Decoding India's healthcare landscape: progress and vision 2047

Technology, infrastructure and strategic initiatives will shape India's evolving healthcare sector 

In brief

• Significant improvement in key health indicators such as neonatal mortality rate, infant mortality rate, under-five mortality rate, and maternal mortality rate.
• Increase in healthcare expenditure as a percentage of GDP, signaling a positive step towards meeting healthcare financing goals.
• India’s leadership in the global pharmaceutical industry, contributing to economic growth and accessibility of essential medicines worldwide.
• Growth in medical value travel, positioning India as an attractive destination for healthcare services and stimulating economic development.

In the past few decades, India's healthcare sector has undergone significant transformations marked by advancements in infrastructure, technology, and accessibility. This journey towards enhancing public health has been propelled by focused efforts to meet Sustainable Development Goals (SDGs) and a commitment to bolstering healthcare infrastructure. While commendable achievements have been made, challenges persist, including fragmentation across various dimensions of healthcare delivery. However, concerted efforts by the Government of India, supported by state governments and various stakeholders, have successfully addressed many of these challenges.

Strategic government-led initiatives like the National Health Policy, which aims to shape the country’s health systems through government interventions, the Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana (PM-JAY), providing a sum insured of INR 5 lakh per family for secondary and tertiary care hospitalization to 104 million beneficiary families, and the Ayushman Bharat Digital Mission, aiming to develop an integrated and interoperable digital health infrastructure, have played a pivotal role in shaping the healthcare landscape. Digital healthcare initiatives such as CoWIN, e-Sanjeevani, Arogya Setu, e-Hospital, etc. have accelerated progress, enhancing healthcare accessibility and delivery. These initiatives aim to build robust healthcare ecosystem and ensure healthcare reaches every doorstep. Additionally, regulatory reforms and supportive policies have boosted the pharmaceutical and medical technology sectors, driving economic growth and innovation. These efforts are enhanced by collaborations with the private sector, non-profits, healthcare startups, and international partners. They have been pivotal in expanding access to advanced medical services, fostering innovation in healthcare delivery, and promoting health equity nationwide.

The fragmentation in health service financing has been substantially reducing over the years because of increased penetration of government health insurance scheme and other social security initiatives. The transition from the Rashtriya Swasthya Bima Yojana (RSBY) to PM-JAY has been particularly impactful, contributing to a significant reduction in out-of-pocket expenditure (OOPE) from 64.2% in 2013-14 to 47.1% in 2019-20. This improvement signifies enhanced affordability and accessibility of healthcare services for the population.

Key achievements

Improving health indicators: The remarkable progress and achievement of National Health Policy targets of key health indicators such as infant mortality, maternal mortality and neonatal mortality rates is a testament to India's efforts in enhancing healthcare delivery and maternal and child health services. These improvements signify a brighter future for generations to come, with better health outcomes and reduced disparities.

Healthcare financing: India's recognition of the importance of healthcare funding is evident from the upward trend of healthcare expenditure as a percentage of GDP, reaching 2.1% in 2022-23 from 1.2% in 2014-15. This trend signifies a positive step towards fulfilling the recommendation of the Fifteenth Finance Commission, which proposed that public health expenditure of Union and State Governments together should be increased in a progressive manner to reach 2.5% of GDP by 2025.

Transforming healthcare infrastructure: The expansion of government hospitals, medical colleges, and healthcare infrastructure is a significant stride towards meeting the evolving healthcare demands of India's burgeoning population and lays the foundation for enhanced healthcare accessibility and delivery. The establishment and operationalization of more than 0.17 million Ayushman Arogya Mandirs in India represent a significant step towards enhancing access to comprehensive primary healthcare services across rural and urban areas. To broaden the reach of specialized medical services, particularly in underserved regions, 11 AIIMS have been established in the last decade. Additionally, five more AIIMS are planned to be established, which will add over 5,000 beds to the country’s healthcare infrastructure.

Strengthening the healthcare workforce: The surge in the number of medical colleges, nursing colleges, MBBS seats and PG medical seats addresses the critical need for a skilled workforce to cater to the growing healthcare demands. In the last two decades, the number of medical colleges has nearly tripled. Further, the government plans to establish 157 new nursing colleges in the country. This investment in human capital not only ensures quality care but also creates employment opportunities and fosters economic growth.

Leadership in the pharmaceutical industry: India's leadership in the global pharmaceutical industry, ranking third in production by volume, underscores its pivotal role in meeting global healthcare needs. India accounts for 60% of global vaccine production and manufactures about 60,000 different generic brands across 60 therapeutic categories, which is equivalent to 20% of the global supply of generics. The industry's contribution to driving the economic growth and supplying essential medicines worldwide highlights India's commitment to healthcare and pharmaceutical innovation and accessibility.

Attractiveness for medical value travel: India's status as an attractive destination for medical value travel speaks volumes about the quality of healthcare services and the effectiveness of healthcare branding initiatives. From 2012 to 2023, there has been a remarkable growth of approximately 10.32% CAGR in the number of medical tourists visiting India, reaching to more than 0.5 million medical tourists in 2023. This not only boosts India's reputation as a healthcare hub, but also stimulates medical tourism, contributing to economic development.

Embracing the digital health revolution: Initiatives like the Ayushman Bharat Digital Mission, CoWIN App, e-Sanjeevani, e-Hospital, etc. represent a paradigm shift in healthcare delivery, leveraging digital technologies to bridge gaps in the healthcare structure in India. These efforts extend healthcare facilities to every corner of the nation, empowering citizens with access to essential services and information.

Way forward: vision 2047

The EY-FICCI report on “Decoding India’s Health Landscape” examines the evolution of India’s health sector over the past two decades and projects its development forward to the year 2047. As India strives towards its healthcare vision for 2047, key imperatives include increasing the number of qualified doctors and nurses to more than five million and 12.5 to 15 million, respectively. It also aims at expanding hospital bed capacity by adding three million more beds, achieving 100% health insurance coverage, establishing one medical college in every district, and accelerating digitally enabled healthcare access.

India's healthcare sector has made significant strides, driven by visionary leadership, strategic initiatives, and collaborative efforts. As we reflect on the progress achieved, it is imperative to remain committed to advancing further and ensuring that healthcare remains a cornerstone of the nation's development journey towards a healthier and more prosperous future for all.