Overview of National Health Programmes in India

India’s vast population and diverse geographic landscape present unique public health challenges. To address these, the Government of India has implemented numerous national health programmes targeting communicable diseases, non-communicable conditions, maternal and child health, and more. These programmes operate through a structured network of healthcare facilities and community health workers, reaching millions of citizens across urban and rural areas.

What are national health programmes? 🔗

National health programmes are pan-India initiatives developed by the central government to address specific public health challenges. The Directorate General of Health Services under the Ministry of Health and Family Welfare is responsible for implementing these programmes in areas of family welfare, prevention, and control of both communicable and non-communicable diseases. These programmes work through state and district-level health systems to ensure services reach every citizen, regardless of their location or economic status.

Universal Immunisation Programme (UIP) 🔗

The Universal Immunisation Programme stands as one of the world’s largest public health initiatives. Launched in 1978 as the Expanded Programme on Immunization, it was renamed UIP in 1985 when coverage extended beyond urban areas to rural regions. The programme targets approximately 2.67 crore newborns and 2.9 crore pregnant women annually.

Diseases covered under UIP 🔗

The programme provides free vaccination against 12 vaccine-preventable diseases: tuberculosis, diphtheria, pertussis (whooping cough), tetanus, poliomyelitis, measles, hepatitis B, rotaviral gastroenteritis, Japanese encephalitis (in endemic districts), rubella, pneumonia caused by Haemophilus influenzae type B, and pneumococcal diseases. The government bears the entire cost of these vaccines through tax funding.

Key achievements 🔗

UIP has achieved significant milestones including India’s polio elimination in 2014 and maternal and neonatal tetanus elimination in 2015. The programme has contributed to reducing the under-5 mortality rate from 45 per 1000 live births in 2014 to 32 per 1000 live births. India’s full immunisation coverage for 2023-24 reached 93.23% nationally.

Mission Indradhanush 🔗

Launched in December 2014, Mission Indradhanush aims to achieve 90% full immunisation coverage by focusing on low-coverage pockets and hard-to-reach areas. Through special catch-up drives, the mission targets children who were left out or dropped out during routine immunisation. The programme also utilises the Electronic Vaccine Intelligence Network (eVIN) for digitising vaccine stock management and temperature tracking.

National Tuberculosis Elimination Programme (NTEP) 🔗

India carries the world’s highest tuberculosis burden. In response, the Revised National Tuberculosis Control Programme was renamed NTEP in 2020 to emphasise the government’s commitment to eliminating TB by 2025-five years ahead of global targets. The programme follows the National Strategic Plan (2017-2025) with strategic pillars: Detect, Treat, Prevent, and Build.

Progress and achievements 🔗

According to the WHO Global Tuberculosis Report 2024, India achieved a 17.7% decline in TB incidence from 2015 to 2023-more than double the global average decline of 8.3%. TB mortality also reduced by 21%, from 28 to 22 deaths per lakh population during the same period. Treatment coverage has risen to 85% through decentralised care at health and wellness centres.

Pradhan Mantri TB Mukt Bharat Abhiyaan 🔗

Launched in September 2022 by the President of India, this initiative promotes community involvement in TB elimination. The Ni-kshay Mitra programme encourages individuals, NGOs, and corporations to provide nutritional, diagnostic, and vocational support to TB patients. Over 2.55 lakh Ni-kshay Mitras have registered, and nutritional support under Ni-kshay Poshan Yojana has been enhanced from ₹500 to ₹1,000 per month.

National AIDS Control Programme (NACP) 🔗

The National AIDS Control Programme, implemented through the National AIDS Control Organization (NACO), is globally recognised as a success story. Launched in 1992 after the first HIV case was detected in Chennai in 1986, the programme has evolved through five phases focusing on prevention, detection, and treatment.

Evolution of NACP 🔗

NACP-I (1992-1999) focused on awareness generation and blood safety. NACP-II (1999-2006) introduced targeted interventions for high-risk groups and launched the National Anti-Retroviral Treatment programme. NACP-III (2007-2012) aimed at halting and reversing the epidemic by scaling up prevention efforts, while NACP-IV consolidated gains and increased government funding. The current phase, NACP-V (2021-2026), aims to end AIDS as a public health threat by 2030.

