A performance audit by the Auditor General's Office of Aasandha has found that expenditure under the national social health insurance scheme increased by 32 per cent between 2019 and 2023.

According to the audit report, while spending under Aasandha rose significantly over the five-year period, the number of people covered by the scheme also increased by seven per cent. The report noted that overall costs have grown faster than service utilisation, highlighting efficiency and sustainability concerns within the system.

Data included in the audit shows that the number of individuals who used Aasandha services fluctuated over the years, standing at 349,550 in 2019, falling to 330,278 in 2020, and then rising steadily to 375,304 by the end of 2023. The report also noted an increase in staffing levels from 2020 onwards, with the total number of employees reaching 375,304 by the end of 2023.

In terms of expenditure, spending on the Aasandha scheme stood at MVR 2.43 billion in 2019, declined to MVR 2.01 billion in 2020, and then increased to MVR 2.28 billion in 2021. Expenditure continued to rise in subsequent years, reaching MVR 2.82 billion in 2022 and MVR 3.21 billion in 2023.

The audit further outlined that State spending on health services includes costs related to Government hospitals, the Aasandha scheme, and medical expenses incurred outside the scheme. From 2019 to 2024, total State expenditure on medical services amounted to MVR 35.8 billion, averaging approximately MVR 5.97 billion per year.

According to the report, the Aasandha scheme accounts for the largest share of health-related expenditure from the State budget. A total of MVR 16.08 billion was spent on the scheme between 2019 and 2024, with an average annual expenditure of MVR 2.68 billion.

The performance audit also presented key statistics on the operation of Aasandha and proposed several amendments aimed at strengthening the efficiency, financial sustainability and overall performance of the national health insurance scheme.