Healthcare expenditure’s share in the general budget increased from 10% in the Iranian year ending March 2014 to 17% in the year ending March 2021.
Per capita health spending in the general budget increased 4.3-fold during the period under review, according to Hamid Pour-Asghari, a deputy for scientific, cultural and social affairs at the Plan and Budget Organization.
“Health and social welfare, higher education, research and technology, public education, technical and vocational trainings, culture, tourism and sports, public and judicial affairs, defense and security account for 95% of the operating budget and 22% of the capital expenditure budget,” he was quoted as saying by Fars News Agency.
Healthcare expenditure refers to aggregate healthcare spending in an economy, including expenditure related to hospitals, prescription drugs, nursing facilities and personal healthcare.
The official put the total health budget in the fiscal 2020-21 at over 1,110 trillion rials ($4.59 billion).
“One of the approaches to the efficient management of financial resources with the priority vulnerable groups of the population is to reduce out-of-pocket expenses, i.e., the people’s share of covered healthcare costs, including the money they pay for deductibles, co-payments and co-insurance,” he said.
“The direct out-of-pocket expenses for patients in urban areas in state-owned hospitals relative to healthcare expenditure reduced from 37% in the year ending March 2014 to 10% in the year ending March 2021. For patients in rural areas, the share reached 5%.”
Pour-Asghari noted that the number of hospitals (both state-run and privately-owned) increased from 900 to 1,057 during the period under review. The figure will reach 1,137 by March 20, 2022.
There were 150,287 hospital beds in Iran last year, indicating a 34.3% growth compared with the year ending March 2014. The number of hospital beds will increase to 178,500 by March 20, 2022.
“Since the start of President Hassan Rouhani’s term in the year ending March 2014, the number of hospital beds increased by 400 monthly,” he said.
“The ratio of hospital beds to the population, usually expressed as the number of available hospital beds for every 1,000 population increased from 1.48 to 1.8 beds [per 1,000 people] during the period.”
The supply of health workers improved by 22.4% to reach 511,583 people over the eight-year period: A 22% growth in workforce in health and treatment sector, a 12% rise in research centers and a 21.5% increase in education sector was registered over the period.
The official said the number of emergency ambulances stood at 6,067 in the year ending March 2021 compared with 3,086 in the year ending March 2014.
“Ambulance stations grew from 2,063 to 2,904. Emergency medical service coverage on freeways, arterial, collector and urban roads hit 89% last year. The number of health and treatment centers in urban and rural areas improved by 14.3% and 13.4%, respectively. At present, there are one health house — centers providing basic healthcare services — per 1,300 people,” he added.
According to Pour-Asghari, infant mortality rate, i.e., the death of children under one year per 1,000 live births, decreased from 15% to 11.6% during the period. Deaths of children under five years per 1,000 live births improved to 14%.
“However, the maternal death rate [the death of a pregnant woman] jumped from 17.7% in the year ending March 2020 to 25% in the year ending March 2021 due to the outbreak of the Covid-19 disease.”
The number of free-of-charge natural childbirth grew by 100% in the year ending March 2021 compared with the year ending March 2014, while caesarean delivery declined by 5.44% during the period.
“The share of locally-produced and imported drugs in total consumption reached 88% and 12% last year, respectively. Over 207.5 million doses of vaccines were delivered last year, of which 60 million doses were imported and the rest were developed domestically,” he said.
Noting that the number of health workers increased by 55,284 during the outbreak of coronavirus, Pour-Asghari said the pending merit pay of health workers up to the month ending Oct. 21, 2020, has been cleared.
“Over 195 trillion rials [$805.78 million] from resources worth €1 billion from the National Development Fund, the sovereign wealth fund of Iran, have been paid, of which 165 trillion rials [$681.81 million] were paid to the health and treatment sector. What’s more, a credit worth 90 trillion rials [$371.9 million] from the general budget have been paid to the coronavirus targeted subsidies,” he added.
Household Spending
The average Iranian household living in urban areas spent 49.64 million rials ($206) on health in the last fiscal year (March 2019-20). That’s a 16.1% increase from 42.75 million rials ($178) they spent in the fiscal 2018-19, according to a report by the Ministry of Cooperatives, Labor and Social Welfare’s Statistics and Strategic Data Center.
The average annual expenses of an urban household increased by 20.8% last year (March 2019-20) to stand at 486 million rials ($2,025) compared with 402 million rials ($1,675) in the preceding year.
The center divides health expenses into two groups of “hygiene and treatment” and “social and medical insurances” costs.
The “hygiene and treatment” costs accounted for 33.34 million rials ($139) — up 12.1% year-on-year — and those of “social and medical insurances” constituted 16.3 million rials ($68) — up 25.5% YOY — of total expenditure of urban families in the fiscal 2019-20.
Findings also show that health expenses accounted for 10.2% of urban households’ total expenditure and 13.5% of non-food expenses.
Health spending has been the fourth largest expense in urban households with 10.2% after “housing and fuels” with 35.5%, “food and tobacco” with 24.2% and “transportation and communications” with 11.5%.
The share of health spending in urban households’ total expenses was the highest for the 10th income decile (the richest) with 11.8% and lowest for the first decile with 7.4% (the poorest).
The health expenditure of urban households belonging to the 10th income decile and those in the first income decile stood at 159.85 million rials ($666) and 9.45 million rials ($39), respectively. In other words, urban households in the 10th income decile spent 17 times more than those spent by the first decile on health.
As for those living in rural areas, health expenses increased by 9.3% for families living in rural areas last year: from 24.12 million rials ($100) in the year ending March 2019 to 26.37 million rials ($109) in the year ending March 2020.
The average annual expenses of a rural household increased by 22% last year (March 2019-20) to stand at 265 million rials ($1,104) compared with 218 million rials ($908) in the preceding year.
The “hygiene and treatment” costs accounted for 19.72 million rials ($82) — up 5.6% YOY — and those of social and medical insurances constituted 6.64 million rials ($27) — up 22.1% YOY — of total expenditure of rural families.
Health spending accounted for 9.9% of rural households’ total expenditure and 16.2% of non-food expenses last year.
Health expense grabbed the fourth largest share of total spending in rural households with 9.9% after “food and tobacco” with 38.6%, “housing and fuels” with 17.7% and “transportation and communications” with 12.8%.
The share of health spending in the total expenditure of rural households has been the highest for 10th decile with 11.9% and lowest for the first decile with 6.2%.
Health expenditure of rural households belonging to the 10th income decile, i.e. those with the highest income and those in the first income decile, i.e. those with the lowest income, stood at 78.8 million rials ($328) and 3.51 million rials ($146), respectively. In other words, rural households in the 10th income decile spent 25 times more than those spent by the first decile on health and treatment.
The average spending on health and treatment by an urban household was 1.9 times more than that of a rural household.
The average Consumer Price Index of “health and treatment” in the 12-month period ending March 19, which marks the final day of the fiscal 2019-20 grew by 25.9% compared with last year’s corresponding period.
