India’s Health Indicators
Health Indicators In India: What Improved, What Stalled, Why
India’s health gains since Independence are real and measurable. Life expectancy has lengthened, children survive at far higher rates, and once-endemic infections like smallpox and polio have been pushed into history. According to the World Bank, life expectancy has steadily risen over decades, while infant and under-five mortality have fallen substantially. According to the World Health Organization, India reported its last case of wild poliovirus in early 2011 and the South-East Asia Region was certified polio-free in 2014. Yet, the picture isn’t simple. Tuberculosis remains a heavy burden, noncommunicable diseases lead most deaths, and medical costs still strain many families despite expanded insurance.
Here’s the thing: India’s biggest wins came from precise targeting, relentless surveillance, and last-mile delivery—backed by political commitment and community partnership. According to India’s National Health Accounts, the government share of total health spending has risen in recent years and the out-of-pocket share has fallen, though households still pay a lot at the point of care. According to the National Family Health Survey, full immunization coverage is now around three-quarters, but anemia among women and stunting in children continue to demand sustained action.
This article traces the health indicators timeline from Independence to the present and explains the why behind the numbers. You’ll see what worked, what’s stuck, and the specific levers that can propel the next decade of progress with equity.
The Long Arc Of India’s Health Indicators Since Independence
India’s long-run trends tell a story of steady progress punctuated by turning points. According to the World Bank, life expectancy at birth has increased dramatically since the mid-20th century, reflecting declines in infectious disease deaths, better maternal and child health services, and broader improvements in living conditions. According to the World Bank, infant and under-five mortality rates have declined sharply over recent decades with the steepest drops following expansions in immunization, institutional delivery, and neonatal care.
Life Expectancy And Child Survival Trends
According to the World Bank, India’s life expectancy has climbed over time, turning infectious-disease-heavy mortality profiles into longer lives with a rising share of chronic conditions in later years. According to the World Bank, infant mortality and under-five mortality have fallen consistently, with especially fast declines over the last three decades as immunization, oral rehydration therapy, and facility-based delivery scaled up.
Maternal Health And Fertility Transitions
According to the Registrar General’s Sample Registration System and United Nations estimates, India’s maternal mortality ratio has fallen substantially since 2000, reflecting increased institutional deliveries, better antenatal care, and referral systems. According to peer-reviewed research, the maternal mortality decline accelerated as financial incentives like Janani Suraksha Yojana nudged births into facilities, though quality of care remained a determinant of outcomes in some settings.
The Epidemiological Turn Toward Noncommunicable Diseases
According to the India State-Level Disease Burden Initiative and allied analyses, noncommunicable diseases now account for roughly two-thirds of deaths nationwide. Hypertension, diabetes, cardiovascular disease, cancer, and chronic respiratory disease increasingly shape health system needs, particularly for long-term management and primary-care continuity.
Eradications, Eliminations, And Big Public Health Campaigns
India’s most celebrated health milestones share common DNA: precise micro-planning, exhaustive surveillance, and community partners.
Smallpox Eradication And The Power Of Surveillance
According to historical accounts and World Health Organization records, India’s last indigenous smallpox case occurred in 1975 in Bihar after an intensified search-and-containment campaign. India’s certification followed sustained zero-case surveillance and field verification. The decisive tactics—case finding, ring vaccination, daily line-listing, and mobile teams—remain a masterclass in public health execution.
Polio-Free India And Micro-Planning At Scale
According to the World Health Organization, India reported the last case of wild poliovirus in January 2011 and the region was certified polio-free in March 2014. The program’s micro-plans mapped every settlement, trained local vaccinators, and engaged religious and community leaders to overcome refusals. Transit teams at rail and bus hubs, repeated rounds, and real-time monitoring proved decisive. This stands as one of India’s most complex and successful eradication efforts.
Universal Immunization Programme To Intensified Rounds
According to NFHS-5, full immunization coverage rose to around three-quarters of children, up from earlier rounds. According to UNICEF and government reports, intensified campaigns, cold chain upgrades, and better tracking improved reach, though urban poor and remote hamlets still show gaps. The implication is clear: when delivery is routine, reliable, and locally owned, coverage climbs.
The Persistent Burdens—Tuberculosis, Malnutrition, And Anemia
Progress coexists with persistent burdens that demand different playbooks.
Tuberculosis: India’s Outsize Share And The Path To Decline
According to the World Health Organization’s Global Tuberculosis Reports, India contributes about a quarter of the world’s TB incidence in recent years. According to recent analyses, incidence and TB deaths have trended downward compared with mid-2010s baselines, aided by expanded diagnostics and treatment coverage, with the government reporting meaningful reductions since 2015. The direction of change is consistent across sources, though exact percentages vary by method and year. The path forward is unambiguous: early detection with molecular tests, nutritional support, adherence technologies, and private-sector engagement at scale.
