Budgetary allocation for health sector projects in local bodies with specific reference to noncommunicable diseases control

Background: The role of local self-government (LSG) bodies in planning community-level interventions for noncommunicable diseases (NCD) control is critical. An understanding of how much priority is given to NCD in decentralized health planning is needed. Objective: The objective of this study is to analyze the pattern of budgetary allocation for health sector projects at different levels of LSGs in Thiruvananthapuram, Kerala, with specific reference to NCD control. Materials and Methods: Secondary data analysis was done on economic review reports and reports on health sector projects obtained from LSG department with permission. The pattern of budgetary allocation of health projects in both urban and rural local bodies of Thiruvananthapuram district for 2019-2020 was studied. Results: The proportion of NCD projects in terms of number and budget allocation, respectively, among health sector projects for gram panchayaths (GP) was 47 projects (5.25%) and 63.19 lakhs (1.8%). Figures for block panchayaths (BP) were 13 (9%) and 98.10 lakhs (10.94%), for district panchayath (DP), 1 (0.9%) and 48 lakhs (3%), for municipalities 1 (1.6%) and 4.66 lakhs (1.2%), and for corporation were 1 (1.4%) and 3 lakhs (0.16%). Only 29 (40%) GP and 5 (45%) BP had at least one NCD project. At the GP level, 21% of projects were community-based interventions and 15% of projects were for cancer screening, mental health, and hospital-based NCD clinics each. Among local bodies with lower allocation for NCD projects, the amount allocated for construction and maintenance work in health institutions was higher. Conclusion: Decision-making in decentralized health planning needs an evidence-based realignment of priorities toward NCD.