Content :
- India’s Healthcare Transformation (2014–2025)
- Digital Employment & Welfare Ecosystem in India (2015–2025)
India’s Healthcare Transformation (2014–2025)
Context and Vision
- Policy Commitment as Catalyst: Over the past decade, India’s healthcare reforms have been guided by goals of accessibility, affordability, equity, and quality in service delivery.
- 2014 Baseline: India faced gaps in physical infrastructure, human resources, diagnostics, medicine availability, and public trust in healthcare.
Relevance : GS 2(Health , Social Issues,Governance)
Foundations of Reform
1. National Health Mission (NHM)
- Core vehicle for systemic reform.
- Impact: Improved maternal and child health outcomes, communicable disease control, and system strengthening.
2. Ayushman Arogya Mandirs (AB-HWCs)
- 1.77 lakh operationalised; doorstep primary care.
- Data: 427.57 crore visits, 36.64 crore teleconsultations, 5.5 crore wellness sessions.
3. Telemedicine Push
- eSanjeevani + TeleMANAS = pan-India digital health bridge.
- Impact: Specialist access in remote areas, mental health mainstreamed.
Maternal & Child Health Revolution
Key Stats:
- MMR decline: 86% vs global average of 48%. (UN-MMEIG)
- IMR decline: 73% vs global 58%.
- Global recognition: India called “exemplar” in reducing child mortality.
Initiatives:
- Targeted NHM interventions, Mission Indradhanush (6 new vaccines).
- U-WIN Portal: 42.75 crore doses administered, 10.68 crore beneficiaries digitized.
Preventive Care over Curative Care
- Cancer screening at Arogya Mandirs: breast, cervical, oral cancers.
- NCD screenings (as of May 2025):
- Hypertension: 28 crore
- Diabetes: 27 crore
- Oral cancer: 27 crore
- Shift: Early diagnosis reduces disease burden and cost.
Communicable Disease Milestones
| Disease | Status | Timeline |
| Polio | Eliminated | 2014 |
| Maternal-Neonatal Tetanus | Eliminated | 2015 |
| Trachoma | Eliminated | 2024 |
| Kala Azar | Eliminated (early) | 2023 |
| Malaria | 80% drop in cases | 2015–2023 |
| Tuberculosis | 17.7% ↓ incidence, 21% ↓ mortality | 2015–2024 |
| TB “missing cases” | From 15 lakh to 1.2 lakh | 2015–2024 |
Financial Protection & Affordability
Trends:
- Government Health Expenditure (GHE): ↑ from 1.13% to 1.84% of GDP.
- Out-of-Pocket Expenditure (OOPE): ↓ from 62.6% to 39.4%.
Key Schemes:
- Free Drugs & Diagnostics (CT, labs in 30+ states).
- Dialysis Program: 28 lakh beneficiaries, ₹8,725 crore saved.
- Ambulance network: 28,000+ vehicles, 1,498 MMUs (including tribal PM-JANMAN services).
Infrastructure & Human Resources
PM-ABHIM (since 2021):
- 18,802 Ayushman Arogya Mandirs
- 602 Critical Care Blocks
- 730 Public Health Labs
Human Resource Surge:
- 5.23 lakh NHM recruits, incl. 1.18 lakh CHOs bridging community–PHC gaps.
- 34,000+ facilities NQAS certified — quality & patient safety.
Digital & Data-Driven Systems
- U-WIN: Vaccine logistics and tracking at population scale.
- eSanjeevani: One of the world’s largest teleconsultation platforms.
- Digitization of health records: Under ABDM (Ayushman Bharat Digital Mission).
Outcome Metrics: A Scorecard
| Indicator | 2014 (Baseline) | 2025 Status |
| MMR | 167 | 22 (est. 86% decline) |
| IMR | 39 | ~11 (est. 73% decline) |
| OOPE | 62.6% | 39.4% |
| GHE as % of GDP | 1.13% | 1.84% |
| NCD Screening (total) | ~<2 crore | 80+ crore |
| eConsultations (cumulative) | Negligible | 36.64 crore |
Critical Reflections & Challenges Ahead
- Sustainability: Will funding levels keep pace with ambitions?
- Quality gaps: Despite quantity, are secondary/tertiary care units improving fast enough?
- Urban-rural equity: Urban India may leap ahead in digital health; rural areas need greater connectivity.
- NCD burden: Preventive efforts must be scaled faster to offset rising NCDs.
Conclusion: The Road to Universal Health Coverage (UHC)
India’s 11-year healthcare journey represents one of the world’s most ambitious and large-scale health transformations. It showcases the interplay of political will, digital innovation, human capital expansion, and financial restructuring. The vision of “Swasth Bharat”—healthcare for all—is now more tangible than ever.
