India's Health Profile — Key Indicators

India has made significant progress on health outcomes over the past three decades, but continues to face challenges of inequity, underfunding, and infrastructure gaps. Understanding the key health indicators is essential for both GS-I (Indian Society) and GS-II (Governance) dimensions.

Latest Health Indicators

IndicatorValueSource/Year
Infant Mortality Rate (IMR)25 per 1,000 live birthsSRS 2023 (provisional)
Maternal Mortality Ratio (MMR)88 per 1,00,000 live birthsSRS 2020–22
Under-5 Mortality Rate (U5MR)Declined by 78% from 1990 to 2023 — surpassing the global decline of 61%UN IGME 2023
Neonatal Mortality Rate (NMR)19 per 1,000 live births (declined 70% from 1990 to 2023 vs 54% globally)SRS 2021
Total Fertility Rate (TFR)2.0 (NFHS-5, 2019–21); estimated at 1.9 as of 2023 — below the replacement level of 2.1NFHS-5; UN estimates
Life expectancy at birth69.6 years (2020) — up from 47.7 years in 1970WHO
Sex ratio at birth929 females per 1,000 males (NFHS-5) — improving but still skewedNFHS-5

Regional Disparities

High-performing StatesLagging States
Kerala (IMR: 6, MMR: 19)Madhya Pradesh (IMR: 43)
Tamil Nadu (IMR: 13)Uttar Pradesh (IMR: 40, TFR: 2.4 in 2023)
Maharashtra (IMR: 16)Bihar (TFR: 3.0 in 2023, highest in India)
Telangana, KarnatakaAssam, Rajasthan, Chhattisgarh

For Prelims: India's TFR has fallen below the replacement level (2.1) to 2.0 as per NFHS-5. As of 2023, all Indian states except Bihar and Uttar Pradesh have achieved below-replacement fertility. Bihar is projected to be the last state to reach replacement fertility, by 2039.


Disease Burden in India

The Epidemiological Transition

India is undergoing a dual burden of disease — communicable diseases remain significant while non-communicable diseases (NCDs) are rapidly rising. This epidemiological transition is incomplete and uneven across states.

Non-Communicable Diseases (NCDs)

FactDetail
Share of deathsNCDs account for approximately 63% of all deaths in India
Major NCDsCardiovascular diseases (CVDs), cancers, chronic respiratory diseases, diabetes
Risk factorsTobacco use, physical inactivity, unhealthy diet, harmful use of alcohol, air pollution
Economic impactNCDs disproportionately affect working-age populations, reducing productivity and increasing household health expenditure
Government responseNational Programme for Prevention and Control of Cancer, Diabetes, CVD and Stroke (NPCDCS) — aims to integrate NCD screening at primary care level

Communicable Diseases

DiseaseStatus in India
Tuberculosis (TB)India has the highest TB burden globally — approximately 27% of the world's TB cases. India set an ambitious target of TB elimination by 2025 (5 years ahead of the global SDG target of 2030), though this target has not been met. The Ni-kshay Poshan Yojana provides nutritional support to TB patients
MalariaSignificant decline — India reported a 69% drop in malaria cases from 2015 to 2023. National Framework for Malaria Elimination (2016–2030) targets elimination by 2030
HIV/AIDSIndia has the third-largest number of people living with HIV globally (approximately 24 lakh). The National AIDS Control Programme (NACP) has achieved significant reduction in new infections
Vector-borne diseasesDengue, chikungunya, Japanese encephalitis remain endemic in many states — exacerbated by urbanisation, poor sanitation, and climate change
COVID-19 legacyIndia was among the most affected countries; the pandemic exposed critical gaps in health infrastructure, oxygen supply, ICU capacity, and surveillance systems

Malnutrition — The Persistent Challenge

IndicatorNFHS-5 (2019–21)
Stunting (low height for age)35.5% of children under 5
Wasting (low weight for height)19.3% of children under 5
Underweight32.1% of children under 5
Anaemia in women (15–49)57%
Anaemia in children (6–59 months)67.1%

For Mains: India faces a "triple burden" of malnutrition — undernutrition (stunting, wasting), micronutrient deficiencies (anaemia, vitamin A deficiency), and rising overnutrition (obesity, particularly in urban areas). The POSHAN Abhiyaan (National Nutrition Mission, launched 2018) targets a 2% annual reduction in stunting, underweight, and anaemia. Despite progress, India still has the highest number of stunted children in the world.


