The cornerstone of high-quality human resources is good health and wellbeing, which also dictate any nation's development plan. It is commonly known that there is a close and intimate relationship between the environment and health (Haque and Singh 2017). The environment should be conserved and protected as a necessary component of good health and well-being. With more people living in cities, there are more urban spaces, making planning necessary, especially in terms of urban health. The Indian government intends to construct 100 new smart cities while taking future needs and demands into consideration. This aligns with the goal of Sustainable Cities and Human Settlements, which is to construct well-planned, resilient, sustainable cities that enhance health and well-being and are ready for emergencies. 

India's recent government policies prioritize access to high-quality, reasonably priced healthcare services for all citizens. This demonstrates a strong commitment to making healthcare accessible to all citizens. This policy is a major step forward for India, which has a large population and a high incidence of infectious diseases. Access to quality healthcare is essential for maintaining a healthy society. India's government has recognized this need and is taking steps to ensure that all citizens have access to quality healthcare. 

With a population of more than 1.4 billion, India faces a variety of health problems, from infectious diseases to non-communicable diseases (NCDs), which are made worse by socioeconomic inequality and a deficient healthcare system. The demographic diversity of the nation presents opportunities and challenges for public health initiatives. The burden of multiple diseases has been exacerbated by elements like industrialization, urbanization, and changing lifestyles. Alongside the rising prevalence of conditions related to lifestyle choices, such as diabetes and cardiovascular disease, there are still communicable diseases like malaria and tuberculosis. Additionally, there are still many unresolved issues related to mother and child health, including inadequate access to healthcare, particularly in rural areas, and malnutrition.

India's average life expectancy, according to World Health Statistics 2023, is 70.8 years. India's Infant Mortality Rate (IMR), according to data from the National Family Health Survey-5, was 35 per 1,000 births in 2019 and 2021—a mere 5.5 percent drop from 2015–16 levels. The consistently high IMR highlights underlying socioeconomic factors, such as malnutrition, which affects 35.5% of children under five who are stunted and 19% who are wasting—low weight for height. India's position on the Global Hunger Index declined, going from 94th out of 116 countries in 2020 to 111th out of 125 in 2023. According to the National Cancer Registry Programme, India's cancer incidence is predicted to be 100.4 per 100,000 people in 2022 and to rise by 12.5% by 2025. India has seen a steady increase in healthcare spending in recent years, which is indicative of the increased focus on healthcare services, infrastructure, and accessibility. Data from the National Health Accounts 2019–20 show that, in addition to the government's share of health spending rising from 20 percent to 41 percent, India’s total healthcare spending as a percentage of GDP increased from 1.13 to 1.35 between 2014–15 and 2019–20. The percentage of money paid out of pocket decreased from 62.6 percent in 2014–15 to 47.1 percent in 2019–20. The percentage of Social Security spent on health increased from 5.7% in 2014–15 to 9.4% in 2019–20.

Since its establishment, the healthcare industry has made great strides in response to the 1946 recommendations made by the Bhore Committee.

Ensuring that the people of India have access to affordable, high-quality healthcare services is imperative. Since its establishment, the healthcare industry has made great strides in response to the 1946 recommendations made by the Bhore Committee. The foundational framework for health planning was established by the committee's recommendations, which subsequently impacted the creation of numerous policies and programmes throughout India.

Health for All by 2000 AD was a global initiative that shaped the Sixth Five-Year Plan (1980–1985). The Indian government unveiled the National Health Policy (NHP) in 1983, with the main goal being the provision of affordable, population-based universal healthcare. The finalized NHP document was released in 2002 with the goal of raising the health standards of the Indian populace to a commendable level. Decentralization, equity, better accessibility to healthcare services, and the availability of reasonably priced private healthcare were all emphasized.  The National Health Mission (NHM) was introduced by the Indian government in 2013. It encompasses the National Rural Health Mission (NRHM) that was founded in 2005 and the National Urban Health Mission (NUHM) that was formed in 2013 within its framework. By bolstering the healthcare system's infrastructure, educating healthcare professionals, and encouraging community involvement in health governance, these important programmes seek to improve healthcare access and quality in both rural and urban areas. NUHM addresses the specific health needs of marginalised and impoverished urban populations. Reproductive, Maternal, Newborn, Child, Adolescent Health and Nutrition (RMNCAH+N) was launched in 2013 by the Ministry of Health & Family Welfare with the goal of promoting critical interventions that lower the morbidity and mortality rates of mothers and children.

