National Health Policy 2017: Towards Universal Health Coverage in India

India’s healthcare landscape underwent a major shift in March 2017 when the Union Cabinet approved a new National Health Policy after a gap of fifteen years. The previous policy was rolled out in 2002, and by 2015 the country’s disease patterns, demographics, and financial realities had changed dramatically. The new policy set out to reach every citizen through a comprehensive approach that moves the system from sick care to wellness, with universal health coverage as its anchor.

Introduction and objectives of NHP 2017 🔗

The National Health Policy 2017 (NHP 2017) is built around a single, ambitious goal: attaining the highest possible level of health and well-being for all people at all ages. It does this through a preventive and promotive orientation woven into all developmental policies, and through universal access to good quality healthcare services without financial hardship. The policy was approved on 16 March 2017 by the Ministry of Health and Family Welfare and replaced the National Health Policy 2002.

The context for the new policy was sobering. With more than 60% of healthcare expenditure coming directly from patients’ pockets, millions of families were being pushed into poverty by medical bills every year. At the same time, the country was facing a double burden of communicable and non-communicable diseases, an ageing population, and widening rural-urban inequalities.

Key objectives 🔗

NHP 2017 lays out three broad objectives: improving health status through cross-sectoral action, achieving universal access to free, comprehensive primary healthcare linked to a health card, and providing access to secondary and tertiary care at a reasonable cost through public hospitals and strategic purchasing from the private sector. A critical financial goal is reducing out-of-pocket expenditure substantially, with the policy aiming to bring it down significantly so that catastrophic health expenditure no longer pushes households below the poverty line.

The policy is also guided by ten core principles, including equity, affordability, universality, patient-centred and quality care, accountability, professionalism, and pluralism. These principles signal that the policy is not just about hospitals and doctors, but about how the entire system serves vulnerable populations.

Key targets for improved health outcomes 🔗

One of the most striking features of NHP 2017 is its set of specific, measurable, time-bound targets. Earlier policies were often criticised for being aspirational without numbers, so this time the government attached clear quantitative goals across three categories: health status and programme impact, health system performance, and health system strengthening.

Mortality and life expectancy targets 🔗

The policy aimed to increase life expectancy at birth from 67.5 to 70 years by 2025. It set a target to reduce the Infant Mortality Rate (IMR) to 28 per 1,000 live births by 2019 and the Under-5 Mortality Rate to 23 per 1,000 live births by 2025. The Maternal Mortality Ratio (MMR) was targeted to be brought down to 100 per lakh live births by 2020, and the Neonatal Mortality Rate to 16 by 2025. These were not pulled out of thin air; they were aligned with the Sustainable Development Goals on health.

India has made real progress on some of these. According to data referenced in policy reviews, MMR dropped from 130 in 2014-16 to 97 in 2018-20, and Under-5 Mortality has fallen sharply. The progress has been uneven across states, but the policy created a framework against which performance could be tracked.

Disease control targets 🔗

NHP 2017 set targets to eliminate kala-azar and lymphatic filariasis by 2017, eliminate leprosy by 2018, achieve a global target of 90:90:90 for HIV/AIDS by 2020, and reduce the prevalence of blindness to 0.25 per 1,000 by 2025. It also aimed to reduce premature mortality from cardiovascular diseases, cancer, diabetes, and chronic respiratory diseases by 25% by 2025.

Health financing targets 🔗

The most discussed target is the commitment to increase public health expenditure to 2.5% of GDP by 2025, up from around 1.15% at the time the policy was framed. A retrospective analysis published in 2024 found that public health expenditure had moved from 0.9% to about 1.6% of GDP between 2017 and 2022, still well below the 2.5% target. This gap is one of the biggest hurdles in delivering on the rest of the policy’s promises.

Emphasis on preventive and promotive health 🔗

The biggest philosophical shift in NHP 2017 is the move from a curative, hospital-centred model to a preventive and promotive one. The policy recognises that India cannot treat its way out of its health problems. Lifestyle-related non-communicable diseases like diabetes, hypertension, heart disease, and cancer are rising rapidly, and these need behaviour change, screening, and early intervention, not just tertiary care.

The seven priority areas 🔗

The policy identifies seven priorities for promotive and preventive health, often called the “Swasth Nagrik Abhiyan” approach. These cover Swachh Bharat Abhiyan for sanitation and clean water, balanced healthy diets and regular exercise, addressing tobacco, alcohol and substance abuse, Yatri Suraksha for road safety, Nirbhaya Nari for action against gender violence, reduced stress and improved safety at workplaces, and reducing indoor and outdoor air pollution.