National Health Policy 2017

Overview

FeatureDetail
AdoptedMarch 2017 — replaces the previous National Health Policy of 2002
VisionAttainment of the highest possible level of health and well-being for all, through a preventive and promotive healthcare approach
Key financial targetRaise public health expenditure progressively to 2.5% of GDP by 2025 (from approximately 1.15% at the time of formulation)
Primary care focusAllocate two-thirds or more of public health resources to primary healthcare

Key Provisions and Targets

Target AreaSpecific Goal
Life expectancyIncrease from 67.5 to 70 years by 2025
IMRReduce to 28 per 1,000 live births by 2019 and 25 by 2025
TFRAchieve replacement level (2.1) at sub-national and national level by 2025 — achieved ahead of schedule
Free drugs and diagnosticsFree essential drugs and diagnostics in all public health facilities
Hospital bedsAchieve 2 beds per 1,000 population — distributed to enable access within the "golden hour"
Out-of-pocket expenditureReduce from 65% to 30% of total health expenditure
Health and Wellness CentresStrengthen comprehensive primary healthcare through HWCs offering an expanded package of services
District hospitalsUpgrade district hospitals to provide multi-speciality services

Assessment of Progress

TargetCurrent Status
Public health expenditureApproximately 1.9% of GDP in FY26 — still below the 2.5% target
IMR25 per 1,000 (2023) — target of 25 by 2025 nearly achieved
TFR2.0 (NFHS-5) — achieved replacement level ahead of schedule
Out-of-pocket expenditureGovernment share of health expenditure increased from 29% in FY15 to 48% in FY22 — a significant improvement but OOP spending remains high
Hospital beds1.3 beds per 1,000 population — far below the target of 2 per 1,000 and the WHO benchmark of 3.5 per 1,000
Doctor-to-population ratio1:811 (including AYUSH practitioners) — closer to the WHO recommendation of 1:1,000 when AYUSH is included

For Mains: The NHP 2017's target of 2.5% GDP spending on health by 2025 remains unmet. India's public health expenditure at approximately 1.9% of GDP is among the lowest in the world. This underfunding is the root cause of most health system failures — inadequate infrastructure, shortage of healthcare workers, high out-of-pocket spending, and poor quality of care. Compare with the UK (7.5%), Germany (9.4%), or even Thailand (3.0%).


Ayushman Bharat — Two Pillars

Pillar 1: Ayushman Arogya Mandirs (formerly Health and Wellness Centres)

FeatureDetail
AnnouncedBudget 2018
ConceptTransform existing Sub-Centres and Primary Health Centres into comprehensive Health and Wellness Centres providing an expanded package of primary healthcare services
Services offeredMaternal and child health, NCDs (screening and management), dental care, eye care, ENT care, mental health, geriatric care, palliative care, emergency medical services
Centres operational1,84,235 Ayushman Arogya Mandirs operational across rural, urban, and tribal regions as of February 2026
SignificanceShifts India's health system from a hospital-centric curative model to a primary-care-led comprehensive model — addressing the root cause of overcrowded hospitals

Pillar 2: Pradhan Mantri Jan Arogya Yojana (PMJAY)

FeatureDetail
Launched23 September 2018 (Pandit Deendayal Upadhyaya Jayanti)
CoverageRs 5 lakh per family per year for secondary and tertiary hospitalisation
Target beneficiariesBottom 40% of the population — approximately 12 crore families (55 crore individuals) identified through SECC 2011 data
Ayushman cards issuedOver 36.9 crore cards created as of March 2025; over 42 crore by October 2025
Empanelled hospitalsApproximately 33,000 hospitals — 17,685 government and 15,380 private facilities
PortabilityFully portable across India — a beneficiary can access treatment at any empanelled hospital in any state
No premiumEntirely government-funded — no premium paid by beneficiaries
Cost savingsEstimated Rs 1.52 lakh crore saved for beneficiary families (as of late 2025)

Expansion: Ayushman Bharat for Senior Citizens (2024)

On 29 October 2024, the government expanded AB-PMJAY to provide free treatment benefits of up to Rs 5 lakh per year to approximately 6 crore senior citizens aged 70 years and above, irrespective of their socio-economic status.

