As per 12th Five Year Plan, Health should be viewed as not merely the absence of disease but as a state of complete physical, mental and social well being.


Why health is important:

  1. A healthy citizenry is the very fundamental requirement for a welfare society like India. Without a happy and healthy citizenry, growth and development are not possible.
  2. Part of Directive Principles of State Policy and vision of our constitution
  3. India is signatory to MDGs and SDGs, both of which encapsulate Universal Health coverage as a must for developmental needs.
  4. Healthy citizens Increases productivity, economic growth



Challenges/Weaknesses in Health Sector in India:

  1. Availability
    1. Shortage of doctor and nursing staff is acute.
    2. Doctor per lakh of population around 45 while the minimum number should be 85.
    3. Similarly lack of nurses and auxiliary midwives (ANMs).
  2. Affordability
    1. Out of pocket expenses of poor are too high (almost 70% of the overall healthcare expenses).
    2. Medicines are too expensive for various communicable and noncommunicable diseases. The private sector forms majority of the health care system but it is out of reach for most of the population.
    3. Prescription drugs reforms, promotion of essential, generic medicines, and making these universally available free of cost to all patients in public facilities
      1. These should be part of the “Essential Health Package” — Price controls and price regulation, especially on essential drugs, should be enforced. The Essential Drugs List should be revised and expanded, and rational use of drugs ensured.
      2. Safeguards provided by Indian patents law and the TRIPS Agreement against the country’s ability to produce essential drugs should be protected
  • Jan Aushadhi Program
  1. Lack of Focus on Preventative Care and Lack of Quality:
    1. Preventative care is in shambles as noted in the poor state of Primary health care centers (PHCs)
    2. Many doctors are not qualified or licensed to practice.
    3. This is also reflected in poor MMR and IMR ratios
  2. Healthcare spending
    1. Public spending is only 1.2% of GDP, which is far below international standards for similar countries.


New institutions needed:

  • The establishment of a National Health Regulatory and Development Authority (NHRDA)
  • A National Drug Regulatory and Development Authority (NDRDA)
  • A National Health Promotion and Protection Trust (NHPPT) is also recommended.




Steps taken:

  1. Universal Health Coverage has been envisaged as the goal of new draft Health care policy
  2. Governance Reforms in Healthcare
    1. Performance linked incentives
    2. Devolution of powers and functions to local health care institutions and making them responsible for the health of the people living in a defined geographical area.
    3. NRHM’s strategy of decentralisation, PRI involvement, integration of vertical programmes, inter-sectoral convergence and Health Systems Strengthening have been partially achieved.
    4. Example: Professional procurement agencies on the lines of Tamil Nadu
  3. National Health Mission
    1. Jnani Suraksha Yojana
    2. Indradhanush for full immunization of children
  4. Rashtriya Swasthya Suraksha Yojana
  5. Focus on developing ANMs, ASHAs
  6. Community involvement through Jan Sunwais and Rogi Kalyan Samitis.
    1. Village Health Sanitation and Nutrition Committee (VHSNC)