2016 was a bad year for Indian healthcare. Demonetisation made it worse

With an investment of a paltry 1.5% on healthcare in India, only small achievements stood out in the year 2016.

The year saw the country rid itself of two infectious diseases - yawns and neonatal tetanus. The latter is caused by unhygienic deliveries and is lethal.

Even the WHO commended India's achievements in eradicating the two infections.

Yawns is a disease the affects the skin and bone and can cause disfigurement of the body. The attempt to eradicate the infection started in the late 1950s.

These achievements notwithstanding, the most important event of the year is the government's decision on the health prospects of surrogate mothers. While the Bill is yet to be passed by Parliament, it proposes a ban on commercial surrogacy and only allows for it in case of 'infertile couples' who have no other option. There is also the dire implication of livelihoods being lost for hundreds who rely on surrogacy as their only source of income.

The Health Ministry also launched the Rota virus vaccine that was made available free of cost at public healthcare centres across four states - Odisha, Himachal Pradesh, Andhra Pradesh and Haryana. Rota virus is cited as cause for about 78,000 deaths in India each year.

The government also launched the "Pradhan Mantri Surakshit Matritva Abhiyan" (PMSMA) which assures fixed-day comprehensive and quality antenatal care to pregnant women on the ninth of every month. The scheme also promises to provide a minimum package of antenatal care services that would be provided to pregnant women in their second or third trimesters at all government health facilities.

But the good news ends there.

Health expenditure by the government is woefully inadequate which means that a large part of the population can't even think of availing good quality healthcare.

A survey conducted this year by ICE 360° shows that 3% of households of among the richest 20% of the population faced a crisis with more than fifth of their income being spent on spent on healthcare. The figure for the bottom of the pyramid -20% of the poorest -- was 7%, which is more than double compared to the rich.

The survey also shows that 47% households consult a doctor at a public health facility when a family member falls ill while 38% households visit a private health facility. 14% households consult an independent medical practitioner. The survey covered 61,000 households making it one of the largest health surveys conducted in India in the last decade.

With respect to health insurance, the survey also showed that only 23% of all households in the country were covered under any health insurance scheme with less than a fifth of the poorest 20% having any health insurance cover. India's out-of-pocket expenditure remains the highest among all south-east Asian countries as we head towards 2017.