Indian Healthcare Sector

Indian Healthcare Sector

Indian Healthcare Sector

This article deals with ‘Indian Healthcare Sector  – for UPSC.’ This is part of our series on ‘Society’, which is an important pillar of the GS-1 syllabus. For more articles, you can click here.

Healthcare Data

Healthcare Expenditure

Healthcare Expenditure in India

Global Burden of Disease Report (2018) by LANCET

Global Burden of Disease Report (2018) by LANCET

Other Relevant Data

Doctor-Population Ratio 1:834 (against the WHO norm of 1:1000)
Number of Hospital Beds per 1000 0.7 (against the WHO norm of 3.5)

Political & Constitutional Angle

  • Health is under the State List. But there is debate regarding whether it should be moved to the Concurrent List, given that even after 70 years of independence, the state of Health in India is still poor. The Centre can only make model laws to which states can voluntarily subscribe.
  • Article 47 of the Indian Constitution (Directive Principle of State Policy) speaks about raising its people’s nutrition levels and living standards and improving public health as among its primary duties.
  • Article 21, i.e. Right to Life is Fundamental Right under the Indian Constitution.

Health and SDG

Sustainable Development Goals also talks about Health and SDG-3 aims to ensure healthy lives and promote well being for all at all ages.

Health and SDG

Primary, Secondary and Tertiary Healthcare

Primary Healthcare

  • Primary Healthcare is the first level of contact between people & health system
  • It includes family planning, immunization, treatment of common diseases, health education etc. 
  • In India, it is provided through a network of 
    • Primary Health Centres in Rural Areas
    • Family Welfare Centres in Urban Areas

Secondary Healthcare

  • Secondary Healthcare denotes the second Tier of the health system.
  • It includes 
    • District Hospitals 
    • Community Health Centre (CHC) at Block Level

Tertiary Healthcare

  • Tertiary Healthcare denotes the third tier of the health system.
  • It provides specialized consultative care.          
  • Tertiary Healthcare is provided through Medical Colleges & Medical Research Institutes. 

Rural Healthcare System

Indian Healthcare Sector

State of Health Services in India

Health services in India need a booster shot, vouched by the following data. 

  • Prominence of Private Sector: According to Economic Survey, out of 4% of expenditure on Healthcare in India, Public Sector accounts for just 1.15% 
  • High Out-of-Pocket Expenditure (OoPE): The OoPE in India is as high as 62% compared to the world average of 18%. High OoPE pushes 39 million people every year under the poverty line. 
  • Indian Doctors are not willing to serve in Rural Areas due to various factors, such as a lack of adequate healthcare infrastructure and low opportunity for professional growth.
  • The dominance of the Medical Council of India has hindered the development of nurses and other health cadres.
  • Hesitancy/Ignorance of common people: Even after a person has TB symptoms, they delay visiting a doctor (for a minimum of 5.2 months, even in Delhi). As a result, their disease becomes worse, and they infect more people. 

With the implementation of the Ayushman Bharat program, the strengthening of SCs and PHCs is being done by converting them into Health and Wellness Centres (HWCs) in a phased manner to deliver comprehensive Primary Healthcare services through these Centres. 

Health Schemes

1. National Health Mission

  • National Health Mission (NHM) is a flagship program of the Indian Government that aims to provide affordable, accessible, affordable, and quality healthcare to all citizens.   
  • It is Core Scheme (60:40 Division) 
National Rural Health Mission (NRHM) In areas having a population below 50,000
National Urban Health Mission (NUHM) In areas having a population above 50,000

2. Pradhan Mantri  Bhartiya Jan Aushadhi Pariyojana (PMBJP)

  • The scheme aims to provide affordable generic medicines to the masses to reduce out-of-pocket expenses. These are made available through Jan Aushadhi Stores. 

3. Rogi Kalyan Samiti

  • Rogi Kalyan Samiti is a registered society consisting of citizens of the area who act as trustees to manage hospital functions.
  • It acts as a check and increases the accountability of doctors.

4. Universal Immunization Program (UIP)

Under Indian Immunisation Program, Vaccine is given for 12 life-threatening diseases

National (11 Diseases) 1. Diphtheria
2. Pertussis (Whooping Cough)
3. Tetanus (DPT)
4. Polio
5. TB
6. Rotavirus Diarrhoea
7. Hepatitis B
8. Meningitis & Pneumonia caused by Haemophilus Influenza Type-B
9. Measles
10. Rubella
11. Pneumococcal Pneumonia (latest entry in 2021, earlier it was given in select districts of Himachal and Bihar)
Sub-National (1 Disease) 12. Japanese Encephalitis

5. Menstruation Health

Government is running following schemes for Menstruation Health.

  • Menstrual Hygiene for Adolescent Girls Scheme: To address the need for menstrual hygiene among adolescent girls residing in rural areas. 
  • Project Stree Swabhiman (by Ministry of Electronics and Information Technology)
  • Menstrual Hygiene Scheme  (by Health Ministry as part of Rashtriya Kishor Swasthya Karyakram. )
  • Rashtriya Madhyamik Shiksha Abhiyan (by Ministry of Human Resource Development)

6. Drug Price Control Order

  • The Drug Price Control Order (DPCO) of India is a regulatory framework established by the government to control and regulate the prices of essential medicines in the country.
  • Schedule 1 of DPCO contains the List of Essential Medicines. Their price can’t be more than the ceiling price.  

Public Health Policy, 2017

The previous policy was formulated in 2002. There was a need for a new policy because 

  • 15 years have passed, and new challenges have come up in the health sector. 
  • At that time, Polio was a major problem. Now, WHO has declared India to be Polio Free.
  • That policy was keeping in view of Millennium Development Goals (MDG). Now, we are in the era of Sustainable Development Goals (SDG).  
  • At that time, Communicable Diseases were a major problem. Now Non-Communicable Diseases have come into the scene.

Provisions of the National Health Policy, 2017

1. Finance 

  • Presently, the government spends 1.15 % of GDP on healthcare. The target is to increase that to 2.5% of GDP by 2025.  

2. Targets to be achieved

  • Increase the life expectancy from 67.5 to 70 by 2025.
  • Reduce premature mortality from Non-Communicable Diseases by 25 per cent by 2025.
  • Achieve the global 2020 HIV target (also termed 90:90:90)

3. Preventive and Curative Care

  • The policy will rely on Preventive as well as Curative Health Care (the 2002 Policy relied just on curative )

4. Focus on Primary Care 

  • Policy advocates allocating two-thirds (or more) of resources to primary care.  

5. Promote AYUSH 

  • AYUSH will be promoted 

6. Promote Make in India

  • Promote drugs and devices manufactured in the country.


  • The policy has abandoned the idea of making health a right proposed under the Draft Health Policy. NHP (2017) speaks of an “assurance-based approach”.
  • Raising Government Expenditure to 2.5% of GDP till 2025 is too far-fetched given problem India is facing is serious. Along with that, no year wise plan of yearly incrementation is given. There is lesser hope that even this will be attained given the past experience that the health policy of 2002 had promised health expenditure of 2% of its GDP on Health by 2010
  • Governance issues are ignored: The policy is silent on whether health should be moved to the Concurrent list.
  • Professional issues are ignored, e.g., MCI issues and private practice by Govt doctors.

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