Sustainable Development Goal (SDG) 3

India’s progress on the Sustainable Development Goal (SDG) 3—Good Health and Well-being has shown some positive advancements, but significant challenges remain, especially in the areas of maternal health, child mortality, and healthcare accessibility.

Status of India’s Progress on SDG 3

1. Maternal Health:

   • Maternal Mortality Ratio (MMR) stands at 97 deaths per 100,000 live births, which is far above the SDG target of 70. Despite some improvements, maternal deaths remain a major issue, particularly in rural and tribal areas where access to healthcare facilities is limited.

2. Child Mortality:

   • The under-five mortality rate is 32 deaths per 1,000 live births, still higher than the target of 25. This indicates that while child health has improved, there are still challenges in reducing preventable child deaths, especially in underprivileged regions.

3. Life Expectancy:

   • India’s average life expectancy is 70 years, which falls short of the SDG target of 73.63 years. This gap underscores challenges in addressing the underlying determinants of health, such as access to clean water, nutrition, and quality healthcare services.

4. Financial Burden of Healthcare:

   • Out-of-pocket healthcare expenditure remains a heavy burden at 13% of total consumption—nearly double the target of 7.83%. This suggests that a large portion of the population is still spending a significant amount on healthcare, which may lead to financial distress, especially among the poor.

5. Immunization:

   • While immunization coverage is at a high 93.23%, it has not yet reached the 100% target. This gap can be attributed to logistical challenges, lack of awareness, and reluctance in some communities to participate in immunization programs.

Reasons for Gaps in Achieving SDG 3 Targets

1. Access Issues:

   • Poor health infrastructure, especially in rural and remote areas, means that people often do not have easy access to quality healthcare. This includes limited access to hospitals, clinics, and skilled healthcare providers.

   • Economic barriers, such as high out-of-pocket expenses and lack of affordable healthcare options, prevent many from seeking medical attention.

2. Non-Economic Factors:

   • Poor nutrition and inadequate sanitation contribute significantly to India’s disease burden. For instance, malnutrition remains a leading cause of child mortality and stunting.

   • Unhealthy lifestyle choices, including smoking, poor diet, and lack of physical activity, are contributing to the rise of non-communicable diseases (NCDs) like diabetes and heart disease.

3. Socio-Cultural Barriers:

   • Cultural practices, social stigma, and misconceptions—particularly related to reproductive health and mental health—are barriers to seeking healthcare. Many women and marginalized communities do not have access to adequate reproductive health services.

   • Gender discrimination and lack of awareness of healthcare services also impede health-seeking behavior.

4. Double Burden of Disease:

   • India faces the dual burden of disease, grappling with both communicable diseases (such as malaria, dengue, and leprosy) and non-communicable diseases (NCDs) like diabetes, cardiovascular diseases, and cancer. The growing prevalence of NCDs places additional strain on the already overwhelmed healthcare system.

5. Impact of Covid-19:

   • The COVID-19 pandemic disrupted critical health services, including immunization programs, maternal care, and disease control initiatives. The pandemic delayed diagnoses, interrupted treatment cycles, and led to a decline in institutional deliveries and vaccination rates.

Measures to Enhance SDG 3 Progress

1. Universal Health Insurance:

   • India should implement universal health insurance schemes like Ayushman Bharat more effectively to reduce the financial burden on families and provide equitable access to healthcare. This would ensure that no one is excluded from essential medical services due to cost.

2. Strengthening PHCs & Digital Health:

   • Primary Health Centres (PHCs) should be strengthened, especially in rural and tribal areas, to offer preventive and primary care services, reducing the need for expensive secondary or tertiary care.

   • Digital health tools, including telemedicine and electronic health records, can help improve access to healthcare in remote areas. Telemedicine can bring specialist consultations to underserved communities.

3. School Health Education:

   • Introducing structured health education programs in schools can foster health literacy from an early age. Topics like nutrition, sanitation, mental health, and reproductive health can be taught to students, ensuring they grow up with a better understanding of maintaining their well-being.

   • Countries like Finland and Japan have demonstrated how school-based health education can significantly improve public health outcomes, including cardiovascular health and hygiene practices.

4. Cross-Sectoral Convergence:

   • Coordination among multiple government departments like the Ministry of Health, Women and Child Development, Jal Shakti, and Environment can foster an integrated approach to tackling issues of nutrition, sanitation, water supply, and healthcare.

   • Panchayati Raj Institutions (PRIs) and Urban Local Bodies (ULBs) should be empowered to implement and manage local health programs and conduct social audits to ensure accountability and transparency.

5. Accelerating Scheme Implementation:

   • Ayushman Bharat (providing ?5 lakh health cover per family), Poshan Abhiyaan (focused on reducing malnutrition and stunting), Mission Indradhanush (expanding child immunization), and LaQshya (improving maternity care) should be fast-tracked. Effective implementation of these schemes can address the root causes of health disparities in rural and tribal areas.

Conclusion

India has made progress on SDG 3, but there are still several challenges to overcome. The gaps in maternal health, child mortality, life expectancy, and financial access to healthcare require comprehensive, multi-sectoral interventions. By enhancing health infrastructure, empowering local bodies, and focusing on preventive care, India can close the gaps and achieve better health outcomes for its population, particularly in underserved and vulnerable areas.