Health System in India :

1) Integrated child development program:

The Integrated Child Development Services (ICDS) scheme is a flagship program of the Indian government that aims to improve the health, nutrition, and education of children . Launched in 1975, ICDS is one of the world’s largest community-based programs for early childhood care and development .

Objectives of ICDS:

• To improve the nutritional and health status of children in the age group of 0-6 years .
• To lay the foundation for the proper psychological, physical, and social development of the child .
• To reduce the incidence of mortality, morbidity, malnutrition, and school dropout .
• To achieve effective coordination of policy and implementation amongst the various departments to promote child development .
• To enhance the capability of the mother to look after the normal health and nutritional needs of the child through proper nutrition and health education .

Beneficiaries:

• Children aged 0-6 years .
• Pregnant women .
• Lactating mothers .
• Adolescent girls (since 1991, for non-formal education and training on health and nutrition) .

Services Provided Under ICDS:

• Supplementary Nutrition: Providing food to children, pregnant women, and lactating mothers . Severely malnourished children receive a higher nutritional rate per day .
• Health Check-ups: Regular health check-ups for children and mothers are conducted at Anganwadi Centres .
• Immunization: Protecting children from vaccine-preventable diseases .
• Referral Services: Providing medical attention to sick or malnourished children .
• Early Childhood Care and Pre-school Education: Providing pre-school education to children aged 3-6 years .
• Nutrition and Health Education: Educating women on health, nutrition, and childcare practices .

Implementation:

• The services are delivered through Anganwadi Centres (AWCs), which are community-based centers managed by Anganwadi Workers (AWWs) .
• AWWs are trained local women who act as a link between the community and the government .
• AWCs serve a population of approximately 1,000 in rural and urban areas and 700 in tribal areas .

Impact:

• ICDS aims to improve the nutritional and health status of children and women .
• The program has contributed to improved child development and school enrollment .

ICDS is a comprehensive program that addresses the multifaceted needs of children and women, contributing to their holistic development .

2) E Sanjeevani :

it is India’s National Telemedicine Service, providing remote health consultations through a digital platform . It aims to offer accessible, equitable, and cost-effective healthcare services to all citizens .

Key aspects of eSanjeevani:

• Functionality: eSanjeevani enables safe and structured video-based clinical consultations between doctors in hospitals and patients at home .
• Accessibility: It bridges gaps in healthcare access, particularly in remote areas, by allowing patients to consult with doctors and specialists from their smartphones or computers .
• Two main models:
  • eSanjeevani AB-HWC: A doctor-to-doctor telemedicine service connecting patients in rural areas with doctors at health and wellness centers .
  • eSanjeevani OPD: A patient-to-doctor telemedicine service that allows citizens to access outpatient services from home .
• Reach: As of April 6, 2025, eSanjeevani has served over 36 crore patients through teleconsultations since its launch in 2020 . Over 230,000 health service providers are onboarded .
• Services Offered: The platform offers a wide range of medical specialities .
• Digital Health Integration: eSanjeevani is a part of India’s digital health ecosystem, integrated with the Ayushman Bharat Digital Mission (ABDM) . This integration securely connects patients, healthcare providers, and health systems through a unified digital infrastructure .

eSanjeevani is the world’s largest telemedicine platform for primary care . It has 131,793 operational spokes and 17,051 hubs established .

How has eSanjeevani impacted healthcare delivery during the pandemic ?

E-Sanjeevani has significantly impacted healthcare delivery during the COVID-19 pandemic by providing a safe and accessible alternative to traditional in-person consultations . It has minimized the risk of cross-transmission of the virus, served as a virtual personal protective equipment (PPE) for healthcare professionals, and ensured continuity of healthcare services for non-COVID-19 illnesses .

Key impacts of eSanjeevani during the pandemic:

• Reduced burden on healthcare systems: E-Sanjeevani acted as a parallel healthcare system, providing “forward triage” and decreasing the burden on healthcare facilities stretched beyond capacity . It also provided services to COVID-19 patients undergoing home quarantine .
• Accessible specialized care: The platform facilitated access to sub-specialty services from tertiary care centers, bridging the gap between service availability and delivery, especially for those with mobility issues .
• Continuity of non-COVID-19 healthcare services: With many outpatient departments shut down to minimize community transmission, e-Sanjeevani ensured that individuals suffering from other illnesses received necessary care .
• Minimized COVID-19 risk: By providing remote consultations, e-Sanjeevani reduced the risk of community spread associated with in-person visits to healthcare facilities .
• Increased adoption of telemedicine: The COVID-19 pandemic accelerated the adoption of telemedicine in India, with more healthcare providers and patients using digital platforms like eSanjeevani for consultations and follow-up care .
• Task-shifting in hospitals: The pandemic led to task-shifting in hospitals, changing inpatient to outpatient care and outpatient to telemedicine-driven home care .
• Rapid implementation: E-SanjeevaniOPD was launched swiftly as the pandemic reached India, with the primary goal of delivering secure health services to the population .
• Improved efficiency: eSanjeevani has streamlined the healthcare process, enabling patients to consult with doctors and specialists within minutes .
• Reduced costs: By providing remote consultations, eSanjeevani has reduced costs for patients, especially those in rural areas, by removing the need to travel to hospitals or clinics .

