The NITI Aayog's (National Institute for Transforming India) health division has observed glaring issues in healthcare with limited budget allocation. Disparity in healthcare exists across states and there is an excessive focus on vertical disease control programmes and inadequate attention to health system strengthening.

Enormous challenges are facing the sector with limited funds. The government will need to look at maximizing returns from available financial resources and also increase investments in health, views the NITI Aayog health division.

India's progress in health outcomes has been slower in comparison to other countries with comparable incomes and at a similar stage of development. For instance, infant mortality rate (IMR) in India has declined by 50 per cent from 1990 to 2012, while the decline in countries such as Bangladesh (67 per cent), Nepal (66 per cent) and Cambodia (60 per cent) has been steeper for the same period.

NITI Aayog in its report on 'Health System in India: Bridging the Gap between Current Performance and Potential', has pointed out that the healthcare needs to access efficient systems are adequate funding resources. The country’s polio elimination, lowering fertility rate, decrease in HIV prevalence, fall in malaria fatality are attributed to National Rural Health Mission (NRHM) through deployment of additional human resources, over 18,000 ambulances for free emergency response, and cash transfers to one crore women annually, providing access to maternal health care services.

Some states have already achieved (ten states namely Delhi, Kerala, Maharashtra, Punjab, Tamil Nadu, Goa, Manipur, Sikkim, Nagaland, Tripura and all UTs except Dadra & Nagar Haveli) Millenium Development Goals-4 (MDG-4).

Andhra Pradesh, Kerala, Tamil Nadu and Maharashtra are at MDG 5. Tamil Nadu has extremely strong health systems founded in primary care and public health. The challenge is to replicate such successes all over the country, noted the NITI Aayog health division.

As per the Twelfth Plan strategy, NRHM has been converted into National Health Mission (NHM) with a universal coverage agenda.

“That the Indian healthcare system continues to function within resource constraints is an undeniable fact. We could achieve much more with meaningful and judicious use of available resources. As a not for profit think tank, ACCESS Health International works with state governments across India. We have experienced first hand many of the challenges. We have also seen systems achieve better outcomes within their current constraints”, said Siddhartha Bhattacharya, country head, India ACCESS Health.

Currently, there is an absence of standard treatment guidelines. There is need to create a reliable routine clinical processes with accountability structures. There should be measurable improvements in quality of care focusing on patient safety, comfort, satisfaction, and clinical outcomes. Indian healthcare systems must place data systems that ensure monitoring, continual certification, verify processes of outcomes, and patient experiences, he added.