For Prelims: Ayushman Bharat has two pillars — Health and Wellness Centres (now called Ayushman Arogya Mandirs) and PMJAY. PMJAY provides Rs 5 lakh per family per year for hospitalisation. Over 1.84 lakh Ayushman Arogya Mandirs are operational as of February 2026. In 2024, coverage was extended to all senior citizens aged 70+.


Health Infrastructure in India

Current Status

ParameterValueBenchmark
Hospital beds1.3 per 1,000 populationWHO recommends 3.5 per 1,000
Doctors (allopathic)13,86,150 registered (as of April 2025)Doctor-to-population ratio: 1:811 (with AYUSH)
AYUSH practitioners7,51,768 registeredSignificant supplementary healthcare workforce
Primary Health Centres~30,000Many lack basic equipment, medicines, and staff
Community Health Centres~6,000Specialist vacancies remain high — 75% of CHCs lack a surgeon
District hospitals~760Being upgraded under various NHM programmes
AIIMS23 AIIMS sanctioned (including the original AIIMS Delhi, 1956)New AIIMS under various stages of construction
Medical collegesOver 700 medical colleges — India added over 300 medical colleges between 2014 and 2025Annual MBBS intake crossed 1.1 lakh seats

Urban-Rural Divide

ParameterUrbanRural
Healthcare facilitiesConcentrated in urban areas; private sector dominatesSub-Centres and PHCs are backbone; but many are non-functional or understaffed
SpecialistsAvailable in district and tertiary hospitalsCHCs severely short of specialists — 75% shortfall in surgeons, OB-GYN, physicians, and paediatricians
Out-of-pocket spendingRelatively lower (more insurance options)Higher — catastrophic health expenditure pushes families into poverty
PreferencePrivate hospitals preferred by those who can affordGovernment facilities used out of necessity, not choice — quality concerns

PM Ayushman Bharat Health Infrastructure Mission (PM-ABHIM)

FeatureDetail
Launched25 October 2021 by the Prime Minister
Financial outlayRs 64,180 crore for 2021–2026
FocusBuilding a resilient, pandemic-ready public health system from primary to tertiary levels
Key components3,382 Block Public Health Units (BPHUs); 730 Integrated Public Health Laboratories (one per district); 602 Critical Care Hospital Blocks in districts with population over 5 lakh
SurveillanceIT-enabled real-time disease surveillance network integrating laboratories at block, district, regional, and national levels
National institutionsStrengthening of the National Centre for Disease Control (NCDC), Integrated Health Information Platform (IHIP), and 15 Health Emergency Operation Centres

National Digital Health Mission (Ayushman Bharat Digital Mission — ABDM)

FeatureDetail
Launched27 September 2021
Core componentAyushman Bharat Health Account (ABHA) — a 14-digit unique health ID for every citizen
ABHA IDs generated80 crore as of late 2025
Health records linked6.7 crore health records securely linked to ABHA IDs
Key registriesHealth Facility Registry (HFR), Health Professional Registry (HPR), and ABHA create the digital backbone
InteroperabilityABDM enables seamless sharing of health records across hospitals, labs, pharmacies, and insurance — with patient consent
VisionCreate a comprehensive digital health ecosystem enabling longitudinal health records, telemedicine, and data-driven public health planning

For Mains: India's digital health mission (ABDM) addresses a critical infrastructure gap — the absence of comprehensive, portable health records. Currently, patients carry paper records, repeat tests, and lose medical history when changing providers. ABHA aims to solve this through a consent-based digital health record system. However, challenges remain — data privacy (DPDP Act implementation), digital literacy of patients, interoperability across diverse health IT systems, and ensuring that the digital divide does not exclude the most vulnerable.


