Key Health Initiatives in India Supporting SDG 3

India’s health story is written in scale. With over 1.4 billion people, a vast rural footprint, and deep regional disparities, the country’s progress toward Sustainable Development Goal 3 – ensuring healthy lives and well-being for all at all ages – is both a political commitment and a monumental administrative challenge. To meet these targets, the government has rolled out a cluster of flagship programmes that together tackle maternal deaths, childhood diseases, tuberculosis, substance abuse, and vector-borne illnesses. Each initiative is a building block in the larger push to achieve universal health coverage by 2030.

Understanding SDG 3 and why it matters 🔗

SDG 3 sets ambitious global benchmarks: reducing maternal mortality to less than 70 per 100,000 live births, ending preventable deaths of newborns and children under five, ending epidemics of AIDS, tuberculosis, malaria, and neglected tropical diseases, and strengthening prevention of substance abuse – all by 2030. For a country that accounts for roughly a quarter of the global disease burden on several of these fronts, meeting these targets demands focused, multi-sectoral interventions rather than broad health spending alone.

The following five initiatives reflect how India has converted SDG 3 from a policy aspiration into programme design, funding allocations, and measurable outcomes on the ground.

Janani Suraksha Yojana: reducing maternal mortality through institutional deliveries 🔗

Launched on 12 April 2005 under the National Rural Health Mission, Janani Suraksha Yojana (JSY) is a safe motherhood intervention aimed at reducing maternal and neonatal mortality by promoting institutional delivery among poor pregnant women. The scheme follows a simple logic: if women deliver in a health facility rather than at home, complications can be managed, bleeding can be controlled, and more mothers and babies survive.

The name itself captures the intent – Janani means mother, Suraksha means protection, and Yojana means scheme. More than 80% of maternal deaths can be avoided through timely institutional care, which is why JSY was structured as a conditional cash transfer that removes the financial barrier keeping poor women away from hospitals.

How the scheme works 🔗

JSY operates as a centrally sponsored scheme that combines cash assistance with delivery and post-delivery care. It gives special attention to Low Performing States such as Uttar Pradesh, Bihar, Madhya Pradesh, Assam, Rajasthan, and Odisha, where institutional delivery rates were historically low. The amount of cash support varies by geography and socio-economic category, and an Accredited Social Health Activist (ASHA) serves as the crucial link – identifying pregnant women, arranging antenatal checkups, escorting them to the facility, and supporting postnatal care.

Impact on maternal health 🔗

The results are striking. Institutional deliveries rose from about 47% in 2005-06 to 88% in recent years, while the Maternal Mortality Ratio fell from 254 per 100,000 live births in 2004-2006 to 97 per 100,000 in 2018-2020. JSY was later complemented by the Janani Shishu Suraksha Karyakram (JSSK) in 2011, which offers free maternal and neonatal services including drugs, diagnostics, and transport. Challenges remain – payment delays, persistent out-of-pocket expenses, and uneven quality of care across states – but JSY has fundamentally shifted how childbirth happens in the country.

Mission Indradhanush: the rainbow of child immunization 🔗

Even after four decades of the Universal Immunization Programme, full immunization coverage plateaued at around 62% – meaning close to 38% of children were missing at least one essential vaccine. Mission Indradhanush (MI) was launched in December 2014 to accelerate coverage and achieve 90% full immunization.

The name draws from the seven colours of the rainbow, symbolising protection against a set of vaccine-preventable diseases. The programme aims to ensure that all children under two years of age and all pregnant women are fully immunized, achieve routine immunization coverage above 90%, strengthen health systems, and introduce newer vaccines into the basket.

Diseases covered and expansion 🔗

Initially, the mission targeted seven diseases – diphtheria, whooping cough, tetanus, polio, tuberculosis, measles, and hepatitis B – with Japanese encephalitis and Haemophilus influenzae type B added in selected states. Later additions have included Rubella, Rotavirus, Pneumococcal conjugate vaccine, and Inactivated Polio Vaccine. In October 2017, the government launched Intensified Mission Indradhanush (IMI), a sharper push focused on high-risk districts with urban slums, migrant settlements, brick kilns, and nomadic communities.