Child Stunting, Wasting, And The Food-Health-Sanitation Nexus
According to NFHS-5, roughly one-third of Indian children under five are stunted, with wasting and underweight also elevated. The pattern is tied to maternal nutrition, infection exposure, diet diversity, and sanitation. According to UNICEF and WHO materials on water and sanitation, reductions in environmental contamination improve child health outcomes; India’s sanitation drive is associated with gains, but sustained safely managed services remain essential. This area requires persistent multisector action magnitudes at population scale.
Anemia In Women And Adolescents
According to NFHS-5 and peer-reviewed summaries, anemia among women of reproductive age affects more than half of women nationally. Adolescent girls and pregnant women are at elevated risk. The drivers—diet quality, infections, menstruation, and inter-pregnancy intervals—are well known; progress needs fortified foods, adherence to supplementation, and deworming where indicated.
Health System Investments, Insurance, And Financial Protection
Spending and financial protection shape whether improvements actually reach households.
Public Spending And The National Health Accounts
According to India’s National Health Accounts, total health expenditure as a share of gross domestic product has edged up, and the government share of total health expenditure has increased compared with the mid-2010s. According to official releases, the government share rose while the out-of-pocket share declined over that period.
Financial Protection And Out-Of-Pocket Trends
According to India’s National Health Accounts and allied analyses, out-of-pocket payments have fallen as a share of total health expenditure compared with earlier years, but remain substantial for many families. Medicine costs, diagnostics, and private hospitalization are the major drivers when public facilities are bypassed or unavailable.
Insurance At Scale: Ayushman Bharat PM-JAY
According to the Ministry of Health and Family Welfare and Press Information Bureau updates, Ayushman Bharat–Pradhan Mantri Jan Arogya Yojana has verified tens of crores of beneficiaries and authorized crores of hospitalizations since launch, with recent expansions to cover all citizens aged seventy and above. The scheme’s promise is protection from catastrophic hospitalization costs and a standardized package of benefits at empaneled hospitals. Evidence suggests measurable savings for beneficiaries on inpatient care, while outpatient costs and medicines outside hospitalization still require attention.
Primary Care And The Frontline—ASHAs, NHM, And Ayushman Arogya Mandirs
India’s frontline is its backbone.
The ASHA Network And Behavior Change
According to official updates, India has over ten lakh Accredited Social Health Activists working at the community level. Their role spans antenatal registration, immunization mobilization, follow-ups for tuberculosis, and health promotion. Evaluations show strong links between ASHA engagement and higher institutional deliveries and child vaccination.
NRHM To NHM: Institutional Deliveries And Continuum Of Care
According to program evaluations and government analyses, the National Rural Health Mission and later the National Health Mission expanded facility capacity and workforce while Janani Suraksha Yojana offered cash incentives for facility births. Studies found large increases in institutional deliveries after the scheme’s launch, with equity gains among poorer households. Quality improvements remain a parallel priority to lock in mortality reductions.
Health And Wellness Centres To Ayushman Arogya Mandirs
According to the Ministry’s annual reports, Health and Wellness Centres—now Ayushman Arogya Mandirs—are expanding comprehensive primary care, including screening for hypertension and diabetes and basic mental health services. The model aims to shift care from hospital-centric to preventive and continuous, aligned with the NCD burden. Early data highlight increased screenings; the long-term impact on outcomes needs continued measurement.
Water, Sanitation, And The Health Dividend
Determinants outside clinics can move indicators faster than any single treatment.
Swachh Bharat Mission And Open Defecation Free Targets
According to UNICEF and government partners, India’s sanitation mission dramatically increased toilet access and drove open defecation reductions across rural districts. The program’s pace and scale are unusual globally, pairing behavior change with infrastructure. The overall ODF achievement claims are documented, while independent measures emphasize sustaining usage and safe fecal sludge management.
What Environmental Studies Show About Contamination
According to UNICEF-supported environmental assessments, ODF areas showed lower fecal contamination in water, soil, and food compared with non-ODF sites in studied districts. This suggests a health dividend beyond immediate convenience and dignity.
Sustaining Gains: From ODF To Safely Managed Sanitation
According to the WHO/UNICEF Joint Monitoring Programme, safely managed sanitation is a higher bar than basic coverage and remains a work in progress across many settings. For India, the path forward is upgrading containment, ensuring safe transport and treatment, and embedding operations and maintenance.
What Worked, What’s Not Working, And Why
The indicators tell a clear story when viewed together.
