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

Indicator Value Source/Year
Infant Mortality Rate (IMR) 25 per 1,000 live births SRS 2023 (provisional)
Maternal Mortality Ratio (MMR) 93 per 1,00,000 live births SRS 2019–21
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 2.1 NFHS-5; UN estimates
Life expectancy at birth 69.6 years (2020) — up from 47.7 years in 1970 WHO
Sex ratio at birth 929 females per 1,000 males (NFHS-5) — improving but still skewed NFHS-5

Regional Disparities

High-performing States Lagging 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, Karnataka Assam, 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)

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

Communicable Diseases

Disease Status 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
Malaria Significant 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/AIDS India 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 diseases Dengue, chikungunya, Japanese encephalitis remain endemic in many states — exacerbated by urbanisation, poor sanitation, and climate change
COVID-19 legacy India 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

Indicator NFHS-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
Underweight 32.1% 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

Feature Detail
Adopted March 2017 — replaces the previous National Health Policy of 2002
Vision Attainment of the highest possible level of health and well-being for all, through a preventive and promotive healthcare approach
Key financial target Raise public health expenditure progressively to 2.5% of GDP by 2025 (from approximately 1.15% at the time of formulation)
Primary care focus Allocate two-thirds or more of public health resources to primary healthcare

Key Provisions and Targets

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

Assessment of Progress

Target Current Status
Public health expenditure Approximately 1.9% of GDP in FY26 — still below the 2.5% target
IMR 25 per 1,000 (2023) — target of 25 by 2025 nearly achieved
TFR 2.0 (NFHS-5) — achieved replacement level ahead of schedule
Out-of-pocket expenditure Government share of health expenditure increased from 29% in FY15 to 48% in FY22 — a significant improvement but OOP spending remains high
Hospital beds 1.3 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 ratio 1:811 (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)

Feature Detail
Announced Budget 2018
Concept Transform existing Sub-Centres and Primary Health Centres into comprehensive Health and Wellness Centres providing an expanded package of primary healthcare services
Services offered Maternal and child health, NCDs (screening and management), dental care, eye care, ENT care, mental health, geriatric care, palliative care, emergency medical services
Centres operational 1,84,235 Ayushman Arogya Mandirs operational across rural, urban, and tribal regions as of February 2026
Significance Shifts 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)

Feature Detail
Launched 23 September 2018 (Pandit Deendayal Upadhyaya Jayanti)
Coverage Rs 5 lakh per family per year for secondary and tertiary hospitalisation
Target beneficiaries Bottom 40% of the population — approximately 12 crore families (55 crore individuals) identified through SECC 2011 data
Ayushman cards issued Over 36.9 crore cards created as of March 2025; over 42 crore by October 2025
Empanelled hospitals Approximately 33,000 hospitals — 17,685 government and 15,380 private facilities
Portability Fully portable across India — a beneficiary can access treatment at any empanelled hospital in any state
No premium Entirely government-funded — no premium paid by beneficiaries
Cost savings Estimated 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

Parameter Value Benchmark
Hospital beds 1.3 per 1,000 population WHO 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 practitioners 7,51,768 registered Significant supplementary healthcare workforce
Primary Health Centres ~30,000 Many lack basic equipment, medicines, and staff
Community Health Centres ~6,000 Specialist vacancies remain high — 75% of CHCs lack a surgeon
District hospitals ~760 Being upgraded under various NHM programmes
AIIMS 23 AIIMS sanctioned (including the original AIIMS Delhi, 1956) New AIIMS under various stages of construction
Medical colleges Over 700 medical colleges — India added over 300 medical colleges between 2014 and 2025 Annual MBBS intake crossed 1.1 lakh seats

Urban-Rural Divide

Parameter Urban Rural
Healthcare facilities Concentrated in urban areas; private sector dominates Sub-Centres and PHCs are backbone; but many are non-functional or understaffed
Specialists Available in district and tertiary hospitals CHCs severely short of specialists — 75% shortfall in surgeons, OB-GYN, physicians, and paediatricians
Out-of-pocket spending Relatively lower (more insurance options) Higher — catastrophic health expenditure pushes families into poverty
Preference Private hospitals preferred by those who can afford Government facilities used out of necessity, not choice — quality concerns

PM Ayushman Bharat Health Infrastructure Mission (PM-ABHIM)