Results on the ground 🔗

The strategy of micro-planning and community outreach has worked. In Gurugram district, full immunization coverage rose from just 23.6% of children to 83.8% by December 2018 – an extraordinary jump that illustrates how active case-finding changes outcomes. Subsequent phases, including IMI 5.0 in 2023, have introduced the U-WIN digital platform for real-time beneficiary tracking, effectively borrowing the playbook that made the polio eradication effort successful.

TB Free India: racing to eliminate tuberculosis by 2025 🔗

Tuberculosis is India’s most stubborn public health adversary. The country still bears the world’s highest TB burden. At the Delhi End TB Summit in March 2018, Prime Minister Narendra Modi issued a call to eliminate TB by 2025 – five years ahead of the SDG target of 2030. In 2020, the Revised National Tuberculosis Control Programme was renamed the National TB Elimination Programme (NTEP) to reflect this accelerated ambition.

The Detect-Treat-Prevent-Build strategy 🔗

The National Strategic Plan 2017-2025 operationalises the elimination goal around four pillars: early diagnosis with quality-assured drugs, engagement with the private sector where a large share of patients seek care, contact tracing and preventive treatment for high-risk groups, and airborne infection control along with a multi-sectoral response to social determinants like undernutrition.

Pradhan Mantri TB Mukt Bharat Abhiyaan 🔗

Launched on 9 September 2022, this campaign brings community participation into the heart of the TB response. As of 31 July 2024, over 1.6 lakh Nikshay Mitras – donors who provide nutritional and emotional support – had been linked with 11.4 lakh TB patients, and approximately 18 lakh support kits had been distributed. This citizen-led model treats TB as a social challenge, not just a clinical one.

Progress and persistent gaps 🔗

Case notifications have improved dramatically, rising from roughly 15 lakh in 2015 to 25.5 lakh in 2023. Private-sector reporting – once a black box – now accounts for a third of all notifications. The TB budget rose from about US$106 million in 2015 to over US$500 million by 2020, and innovations like AI-based screening tools, shorter drug regimens, and direct benefit transfers have reshaped the response. Yet stigma, rural access, and the scale of drug-resistant TB continue to test the 2025 deadline.

Nasha Mukt Bharat Abhiyaan: tackling substance abuse and promoting healthy lifestyles 🔗

SDG 3.5 explicitly calls for strengthened prevention of substance abuse. India’s first-ever comprehensive national survey on substance use, published in 2019, flagged the scale of the problem – approximately 7.1 crore Indians engaged in some form of substance use, with alcohol, cannabis, and opioids leading the list.

In response, the Ministry of Social Justice & Empowerment launched the Nasha Mukt Bharat Abhiyaan (NMBA) on 15 August 2020 in 272 of the most vulnerable districts, and later expanded it nationwide from 15 August 2023. The initiative is built around a three-pronged attack: supply curb by the Narcotics Control Bureau, demand reduction through awareness by the Ministry of Social Justice & Empowerment, and treatment through the Health Department.

Key components 🔗

NMBA’s work spans awareness generation in schools, colleges, youth clubs, and women’s groups; community outreach through Master Volunteers in every district; and treatment infrastructure that includes Integrated Rehabilitation Centres for Addicts (IRCAs), Community Peer Led Interventions (CPLI) for adolescents, Outreach and Drop-in Centres (ODIC), District De-addiction Centres, and Addiction Treatment Facilities in government hospitals.

Reach and impact 🔗

The Abhiyaan has moved beyond government organisation into a genuine community movement. NMBA has reached over 23 crore individuals, including more than 7.81 crore youth, 5.24 crore women, and 17 lakh educational institutions. Crucially, the campaign positions healthy lifestyle promotion – sports, cultural events, peer mentoring – as an alternative to the pathways that lead to dependency.

National Framework for Malaria Elimination: ending the disease by 2030 🔗

Malaria has shadowed India’s public health landscape for decades, especially in forested, tribal, and hard-to-reach districts. The National Framework for Malaria Elimination in India 2016-2030 sets two clear goals: eliminate malaria (zero indigenous cases) throughout the country by 2030, and maintain malaria-free status in areas where transmission has been interrupted.