Five Levers Behind Big Wins
According to WHO, UNICEF, and government documentation, India’s eradication and elimination successes relied on micro-planning, real-time surveillance, community engagement, reliable supply chains, and political ownership. According to NFHS and program analyses, financial nudges like Janani Suraksha Yojana and the presence of ASHAs moved behaviors rapidly.
Three System Gaps Slowing Today’s Progress
First, chronic disease care needs longitudinal primary care and affordable medicines; hospital insurance alone doesn’t solve outpatient costs. Second, TB needs stronger nutritional and social support layered on diagnostics and drugs. Third, quality of care must rise alongside utilization—protocol adherence, respectful care, and continuity matter.
Priorities For The Next Decade
Act on NCDs through community screening tied to treatment and affordable medicines. Finish the TB push with nutrition support and private-sector integration. Lock in maternal-child gains through quality improvement, respectful maternity care, and newborn units. Protect households by further reducing out-of-pocket burdens on outpatient care and drugs. And sustain WASH by moving from ODF to safely managed services with financing for operations, not just builds.
TLDR
Life expectancy rose and child deaths fell sharply; according to World Bank data, these gains accelerated alongside immunization, facility births, and neonatal care. Action: keep funding proven maternal-child interventions while upgrading quality.
India eradicated smallpox and became polio-free after the last wild poliovirus case in early 2011; according to WHO, meticulous micro-planning and surveillance made the difference. Action: reuse these playbooks for TB and measles-rubella.
According to NFHS-5, full immunization covers about three-quarters of children, but urban poor and remote pockets lag. Action: push last-mile tracking with ASHA support and defaulter follow-up.
According to WHO, India carries about one-quarter of global TB; recent years show declines from mid-2010s levels. Action: expand molecular testing, nutrition support, and adherence technologies, especially in private settings.
According to NFHS-5, child stunting remains around one-third and anemia affects most women of reproductive age. Action: scale fortified staples, iron-folic acid adherence, and infection control, linked with WASH.
According to National Health Accounts, government spending’s share of total health expenditure has risen while out-of-pocket shares have fallen compared with 2014–15. Action: further reduce household costs for outpatient care and medicines.
According to MoHFW, Ayushman Bharat–PM-JAY has verified tens of crores of beneficiaries and authorized crores of hospitalizations, with coverage expansions to older adults. Action: integrate PM-JAY with primary care and drug price protections.
According to UNICEF and partners, Swachh Bharat reduced open defecation and is linked with lower environmental contamination in studied sites. Action: invest in safely managed sanitation and fecal sludge treatment for durable health gains.
According to evaluations of NRHM/NHM, ASHAs and cash transfers boosted institutional deliveries; quality gaps remain. Action: invest in labor room quality, respectful care, and newborn stabilization units.
According to disease burden studies, noncommunicable diseases cause about two-thirds of deaths. Action: pivot to prevention, primary care follow-up, and affordable chronic medicines.
Key Takeaways
India’s health journey shows how scale, surveillance, and social mobilization can shift national indicators. The biggest wins—smallpox eradication, polio-free certification, expanded immunization, and institutional deliveries—came from meticulous micro-planning and trusted community workers. Yet the disease burden has shifted, and so must the system. Noncommunicable diseases now dominate, calling for strong primary care, affordable medicines, and continuity far beyond hospital insurance. Tuberculosis needs decisive, people-centered supports like nutrition and adherence incentives, not just drugs. Families still feel costs, especially for outpatient visits and chronic treatments; targeted financial protection must move upstream. Finally, the sanitation revolution must evolve from toilet construction to safely managed systems that protect water, soil, and food.
Your next steps can be practical. If you run a program, tie screening data to medicine refills and follow-ups at Ayushman Arogya Mandirs. If you manage a hospital, link discharge to ASHA-powered home follow-up for TB and high-risk pregnancies. If you work in government or philanthropy, fund operations and maintenance for sanitation and cold chain, not only one-time builds. And if you’re a citizen, use services you’re eligible for, demand quality, and help neighbors access entitlements. India has already proven it can do the impossible. The next decade is about doing it consistently, for chronic conditions, with dignity and value for every rupee.
Sources and Further Reading
Life expectancy at birth, total (years) – India. World Bank Data, 2025.
Mortality rate, infant and under-5 – India. World Bank Data, 2025.
Maternal Mortality in India 2020–22. Government of India, 2025.
1.1 TB incidence – Global Tuberculosis Report 2023/2024, WHO.
National Health Accounts 2021–22: Government share and OOPE trends
Environmental impact of the Swachh Bharat Mission (Rural). UNICEF, 2020.
Trends from NFHS-1 to NFHS-5 on full immunization. IIPS, 2022