{"id":80658,"date":"2026-08-03T18:46:16","date_gmt":"2026-08-03T13:16:16","guid":{"rendered":"https:\/\/www.nextias.com\/ca\/?p=80658"},"modified":"2026-08-03T19:11:35","modified_gmt":"2026-08-03T13:41:35","slug":"strengthening-public-health-systems-india","status":"publish","type":"post","link":"https:\/\/www.nextias.com\/ca\/editorial-analysis\/03-08-2026\/strengthening-public-health-systems-india","title":{"rendered":"Strengthening Public Health Systems in India"},"content":{"rendered":"\n<p><strong>Syllabus: GS2\/Issue Related Health<\/strong><\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>Context<\/strong><\/h2>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Global cuts in <strong>Development Assistance for Health (DAH),<\/strong> rising public debt, and concerns over under-utilisation of health budgets have renewed focus on improving the efficiency and governance of public health systems, particularly in India and other developing countries.<\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>About Public Health Systems in India<\/strong><\/h2>\n\n\n\n<ul class=\"wp-block-list\">\n<li>India\u2019s public health system is built on a <strong>three-tier healthcare structure<\/strong> i.e. Sub-Centres\/Health &amp; Wellness Centres (HWCs), Primary Health Centres (PHCs), Community Health Centres (CHCs), district hospitals, and tertiary institutions.<\/li>\n\n\n\n<li>It is guided by the <strong>National Health Policy (2017)<\/strong> and implemented primarily through the <strong>National Health Mission (NHM)<\/strong>.<\/li>\n\n\n\n<li>Key features include:\n<ul class=\"wp-block-list\">\n<li><strong>National Health Mission (NHM):<\/strong> Strengthens basic health care, maternity and child health, disease control and health infrastructure.<\/li>\n\n\n\n<li><strong>Ayushman Bharat Scheme:<\/strong>\n<ul class=\"wp-block-list\">\n<li><strong>Health and Wellness Centres (AB-HWCs):<\/strong> Provide integrated primary health care.<\/li>\n\n\n\n<li><strong>PM-JAY:<\/strong> Offers health insurance cover of \u20b95 lakh per household for secondary and tertiary treatment.<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li><strong>Digital Health Initiatives:<\/strong> The Ayushman Bharat Digital Mission (ABDM) seeks to develop a digital health ecosystem.<\/li>\n\n\n\n<li><strong>WHO India Partnership:<\/strong> Strengthens health system by improving governance, workforce development, surveillance and Universal Health Coverage (UHC).<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>Concerns &amp; Issues in Public Health Systems<\/strong><\/h2>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Lack of Funding for Public Health: <\/strong>The percentage of public health expenditure in GDP still remains around 2%, below the aim of 2.5% set in the National Health Policy.\n<ul class=\"wp-block-list\">\n<li>Although the difference in terms of GDP share is reducing, per capita public health expenditure in LMICs remains much lower than in high-income nations.<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li><strong>Declining External Health Assistance:<\/strong> Major cuts to falling external health aid<strong> Development Assistance for Health (DAH)<\/strong>, which peaked under COVID-19, are falling dramatically.\n<ul class=\"wp-block-list\">\n<li>Major contributors including the <strong>United States, United Kingdom, France and Germany<\/strong> have cut foreign health support, impacting health projects around the world.<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li><strong>Poor Budget Utilisation:<\/strong> The health budgets in many LMICs are implemented only to the <strong>extent of 85\u201390%<\/strong> which is less than sectors like education. In India:\n<ul class=\"wp-block-list\">\n<li>Much of the allocations under the <strong>Health Infrastructure Mission <\/strong>was unspent.<\/li>\n\n\n\n<li><strong>26% <\/strong>of funds allocated to communicable and non-communicable disease programmes under NHM were utilised in 2024-25.<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li><strong>Skewed Spending Pattern: <\/strong>Higher spending on s<strong>econdary and tertiary curative care.<\/strong>\n<ul class=\"wp-block-list\">\n<li>Preventive and basic healthcare still receive comparatively lower financing.<\/li>\n\n\n\n<li>Immunisation, sanitation, surveillance and health promotion as preventive health measures have continued to be under-prioritised.<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li><strong>Governance Challenges: <\/strong>Weak public financial management; delays in fund release; procurement inefficiencies; capacity gaps at State and district levels; corruption and administrative inefficiencies reduce the effectiveness of public expenditure.<\/li>\n\n\n\n<li><strong>Emerging Health Challenges: <\/strong>Rising burden of <strong>Non-Communicable Diseases (NCDs)<\/strong>; ageing population; climate-sensitive diseases; and pandemic preparedness requirements.<\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>Related Efforts &amp; Initiatives<\/strong><\/h2>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>National Health Mission (NHM)<\/strong> for strengthening primary healthcare.<\/li>\n\n\n\n<li><strong>Ayushman Bharat (AB-PMJAY &amp; Health and Wellness Centres).<\/strong><\/li>\n\n\n\n<li><strong>Ayushman Bharat Digital Mission (ABDM).<\/strong><\/li>\n\n\n\n<li>The <strong>PM Ayushman Bharat Health Infrastructure Mission (PM-ABHIM) <\/strong>intends to increase disease surveillance, critical care, laboratories and public health infrastructure.<\/li>\n\n\n\n<li>Medical colleges and health workforce expansion.<\/li>\n\n\n\n<li><strong>International Support:<\/strong>\n<ul class=\"wp-block-list\">\n<li><strong>WHO India<\/strong> promotes health system strengthening through <strong>Universal Health Coverage (UHC)<\/strong>, health workforce development, health funding reforms, disease surveillance and emergency preparedness.