NUHM addresses the specific health needs of marginalised and impoverished urban populations.

Acknowledging the strong correlation between health outcomes and sanitation, the Swachh Bharat Mission (SBM), which was initiated in 2014, aimed to eradicate open defecation and attain universal sanitation coverage. In addition to preventing infectious diseases, improved sanitation facilities also improve people's general health, especially for women and children. In order to promote a clean culture, SBM places a strong emphasis on behaviour change communication and community mobilisation. In December 2014, Mission Indradhanush (MI) was launched as a response to the issue of low childhood immunization coverage. This mission specifically targeted unvaccinated and partially vaccinated children who had been missed during routine immunisation efforts, with a particular emphasis on reaching those in remote and underserved areas.

One of the most comprehensive healthcare programmes in the world, Ayushman Bharat Yojana (National Health Protection Mission) 2018 aims to protect the financial well-being of over 500 million vulnerable people through two flagship programmes: the Pradhan Mantri Jan Arogya Yojana (PMJAY) and the Health and Wellness Centres (HWCs). While PMJAY targets the poorest households and offers health insurance coverage of up to 5 lakh rupees per family annually, HWCs concentrate on comprehensive primary healthcare services.

Initiated in 2018, the POSHAN Abhiyaan employs a multisectoral approach to tackle low birth weight, aneamia, stunting, and undernutrition. In India, malnutrition is still a serious problem for the general public, particularly for women and children. Initiated in 2018, the POSHAN Abhiyaan employs a multisectoral approach to tackle low birth weight, aneamia, stunting, and undernutrition. The goals of this programme are to support grassroots healthcare and nutrition services, enhance access to wholesome food, and promote the best feeding practices for newborns and early children.

India's commitment to improving public health is demonstrated by these policies and initiatives, which tackle a variety of health-related issues such as inadequate funding, unequal resource distribution, inadequate governance of health systems, and limited access to healthcare services for different groups of people. In order to attain universal health coverage and address the root causes of subpar health outcomes, there is a need for continued political commitment, more funding for healthcare personnel and infrastructure, and improved cooperation between public and private sectors as well as civil society.

Well, To Summarize...

Enhancing Population Health: India’s Comprehensive Policies and Programmes

India, with its diverse and vast population, faces significant health challenges. To address these, the Indian government has implemented a range of policies and programmes aimed at enhancing population health. These initiatives span across various domains such as maternal and child health, communicable and non-communicable diseases, nutrition, sanitation, and universal healthcare access. This article delves into the key policies and programmes that are shaping India's health landscape.

Maternal and Child Health

Ensuring the health of mothers and children is fundamental to improving overall public health outcomes. India has introduced several programmes to address this critical area:

• Janani Suraksha Yojana (JSY): Launched to reduce maternal and neonatal mortality by promoting institutional deliveries among poor pregnant women, JSY provides financial incentives to mothers who choose institutional births. This scheme has been instrumental in increasing the rate of institutional deliveries, thereby reducing maternal and infant mortality rates.
• Integrated Child Development Services (ICDS): One of the world’s largest programmes for early childhood development, ICDS offers a package of six services: supplementary nutrition, immunization, health check-ups, referral services, pre-school non-formal education, and nutrition and health education. It targets children under six years of age, pregnant women, and lactating mothers, aiming to combat malnutrition and improve early childhood development.

Communicable Diseases

India has made significant strides in combating communicable diseases, with targeted programmes focusing on prevention, control, and elimination:

• National Tuberculosis Elimination Program (NTEP): Formerly known as the Revised National Tuberculosis Control Program (RNTCP), NTEP aims to eliminate tuberculosis by 2025. It provides free diagnosis and treatment services, including for multi-drug-resistant TB. The programme also focuses on community engagement and awareness to reduce the stigma associated with TB.
• National AIDS Control Program (NACP): This initiative focuses on preventing HIV transmission, providing treatment and care to those affected, and reducing the stigma associated with HIV/AIDS. The programme has successfully reduced HIV prevalence through comprehensive strategies involving awareness campaigns, condom distribution, and antiretroviral therapy (ART) services.