Mental Health

Scale of the Problem

FactDetail
PrevalenceThe National Mental Health Survey (2016) estimated that approximately 10.6% of adults in India suffer from mental health disorders
Treatment gapOver 80% of people with mental health conditions in India do not receive treatment
SuicideIndia accounts for approximately one-third of global female suicides; the Mental Healthcare Act, 2017 decriminalised suicide (Section 115 — suicide attempt presumed to be a result of severe stress)
Psychiatrist shortageIndia has approximately 0.3 psychiatrists per 1,00,000 population — against the WHO recommendation of at least 3 per 1,00,000

Key Programmes

ProgrammeDetail
National Mental Health Programme (NMHP)Launched in 1982 — India's first mental health programme; restructured in 2003 to include District Mental Health Programme (DMHP)
Mental Healthcare Act, 2017Rights-based legislation — guarantees access to mental healthcare and treatment; establishes Central and State Mental Health Authorities; decriminalises suicide; recognises advance directives
Tele-MANASNational Tele-Mental Health Programme launched in Budget 2022; 53 Tele-MANAS cells operational across 36 States/UTs; services in 20 languages; over 20 lakh calls handled; mobile app launched on World Mental Health Day (10 October 2024)
Government allocationOver Rs 230 crore allocated for NTMHP in the last three years

One Health Approach

Concept

FeatureDetail
DefinitionAn integrated approach recognising that human health, animal health, and environmental health are interconnected and interdependent
OriginGained global prominence after zoonotic disease outbreaks (SARS, H5N1, Ebola, COVID-19) — approximately 75% of emerging infectious diseases are zoonotic
Key areasZoonotic diseases, antimicrobial resistance (AMR), food safety, vector-borne diseases, environmental contamination
Quadripartite allianceWHO, FAO, WOAH (World Organisation for Animal Health), and UNEP jointly promote One Health

One Health in India

AspectDetail
National One Health ProgrammeIndia established a National One Health Programme for prevention and control of zoonoses
Institutional structureNational Standing Committee on Zoonoses; National Centre for Disease Control (NCDC) is the nodal agency
ChallengesFragmented governance — human health (MoHFW), animal health (Department of Animal Husbandry), environment (MoEFCC) operate in silos
COVID-19 lessonThe pandemic demonstrated the catastrophic consequences of ignoring the animal-human-environment interface

Antimicrobial Resistance (AMR)

The Threat

FactDetail
Global impactAMR is estimated to cause approximately 4.95 million deaths annually worldwide (associated with drug-resistant infections)
India's vulnerabilityIndia is among the highest consumers of antibiotics globally; widespread over-the-counter sale without prescription; irrational antibiotic use in human healthcare, animal husbandry, and agriculture
Key concernIndia has detected bacteria resistant to last-resort antibiotics (carbapenems, colistin) — raising the spectre of untreatable infections

Government Response

InitiativeDetail
National Action Plan on AMR 1.0Launched in 2017 — covered awareness, surveillance, infection control, and research
National Action Plan on AMR 2.0Launched on 18 November 2025 — five-year plan (2025–2029); strengthens inter-sectoral coordination, expands private sector engagement, and ensures accountability across ministries
AMR Surveillance NetworkIndian Council of Medical Research (ICMR) operates a network of AMR surveillance labs across India
Red Line campaignVisual indicator on antibiotic packaging — a red line distinguishes prescription-only antibiotics to discourage over-the-counter sales
One Health approachAMR requires addressing antibiotic use in humans, animals, and agriculture simultaneously — central to NAP-AMR 2.0

India as "Pharmacy of the World"

Vaccine and Pharmaceutical Manufacturing

FactDetail
Generic drugsIndia supplies approximately 20% of the world's generic medicines by volume
VaccinesIndia manufactures approximately 60% of the world's vaccines; the Serum Institute of India is the world's largest vaccine manufacturer by doses produced
COVID-19 contributionIndia supplied vaccines to over 100 countries during the pandemic — through the "Vaccine Maitri" initiative and COVAX facility
Pharma marketIndia's pharmaceutical market is the third-largest by volume and 14th-largest by value globally
ExportIndia exports pharmaceuticals to over 200 countries; the USA is the largest market for Indian generic drugs
Key enablerIndia's Patents Act, 1970 (as amended in 2005) — Section 3(d) prevents evergreening of patents; allows India to produce affordable generic versions of essential medicines

For Mains: India's role as the "pharmacy of the world" is a strategic asset with ethical dimensions. The TRIPS Agreement creates tension between patent protection (which incentivises innovation) and access to affordable medicines (which saves lives). India's use of TRIPS flexibilities — compulsory licensing, Section 3(d), and parallel imports — has been critical in keeping medicine prices affordable for developing nations. This raises the ethical question: should life-saving medicines be treated as commodities subject to patent monopolies, or as public goods?


