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Family needs to be at the heart of India’s health system

GS Paper 2

Syllabus:  Issues Relating to Health, Education, Human Resources.


Source: Indian Express

Direction: Go through once to understand the issue.

Context: Evaluation of health care in India

Health Care System in India: multi-tiered structure.

  • Village-level PHC: a community worker operates and provides services covering 12 diseases/needs.
  • Block-level: there is a 30-bed community health centre operated by four specialists
  • District level: Hospital/medical college


History of healthcare reforms: Bhore Committee Report (1946), the Kartar Singh Committee Report (1973), National Rural Health Mission (NRHM) of 2005 and the Ayushman Bharat Mission of 2019.

NRHM was remarkable as it set the Indian Public Health Standards (IPHS) for physical infrastructure, human resources and service delivery, and led to a three-fold increase in budget.

Outcomes out of NRHM:

  • Institutional deliveries improved from 41% in 2005 to 89% in 2021,
  • The maternal mortality ratio (MMR) went down from 407 per one lakh women in 2,000 to 113 per one lakh women in 2021,
  • The infant mortality ratio reduced from 58/1,000 live births in 2005 to about 28/1,000 live births in 2021
  • The healthcare system’s footfall has registered an impressive improvement in states like Bihar and UP.

Limitations: The primary healthcare system continues to be plagued with gaps and deficiencies, over-

crowding, poor facilities, low budget (barely 1.1% of GDP)


Case study: The Kerala Model -Healthcare system

It is based on UK’s GP (general practitioners) system. Kerela’s model emphasizes Primary Health care, a community-anchored delivery system, a continuum of care (from birth to death), and patient-centred, protocol-driven, evidence-based treatment.

Focus on Family: The Primary health centre (PHC) facilities have been renamed as family health centres (FHCs) which underlines the centrality of the family in the endeavour.

A series of coordinated interventions were made, like changing timings, redesigning the centres and equipping them with patient and people-friendly facilities, providing intensive training to the staff to undertake new functions and responsibilities, etc.

Other solutions

  • National policy should be nimble and allow for differential strategies because a single system may not be apt for the entire country.
  • The Centre should adopt the principles of flexibility, and decentralisation and provides the space for innovation for states and districts to plan, design and implement primary care in accordance with local needs. The Centre government’s role should be limited to measuring outcomes.

Insta Links

Issues related to the Health sector

Mains Links

Q. Mention the issues with the public healthcare system in India. How can these issues be addressed? Explain. (250 Words)