New Delhi [India], April 29 : A fresh National Statistical Office (NSO) 80th round survey on household consumption related to health has pointed to a marked improvement in healthcare access across India, driven by expanded public health infrastructure, higher insurance penetration, and sustained government spending in the sector, the release said.
The Ministry of Health and Family Welfare stated that in both rural and urban areas across the country, the survey canvassed 1,39,732 households, including 76,296 in rural areas and 63,436 in urban areas, thereby offering robust, ground-level insights into healthcare access, affordability, and utilisation patterns.
The findings of the NSO 80th Round are underpinned by the Government's sustained increase in public investment in the health sector over the years. Enhanced budgetary allocations have enabled significant expansion of healthcare infrastructure across primary, secondary, and tertiary levels, strengthened human resources, and supported the scaling up of key initiatives focused on preventive, promotive, and curative care.
This continued prioritisation of health in public expenditure has been instrumental in improving access, enhancing service delivery, and reducing the financial burden of healthcare on households across the country.
The median Out-of-Pocket Medical Expenditure (OOPE) per hospitalisation case in 2025 has been recorded to be at Rs 11,285, indicating that in over half of the hospitalisations in the country, relatively low expenditure is incurred. The report further adds that only a small number of high-cost cases have been observed to push up the average (mean value). This shows that high expenditure is not widespread but limited to specific cases requiring specialised treatment.
Moreover, the OOPE in more than half of the entire hospitalisation cases in the public health facilities incurs only Rs. 1,100. Importantly, for non-hospitalisation (outpatient) care, the median OOPE in public health facilities is zero, reflecting that a large proportion of citizens are able to access essential healthcare services entirely free of cost.
The Government's Free Drugs Service Initiative (FDSI) and Free Diagnostics Initiative (FDI), launched in 2015, have ensured availability of free medicines and diagnostic services to people even in the remotest areas of the country. This paradigm shift in primary and essential healthcare accessibility is also aided by over 1.84 lakh Ayushman Arogya Mandirs (AAMs) situated across the country and significantly expanding the scope of comprehensive primary healthcare by delivering preventive, promotive, and curative services closer to communities. These centres are also leveraging digital health innovations to improve access.
Strengthening of diagnostics through the in-house hub-and-spoke model with sample transportation has improved accessibility and availability of diagnostic services across different tiers of healthcare. Further, the Affordable Medicines and Reliable Implants for Treatment (AMRIT) initiative, with over 220 pharmacies across 29 States/UTs, provides more than 6,500 drugs at discounts of up to 50% on market rates, significantly improving the affordability of treatment. These gains have been further reinforced by Ayushman Bharat - Pradhan Mantri Jan Arogya Yojana (PM-JAY) and other targeted Government interventions, which have enhanced access, reduced financial barriers, and strengthened trust in public healthcare systems.
Encouragingly, this enhanced affordability has coincided with a substantial increase in healthcare demand. The Proportion of Population Reporting Ailments (PPRA) has nearly doubled between the 75th and 80th roundsfrom 6.8% to 12.2% in rural areas and 9.1% to 14.9% in urban areas, signalling improved awareness and a decisive shift towards proactive health-seeking behaviour.
The survey also captures an important epidemiological transition, with a decline in infectious diseases and a rising prevalence of non-communicable diseases such as diabetes and cardiovascular conditions. This reflects the impact of sustained Information, Education and Communication (IEC) efforts, intersectoral convergence through community-based platforms such as Village Health, Sanitation and Nutrition Committees (VHSNCs); and large-scale screening initiatives at the primary care and community levels.
In response to rising demand, the utilisation of public healthcare facilities has strengthened, particularly for outpatient care in rural areas, where utilisation has increased from 33% to 35%. This improvement is attributable to the expansion of comprehensive primary healthcare services, with an emphasis on preventive, promotive, and early diagnostic care, supported by the availability of free drugs and diagnostics.
Financial risk protection has expanded significantly with the rapid scaling up of Government-financed health insurance coverage, including under Ayushman Bharat - Pradhan Mantri Jan Arogya Yojana (PM-JAY) and various State schemes.
The percentage of population covered under these Government Health Financed/Insurance Schemes in the country has notably increased from 12.9% to 45.5% in rural areas and from 8.9% to 31.8% in urban areas, representing more than a threefold expansion. This marks a major milestone in safeguarding vulnerable populations against catastrophic health expenditures and advancing equity in healthcare access.
Further reinforcing this trend, granular household-level data reveal a declining trajectory of out-of-pocket expenditure among the bottom two consumption quintiles, demonstrating that economically weaker sections are deriving the greatest benefit from Government interventions. The data is ground-level evidence towards the government's initiatives towards universal, equitable public health services and coverage of government-financed assurance/insurance schemes such as Ayushman Bharat PM-JAY.
The survey also highlights continued progress in maternal and child health outcomes, with institutional deliveries increasing from 90.5% in 2017-18 to 95.6% in 2025 in rural areas and from 96.1% to 97.8% in urban areas during the same time period. This reflects sustained efforts to promote safe motherhood and strengthen access to quality maternal healthcare services by the Government through schemes including Quality Assurance, Janani Suraksha Yojana (JSY), Janani Shishu Suraksha Karyakaram (JSSK), and Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA). The survey further mentions that nearly two-thirds (66.8%) of rural deliveries occur in Government Health facilities, while it is 47% (nearly half) for the urban deliveries.
The NSO survey also reveals the increasing trend towards utilisation of public health facilities over the last three rounds. It shows that whereas in 2014 around 28% of the rural population headed to public facilities for outpatient care, the same has surged to 35% in 2025.
The findings of the NSO survey reaffirm the Government's commitment to ensuring affordable, accessible, and equitable healthcare for all.
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