Transformative Progress in India's Healthcare System

Exam-Focused Notes on Health Survey Findings by NSO

1. Survey Overview: The 80th round of the National Statistical Office (NSO) survey focuses on health-related domestic social consumption, highlighting transformative progress in India’s health system.

2. Health Expenditure:

   • Average health expenditure remains low, indicating reduced financial burden.
   • Average out-of-pocket expenditure (OOPE) for over half of hospitalization cases is ₹1,100, reflecting the government's commitment to affordable healthcare.

3. Health Behavior Improvement:

   • The proportion of the sick population reporting health issues has nearly doubled from 2017-18 to 2025:
     • Rural: 6.8% to 12.2%
     • Urban: 9.1% to 14.9%

4. Public Health Facility Utilization:

   • Increased usage of public health facilities in rural areas due to expanded primary health services.
   • Outpatient care utilization rose from 28% in 2014 to 35% in 2025.

5. Government Health Insurance Coverage:

   • Coverage from government health insurance schemes has tripled:
     • Rural: 12.9% to 45.5%
     • Urban: 8.9% to 31.8%
   • Lower out-of-pocket expenses in economically disadvantaged groups demonstrate targeted government interventions.

6. Improvement in Maternal Health:

   • Institutional births increased significantly:
     • Rural: 90.5% to 95.6%
     • Urban: 96.1% to 97.8%
   • Government initiatives like Janani Suraksha Yojana (JSY) and Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA) have contributed to this progress.

7. Access to Free Health Services:

   • Average OOPE for outpatient care in public health facilities is zero, indicating that many citizens receive essential health services for free.
   • Initiatives like the Free Drugs Service Initiative (FDSI) and Free Diagnostics Initiative (FDI) have made healthcare more accessible, even in remote areas.

8. Ayushman Bharat Scheme:

   • The Ayushman Bharat - Pradhan Mantri Jan Arogya Yojana (PM-JAY) has played a crucial role in enhancing healthcare access and reducing financial barriers.
   • Over 1.84 lakh Ayushman Arogya Mandirs (community health centers) have expanded the scope of primary healthcare.

9. Epidemiological Trends:

   • Shift in disease prevalence from infectious diseases to non-communicable diseases like diabetes and heart diseases, reflecting better health awareness and proactive health behavior.

10. Public Health Infrastructure Investment:

    • Continuous increase in public investment in health care has led to significant expansion at primary, secondary, and tertiary levels.
    • Strengthening of human resources and promotion of preventive care initiatives.

11. Economic Indicators:

    • Average medical expenditure per hospitalization recorded at ₹11,285 in 2025, with minimal cases showing higher expenditure, indicating affordability in healthcare.

12. Community Health Initiatives:

    • Enhanced inter-sectoral coordination through platforms like Village Health, Sanitation, and Nutrition Committees (VHSNC) has led to widespread screening initiatives.

13. Conclusion: The NSO survey results underscore the Indian government's commitment to ensuring affordable, accessible, and equitable healthcare through targeted policies and initiatives, significantly improving health outcomes across rural and urban populations.

References:

• National Health Policies
• Ayushman Bharat Scheme
• Janani Suraksha Yojana (JSY)
• Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA)