National Health Policy 2017: Aligning with India’s Health Goals

Healthcare in any large country is a balancing act between ambition and reality. When the Union Cabinet approved the National Health Policy (NHP) in March 2017, it marked the first major overhaul of the country’s health vision in 15 years. The policy arrived at a moment when non-communicable diseases were rising, out-of-pocket medical costs were pushing families into poverty, and the global community had just adopted the Sustainable Development Goals. NHP 2017 attempts to pull together these threads into a coherent roadmap for a healthier population.

Why a new health policy was needed 🔗

The previous National Health Policy dates back to 2002, and the healthcare landscape had shifted dramatically in the intervening years. Four big changes triggered the rethink. First, disease priorities were evolving – maternal and child mortality had declined, but non-communicable diseases (NCDs) like diabetes, cardiovascular illness, and cancer were climbing rapidly. Second, a robust private healthcare industry had emerged, growing at double-digit rates. Third, catastrophic household health expenditures had become a leading cause of impoverishment. Fourth, rising economic growth had expanded the government’s fiscal capacity to invest in health.

The Cabinet approved the policy on 15 March 2017, after a consultative process that began with a draft circulated in late 2014 and incorporated feedback from state governments, stakeholders, and the Central Council for Health & Family Welfare.

The big vision: health and well-being for all 🔗

The heart of NHP 2017 is a goal that sounds simple but is enormously demanding in practice: the highest possible level of health and well-being for all at all ages, achieved through a preventive and promotive orientation across every development policy, combined with universal access to quality healthcare without financial hardship.

This language is deliberate. It signals a shift from a sick-care model – where the system waits for people to fall ill – to a wellness model that invests in keeping people healthy in the first place. It also explicitly embraces Sustainable Development Goal 3, which aims to ensure healthy lives and promote well-being for all ages. SDG 3’s centrepiece, Universal Health Coverage (UHC), sits at the core of NHP 2017 as well.

Ten guiding principles of NHP 2017 🔗

The policy rests on a set of principles that shape how healthcare is organised, financed, and delivered. These aren’t abstract slogans – they determine how the system treats a pregnant woman in a remote village or an elderly diabetic in an urban slum.

Professionalism, integrity, and ethics 🔗

The policy commits to the highest professional standards across the health system, supported by a transparent and accountable regulatory environment. This principle targets one of the long-standing weaknesses in public health delivery – trust deficit born of corruption, absenteeism, and unethical practice in both public and private sectors.

Equity 🔗

Reducing inequity means affirmative action to reach the poorest. The policy specifically calls for minimising disparity based on gender, poverty, caste, disability, social exclusion, and geography. Health outcomes in tribal districts and urban slums often lag far behind state averages, and equity is meant to close that gap.

Affordability 🔗

Affordability in NHP 2017 is about preventing catastrophic household healthcare expenditures – medical bills so large they push families below the poverty line. With India ranking among the top countries for out-of-pocket expenditure, this principle directly addresses a structural injustice in the system.

Universality 🔗

Everyone, regardless of social or economic status, should have access to healthcare. This is the foundation of UHC and aligns the policy with SDG Target 3.8.

Patient-centred and quality care 🔗

Services should be safe, effective, and convenient, delivered with dignity and confidentiality. The policy envisions a health system where patients are partners rather than passive recipients.

Accountability 🔗

Clear responsibilities and performance metrics apply at every level – from the sub-centre in a panchayat to the national ministry. The policy calls for monitoring frameworks that allow real-time course correction.

Inclusive partnerships 🔗

NHP 2017 explicitly engages multiple stakeholders – state governments, the private sector, not-for-profit agencies, academic institutions, and the health industry. It frames the private sector as a strategic partner for gap-filling, skill development, and strengthening services such as mental health and disaster management.

Pluralism 🔗

Patients can choose from different medical traditions where appropriate. The policy actively promotes integration of AYUSH – Ayurveda, Yoga, Unani, Siddha, and Homeopathy – alongside modern medicine, recognising the country’s rich heritage of traditional systems.

Decentralisation 🔗

Decision-making moves closer to the community level so that local health needs guide local responses. A malaria-prone district and a diabetes hotspot need very different strategies, and the policy acknowledges that.

Dynamism and adaptiveness 🔗

The system is expected to continuously improve based on new evidence, community feedback, and learning from national and international partners. This principle keeps the policy alive rather than static.

Key objectives that drive the policy 🔗

Guided by these principles, NHP 2017 translates vision into concrete objectives.

Free and comprehensive primary healthcare 🔗

The policy’s flagship commitment is comprehensive primary healthcare that is universal, free, and closer to the community. This vision materialised through the Health and Wellness Centres (HWCs, since renamed Ayushman Arogya Mandirs), where existing sub-centres and primary health centres are being upgraded to deliver an expanded package of services. The package goes beyond the traditional focus on maternal and child health to include care for NCDs, mental health, palliative and rehabilitative care, and emergency first-level response. Over 1.5 lakh such centres have been operationalised across the country.

