issues to achieve long-term results such as anaemia, typhoid and HIV will make the lasting impact on women and children’s healthcare,” the report said.

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