Health For All: The Evolving Role Of India’s Ministry Of Health And Family Welfare In The 21st Century

Policy Update
Diva Bhatia

Background

The Ministry of Health and Family Welfare (established in 1947) serves as the central agency in health policy formulation, regulation, and implementation in India, its scope encompasses preventive, promotive, and curative services (MoHFW, 2025a). Ayushman Bharat was instituted by the Government of India in February 2018, with two components running as flagships: the Pradhan Mantri Jan Arogya Yojana (PMJAY), providing secondary and tertiary care insurance, and the upgradation of 150,000 existing sub-centres and primary health centres to Health and Wellness Centres that deliver comprehensive primary health care (Press Information Bureau, 2018) .

Parallelly, MoHFW directs national programmes including the Universal Immunization Programme (UIP), National TB Elimination Programme (NTEP), and the recently instituted Ayushman Bharat Digital Mission (ABDM) for the establishment of a common digital health ecosystem (MoHFW, 2025b).

India grapples with the dual burden of communicable and non-communicable diseases, the aging population, and systemic inequities in access to healthcare; hence, the MoHFW’s ever-changing policy architecture aims to achieve Universal Health Coverage (UHC) by 2030, in line with Sustainable Development Goal (WHO, 2019). Over the last three years, the ministry has focused on digital health, pandemic preparedness, and extending insurance coverage, symbolizing a move away from disease-specific programmes towards integrated service delivery ( MoHFW, 2024).

Features and Functions

MoHFW has important duties that involve policy development, formulation of standards, regulation and allocation of resources in its vertical programmes and schemes (MoHFW, 2025a). They comprise:

Pradhan Mantri Jan Arogya Yojana (PM-JAY): covers hospitalization of more than 10 crore low-income families identified through the Socio-Economic Caste Census for an amount up to ₹5 lakh per family per annum for hospitalisation includes ancillary costs including pre-hospitalisation and post-hospitalisation. (Press Information Bureau,2018).
Health and Wellness Centres (HWCs): deliver extended services that comprise a package of 12 including maternal and child health services, screening for non-communicable diseases, mental health, palliative care delivery, as well as free essential medicines and diagnostics. (The Hindu,2023 ).
Ayushman Bharat Digital Mission (ABDM): provides secure, interoperable digital health infrastructure – more than 76 crore Ayushman Bharat Health Accounts (ABHA), 5.95 lakh verified healthcare professionals, and more than 52 crore health records linked. (MoHFW, 2025b).
National Telemedicine Service (e-Sanjeevani): provides consultations remotely via 17,051 centres and 131,793 spokes, serving more than 36 crore patients since 2020. (MoHFW, 2025b).
Universal Immunization Programme (UIP) and Intensified Mission Indradhanush: national initiation to keep >90% full immunisation coverage from routine and campaign based approaches for children and pregnant women. (MoHFW, 2024).

Institutionally, MoHFW functions through the Secretary (HFW) and various departments; Health, Family Welfare, and Health Research; coordinating with States via Centrally Sponsored Schemes under stipulated cost-sharing norms (MoHFW, 2025a).

Performance and Impact

Insurance Coverage and Financial Protection:
By March 2025, PM-JAY had verified more than 9 crore hospital visits, disbursed claims totaling ₹1.38 lakh crore, and potentially extended coverage to 38 crore beneficiaries, which was estimated to have reduced out-of-pocket expenditure among enrolled families by 32% (MoHFW, 2025a).
Uptake of Primary Healthcare:
As of 30 June 2024, HWCs conducted 122 crore non-communicable disease screenings (41.8 crore for hypertension and 36.2 crore diabetes) and conducted 2.16 crore wellness sessions with 23.8 crore participants, indicating a positive change in community engagement (MoHFW, 2025a).
Digital Health Ecosystem:
The ABHA registry of ABDM reached over 76 crore accounts by April 2025, onboarding 3.86 lakh health facilities and verifying 5.95 lakh professionals. The e-Sanjeevani recorded a 40% increase in teleconsultation in 2023–25 compared to the previous year, indicating a shift in modality to remote care (MoHFW, 2025b).
Immunisation and Disease Control:
As part of the UIP, 88% of full immunisation was achieved in 2023–24 versus 81% in 2021–22, while the NTEP recorded a 10% reduction in incidence of TB year-on-year, partly driven by active screening and co-location of services at HWCs (MoHFW, 2024).

Case Study 1: “Scan and Share” Use Case

During a pilot intervention at 450+ government healthcare facilities, the “Scan and Share” component of the ABDM project decreased OPD registration average wait times from 50 minutes to 4-5 minutes, facilitating patient flow and accuracy of demographic data (India.gov.in., 2021).

Case Study 2: Wellness Package Scalability

In Madhya Pradesh, the addition of yoga, counselling, and lifestyle modification consultations to HWCs, a 15% increase in follow-up visits amongst patients with hypertension over the course of a year was shown to demonstrate the outcome of a preventive care outreach (Press Information Bureau,2018).