3) POSHAN ABHIYAN :

POSHAN Abhiyaan, also known as the National Nutrition Mission, is the Indian government’s flagship program to improve the nutritional status of children, adolescent girls, pregnant women, and lactating mothers . Launched on March 8, 2018, in Jhunjhunu, Rajasthan, it aims to create a malnutrition-free India through a comprehensive and convergent approach .

Objectives:
The program strives to reduce :

• Stunting in children (0-6 years)
• Undernutrition in children (0-6 years)
• Anemia among children (6-59 months), women (15-49 years), and adolescent girls
• Low birth weight in newborns

Key Features:

• Convergence: POSHAN Abhiyaan integrates various existing schemes like the Integrated Child Development Services (ICDS), Pradhan Mantri Matru Vandana Yojana (PMMVY), and National Health Mission (NHM) to ensure coordinated service delivery .
• Technology: The program uses digital tools like the ICDS-CAS (Common Application Software) app on mobile phones for Anganwadi workers to track beneficiaries, monitor service delivery, and capture real-time data . The Poshan Tracker app helps monitor nutrition data in real time .
• Community Participation (Jan Andolan): POSHAN Abhiyaan promotes public involvement to raise awareness about good nutrition through panchayats, self-help groups, schoolteachers, and frontline health workers . September is celebrated as Poshan Maah to focus on important topics like pregnancy care, breastfeeding, anemia prevention, and growth monitoring .
• Focus on First 1,000 Days: Recognizing the critical period from conception to a child’s second birthday, the program promotes prenatal care, institutional delivery, exclusive breastfeeding, timely immunization, and appropriate complementary feeding .
• Holistic Monitoring: POSHAN Abhiyaan monitors nutrition programs, ensuring departments work together effectively .

Pillars:
The program is based on four main pillars :

1. Quality Services Access through schemes like ICDS, NHM, and PMMVY
2. Cross-Sectoral Coordination among sectors like sanitation and clean drinking water
3. Technology Use through the Poshan Tracker App
4. Community Engagement (Jan Andolan) to encourage public participation

Mission Saksham Anganwadi and Poshan 2.0:
Mission Saksham Anganwadi and Poshan 2.0 aims to improve health, nutrition, and immunity, and modernize Anganwadi Centers (AWCs) across States/UTs .

Impact and Achievements:

• Since its launch, POSHAN Abhiyaan has conducted over 90 crore Jan Andolan activities .
• It has improved convergence between ministries and promoted diet diversity and millets .
• There is a stronger focus on Maternal Health and Child Development .

Challenges:
Despite the variety of schemes and programs, India has continued to face a serious malnutrition challenge .

Poshan Pakhwada:
Poshan Pakhwada is organized to engage communities and spread awareness through rallies, cooking competitions, health camps, and workshops . The 7th edition of Poshan Pakhwada is being organized from April 8 to April 23, 2025, focusing on maternal and infant nutrition, digital tools for beneficiaries, and combating childhood obesity .

4) TELE -MANAS :

Tele MANAS (Tele Mental Health Assistance and Networking Across States) is an initiative by the Indian government to provide free, round-the-clock mental health support via telephone . Launched in October 2022, it aims to improve access to quality mental health counselling and care services throughout the country .

Key Features of Tele MANAS:

• Accessibility: Tele MANAS offers 24/7, free mental health support through a phone-based service . A toll-free number, 14416, has been set up across the country .
• Comprehensive Support: The program supports a range of mental health issues, from general well-being to severe mental disorders .
• Digital Integration: Tele MANAS functions as the digital arm of the District Mental Health Programme . A mobile application was launched in October 2024 to provide comprehensive mental health support .
• Extensive Network: As of February 3, 2025, 36 States and Union Territories have established 53 Tele MANAS Cells . The services are available in 20 languages, based on the preferences of the States .
• Services for Armed Forces: A dedicated Tele-MANAS Cell has been established at the Armed Forces Medical College (AFMC), Pune, to provide tele-mental health assistance to armed forces personnel and their families .
• Integration with Primary Healthcare: Mental health services have been integrated into the Comprehensive Primary Health Care package provided at over 1.73 lakh Ayushman Arogya Mandirs .

Objectives of Tele MANAS:

• Scale-Up Reach: To expand mental health services to anyone in India who needs them, any time, by establishing 24/7 tele-mental health facilities in every State and Union Territory .
• Integrated Network: To implement a comprehensive mental health service network that offers counselling and integrated medical and psychosocial interventions .
• Focus on Vulnerable Groups: To extend services to vulnerable and difficult-to-reach populations .

Implementation and Impact:

• National Apex Centre: The National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, serves as the National Apex Centre, coordinating Tele MANAS activities across India .
• Calls Handled: As of February 2025, Tele MANAS had handled more than 18,13,000 calls on its helpline number .
• Budget Allocation: The government has allocated significant funds to the National Tele Mental Health Programme (NTMHP), with ₹120.98 crore, ₹133.73 crore, and ₹90.00 crore allocated for the years 2022-23, 2023-24, and 2024-25, respectively .

