Health Sector

• The old saying “Health is Wealth” aptly conveys the importance of good health for an individual as well as for society. Health represents a state of complete physical and mental well-being. Without sound health, one cannot enjoy the good things in life, nor is it possible to earn a stable livelihood.
• At the societal level, the health of people contributes directly to efficiency, productivity, and overall progress. There exists a strong and direct relationship between good health and economic growth. A healthy population forms the foundation of a strong workforce, which in turn strengthens national development.

Situation at the Time of Independence

• The health situation in India at the time of Independence was extremely unsatisfactory. Due to the lack of proper medical and health facilities, the country witnessed very high death rates and infant mortality rates. India was often described as the land of epidemics, where diseases such as smallpox, cholera, malaria, typhoid, and tuberculosis took a heavy toll on human lives.
• These problems were compounded by widespread poverty, illiteracy, and ignorance about preventive healthcare. Medical infrastructure was insufficient and largely concentrated in urban areas, leaving the vast rural population without access to even basic healthcare services.
• The statistics highlight the grim reality: in 1951, the infant mortality rate in India was as high as 219 per 1000 live births, while life expectancy was a mere 32 years. These figures reflected not only the poor state of healthcare but also the urgent need for comprehensive reforms in the health sector.
• From 2014 to 2025, India’s healthcare system has undergone a profound transformation under the dynamic leadership of Prime Minister Narendra Modi. With a people-first approach, the government has focused on making quality healthcare accessible and affordable to all citizens, especially the underprivileged and rural populations. Whether it’s the world’s largest health insurance scheme, Ayushman Bharat, or the far-reaching eSanjeevani telemedicine platform, the focus has been clear: affordable, accessible, and accountable healthcare for all. India didn’t just navigate the COVID-19 crisis—it led from the front, administering over 220 crore vaccine doses and emerging as a global health partner to the world. Preventive care has surged through mass immunisation campaigns like Mission Indradhanush. Medical education has been overhauled, with a record expansion of AIIMS institutions and MBBS seats, empowering a new generation of doctors from every corner of the country. Generic medicines have become easily available through Jan Aushadhi Kendras, saving families lakhs in medical expenses. This is not just a story of infrastructure—it is a story of impact. Maternal deaths are down. Access is up. Confidence in the public health system has never been stronger. As India enters Amrit Kaal, its health journey is no longer just about treating illness—it’s about nurturing a nation. Health has become a right, not a privilege. And under the Modi Government, every Indian life matters—with dignity, care, and hope at the core.

Structure of the Indian Healthcare System

India’s healthcare delivery is structured into a three-tiered model: Primary, Secondary, and Tertiary care, each with defined responsibilities and service levels. Primary care, delivered through Sub-Centres, Primary Health Centres (PHCs), and Health and Wellness Centres (HWCs), focuses on disease prevention, maternal-child health, and basic outpatient services. Secondary care, offered at District Hospitals and Community Health Centres (CHCs), provides specialized treatment and handles referral cases from the primary level. Tertiary care, managed by apex institutions like AIIMS and PGIMER, delivers super-specialty services and advanced diagnostics. While state governments oversee most healthcare delivery, key tertiary hospitals and national health programs fall under the Central Government’s purview.

Regulatory Framework of the Healthcare Sector

• India’s healthcare system is governed by a network of regulatory bodies ensuring quality, safety, and ethical standards. The Central Drugs Standard Control Organization (CDSCO) oversees pharmaceuticals and medical devices, while the National Medical Commission (NMC) has replaced the Medical Council of India to regulate medical education and licensing. The Pharmacy Council of India (PCI), Insurance Regulatory and Development Authority of India (IRDAI), and National Accreditation Board for Hospitals and Healthcare Providers (NABH) also play vital roles. Legal instruments such as the Clinical Establishments Act (2010), Drugs and Cosmetics Act (1940), and the National Medical Commission Act (2019) form the backbone of health regulation.