Emerging Issues

Despite significant strides under Ayushman Bharat, the Ministry of Health and Family Welfare continues to grapple with several systemic challenges. First, fraud and leakages remain a thorn in the side of PMJAY’s financial integrity: analyses suggest that nearly 3% of disbursements may involve over-billing or duplicate claims, underscoring the urgent need for advanced analytics and strengthened social audit mechanisms to curb malfeasance (MoHFW, 2025a). Second, persistent awareness gaps mean that almost one in five eligible families, especially those in remote tribal areas, remain uninformed about their entitlements, limiting the scheme’s reach and efficacy.

Third, rural Health and Wellness Centres frequently face severe infrastructure and workforce shortages, with many centres lacking specialists or essential diagnostics, which impedes timely service delivery and undermines referral linkages to higher-level facilities). Finally, the digital divide continues to marginalize vulnerable populations: inadequate internet connectivity and low digital literacy obstruct enrollment under the Ayushman Bharat Health Account (ABHA) system and access to telemedicine services such as e-Sanjeevani (MoHFW, 2025b).

Way Forward

To sustain the momentum of Ayushman Bharat and ensure that its benefits translate into tangible health gains for every citizen, the Ministry of Health and Family Welfare must adopt a multi-pronged, data-driven strategy that bridges policy intent and on-the-ground execution. Central to this approach is the deployment of advanced technologies, bolstered community engagement, and robust governance; each reinforcing the other to safeguard financial integrity, widen coverage, and elevate service quality (WHO, 2019).

Strengthening fraud control is imperative: integrating AI-based anomaly detection into PM-JAY’s claims processing pipeline can flag suspicious billing patterns in real time, while scaling up independent third-party audits will further deter malpractices and uphold program integrity.
Increase awareness campaigns: Use Community Health Officers and local NGOs to do specific IEC (Information, Education, Communication) campaigns so there is 100% awareness of PM-JAY benefits by December 2026.
Improve rural infrastructure: Establish incentive schemes including higher reimbursement amounts to empanel private facilities in underserved districts; improve district hospitals (including tele – ICU services).
Improve digital inclusivity: Establish community digital kiosks at panchayat offices for ABHA enrolment, and integrate digital literacy into the existing outreach of HWCs.
Improve preventive services: Expanding the HWC service basket to include geriatric care services and structured palliative services is necessary; create public-private partnerships for uninterrupted essential medicine and diagnostics supply management.
Improve financing: As a public health case building towards atowards to a larger scale of systemic resilience and a greater reach of services, aim to increase public health spending to 2.5% of GDP by 2027 from 1.4% of GDP to achieve the threshold of WHO recommendations (WHO, 2019).

Conclusion

In the last three years, MoHFW’s integrated policy framework, which is fundamentally guided by its Ayushman Bharat vision, has propelled India’s UHC agenda forward considerably with increased insurance coverage, renewed focus on primary care, and a rapidly advancing digital health landscape. Real-life applications, such as the “Scan and Share” use case and wellness package packages at HWCs demonstrate the possibility of a reformation in service delivery (India.gov.in, 2021). However, to realize equitable and quality care the ministry must tackle the urgent issues of fraud, awareness, infrastructure, and digital access challenges. We believe that with the help of technology, increased community outreach, and increased focus on sustainable financing, India can create a strong path to health for all by 2030.

References

India.gov.in. (2021). Ayushman Bharat Digital Mission (ABDM). National Portal of India.https://www.india.gov.in/spotlight/ayushman-bharat-digital-mission-abdm
Ministry of Health and Family Welfare. (2024). Annual Report 2023–24
.https://www.mohfw.gov.in/sites/default/files/Annual%20Report%202023%2024%20DoHFW%20English_0.pdf
Ministry of Health and Family Welfare. (2025a). Annual Report 2024-25 https://mohfw.gov.in/sites/default/files/Final%20Printed%20English%20AR%202024-25.pd
Ministry of Health and Family Welfare. (2025b).Strengthening Indian Healthcare for a Resilient Future https://mohfw.gov.in/?q=node/8677
Press Information Bureau. (2018, March 21). Cabinet approves Ayushman Bharat – National Health Protection Mission https://pib.gov.in/PressReleasePage.aspx?PRID=1525683
Rao, M., & Kapoor, A. (2024). Scan and Share: A use case under Ayushman Bharat Digital Mission. Journal of Health Informatics, 12(3), 45–52.
The Hindu. Centre adding more services to Ayushman Bharat-Health and Wellness Centres. https://www.thehindu.com/sci-tech/health/biggest-ever-expansion-of-services-underway-for-ayushman-bharat-health-and-wellness-centres-programme/article67057379.ece
World Health Organization. (2019). Primary Health Care on the Road to Universal Health Coverage: 2019 Monitoring Report.https://www.who.int/publications/i/item/primary-health-care-on-the-road-to-universal-health-coverage-2019-monitoring-report

About the Contributor: Diva Bhatia is a research intern at IMPRI and currently pursuing a major in Political Science from Jesus and Mary College, University of Delhi. Her research interests include gender studies, international relations and exploring the socio-political intricacies of North East India.

Acknowledgement: The author sincerely thanks Aasthaba Jadeja and IMPRI fellows for their valuable contribution.

Disclaimer: All views expressed in the article belong solely to the author and not necessarily to the organisation.