Recent Developments (2024–2026)

Ayushman Bharat Expanded to All Senior Citizens (70+) — October 2024

The Union Cabinet on 29 October 2024 approved extending AB-PMJAY to all Indian citizens aged 70 years and above, irrespective of income. Approximately 6 crore senior citizens across 4.5 crore families now receive ₹5 lakh annual health cover under the "Ayushman Vay Vandana Card." Families already enrolled in AB-PMJAY get an additional top-up of ₹5 lakh for senior family members — enabling up to ₹10 lakh in annual health coverage.

As of March 2025, over 36.9 crore Ayushman cards have been created overall (including the new senior citizen cards). The AB-PMJAY budget was raised from ₹7,300 crore in 2024–25 to ₹9,406 crore in 2025–26 — a nearly 24% increase to accommodate the senior citizens expansion. The National Health Mission (NHM) was allocated ₹38,183 crore in 2024–25 (up 12.7% from 2023–24). Total health spending remained at approximately 1.9% of GDP — below the NHP 2017 target of 2.5% of GDP.

UPSC angle: Prelims — AB-PMJAY expanded to 70+ (October 2024); Ayushman Vay Vandana Card; 36.9 crore total Ayushman cards; NHM allocation ₹38,183 crore. Mains (GS2) — universalisation pathway for health coverage; elderly healthcare challenge; gap between NHP 2017 targets and current spending.


TB Elimination Target — Status (2024–2025)

India's target to eliminate tuberculosis (TB) by 2025 — the Pradhan Mantri TB Mukt Bharat Abhiyaan goal, set 5 years ahead of the global 2030 target — was not met. India notified 26.07 lakh TB cases in 2024 — the highest in the world by volume, accounting for approximately 25% of global TB burden (WHO Global TB Report 2025). India now aligns efforts toward the global 2030 elimination target.

The Central TB Division's 2024 data shows that while case notification has improved (meaning better detection), incidence reduction has been slower than required for elimination. Challenges include: high proportion of drug-resistant TB (India has 27% of global DR-TB burden), nutritional co-morbidity (malnutrition accelerates TB progression), delayed diagnosis in rural areas, and stigma preventing early care-seeking. The Ni-kshay Poshan Yojana (₹500/month nutritional support for TB patients) reached over 24 lakh patients in 2023–24.

UPSC angle: Prelims — PM TB Mukt Bharat Abhiyaan; India: 25% global TB burden (WHO 2025); Nikshay Poshan Yojana ₹1,000/month (raised from ₹500); TB elimination target 2025 was missed (incidence ~187/lakh; India now targets 2030). Mains (GS2) — disease burden vs elimination targets; nutrition-infection nexus in TB; One Health approach to infectious disease.


India's Infant and Maternal Mortality — Latest Data (SRS 2023)

The Sample Registration System (SRS) 2023 data — released by the Registrar General of India — shows India's Infant Mortality Rate (IMR) at 25 per 1,000 live births (down from 28 in 2020), and Maternal Mortality Ratio (MMR) at 88 per 1,00,000 live births (SRS 2020–22, released 2024) — down from 97 in 2018–20. Both figures represent significant progress but remain above NITI Aayog's 2030 targets (IMR: 23; MMR: 70 by 2030).

The Total Fertility Rate (TFR) stands at 2.0 — below replacement level for the first time in India's demographic history (NFHS-5), confirming India has achieved demographic transition. However, wide regional disparities persist: Bihar's TFR is 3.0, UP is 2.4, while Kerala and Tamil Nadu are 1.8 and 1.7 respectively. The gap between high-performing southern states and lagging northern states in health outcomes remains the central challenge for the National Health Mission.

UPSC angle: Prelims — IMR 25 (SRS 2023); MMR 88 (SRS 2020-22); TFR 2.0 (NFHS-5, below replacement). Mains (GS1) — demographic transition implications; regional health disparities; connection between education, women's empowerment and reproductive health outcomes.



