Health Sector – UHC, National Health Policy, Family Planning, Health Insurance, etc.

Building a robust healthcare system


From UPSC perspective, the following things are important :

Prelims level: Maternal Mortality Rate, Infant Morality Rate

Mains level: Paper 2- Disparity among states in health parameters

The article focuses on the wide variation across the state in terms of the important health parameters and suggests prioritising health.

Variation across the states

  • The efficacy of the public health system varies widely across the country since it is a State subject.
  • Public health system can be judged just by looking at certain health parameters such as Infant Mortality Rate, Maternal Mortality Ratio and Total Fertility Rate.
  • In Madhya Pradesh, the number of infant deaths for every 1,000 live births is as high as 48 compared to seven in Kerala. In U.P. the Maternal Mortality Ratio is 197 compared to Kerala’s 42 and Tamil Nadu’s 63.
  • The northern States are performing very poorly in these vital health parameters.
  • The percentage of deliveries by untrained personnel is very high in Bihar, 190 times that of Kerala.
  • Since health is a State subject, the primary onus lies with the State governments.
  • Each State government must focus on public health and aim to improve the health indicators mentioned above.
  • Unless all the States perform well, there will be no dramatic improvement in the health system.

Steps needed to be taken

  • The governments — both at the Centre and the Empowered Action Group States — should realise that public health and preventive care is a priority and take steps to bring these States on a par with the southern States.
  • The Government of India has a vital role to play.
  • Public and preventive health should be his focus by holding the Empowered Action Group States accountable to the SDGs.
  • They must be asked to reach the levels of the southern States within three to five years.
  • An important measure that can make a difference is a public health set-up in these States that addresses primary and preventive health.


Unless we invest in human capital, FDI will not help.  Investing in health and education is the primary responsibility of any government. It is time the governments — both at the Centre and States — gave health its due importance.

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