Feature Detail
Launched 25 October 2021 by the Prime Minister
Financial outlay Rs 64,180 crore for 2021–2026
Focus Building a resilient, pandemic-ready public health system from primary to tertiary levels
Key components 3,382 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
Surveillance IT-enabled real-time disease surveillance network integrating laboratories at block, district, regional, and national levels
National institutions Strengthening 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)

Feature Detail
Launched 27 September 2021
Core component Ayushman Bharat Health Account (ABHA) — a 14-digit unique health ID for every citizen
ABHA IDs generated 80 crore as of late 2025
Health records linked 6.7 crore health records securely linked to ABHA IDs
Key registries Health Facility Registry (HFR), Health Professional Registry (HPR), and ABHA create the digital backbone
Interoperability ABDM enables seamless sharing of health records across hospitals, labs, pharmacies, and insurance — with patient consent
Vision Create 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

Fact Detail
Prevalence The National Mental Health Survey (2016) estimated that approximately 10.6% of adults in India suffer from mental health disorders
Treatment gap Over 80% of people with mental health conditions in India do not receive treatment
Suicide India 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 shortage India has approximately 0.3 psychiatrists per 1,00,000 population — against the WHO recommendation of at least 3 per 1,00,000

Key Programmes

Programme Detail
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, 2017 Rights-based legislation — guarantees access to mental healthcare and treatment; establishes Central and State Mental Health Authorities; decriminalises suicide; recognises advance directives
Tele-MANAS National 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 allocation Over Rs 230 crore allocated for NTMHP in the last three years

One Health Approach

Concept

Feature Detail
Definition An integrated approach recognising that human health, animal health, and environmental health are interconnected and interdependent
Origin Gained global prominence after zoonotic disease outbreaks (SARS, H5N1, Ebola, COVID-19) — approximately 75% of emerging infectious diseases are zoonotic
Key areas Zoonotic diseases, antimicrobial resistance (AMR), food safety, vector-borne diseases, environmental contamination
Quadripartite alliance WHO, FAO, WOAH (World Organisation for Animal Health), and UNEP jointly promote One Health

One Health in India

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

Antimicrobial Resistance (AMR)

The Threat

Fact Detail
Global impact AMR is estimated to cause approximately 4.95 million deaths annually worldwide (associated with drug-resistant infections)
India's vulnerability India 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 concern India has detected bacteria resistant to last-resort antibiotics (carbapenems, colistin) — raising the spectre of untreatable infections

Government Response

Initiative Detail
National Action Plan on AMR 1.0 Launched in 2017 — covered awareness, surveillance, infection control, and research
National Action Plan on AMR 2.0 Launched on 18 November 2025 — five-year plan (2025–2029); strengthens inter-sectoral coordination, expands private sector engagement, and ensures accountability across ministries
AMR Surveillance Network Indian Council of Medical Research (ICMR) operates a network of AMR surveillance labs across India
Red Line campaign Visual indicator on antibiotic packaging — a red line distinguishes prescription-only antibiotics to discourage over-the-counter sales
One Health approach AMR 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

Fact Detail
Generic drugs India supplies approximately 20% of the world's generic medicines by volume
Vaccines India 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 contribution India supplied vaccines to over 100 countries during the pandemic — through the "Vaccine Maitri" initiative and COVAX facility
Pharma market India's pharmaceutical market is the third-largest by volume and 14th-largest by value globally
Export India exports pharmaceuticals to over 200 countries; the USA is the largest market for Indian generic drugs
Key enabler India'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?

Key Terms for Quick Revision

Term Meaning
IMR Infant Mortality Rate — deaths of infants under 1 year per 1,000 live births
MMR Maternal Mortality Ratio — maternal deaths per 1,00,000 live births
TFR Total Fertility Rate — average number of children born to a woman over her lifetime; replacement level is 2.1
NCD Non-Communicable Disease — chronic diseases not transmitted from person to person (CVD, cancer, diabetes)
PMJAY Pradhan Mantri Jan Arogya Yojana — health insurance for Rs 5 lakh per family per year
ABHA Ayushman Bharat Health Account — 14-digit unique digital health ID
PM-ABHIM PM Ayushman Bharat Health Infrastructure Mission — Rs 64,180 crore for pandemic-ready health infrastructure
AMR Antimicrobial Resistance — resistance of microorganisms to drugs that previously treated infections caused by them
One Health Integrated approach linking human, animal, and environmental health
NFHS National Family Health Survey — India's primary source for demographic and health data
NCDC National 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 (2023), MMR 93 (2019–21), 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 TB elimination target was 2025. NCDs cause 63% of deaths.