National Dental Commission (NDC) — Replacing Dental Council of India (March 2026)

The National Dental Commission Act (NDC Act) came into force on 19 March 2026, dissolving the Dental Council of India (DCI) and simultaneously repealing the Dentists Act, 1948 — the colonial-era law that had governed dental regulation for 78 years. The NDC is the new apex statutory body for regulation of dental education and the dental profession in India, structured along the lines of the National Medical Commission (NMC) Act, 2020 — the landmark reform that replaced the Medical Council of India in 2020.

FeatureDetail
NDC Act in force19 March 2026
Dissolved bodyDental Council of India (DCI) — dissolved 19 March 2026
Repealed lawDentists Act, 1948
Nodal ministryMinistry of Health and Family Welfare
ChairpersonDr. Sanjay Tewari (first Chairperson of NDC)
Part-Time MemberDr. Mousumi Goswami
ModelStructurally aligned with NMC (National Medical Commission) — 2020 precedent

The NDC is supported by three autonomous boards:

  1. Undergraduate and Postgraduate Dental Education Board — sets curriculum standards, accredits dental colleges, and oversees dental education at UG and PG levels
  2. Dental Assessment and Rating Board — conducts institutional assessments, inspections, and ratings; ensures quality of dental colleges
  3. Ethics and Dental Registration Board — maintains the National Register of Dentists; governs professional conduct, disciplinary proceedings, and ethics in dental practice

The NDC reform addresses long-standing criticisms of the DCI: opacity in college approvals, regulatory capture, inadequate quality control, and misaligned incentives. Like the NMC for medicine, the NDC introduces more transparent accreditation, a unified national register, and separation of education regulation from the examining function.

UPSC angle: The NDC (March 2026) mirrors the NMC (2020) reform pathway — replacing a legacy professional council with a multi-board commission for regulatory separation and transparency. For GS-2: the pattern of replacing MCI → NMC (2020) and now DCI → NDC (2026) represents India's systematic overhaul of health professional regulation. Prelims — NDC Act force: 19 March 2026; Dentists Act 1948 repealed; DCI dissolved; Chairperson: Dr. Sanjay Tewari; three boards (Undergraduate/PG Education Board, Assessment and Rating Board, Ethics and Registration Board).


Key Terms for Quick Revision

TermMeaning
IMRInfant Mortality Rate — deaths of infants under 1 year per 1,000 live births
MMRMaternal Mortality Ratio — maternal deaths per 1,00,000 live births
TFRTotal Fertility Rate — average number of children born to a woman over her lifetime; replacement level is 2.1
NCDNon-Communicable Disease — chronic diseases not transmitted from person to person (CVD, cancer, diabetes)
PMJAYPradhan Mantri Jan Arogya Yojana — health insurance for Rs 5 lakh per family per year
ABHAAyushman Bharat Health Account — 14-digit unique digital health ID
PM-ABHIMPM Ayushman Bharat Health Infrastructure Mission — Rs 64,180 crore for pandemic-ready health infrastructure
AMRAntimicrobial Resistance — resistance of microorganisms to drugs that previously treated infections caused by them
One HealthIntegrated approach linking human, animal, and environmental health
NFHSNational Family Health Survey — India's primary source for demographic and health data
NCDCNational Centre for Disease Control — India's nodal agency for disease surveillance

Exam Strategy

For Mains Answer Writing: Health questions appear frequently in both GS-I (Indian Society — population, urbanisation, social issues) and GS-II (Governance — government policies, welfare schemes). For GS-I, focus on the demographic transition, disease burden, and social determinants of health. For GS-II, discuss specific schemes (Ayushman Bharat, PM-ABHIM, ABDM), their design, implementation challenges, and impact. Always cite latest data (IMR, MMR, TFR) and compare India's spending with global benchmarks. The NHP 2017's unmet targets and the health infrastructure deficit provide critical analytical content.

For Prelims: Key numbers to remember — TFR 2.0 (NFHS-5), IMR 25 (SRS 2023), MMR 88 (SRS 2020–22), PMJAY cover Rs 5 lakh, over 1.84 lakh Ayushman Arogya Mandirs, ABHA 80 crore IDs, PM-ABHIM outlay Rs 64,180 crore, India's health spending approximately 1.9% of GDP. India's 2025 TB elimination target was missed; now targeting 2030. NCDs cause 63% of deaths.