Tele MANAS is bridging gaps in mental healthcare access by offering counselling, psychotherapy, and referrals, and ensuring that quality mental health support is available to all .

5 ) NIMHANS :

The National Institute of Mental Health and Neuro Sciences (NIMHANS) is a multidisciplinary institute in Bangalore, India, that focuses on mental health and neurosciences . It is an Institute of National Importance .

Key aspects of NIMHANS:

• History: NIMHANS was established in 1974 and operates autonomously . Its history traces back to the 19th century, influencing the evolution of mental healthcare in India .
• Recognition: NIMHANS was declared a ‘Deemed University’ in 1994 and was conferred the status of an ‘Institute of National Importance’ in 2012 .
• Mandate: NIMHANS is dedicated to patient care, academic pursuits, and cutting-edge research in mental health and neurosciences .
• Global Leader: NIMHANS has become a global leader in clinical care, research, and education, shaping mental health policies and practices worldwide .
• Community Mental Health: The “Bellary model” of community-based mental healthcare, pioneered by NIMHANS, has set benchmarks in mental health delivery . The institute also provides community psychiatry services, including training, research, capacity building, outreach programs, and community-based rehabilitation .
• Telemedicine: NIMHANS has been a pioneer in telemedicine for mental health since 2007 . It contributed to the Telemedicine Practice Guidelines 2020 .
• Forensic Psychiatry: NIMHANS offers forensic psychiatry services to both in-patients and out-patients, along with research and academic activities .
• Tele MANAS Coordination: NIMHANS is the apex coordinating center for Tele MANAS, a nationwide tele-mental health service .
• New Facilities: Recent additions to NIMHANS include a Psychiatry Speciality Block, Central Laboratory Complex, Bhima Hostel, Next Generation 3T MRI Scanner, and Advanced DSA System .
• Global Recognition: NIMHANS received the Nelson Mandela Award for Health Promotion from the World Health Organization (WHO) .
• Training and Education: NIMHANS offers various advanced programs, including M.Phil in Clinical Psychology and Ph.D. programs . It trains over 1000 students for Tele MANAS and counselling .
• Mental Health Advocacy: NIMHANS provides tele-yoga services to persons with mental illness, caregivers, and healthcare workers .
• Patient Footfall: Patient footfall in NIMHANS has grown significantly, from under 10 lakhs in the 1970s to over 50 lakhs in the last decade .

NIMHANS plays a pivotal role in national policy and programming, shaping the mental health landscape in India .

6) AYUSHMAN BHARAT DIGITAL MISSION :

The Ayushman Bharat Digital Mission (ABDM) is an initiative by the Indian government to develop the integrated digital health infrastructure of the country . Launched in 2021, ABDM aims to create a unified digital health ecosystem that connects patients, healthcare providers, and systems securely . It operates under the National Health Authority (NHA) .

Key Objectives and Features:

• Digital Health Ecosystem: ABDM aims to support universal health coverage by providing real-time data, information, and infrastructure .
• ABHA (Ayushman Bharat Health Account): A central aspect of ABDM is the creation of Ayushman Bharat Health Accounts (ABHA), which are unique health IDs for citizens . As of April 5, 2025, over 76 crore ABHAs have been created .
• Healthcare Professionals and Facilities Registry: ABDM includes a registry of verified healthcare professionals and health facilities . As of April 2025, over 5.95 lakh healthcare professionals and over 3.86 lakh health facilities are registered under the mission .
• Health Records Linkage: The mission facilitates the linking of health records to ABHAs, enabling seamless access to and management of personal health information . More than 52 crore health records have been linked under ABDM .
• Interoperability: ABDM promotes interoperability among different digital health systems, ensuring that health information can be exchanged seamlessly across platforms .
• Digital Empowerment: The mission aims to empower individuals with accurate and reliable health information, enabling informed decisions .
• WhatsApp Chatbot: The National Health Authority has introduced a WhatsApp Chatbot to train stakeholders involved in ABDM .
• Use of Technology: ABDM aims to improve healthcare access and service delivery using digital technology .
• Security and Privacy: The ABDM framework ensures the security and privacy of health data .
• Universal Health Coverage: ABDM supports universal health coverage by providing real-time data, information, and infrastructure .

Pillars of ABDM:

The main building blocks of ABDM include :

• ABHA (Ayushman Bharat Health Account)
• Healthcare Professionals Registry (HPR)
• Health Facility Registry (HFR)
• Health Information Exchange & Consent Manager

Impact and Significance:

• Improved Healthcare Access: ABDM enhances healthcare access, especially in remote areas, by enabling telemedicine and digital health services .
• Better Coordination: The mission facilitates better coordination and access to health services through the linkage of health records .
• Efficiency and Transparency: ABDM aims to bring efficiency and transparency to the healthcare system through the use of digital technologies .

ABDM is designed to strengthen the digital health ecosystem, improve healthcare delivery, and promote universal health coverage in India .