This list is significant because it places health beyond the Ministry of Health. Clean air, safe roads, women’s safety, and good nutrition are recognised as health interventions. The policy explicitly calls for “Health in All Policies”, asking other ministries and departments to consider health impact in their decisions.

Health and Wellness Centres 🔗

To deliver preventive and promotive care on the ground, NHP 2017 envisaged transforming existing sub-centres and primary health centres into Health and Wellness Centres that would provide a comprehensive package of services. These centres would deliver maternal and child health services, screen for non-communicable diseases, provide essential medicines and diagnostics free of cost, and link families to higher levels of care. This vision was operationalised in 2018 through the Ayushman Bharat programme, which became the main vehicle for implementing NHP 2017.

Role of technology, AYUSH, and human resources in health 🔗

NHP 2017 is forward-looking in three additional ways. It places digital technology, traditional medicine systems, and a skilled health workforce at the centre of the new health architecture.

Digital health 🔗

The policy advocates the extensive deployment of digital tools to improve the efficiency and outcomes of the healthcare system. It proposed setting up a National Digital Health Authority to regulate, develop and deploy digital health systems. It also called for the creation of district-level electronic databases of information on health system components by 2020, and a federated integrated health information architecture, electronic health records, health information exchanges, and a national health information network.

This vision has since taken concrete shape through the Ayushman Bharat Digital Mission, which is building the digital backbone for India’s health system, including unique health IDs, digital health records, and a registry of healthcare providers and facilities.

Mainstreaming AYUSH 🔗

India has one of the richest pluralistic medical traditions in the world. NHP 2017 acknowledges Ayurveda, Yoga and Naturopathy, Unani, Siddha, Sowa-Rigpa, and Homeopathy as a core component of the health system. The policy moves AYUSH from a “stand-alone” position to a “three-dimensional mainstreaming” approach, where AYUSH services are co-located in public health facilities, integrated into national programmes, and used for preventive and promotive strategies, particularly for lifestyle diseases.

A 2025 review in the Journal of Family Medicine and Primary Care notes that the policy has spurred the growth of integrated AYUSH hospitals, herbal medicine exports, and AYUSH educational institutions. Yoga, in particular, is being promoted in schools and workplaces as a form of health promotion, reflecting how the policy seeks to make traditional knowledge a tool for everyday wellness, not just an alternative for the sick.

Human resources for health 🔗

No policy can deliver without people, and NHP 2017 recognises that India faces a serious shortage of doctors, nurses, paramedics, and community health workers, particularly in rural and high-priority districts. The policy calls for ensuring availability of paramedics and doctors as per the Indian Public Health Standards (IPHS) in high-priority districts by 2020, and for increasing the community health volunteer to population ratio by 2025.

To strengthen human resources, the policy supports expanding medical and nursing education, creating mid-level health providers through bridge courses, and using a “giving back to society” initiative for voluntary service in rural areas by recognised professionals. It also pushes for performance-based incentives, better living conditions in rural postings, and continuous skill development for the existing workforce.

Strengths, gaps and the road ahead 🔗

NHP 2017 is widely seen as a significant step forward because it set measurable targets, moved the focus to wellness, mainstreamed AYUSH, and laid the foundation for both Ayushman Bharat and India’s digital health infrastructure. Its emphasis on primary care through Health and Wellness Centres, free drugs and diagnostics, and financial protection for the poor reflects a clear commitment to universal health coverage.

However, the gap between intent and execution remains. Public health expenditure is still well below the 2.5% of GDP target, out-of-pocket spending continues to be high, and rural areas still struggle with workforce shortages and infrastructure gaps. Achieving the policy’s vision by 2025 will require not just more money, but better coordination between the Union and states, stronger regulation of the private sector, and sustained political will.

What do you think? Should public health be moved to the Concurrent List of the Constitution so that the Union can play a stronger role in financing and regulation, or would that weaken the flexibility states currently enjoy in designing their own health responses? And in a country as diverse as ours, what should take priority over the next decade – building more hospitals, expanding insurance coverage, or doubling down on preventive and promotive care?

References

1. https://www.pmindia.gov.in/en/news_updates/cabinet-approves-national-health-policy-2017/
2. https://polsci.institute/public-policy-administration-india/national-health-policy-2017-overview/
3. https://www.drishtiias.com/daily-updates/daily-news-analysis/indias-low-public-health-spending
4. https://testbook.com/ias-preparation/national-health-policy
5. https://pmc.ncbi.nlm.nih.gov/articles/PMC11633271/
6. https://nha.gov.in/NDHM
7. https://journals.lww.com/jfmpc/fulltext/2025/05000/policy_mandates_for_ayush_in_national_health.5.aspx