Key Challenges in Indian Healthcare

• Despite progress, India’s healthcare system faces multiple systemic challenges. A major concern is the rural-urban divide, where 68% of the population in rural areas struggles with limited healthcare access, despite 80% of doctors being concentrated in cities. Affordability continues to be an issue, with out-of-pocket expenditure (OOPE) still at 47.1% as of FY23, despite schemes like PM-JAY. The quality of services remains inconsistent, with public facilities facing overcrowding, infrastructure gaps, and staff shortages. Substandard drug quality also persists, with over 3,000 drugs failing quality tests in 2022–23. Furthermore, the rise of non-communicable diseases (NCDs) such as diabetes and hypertension has become a silent epidemic, requiring long-term care and preventive strategies.

Issues in Healthcare Coverage and Infrastructure

• While flagship schemes like Ayushman Bharat have expanded coverage, a significant portion of eligible populations remains unaware or unable to access services due to poor outreach and implementation gaps. Infrastructure deficiencies continue, especially in remote tribal and hilly regions, despite the construction of new facilities. Additionally, health insurance coverage remains shallow, with India’s insurance penetration dropping to 3.7% of GDP in 2023–24. The dominance of unregulated private hospitals, which account for nearly 70% of healthcare services, raises concerns about cost transparency and patient exploitation.

Policy Reforms and Government Initiatives

• The Indian government has responded with policy innovations such as the National Health Policy (2017), the Ayushman Bharat Digital Mission (ABDM), and the PM-Ayushman Bharat Health Infrastructure Mission (PM-ABHIM). The Clinical Establishments Act and the NMC Act are being implemented to standardize care delivery. Regulation of telemedicine (MCI’s 2020 guidelines) and emerging sectors like e-pharmacy are being institutionalized. Initiatives like eSanjeevani have successfully expanded remote consultations, particularly during the COVID-19 pandemic.

Recommendations to Strengthen Indian Healthcare

To make healthcare truly universal and efficient, India must scale up its primary care network and fully operationalize Health and Wellness Centres. Investment in human resources is critical, including increasing the number of medical colleges and training Community Health Officers (CHOs) for rural deployment. Leveraging digital tools and telemedicine can bridge the accessibility gap. Strengthening public-private partnerships (PPPs), reforming health insurance, boosting public expenditure (to 2.5% of GDP), and incentivizing healthcare startups can further improve service delivery. A focus on preventive care, regulatory tightening of private healthcare, and integration of traditional Indian medicine with modern systems can create a more robust and inclusive health ecosystem.

Global Best Practices India Can Learn From

• India can draw lessons from countries like the UK, where the NHS ensures universal access through tax-funded care; Brazil, which deploys community health workers in rural zones; Estonia’s integrated digital health systems; Singapore’s PPP-driven infrastructure; and Japan’s emphasis on prevention. Adopting these practices can guide India in its journey toward a sustainable, equitable, and resilient healthcare model.

Universal Health Coverage through Ayushman Bharat

Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana (PM-JAY)

In 2018, the government launched Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana (PM-JAY), the world’s largest health assurance programme, aimed at protecting economically vulnerable Indians from catastrophic healthcare expenditures. Targeting the bottom 40% of India’s population, the scheme covers approximately 12.37 crore families, benefitting nearly 55 crore individuals.

• In a landmark expansion on 29th October 2024, the government introduced Ayushman Vay Vandana, extending AB-PMJAY benefits to all senior citizens aged 70 and above, irrespective of income or socio-economic status. Under this scheme, more than 58 lakh senior citizens have already enrolled, with over 2.67 lakh treatments worth ₹496 crore availed. With only Aadhaar required for registration, the scheme ensures easy and accessible healthcare for the elderly, recognising their vulnerabilities and guaranteeing dignified, worry-free treatment in later years.
• Beyond senior citizens, the scheme also prioritises the frontline health workforce, including ASHA workers, Anganwadi Workers (AWWs), and Anganwadi Helpers (AWHs), ensuring their health and wellbeing while they serve the nation.
• Thus, AB-PMJAY is not merely a health scheme but a social revolution in healthcare access, empowering India’s most vulnerable citizens with dignity, quality care, and financial protection.

