India has made significant improvements in the health outcomes of its people. Life expectancy at birth increased to 69.6 years in 2020, from expected 47.7years in 1970. MMR declined from 301 to 130 per 100 000 live births between 2003 and 2014-16, and IMR declined from 68 in the year 2000 to 24 per 1000 live births in 2016. However progress is uneven across states, and demographic and epidemiological changes means, the country faces a double burden of disease and an ageing population. The top three causes of death in 2019 were ischaemic heart disease, COPD and stroke.

India has a mixed health-care delivery system. Policy recommendations in the 1940s laid the foundation for a government-funded, three-tiered public health system to deliver preventive and curative health care services. By the 1980s the private sector’s role in health began to gain prominence. Today, nearly 70% of all outpatient visits, about 58% of all inpatient episodes are provided by either for-profit or not-for-profit private providers. Quality of care, accessibility and affordability of health care services, medicines and diagnostics are a challenge. There are also differences in health outcomes between states. Several policy initiatives since the 2000s have been launched to strengthen India’s health system towards providing UHC and improving health outcomes and the Ayushman Bharat programme is attempting to tackle these issues at both hospital and outpatient settings, it is still too early to look at its impact.

The India Health System Review presents a comprehensive overview of the country’s health system. It presents key information of India’s mixed health system which demonstrates varying levels of maturity across states, and serves the needs a country with vast heterogeneity in health and development indicators, and contexts.