India has a mixed health system consisting of both public and private healthcare providers. The public sector focuses on universal, affordable health services, while the private sector contributes significantly through hospitals, clinics, and diagnostic centers. This article explains the structure of the public and private health system in India and provides a clear overview of the National Health Mission (NHM).
Public Health System in India
The public health system is operated by the government and aims to provide accessible, affordable, and equitable healthcare services to all citizens, especially the poor and rural population. It is organized into a well-structured hierarchy.
1. Sub-centres (SCs)
These are the first contact points between the community and the health system. Each Sub-centre serves 3,000–5,000 people and is staffed by ANMs and health workers. They focus on maternal and child health, immunization, family planning, and basic disease prevention.
2. Primary Health Centres (PHCs)
PHCs are the first level of medical officers and serve around 20,000–30,000 people. They provide outpatient care, minor surgeries, disease control programs, and referral services to higher centers.
3. Community Health Centres (CHCs)
CHCs act as referral centers for four PHCs and cover about 80,000–1,20,000 people. They provide specialist services such as obstetrics, pediatrics, surgery, and general medicine.
4. District Hospitals
District hospitals provide secondary-level care with specialists, advanced diagnostics, and inpatient services. They support disease control programs, emergency care, and major surgeries.
5. Tertiary Care Hospitals
Medical colleges, AIIMS, and apex institutions form the tertiary care system. These hospitals offer specialized treatments, advanced diagnostics, training, and research.
Strengths of the Public Health System
- Highly affordable services
- Focus on rural, tribal, and vulnerable populations
- Strong network for immunization, maternal and child health, and disease control
- Government-funded schemes such as Ayushman Bharat
Challenges in the Public Sector
- Shortage of doctors and specialists
- Infrastructure gaps
- Overcrowding in government hospitals
- Limited availability of advanced diagnostics
Private Health System in India
The private health sector is a major provider of medical services in India. It includes a wide range of hospitals, clinics, diagnostic centers, pharmacies, and corporate healthcare networks.
Types of Private Healthcare Providers
- Corporate hospitals: Multi-specialty and super-specialty institutions like Apollo, Fortis, and Max Healthcare.
- Nursing homes and small hospitals: Provide inpatient and outpatient care in urban and semi-urban areas.
- Clinics and private practitioners: General physicians and specialists offering personal consultations.
- Diagnostic centers: Advanced imaging, pathology, and laboratory services.
- Pharmacies and retail medicine outlets
Strengths of the Private Health Sector
- Fast and efficient services
- Advanced technology and diagnostics
- Wide presence in urban areas
- More specialist availability
Challenges in the Private Sector
- High cost of treatment
- Limited reach in rural areas
- Risk of commercialization and unnecessary procedures
- Lack of uniform regulation
National Health Mission (NHM)
The National Health Mission, launched by the Government of India in 2013, aims to strengthen public healthcare through accessible, affordable, and quality services. It combines two major initiatives:
- NRHM – National Rural Health Mission (launched in 2005)
- NUHM – National Urban Health Mission (launched in 2013)
Goals of the National Health Mission
- Reduce maternal, infant, and child mortality
- Strengthen primary healthcare through Health and Wellness Centres
- Improve availability of essential drugs and diagnostics
- Promote community participation through ASHA workers
- Strengthen disease surveillance and public health programs
- Ensure equity in access to quality healthcare
Key Components of NHM
- ASHA workers: Link workers providing health education, maternal care, and community mobilisation.
- Health and Wellness Centres (HWCs): Provide comprehensive primary care including NCD screening.
- Janani Suraksha Yojana (JSY): Promotes institutional delivery to reduce maternal mortality.
- RMNCH+A: Focus on reproductive, maternal, newborn, child, and adolescent health.
- Free drugs and diagnostics initiative
- Mobile Medical Units (MMUs): Provide outreach services in remote areas.
Importance of NHM in the Indian Context
NHM has significantly transformed India’s public health system. It has improved infrastructure, strengthened immunization, reduced mortality rates, and expanded community-based services. The mission promotes equity, focuses on primary care, and bridges gaps between rural and urban health needs.