Optimising existing health resources 🔗

Rather than starting from scratch, the policy reorganises what already exists. This includes strengthening Indian Public Health Standards, deploying a new cadre of Community Health Officers, ensuring availability of essential drugs and diagnostics, and building referral systems that link primary care with secondary and tertiary facilities.

Increasing public health expenditure 🔗

NHP 2017 set an ambitious financing target: raise public health spending to 2.5% of GDP by 2025. When the policy was formulated, spending sat at roughly 1.15% of GDP. Progress has been slow. A study of health expenditure from 2017 to 2022 found that public health spending moved from 0.9% to 1.6% of GDP – a meaningful increase, but well short of the target. The COVID-19 pandemic exposed just how costly this shortfall can be.

Reinforcing citizen trust in public health systems 🔗

A recurring theme in the policy is the need to rebuild confidence in government healthcare. The strategy involves assuring free essential drugs, diagnostics, and emergency care at public hospitals; reducing waiting times; improving quality of clinical care; and making facilities more welcoming. When people trust public services, they stop turning to expensive private providers for routine care.

Aligning the private sector with public health goals 🔗

Roughly two-thirds of outpatient and half of inpatient care in the country flows through private providers. The policy therefore seeks strategic purchasing from private hospitals, collaboration on capacity building, and financial as well as non-financial incentives to align private provision with public objectives.

Preventive and promotive healthcare at the centre 🔗

One of the most distinctive features of NHP 2017 is how strongly it emphasises prevention. The policy identifies seven priority areas: swachh bharat (cleanliness), balanced and healthy diet, addressing tobacco and alcohol harm, yatri suraksha (road safety), nirbhaya nari (addressing gender-based violence), reducing stress and workplace safety, and reducing environmental and air pollution.

School health forms a major pillar of this approach. The policy calls for health education in curricula, promotion of hygiene and safe practices, and using schools as sites of primary care. Yoga and AYUSH-based wellness approaches are integrated into workplaces, schools, and community settings. Routine screening for common chronic conditions – both communicable and non-communicable – is another cornerstone, since early detection keeps treatment simpler and cheaper.

How NHP 2017 connects to the Sustainable Development Goals 🔗

The policy explicitly recognises SDG 3 as a strategic anchor. The connection runs deeper than alignment on paper. SDG 3 covers maternal and child health, infectious diseases, non-communicable diseases, mental health, injuries, pollution-related illness, and health system strengthening – essentially the same ground NHP 2017 covers. Both frameworks make Universal Health Coverage the organising idea.

To operationalise this alignment, the government launched Ayushman Bharat in 2018. Its two wings – Pradhan Mantri Jan Arogya Yojana for secondary and tertiary care, and Health and Wellness Centres for primary care – are the principal delivery vehicles for the NHP vision. PM-JAY provides health cover up to ₹5 lakh per family per year for hospitalisation expenses, targeting the poorest 40% of the population.

Quantitative goals: targets to watch 🔗

NHP 2017 set time-bound measurable targets to hold the system accountable. Some of the notable ones include:

Increase life expectancy at birth from 67.5 to 70 years by 2025. Reduce total fertility rate to 2.1 nationally and at the sub-national level by 2025. Reduce premature mortality from cardiovascular diseases, cancer, diabetes, and chronic respiratory diseases by 25% by 2025. Reduce infant mortality to 28 per 1,000 live births by 2019. Eliminate kala-azar and lymphatic filariasis in endemic pockets. Achieve 90% immunisation coverage by 2025. Establish a federated integrated health information architecture by 2025.

The implementation challenge 🔗

A policy is only as strong as its execution, and NHP 2017 faces genuine hurdles. Beyond the financing gap, India faces shortages of doctors, nurses, and allied professionals, especially in rural areas. Urban-rural disparities in infrastructure remain stark, high out-of-pocket expenditure continues to push families into poverty, and coordination between public and private sectors is still fragmented. The rising burden of NCDs and emerging infectious diseases – vividly underlined by COVID-19 – places constant pressure on the system.

Yet the policy has delivered measurable progress: over 1.5 lakh Health and Wellness Centres operationalised, expanded immunisation coverage through Mission Indradhanush, affordable generic medicines through Jan Aushadhi Kendras, and a digital health ecosystem taking shape through the Ayushman Bharat Digital Mission.

What do you think? Do you think meeting the 2.5% of GDP public health spending target should be treated as a non-negotiable national priority? And how should citizens, governments, and the private sector share responsibility for turning NHP 2017’s vision of universal, affordable healthcare into a lived reality?

References

1. https://nhsrcindia.org/sites/default/files/2021-07/National%20Health%20Policy%202017%20(English)%20.pdf
2. https://www.pib.gov.in/newsite/Printrelease.aspx?relid=159376
3. https://pmc.ncbi.nlm.nih.gov/articles/PMC6319280/
4. https://nhsrcindia.org/practice-areas/cpc-phc/comprehensive-primary-health-care
5. https://pmc.ncbi.nlm.nih.gov/articles/PMC11633271/
6. https://www.who.int/india/health-topics/universal-health-coverage
7. https://www.nextias.com/blog/national-health-policy-nhp/