Pradhan Mantri Ayushman Bharat Health Infrastructure Mission (PM-ABHIM)

• The Pradhan Mantri Ayushman Bharat Health Infrastructure Mission (PM-ABHIM) is a landmark Centrally Sponsored Scheme (with select Central Sector components), launched with a total outlay of ₹64,180 crore for the period 2021–22 to 2025–26.
• This transformative initiative seeks to strengthen and integrate health service delivery across primary, secondary, and tertiary care levels, while creating a robust health system that can effectively respond to present and future pandemics, public health emergencies, and disasters.
• Under its Central Sector components, construction of Critical Care Hospital Blocks (CCHBs) has been sanctioned in 12 central institutions, with projects currently at various stages of development.
• Together, these measures represent a new generation of health sector reforms, aimed at delivering a seamless, resilient, and responsive continuum of care across India.

Comprehensive Cancer Care

In response to the rising burden of cancer in India, the Government has adopted a robust multi-tiered strategy focusing on early detection, infrastructure development, and affordable treatment, aligned with the vision of Universal Health Coverage.

Early Diagnosis

Early diagnosis is the cornerstone of cancer control. Under the National Health Mission (NHM), large-scale screenings at the primary healthcare level have yielded remarkable results (as per the National NCD Portal, 1st June 2025):

• Oral Cancer: Over 31.70 crore screenings
• Breast Cancer: Over 16.68 crore screenings
• Cervical Cancer: Over 9.97 crore screenings

These screenings, conducted primarily at Ayushman Arogya Mandirs (Health and Wellness Centres), ensure preventive care reaches the community’s doorstep.

Infrastructure Development

• To decentralize treatment, 46 Day Care Cancer Centres (DCCCs) have been approved under the Programme Implementation Plan (PIP) of NHM. These facilities, located in district hospitals, reduce the burden on tertiary hospitals.
• At the tertiary level, over ₹3,000 crore has been invested in the last decade for developing 19 State Cancer Institutes and 20 Tertiary Cancer Care Centres. Cancer facilities have also been established in all 23 new AIIMS, while national-level institutions like the National Cancer Institute (NCI), Jhajjar, and the Second Campus of Chittaranjan National Cancer Institute (CNCI) further strengthen the cancer care ecosystem.

Affordable Treatment

• Affordability is ensured through 217 AMRIT pharmacies, providing 289 cancer medicines at discounts of up to 50%, along with the Pradhan Mantri Bhartiya Janaushadhi Pariyojana (PMBJP), which supplies low-cost anti-cancer drugs.

Making Health Services Reach All

Making Medicines Affordable

• Ensuring affordable access to medicines has been central to India’s healthcare reforms, reducing financial hardships for millions of families.

Jan Aushadhi Kendras

• Launched in 2016, the Pradhan Mantri Bhartiya Janaushadhi Pariyojana (PMBJP) provides high-quality generics at 50–90% lower rates than branded medicines. These outlets have transformed access to affordable, reliable medications.

AMRIT Pharmacies

• Complementing PMBJP, the Affordable Medicines and Reliable Implants for Treatment (AMRIT) initiative supplies essential drugs, consumables, and medical implants—particularly for advanced and high-cost treatments.

Bridging the Digital Health Divide

eSanjeevani – National Telemedicine Service

• The eSanjeevani telemedicine platform has revolutionized healthcare delivery by connecting patients with doctors and specialists remotely. As of 2025, more than 37.15 crore beneficiaries have accessed care, effectively bridging the urban–rural gap. The service is accessible both through smartphones and at Ayushman Bharat Health & Wellness Centres.

Child and Maternal Health

Universal Immunization Programme (UIP)

• One of the largest immunization programmes globally, UIP annually targets 2.6 crore newborns and 2.9 crore pregnant women. A child is considered fully immunized after receiving all vaccines under the National Immunization Schedule (BCG, OPV, Pentavalent, MR, etc.). India’s Full Immunization Coverage (FIC) has now reached 94.1%.