Digital Employment & Welfare Ecosystem in India (2015–2025)
The Digital Governance Framework
- Vision: Leverage digital tools for efficient, citizen-centric delivery of employment services and social security.
- Transformation Pillars:
- Interlinked platforms (NCS, e-Shram, EPFO)
- Aadhaar-based targeting
- Real-time data flow
- Integrated service delivery
- Crisis-resilient infrastructure
Relevance :GS 2( Labour welfare , Governance , Social Issues)
Digital Public Infrastructure for Jobs & Skills
1. National Career Service (NCS) Portal
- Launch: 2015, by Ministry of Labour & Employment
- Scale: 5.5 crore+ job seekers, 57,000 job fairs
- Integrated With: SID, Udyam, e-Shram, EPFO, ESIC, DigiLocker, PM GatiShakti
- Features:
- Career counseling
- Job search by skill/location
- Internship/apprenticeship listings
- Impact: Democratized job access via phone; links job seekers with 30+ state/private job portals
2. Skill India Digital Hub (SIDH)
- Enables skill tracking, upskilling, certifications
- Integrated with NCS for seamless training-to-employment mapping
Compliance, Grievance & Transparency Portals
- Shram Suvidha: One-stop portal for labour law compliance
- Samadhan: Worker grievance redressal and settlement of claims
- ESIC Dhanwantari Module: Digitised patient records, better hospital care
- UMANG App: Access point for EPFO, e-Shram, ESIC
Social Security for the Unorganised Sector
1. e-Shram Portal
- Launch: 2021; Registrations: 30.7 crore+
- Integrated Schemes: 13+ Central + 32 State schemes
- Features:
- Unique ID card for each unorganised worker
- 22-language multilingual access (via MEITY’s Bhashini)
- State Microsites, Mobile Apps for ease
- Union Budget 2025-26:
- Extended e-Shram to gig/platform workers
- Coverage under PM Jan Arogya Yojana enabled
2. Interlinkages
- Connected to PM-SYM, myScheme, DISHA, NCS, SIDH
- Workers can register once and access pensions, insurance, jobs, skills
3. Global Recognition
- ILO Social Protection Data (2025):
- Coverage jumped from 19% (2015) → 64.3% (2025)
- India ranks 2nd globally in beneficiary count (94.13 crore)
- Recognised in WSPR 2026 as the first country to report comprehensive central + state scheme data
EPFO 2.0: Digitisation & Pension Reforms
| Metric | Value/Impact (2025) |
| Members | 34.6 crore+ |
| Pensioners under CPP System | 77 lakh |
| Auto-settlement limit raised | ₹1 lakh |
| Members benefitting (auto-claims) | 7.5 crore |
| Yearly fund transfer | ₹90,000 crore |
| E-passbook, UAN, Digital Life Cert. | Ease & transparency |
- Centralised pension disbursement improves accessibility
- Fund transfer process simplified: 1.25 crore+ members benefit
Benefits of Interlinked Portals
| Stakeholder | Benefits |
| Job Seekers | Access to national jobs, skills, benefits on one screen |
| Workers (Unorganised/Gig) | ID-based access to multiple schemes and insurance |
| Employers | National talent pool, paperless compliance |
| Policymakers | Real-time databases for targeted interventions |
| State Governments | Better planning from e-Shram’s shared data |
Crisis-Responsive Infrastructure
- Pandemic Preparedness: e-Shram and NCS databases allow quick identification of distressed workers
- Resilience in Real Time: Portals can deliver benefits directly, even in lockdowns or disasters
Summary Scorecard: Key Achievements
| Parameter | 2015 Baseline | 2025 Outcome |
| NCS Registered Users | <1 crore | 5.5 crore+ |
| e-Shram Registered Workers | NA | 30.7 crore+ |
| Social Security Coverage (ILO) | 19% | 64.3% |
| Job Fairs | Few hundred | 57,000 |
| Scheme Integration | Fragmented | 32 central + all states |
| Digital Settlement (EPFO) | Manual dominant | 7.5 crore+ auto-claims, UAN |
Challenges and Way Forward
Challenges:
- Fragmentation still exists in regional portals
- Gig/platform workers’ contributions to funds remain unstructured
- Awareness and digital literacy gaps, esp. in tribal and remote areas
Recommendations:
- Encourage private-sector data sharing with e-Shram
- Incentivize gig platforms to co-contribute to workers’ welfare
- Expand digital training for workers on using scheme portals
- Create portable, stackable benefits across state boundaries
Conclusion: Tech-Driven Welfare State
India’s digital welfare architecture represents a new model of inclusive, responsive governance. With real-time databases, interoperable portals, and universal access frameworks, India is now closer than ever to ensuring every citizen is not only employed but also protected.
