Primary Healthcare Must Prevail
India’s health policy is increasingly drifting toward wellness branding and digitalisation, while the most urgent need—affordable curative care—remains inadequately addressed. Public health must reconnect with people’s immediate requirements rather than rely on populist schemes or data-centric initiatives.
Public Health Policy and Its Role
Public health policy is central to improving population health and enabling India to harness its demographic dividend. Universal Health Coverage (UHC) must ensure access without financial hardship, guided by evidence and measurable outcomes. Rising private-sector costs and weak public facilities highlight the urgent need to prioritise curative care.
Wellness Centres: Promise and Pitfalls
The Ayushman Bharat Health and Wellness Centres, launched in 2018, sought to strengthen grassroots infrastructure. Yet, renaming sub-centres, PHCs, and CHCs under a common prefix blurred their distinct roles. The wellness narrative shifted focus from population health outcomes to individual well-being—an approach difficult to measure and prone to neglecting structural determinants like poverty, sanitation, and nutrition.
Health Promotion vs. Wellness
Health promotion offers a more suitable public health framework, recognising social and environmental conditions that shape health outcomes. Unlike wellness, which emphasises individual responsibility, health promotion enables measurable outcomes such as service coverage, disease burden, and mortality reduction. Excessive reliance on wellness risks diluting the public health agenda.
Digital Health Mission: Data Without Delivery
The Ayushman Bharat Digital Health Mission (ABDHM) aims to create digital health IDs and registries. While useful for information management, digital records cannot substitute for doctors, medicines, or hospitals. Allocating significant funds to ABDHM without linking it to improved access raises concerns about misplaced priorities.
Barriers to Access
India’s health-care crisis is defined by unaffordable private care, poor-quality public facilities, and infrastructure deficits. Out-of-pocket expenditure continues to push households into financial distress. Affordable curative care—emergency services, chronic disease management, maternal and child health—remains the most pressing need.
Governance Challenges
Weak public institutions, policy mismatches, and implementation deficits undermine health outcomes. Renaming centres or digitising records does not automatically improve service delivery. Policies centred on wellness and data risk becoming provider-driven rather than people-focused.
The Way Forward
-
Strengthen PHCs, CHCs, and sub-centres with staff, medicines, diagnostics, and referral systems.
-
Prioritise affordable curative care as the core of public health.
-
Increase public spending to reduce out-of-pocket costs.
-
Measure outcomes through morbidity, mortality, access, and affordability indicators.
-
Integrate digital health with service delivery and insurance support.
-
Address social determinants—nutrition, sanitation, water, housing, and income.
-
Build preventive and promotive care on population-level health promotion.
-
Ensure independent evaluation and accountability.
Conclusion
India’s health policy must return to basics: strong public institutions, affordable curative care, and measurable outcomes. Wellness narratives and digitalisation are valuable, but they cannot replace the foundational need for accessible, quality healthcare. Primary healthcare must remain the backbone of India’s public health architecture.