Mission Indradhanush

• Launched on 25th December 2014, this catch-up campaign targets children and pregnant women who missed routine immunizations, focusing on low-coverage regions to ensure no child is left behind.

U-WIN Platform

• The digital U-WIN initiative streamlines immunization delivery. By 30th May 2025, it registered 10.48 crore beneficiaries, supported 93.91 lakh deliveries, conducted 1.88 crore vaccination sessions, and recorded 41.73 crore doses.

Maternal Health Schemes

• Janani Shishu Suraksha Karyakaram (JSSK): Since 2014–15, benefitted 16.60 crore women and newborns with free delivery and neonatal care.
• Janani Suraksha Yojana (JSY): Incentivized institutional deliveries for 11.07 crore women up to March 2025.
• Surakshit Matritva Aashwasan (SUMAN): Promoted respectful maternity care, with 90,015 SUMAN facilities notified by March 2025.

Additionally, the Medical Termination of Pregnancy (Amendment) Act, 2021 has expanded safe abortion access, protecting women’s reproductive rights.

Health Outcomes

• Maternal Mortality Ratio (MMR): Reduced from 103 (2020) to 80 per lakh live births (2023).
• Under-five Mortality Rate: Fell from 48 (2015) to 28 (2023) per 1,000 live births (42% decline).
• Neonatal Mortality Rate: Dropped from 28 (2015) to 17 (2023) per 1,000 live births (39% decline).

The UN has recognized India as a global exemplar in reducing child mortality.

Medical Education and Public Health

Over the last decade, reforms have transformed medical education, expanding capacity and enhancing transparency.

• AIIMS Expansion: 23 AIIMS now operational, including the first in the Northeast (Assam).
• Medical Colleges: Total 2,045 (780 Allopathy, 323 Dental, 942 AYUSH).
• Seats: MBBS seats rose 130% (51,348 → 1,18,190), PG seats rose 138% (31,185 → 74,306).
• Nursing: 157 new nursing colleges approved; B.Sc. Nursing seats increased 53% (to 1,27,290); M.Sc. Nursing up 39% (to 14,986).
• Nurses Registration & Tracking System (NRTS): Digitally tracks over 12.39 lakh nurses.

Key Reforms

• National Medical Commission Act, 2019 replaced MCI with NMC.
• National Commission for Allied and Healthcare Professions Act, 2021
• National Dental Commission Act, 2023
• National Nursing and Midwifery Commission Act, 2023
• NEET (2016): Established a transparent, merit-based admission system.

Competency-based curricula for allied health professions have been rolled out. In 2024, the National Consortium for Ph.D. in Nursing was launched to promote advanced nursing research.

India’s Response During COVID-19

Proactive Interventions

India acted swiftly—launching airport screenings before the first domestic case, enforcing mask mandates before WHO advisories, and establishing a vaccine task force (April 2020) ahead of global counterparts. The nationwide lockdown provided critical time to ramp up infrastructure.

Vaccination Drive

Launched on 16 January 2021, the National COVID-19 Vaccination Programme became the world’s largest, covering all adults and later expanded to those above 12 years. India administered over 2.2 billion doses, powered by indigenous vaccines and the CoWIN platform.

Infrastructure Ramp-Up

• Oxygen Express Trains: Nearly 900 trains transported 36,840 tonnes of oxygen.
• IAF Airlifts: Rapid transport of oxygen tankers and equipment.
• Isolation Coaches: 4,176 railway coaches converted into quarantine facilities.
• PSA Oxygen Plants: Over 1,563 sanctioned nationwide.
• Makeshift Facilities: Set up by paramilitary forces and central agencies.

Emergency COVID Response Package (ECRP)

• ECRP-I: ₹8,584.33 crore allocated.
• ECRP-II: ₹12,740.22 crore allocated.

These funds strengthened ICU capacity, ventilator supply, testing, and surveillance under NHM.