Key strategies 🔗

The programme operates through 35 State AIDS Control Societies providing HIV prevention, testing, and treatment services nationwide. Services include targeted interventions for high-risk groups, counselling and testing centres, prevention of parent-to-child transmission programmes, and free antiretroviral therapy. The HIV and AIDS (Prevention and Control) Act, 2017 serves as the legal framework for protecting the rights of people living with HIV.

National Vector Borne Disease Control Programme (NVBDCP) 🔗

The National Vector Borne Disease Control Programme is the central nodal agency for preventing and controlling six vector-borne diseases: malaria, dengue, lymphatic filariasis, kala-azar, Japanese encephalitis, and chikungunya. The programme evolved from the National Malaria Control Programme launched in 1953.

Malaria control strategies 🔗

India’s malaria control efforts include early diagnosis through rapid diagnostic tests, treatment with artemisinin-based combination therapy (ACT), vector control through indoor residual spraying, and distribution of long-lasting insecticidal nets in high-risk areas. The programme operates through 677 district-level malaria units and involves community health workers including ASHAs for detection and treatment at the village level.

Other vector-borne diseases 🔗

The programme targets elimination of lymphatic filariasis through mass drug administration with DEC and albendazole tablets. Kala-azar elimination efforts focus on indoor residual spraying and early case detection in endemic districts of Bihar, West Bengal, Jharkhand, and Uttar Pradesh. For dengue and chikungunya, the focus remains on vector surveillance, source reduction, and rapid outbreak response.

Non-communicable disease control programmes 🔗

With India’s epidemiological transition, non-communicable diseases now account for a significant disease burden. The National Health Mission implements several programmes targeting NCDs.

Key NCD programmes 🔗

The National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS) focuses on health promotion, early diagnosis, and management at primary healthcare level. The National Mental Health Programme, launched in 1982, aims to ensure accessible mental healthcare through the District Mental Health Programme. Other programmes address blindness prevention, deafness control, tobacco control, oral health, elderly healthcare, and palliative care.

National Health Mission: the umbrella framework 🔗

The National Health Mission serves as the flagship programme of the Ministry of Health and Family Welfare. It comprises two sub-missions: the National Rural Health Mission (launched 2005) and the National Urban Health Mission (launched 2013). NHM provides free services including maternal and child health, family planning, immunisation, and treatment for major diseases.

Support initiatives under NHM 🔗

Major initiatives include Janani Shishu Suraksha Karyakram providing free drugs, diagnostics, transport, and diet for pregnant women and newborns. Rashtriya Bal Swasthya Karyakram offers child health screening for birth defects, diseases, deficiencies, and developmental delays. The Free Drugs and Free Diagnostics Service Initiatives ensure essential medicines and tests are available at public health facilities.

Challenges and the way forward 🔗

Despite remarkable progress, challenges remain including healthcare access in remote areas, strengthening primary healthcare infrastructure, addressing emerging diseases, and tackling the dual burden of communicable and non-communicable diseases. The government continues to strengthen these programmes through technological innovations, community participation, and public-private partnerships.

What do you think? How can community participation be further enhanced to support these national health programmes? What role can nursing professionals play in bridging the gap between health services and underserved populations?

References

1. https://dghs.gov.in/content/1347_3_HealthProgrammes.aspx
2. https://nhm.gov.in/index1.php?lang=1&level=2&sublinkid=824&lid=220
3. https://www.pib.gov.in/PressReleasePage.aspx?PRID=2071949
4. https://dghs.mohfw.gov.in/national-tuberculosis-elimination-programme.php
5. https://www.pib.gov.in/PressReleaseIframePage.aspx?PRID=2070942
6. https://www.pib.gov.in/PressReleasePage.aspx?PRID=2114549
7. https://naco.gov.in/nacp
8. https://pmc.ncbi.nlm.nih.gov/articles/PMC5337408/
9. https://naco.gov.in/sites/default/files/NACP_V_Strategy_Booklet.pdf
10. https://dghs.gov.in/content/1364_3_NationalVectorBorneDiseaseControlProgramme.aspx
11. https://nhm.gov.in/index1.php?lang=1&level=1&sublinkid=1041&lid=614
12. https://www.pib.gov.in/pressreleaseshare.aspx?prid=1576128