National Health Policy

The National Health Policy (NHP) is a comprehensive framework formulated by the Government of India to guide the development of the health sector and ensure equitable, affordable, and quality healthcare for all citizens. The latest version, the National Health Policy 2017, replaced the earlier policies of 1983 and 2002, aligning India’s health objectives with contemporary challenges and the global goal of Universal Health Coverage (UHC).
It emphasises preventive and promotive healthcare, strengthening public health systems, improving access to affordable medicines, and integrating private sector participation under a regulated framework.

Evolution of National Health Policies in India

1. National Health Policy 1983:
   • First health policy after independence.
   • Aimed at achieving “Health for All by 2000 AD.”
   • Focused on primary healthcare, rural health infrastructure, and community participation.
2. National Health Policy 2002:
   • Emphasised private sector collaboration and decentralised governance.
   • Addressed emerging challenges such as non-communicable diseases (NCDs) and urban health.
   • Sought to increase health expenditure to 2% of GDP.
3. National Health Policy 2017:
   • Formulated in the context of new health priorities — rising NCDs, ageing population, health inequities, and financial hardship due to out-of-pocket expenditure.
   • Reoriented focus toward universal access, preventive health, digital health, and financial protection.

Vision and Goal

The vision of the National Health Policy 2017 is:

“Attainment of the highest possible level of health and well-being for all, through a preventive and promotive healthcare orientation in all developmental policies, and universal access to good-quality healthcare services without anyone having to face financial hardship.”

Key Goal: Achieve universal health coverage (UHC) through accessible, affordable, accountable, and quality healthcare services.

Major Objectives of NHP 2017

The policy sets forth broad objectives under three dimensions — health status improvement, healthcare system strengthening, and financial protection.

1. Improving Health Outcomes:
   • Increase life expectancy and reduce maternal, infant, and under-five mortality rates.
   • Achieve decline in total fertility rate (TFR) to 2.1 by 2025.
   • Reduce premature deaths from non-communicable diseases by 25% by 2025.
2. Strengthening Health Systems:
   • Expand primary healthcare coverage through a network of Health and Wellness Centres (HWCs).
   • Ensure availability of trained human resources in rural and urban areas.
   • Promote digital and telemedicine-based service delivery.
3. Financial Protection:
   • Reduce out-of-pocket expenditure (OOPE) from 65% (2015) to 30% by 2025.
   • Increase government health spending to 2.5% of GDP by 2025.
   • Expand publicly financed health insurance and social protection schemes.

Key Principles and Policy Framework

1. Preventive and Promotive Health:
   • Shift focus from curative services to health promotion through awareness, hygiene, nutrition, and vaccination.
   • Strengthen programmes against communicable and non-communicable diseases.
2. Primary Healthcare Reforms:
   • Establish Health and Wellness Centres (HWCs) as the foundation of India’s health system.
   • HWCs provide comprehensive primary care including maternal, child, adolescent, and mental health services.
3. Quality and Patient Safety:
   • National quality assurance frameworks for healthcare facilities.
   • Promotion of evidence-based standards and accreditation systems.
4. Human Resources for Health:
   • Bridge shortages of doctors, nurses, and allied health professionals, especially in rural areas.
   • Introduce new cadres such as Mid-Level Health Providers (MLHPs).
5. Access to Medicines and Technology:
   • Strengthen the Jan Aushadhi Scheme for affordable generic drugs.
   • Encourage research and innovation in pharmaceuticals and medical devices.
   • Establish a National Digital Health Authority to promote electronic health records and digital governance.
6. Public-Private Partnerships (PPPs):
   • Encourage private sector participation in infrastructure, diagnostics, and specialised care under regulated frameworks.
   • Promote social insurance models for inclusive coverage.
7. Gender and Equity:
   • Focus on women’s and children’s health, especially in vulnerable groups.
   • Address social determinants such as education, sanitation, and gender equality.
8. Decentralised Governance:
   • Empower state and local governments for health planning under a cooperative federal framework.
9. Emergency and Disaster Preparedness:
   • Strengthen surveillance, response, and laboratory networks for emerging epidemics and natural disasters.

Quantitative Targets of NHP 2017

The policy outlines measurable goals to be achieved by 2025:

Integration with Other Health Initiatives

The policy complements several flagship schemes:

• Ayushman Bharat (2018): Implements the NHP vision through two components — Health and Wellness Centres for primary care and Pradhan Mantri Jan Arogya Yojana (PM-JAY) for secondary and tertiary care coverage.
• National Digital Health Mission (NDHM): Strengthens digital infrastructure and electronic health records.
• Mission Indradhanush: Expands immunisation coverage for children and pregnant women.
• Poshan Abhiyaan: Addresses malnutrition through multi-sectoral interventions.
• National Health Mission (NHM): Continues as the umbrella programme for health system strengthening.

Achievements Since NHP 2017

• Over 1.6 lakh Health and Wellness Centres established across India.
• Expansion of PM-JAY, covering over 500 million beneficiaries.
• Significant progress in maternal and child health indicators.
• Increased adoption of digital health technologies post-COVID-19 pandemic.
• Greater attention to mental health through the National Mental Health Programme.

Challenges in Implementation

Despite progress, several challenges persist:

• Low public expenditure: Government health spending remains below target.
• Urban-rural disparities: Health infrastructure and human resources remain concentrated in cities.
• High out-of-pocket costs: Many families still incur heavy expenses on private healthcare.
• Disease burden: Rising prevalence of lifestyle diseases such as diabetes and hypertension.
• Health workforce shortages: Persistent vacancies in rural health centres.
• Coordination issues: Fragmented health governance between central and state levels.