<\/li>\n\n\n\n<li><strong>Sustainable Development Goal (SDG) 3<\/strong> is one of the 17 SDGs established by the United Nations General Assembly in 2015.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>Prioritizing Better Public Health Spending<\/strong><\/h2>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Better Budget Utilisation:<\/strong> Timely release of funds, better monitoring of expenditure, accountability of implementing agencies, and better coordination between Union and State governments.<\/li>\n\n\n\n<li><strong>Prioritise spending on High-Impact Interventions: <\/strong>Greater focus should be given to preventive healthcare, immunisation, nutrition, sanitation and hygiene, disease surveillance, health promotion and early screening for NCDs.\n<ul class=\"wp-block-list\">\n<li>Public resources should be directed to public goods in areas where market failures exist, such as epidemic control and vaccination, with the private sector offering complementary cheap curative services.<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li><strong>Enhance Governance and Efficiency:<\/strong> Improve public financial management; boost transparency in procurement; digitise the tracking of funds; give district-level health administrations more authority; include frontline health providers in planning and budgeting; and develop flexible budgeting mechanisms for emergencies.<\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>Way Forward: Strengthening Measures<\/strong><\/h2>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Increase public health spending to<strong> 2.5% of GDP as per the National Health Policy.<\/strong><\/li>\n\n\n\n<li>Promote <strong>primary and preventative health care<\/strong> rather than excessive curative expenditure.<\/li>\n\n\n\n<li>Enhance credibility of the <strong>budget, utilisation and results-based financing.<\/strong><\/li>\n\n\n\n<li>Strengthen <strong>Health and Wellness Centres <\/strong>as the cornerstone of Universal Health Coverage.<\/li>\n\n\n\n<li>Invest in monitoring, laboratories, digital health and disaster planning to build resilient health systems.<\/li>\n\n\n\n<li>Strengthen State and local governance and capabilities to promote cooperative federalism.<\/li>\n\n\n\n<li>Support resource allocation based on evidence of illness burden and health outcomes indicators.<\/li>\n\n\n\n<li>Grow public-private partnerships while guaranteeing equity and affordability.<\/li>\n<\/ul>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>Conclusion<\/strong><\/h3>\n\n\n\n<ul class=\"wp-block-list\">\n<li>The immediate priority is to <strong>spend existing resources more efficiently <\/strong>while increasing health expenditure remains essential.<\/li>\n\n\n\n<li>Better budget execution, strategic planning of resource allocation towards preventative care, and better governance can yield large health gains even in a tight budgetary context.<\/li>\n\n\n\n<li>Long-term sustained investment and institutional reforms would be key to achieving <strong>Universal Health Coverage (UHC)<\/strong> and creating a sustainable, equitable and inclusive public health system in India.<\/li>\n<\/ul>\n\n\n\n<figure class=\"wp-block-table\"><table class=\"has-background has-fixed-layout\" style=\"background-color:#fff2cc\"><tbody><tr><td><strong>Daily Mains Practice Question<\/strong><br><strong>[Q] <\/strong>Increasing public health expenditure alone is insufficient to improve health outcomes unless accompanied by efficient governance and strategic allocation of resources. Discuss in the context of strengthening India&#8217;s public health system.<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n<p><a href=\"https:\/\/www.thehindu.com\/opinion\/op-ed\/strong-health-systems-for-all-with-better-public-spending\/article71298594.ece\" target=\"_blank\" rel=\"noopener\">Source: TH<\/a><\/p>\n\n\n\n<div class=\"wp-block-buttons is-layout-flex wp-block-buttons-is-layout-flex\">\n<div class=\"wp-block-button\"><a class=\"wp-block-button__link wp-element-button\" href=\"https:\/\/www.nextias.com\/ca\/wp-content\/uploads\/2026\/08\/Daily-Editorial-Analysis-03-08-2026.pdf\"><strong>Download PDF<\/strong><\/a><\/div>\n<\/div>\n\n\n\n<p><\/p>\n","protected":false},"excerpt":{"rendered":"<p><strong>Published on:<\/strong> 3 August, 2026<\/p>\n<p>Global cuts in Development Assistance for Health (DAH), rising public debt, and concerns over under-utilisation of health budgets have renewed focus on improving the efficiency and governance of public health systems, particularly in India and other developing countries.<\/p>\n","protected":false},"author":15,"featured_media":80660,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[22],"tags":[],"class_list":["post-80658","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-editorial-analysis"],"acf":[],"jetpack_featured_media_url":"https:\/\/wp-images.nextias.com\/cdn-cgi\/image\/format=auto\/ca\/uploads\/2026\/08\/public-health-systems-in-india.webp","_links":{"self":[{"href":"https:\/\/www.nextias.com\/ca\/wp-json\/wp\/v2\/posts\/80658","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.nextias.com\/ca\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.nextias.com\/ca\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.nextias.com\/ca\/wp-json\/wp\/v2\/users\/15"}],"replies":[{"embeddable":true,"href":"https:\/\/www.nextias.com\/ca\/wp-json\/wp\/v2\/comments?post=80658"}],"version-history":[{"count":2,"href":"https:\/\/www.nextias.com\/ca\/wp-json\/wp\/v2\/posts\/80658\/revisions"}],"predecessor-version":[{"id":80663,"href":"https:\/\/www.nextias.com\/ca\/wp-json\/wp\/v2\/posts\/80658\/revisions\/80663"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.nextias.com\/ca\/wp-json\/wp\/v2\/media\/80660"}],"wp:attachment":[{"href":"https:\/\/www.nextias.com\/ca\/wp-json\/wp\/v2\/media?parent=80658"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.nextias.com\/ca\/wp-json\/wp\/v2\/categories?post=80658"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.nextias.com\/ca\/wp-json\/wp\/v2\/tags?post=80658"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}