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“Besides being a moral imperative of a Welfare State, primary health structure is a necessary precondition for sustainable development.” Analyse.(150 words)

The Directive Principles of State Policy (Articles 38, 39, 42, and 47) mandate the State to ensure the health and well-being of all citizens.

Moral Imperative of the Welfare State

Right to Health forms part of Article 21 (Right to Life)

Ensuring accessible, affordable, and equitable healthcare upholds social justice and human dignity.

Primary healthcare represents state accountability towards vulnerable groups, fulfilling the ethos of “Sabka Saath, Sabka Vikas.”

Reduces out of pocket expenditure and vicious cycle of poverty

Primary Health as a Precondition for Sustainable Development

SDG-3 emphasizes ensuring healthy lives and well-being for all.

Social Development – Reduces disease burden, enhances productivity, and improves quality of life. Eg- Reduction in IMR (24) and MMR (97)

Economic Development – World Bank (2023):

Strong primary healthcare ensures better productivity, improved livelihoods, and universal healthcare access.

Institutional Sustainability – Strengthens local governance and community participation in health planning. Eg- ASHA workers

Supported by the Astana Declaration and National Health Policy 2017, which envisions comprehensive and affordable healthcare.

Key Challenges

India spends only 1.9% of GDP on healthcare (Economic Survey 2024), far below the WHO’s recommendation of 2.5%.

Overemphasis on tertiary care- only 15% of public funds go to primary care

Human resource shortage: Shortfall of 76% doctors at PHCs (RHS 2023).

Urban-Rural Disparities (Spatial Inequity) – only 33% of doctors and 25% of hospital beds in rural areas.

Way Forward

Increase Public Health Expenditure to 2.5% of GDP as per National Health Policy 2017.

Decentralize Planning and Monitoring via Panchayati Raj Institutions. (Kerala Model)

Strengthen ASHAs, ANMs, and geriatric caregivers at village level.

Use of telemedicine (eSanjeevani) and digital records for continuum of care.

Strong primary and preventive healthcare is essential to achieve equitable and sustainable development and achieve Viksit Bharat @2047.