This aligns India’s efforts with the WHO Global Technical Strategy for Malaria 2016-2030 and the Asia Pacific Leaders Malaria Alliance Elimination Roadmap.

The staged, district-based approach 🔗

The framework does not treat malaria uniformly across geography. States and union territories are classified into categories based on the Annual Parasite Incidence (API): prevention-of-reestablishment, elimination, pre-elimination, and intensified control. Districts are the strategic unit for planning interventions. The National Strategic Plan 2017-2022 set a roadmap to end malaria in 571 of the country’s 678 districts by 2022, with subsequent milestones in 2024 and 2027 leading to nationwide elimination by 2030.

Key interventions 🔗

The framework leans on a combination of tools: artemisinin-based combination therapy (ACT) for Plasmodium falciparum, rapid diagnostic tests for early detection, long-lasting insecticidal nets (LLINs) for vector control, indoor residual spraying, and strengthened surveillance through platforms like the integrated disease reporting system.

Progress so far 🔗

The numbers reflect steady progress. Reported malaria cases dropped from roughly 1 million in 2016 to 158,326 cases and 80 deaths in 2021 – an approximately 85% reduction. The high-burden states – Odisha, Chhattisgarh, Jharkhand, and the Northeast – have shown some of the fastest declines, though the last mile in forested and tribal pockets remains the most difficult.

The common thread: governance, data, and community 🔗

Looking across these five initiatives, certain administrative patterns stand out. Each programme relies on centre-state coordination, with the central government funding and setting strategy while states implement and adapt. Each depends on frontline workers – ASHAs, ANMs, Anganwadi workers, Master Volunteers – who bridge the state and the household. And each increasingly uses digital platforms like U-WIN, Ni-kshay, and the NMBA dashboard to enable real-time tracking and accountability.

What these initiatives also show is that public health in the twenty-first century is as much about addressing social determinants – nutrition, housing, gender, education, livelihood – as it is about vaccines, drugs, and hospital beds. A woman who delivers in a hospital is protected not only by the obstetrician but by the ASHA who convinced her to come, the road that got her there, and the cash transfer that offset her lost wages.

Challenges that will shape the next decade 🔗

Ambitious targets are only as strong as the systems behind them. Across these programmes, the recurring pressure points are predictable: regional inequities that leave some states and tribal districts behind, payment and supply-chain delays that erode trust, workforce shortages at the primary care level, gaps in the quality of care even where access has improved, and the private sector’s uneven integration into national disease programmes. The COVID-19 pandemic also disrupted routine immunization, TB case-finding, and malaria surveillance, pushing some milestones back.

The road to 2030 will test whether these initiatives can move from high visibility campaigns to durable, institutionalised services that treat every citizen equally, wherever they live.

What do you think? Which of these initiatives do you believe has the greatest potential to transform public health outcomes in the next five years, and where would you direct additional resources – toward preventive awareness, frontline workforce, or digital monitoring systems?

References

1. https://sdgs.un.org/goals/goal3
2. https://nhm.gov.in/index1.php?lang=1&level=3&lid=309&sublinkid=841
3. https://pmc.ncbi.nlm.nih.gov/articles/PMC3763618/
4. https://patimes.org/mitigating-maternal-mortality-and-child-mortality-the-transformative-impact-of-janani-suraksha-yojana-in-india/
5. https://pmc.ncbi.nlm.nih.gov/articles/PMC10795861/
6. https://beed.gov.in/en/scheme/mission-indradhanush/
7. https://www.who.int/southeastasia/news/feature-stories/detail/india-a-mission-to-reach-everyone-with-immunization
8. https://dghs.mohfw.gov.in/national-tuberculosis-elimination-programme.php
9. https://pmc.ncbi.nlm.nih.gov/articles/PMC11973646/
10. https://nmba.dosje.gov.in/content/about-us
11. https://nmba.dosje.gov.in/
12. https://www.who.int/india/health-topics/malaria/india-launches-the-national-framework-to-eliminate-malaria
13. https://pmc.ncbi.nlm.nih.gov/articles/PMC11310619/
14. https://www.who.int/health-topics/social-determinants-of-health