A Philosophy of Care

A Philosophy of Care

Why in News?
Union Minister Jagat Prakash Nadda has outlined the substantial strides India’s healthcare system has taken in the past 11 years under the Modi government, emphasizing a shift towards affordable, accessible, equitable, and quality healthcare for all citizens. This marks a significant milestone in India’s public health journey, showcasing transformational reforms led by a philosophy of comprehensive care.

Introduction

Over the last decade, India has experienced a revolutionary transformation in its healthcare system. Spearheaded by political will, increased funding, and a deep commitment to equitable public health, the healthcare ecosystem has evolved with major structural and policy reforms. The goal is clear: build a robust healthcare system that prioritizes the well-being of every citizen. The philosophy of care guiding these changes emphasizes proactive and preventive healthcare, making services more inclusive and equitable across urban and rural landscapes.

Key Issues and Background

1. Challenges in 2014
   In 2014, India’s healthcare infrastructure was plagued with several pressing issues. Gaps in infrastructure, limited availability of trained human resources, insufficient medical equipment and diagnostics, and lack of essential medicines posed significant barriers to public health. The system was reactive, overburdened, and inaccessible to many, especially the rural poor and marginalized.

2. National Health Mission (NHM) – A Cornerstone
   The National Health Mission (NHM) emerged as a foundational element of the government’s healthcare reform. It focused on strengthening health systems, addressing maternal and child mortality, combating communicable diseases, and extending healthcare access to underserved areas. NHM interventions have led to substantial improvements in maternal and child health indicators, such as:

   • Infant mortality dropped by 73%, compared to a global average decline of 58%.

   • Maternal mortality rate significantly reduced.

3. Technological and Platform-Driven Innovations
   Platforms like Ayushman Arogya Mandirs, eSanjeevani, and TeleMANAS have democratized access to healthcare by connecting citizens with medical professionals and specialists remotely. These platforms focus on preventive care, screenings, and regular health monitoring.

4. Universal Immunisation Programme and Disease Eradication
   India continues to excel in immunization efforts:

   • Six new vaccines have been introduced.

   • 5.46 crore children and 1.32 crore pregnant women were vaccinated under Mission Indradhanush.

   • U-WIN, a digital vaccination platform, was launched to track and administer vaccinations.

   • India eradicated polio in 2014 and maternal and neonatal tetanus in 2015.

   • Malaria cases reduced by 66% between 2015-2022.

   • Kala Azar elimination achieved in 2023.

5. Non-Communicable Diseases (NCDs) and Preventive Health
   Screening for NCDs such as cancer, diabetes, and hypertension is being conducted proactively under Ayushman Arogya Mandirs.

   • By May 2025, 28 crore people were screened for hypertension, 27 crore for diabetes, and 27 crore for oral cancer.

6. Reduction in Out-of-Pocket Expenditure (OOPE)

   • OOPE reduced from 62.6% to 39.4% due to programs like the Free Drugs and Diagnostics Service Initiative.

   • This initiative ensured accessibility to laboratory services in 36 States/UTs, CT scans in 34 States, and tele-radiology in 12 States/UTs.

7. Pradhan Mantri National Dialysis Programme

   • Benefitted over 28 lakh patients, saving them from catastrophic health expenditures.

   • Emergency response systems like National Ambulance Services (NAS) and Mobile Medical Units (MMUs) now serve remote areas efficiently.

5 Key Observations

1. From Reactive to Proactive Care
   India’s health system has evolved from simply treating illness to preventing it. Screening, vaccinations, and early interventions are now central to healthcare delivery.

2. Digital and Decentralized Access
   Through eSanjeevani and TeleMANAS, India has moved healthcare closer to its citizens, bridging the urban-rural divide. Patients now consult specialists from the remotest areas.

3. Immunisation and Disease Elimination Successes
   The eradication of polio, and maternal and neonatal tetanus, and the substantial reduction in malaria and kala azar, demonstrate the effectiveness of India’s public health campaigns.

4. Drastic Reduction in Financial Burden
   The drop in out-of-pocket expenditure highlights the government’s commitment to ensuring no citizen faces financial hardship due to medical needs. Free drugs and diagnostics have been a game changer.

5. Infrastructure Development with PHC Reforms
   The Ayushman Bharat Health Infrastructure Mission (PM-ABHIM) and the rollout of 18,802 Ayushman Arogya Mandirs, 602 Critical Care Hospital Blocks, and 730 District Integrated Public Health Labs mark a massive step in strengthening health infrastructure.

Challenges and the Way Forward

Despite massive strides, several challenges remain. These include:

• Uneven healthcare access in certain remote or tribal areas.

• Need for continued focus on mental health and geriatric care.

• Enhancing the doctor-to-population ratio, especially in rural India.

• Strengthening data-driven and AI-supported health infrastructure for real-time monitoring.

• Building public awareness around preventive healthcare and healthy lifestyles.

Way Forward:
To build on these achievements, India must prioritize continuous medical education, invest in healthcare research and innovation, and ensure health equity across all demographics. Future reforms must keep people at the center of care and bridge any remaining gaps through robust policy support and public-private partnerships.

Conclusion

India’s transformation in the health sector over the past 11 years has been nothing short of revolutionary. From enhancing infrastructure to democratizing healthcare access, and from reducing infant mortality to introducing path-breaking health tech platforms, India is now poised as a global example in public health. As Union Minister J.P. Nadda aptly highlights, this transformation is driven by a philosophy of care, which focuses on wellness rather than illness, equity rather than privilege, and prevention rather than cure.

The next decade offers an opportunity to further consolidate gains, integrate cutting-edge health technology, and ensure healthcare as a fundamental right rather than a luxury.

5 Questions and Answers

Q1. What are the key focus areas of India’s health transformation in the last 11 years?
A: The focus areas include infrastructure improvement, expanding trained human resources, increasing the availability of diagnostics and medicines, maternal and child health interventions, disease eradication efforts, reduction in OOPE, and the use of digital health platforms for better access.

Q2. What role has the National Health Mission (NHM) played in this transformation?
A: NHM is the cornerstone of India’s health reform. It has strengthened primary healthcare systems, reduced maternal and child mortality, and promoted access through health centers, digital consultations, and health outreach programs.

Q3. How has India tackled vaccine-preventable and communicable diseases under the new model?
A: Through Mission Indradhanush, six new vaccines were added, millions of children and pregnant women were immunized, and polio, maternal/neonatal tetanus, and kala azar have been eliminated or reduced substantially. Malaria cases dropped by 66%.

Q4. What impact has Ayushman Bharat and PM-ABHIM had on healthcare accessibility?
A: These missions have led to the creation of thousands of healthcare centers (Ayushman Arogya Mandirs), critical care blocks, and labs. They have increased preventive care access, brought services closer to communities, and boosted emergency response capabilities.

Q5. What are the outcomes of reducing Out-of-Pocket Expenditure (OOPE)?
A: OOPE dropped from 62.6% to 39.4%. This reduction means less financial burden on families for treatment. Free drugs and diagnostics, dialysis programs, and ambulance services have made healthcare more affordable and accessible.