Non-Communicable Diseases

The burden of non-communicable diseases (NCDs) is rapidly increasing in India. In response, the government has launched several programmes to manage and prevent these diseases:

National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS): 

NPCDCS aims to raise awareness about NCDs, promote early diagnosis, and provide effective management of these conditions. The programme includes screening camps, lifestyle modification counselling, and treatment facilities.

• Ayushman Bharat: Pradhan Mantri Jan Arogya Yojana (PM-JAY): This flagship health insurance scheme provides financial protection to economically disadvantaged families. It covers secondary and tertiary care hospitalization for a wide range of non-communicable diseases, ensuring access to quality healthcare without financial hardship.
• Nutrition: Nutrition is a cornerstone of good health. India has launched ambitious programmes to tackle malnutrition and ensure better nutritional outcomes:
• Mid-Day Meal Scheme: This programme provides free lunches to school children on working days, improving their nutritional status and encouraging school attendance. It aims to address hunger and malnutrition among school-going children, contributing to better educational and health outcomes.
• Poshan Abhiyaan (National Nutrition Mission): Launched to comprehensively tackle malnutrition among children, pregnant women, and lactating mothers, Poshan Abhiyaan focuses on reducing stunting, undernutrition, anemia, and low birth weight. The programme integrates various services and promotes community participation to achieve its goals.

Sanitation and Hygiene

Sanitation and hygiene are critical for preventing diseases and ensuring public health. India’s flagship sanitation programme is a testament to its commitment to improving these aspects:

• Swachh Bharat Mission (Clean India Mission): This mission aims to eliminate open defecation and improve solid waste management across the country. It promotes the construction of household and community toilets and fosters behavioral change through extensive awareness campaigns. The mission has significantly improved sanitation coverage and hygiene practices.

Universal Health Coverage

To achieve the goal of universal health coverage, India has implemented various schemes to ensure that every citizen has access to affordable and quality healthcare:

• National Health Mission (NHM): Encompassing the National Rural Health Mission (NRHM) and National Urban Health Mission (NUHM), NHM aims to provide accessible, affordable, and quality health services to both rural and urban populations. It focuses on strengthening healthcare infrastructure, improving healthcare delivery, and addressing the healthcare needs of underserved populations.
• Ayushman Bharat: Health and Wellness Centres (HWCs): These centers are being established across the country to provide comprehensive primary healthcare services. HWCs offer services like maternal and child health care, non-communicable disease management, and free essential drugs and diagnostics, ensuring holistic healthcare at the grassroots level.

Other Key Initiatives

Several other initiatives complement these efforts to enhance population health in India:

• Pradhan Mantri Swasthya Suraksha Yojana (PMSSY): This scheme aims to correct regional imbalances in the availability of reliable tertiary healthcare services and augment facilities for quality medical education. It involves setting up new AIIMS-like institutions and upgrading existing government medical colleges.
• National Digital Health Mission (NDHM): NDHM seeks to digitize healthcare data and provide every citizen with a digital health ID, making healthcare delivery more efficient and integrated. It aims to create a robust digital health ecosystem that enhances accessibility, transparency, and quality of healthcare services.

Challenges and Future Directions

Despite significant progress, India faces ongoing challenges in enhancing population health. These include healthcare infrastructure deficits, workforce shortages, and inequities in healthcare access, particularly in rural and remote areas. Addressing these challenges requires a multi-faceted approach:

Strengthening Primary Healthcare: Enhancing primary healthcare infrastructure and services is crucial for early diagnosis and management of diseases. Investment in training and retaining healthcare workers, especially in underserved areas, is essential.

Leveraging Digital Health Technologies: Expanding digital health initiatives can improve healthcare delivery and access. Telemedicine, health information systems, and mobile health applications can bridge gaps in healthcare services.

Sustainable Financing: Ensuring sustainable financing for health programmes is critical. Innovative financing mechanisms, public-private partnerships, and efficient resource allocation can enhance the impact of health initiatives.

In conclusion, India's comprehensive policies and programmes have laid a robust foundation for enhancing population health. Continued efforts to address existing challenges and leverage new opportunities will be vital in achieving the vision of a healthier India. These initiatives not only aim to improve health outcomes but also strive to reduce healthcare disparities, fostering a more equitable and healthy society.

.    .    .