As India approaches its centenary, the vision of Viksit Bharat—a developed and equitable nation—guides our aspirations. While a thriving economy, empowered workforce, and quality education are critical pillars, the foundation of all remains a healthy population. Health, intricately linked to Sustainable Development Goals (SDGs), shapes broader outcomes like poverty reduction and social equity.
However, the rural-urban divide remains one of India’s most pressing challenges in healthcare. While 70% of the population resides in rural areas, only a third of the nation’s doctors serve these communities. This disparity is exacerbated by inadequate infrastructure, limited economic opportunities, and a dual burden of communicable and non-communicable diseases. Key health indicators underscore this inequity: rural India experiences an infant mortality rate of 31 per 1,000 live births, compared to 19 per 1,000 in urban areas. Institutional delivery rates are at 86% in rural regions, compared to 93% in urban centres. Immunisation coverage is hindered by logistical barriers and limited awareness.
These disparities highlight challenges of access, quality, and deep-rooted cultural scepticism toward modern medicine, further complicating health outcomes in rural areas. Addressing this divide requires a systems-focused approach that integrates community-driven solutions with inclusive practices. This must be supported by compassionate leadership and strengthened by robust information networks, paving a path for sustainable and equitable healthcare systems.
Strengthening healthcare leadership at the grassroots
India’s frontline healthcare workers—Accredited Social Health Activists (ASHAs), Auxiliary Nurse Midwives (ANMs) and aanganwadi workers—are the backbone of rural healthcare delivery. These frontline workers are critical in providing maternal, child, and adolescent healthcare, often serving as the primary link between rural communities and the healthcare system. However, their potential is often hindered by limited training and inadequate support systems, including proper housing, transport, and professional mentorship.
Initiatives like District Mentoring Teams (DMTs) in Bihar are changing this narrative. These teams, led by experienced nurses, mentor ANMs to focus on critical areas such as pregnancy-induced hypertension, anaemia during pregnancy, and maternity care. By balancing capacity-building with hands-on support, DMTs not only enhance the skills of healthcare workers but also cultivate a pipeline of professionals deeply attuned to the needs of communities.
The success of such initiatives, however, hinges on a healthcare system driven by empathetic leaders who inspire collective action and foster trust. By investing in leadership development, we can create a cadre of healthcare professionals who can manage systems while building a legacy of accountability and compassion. Healthcare leadership must extend beyond technical proficiency to embrace a human-centred approach grounded in ethics and empathy. It is about ensuring that every patient feels seen, heard, and valued—because dignity is as essential to healing as medicine itself.
It is imperative that young doctors during their internship are trained in building empathy and understanding, the building blocks to providing compassionate healthcare that considers the sensitivities of the communities they serve, ensuring care is delivered respectfully and without judgment. This will go a long way in helping bridge the trust deficit in rural communities, where people distrust formal healthcare systems.
This vision of leadership must also integrate diverse voices from the community. In rural and tribal areas, traditional healers command deep trust and influence. Incorporating certified tribal healers into the healthcare workforce bridges the gap between traditional practices and modern medicine. When these healers recommend individuals to seek advanced care at medical facilities, they initiate a cycle of trust, breaking down social and cultural stigmas surrounding modern healthcare. Such integration of traditional wisdom with evidence-based practices fosters a holistic and inclusive rural healthcare system—one built on compassion, collaboration, and community empowerment.
Partnerships power progress
Building a skilled healthcare workforce requires collaboration across public and private sectors to scale initiatives and bridge healthcare gaps. These partnerships are transforming healthcare in underserved regions through training programs, technology, and logistical support. Public private partnerships have successfully connected remote communities to vital healthcare networks through telemedicine hubs like eSanjeevani. Similarly, partnerships with the National Health Mission (NHM) have yielded remarkable outcomes in Assam, where Mobile Medical Units were able to reach over 54.5 million beneficiaries in the past 16 years.
Alongside workforce development, robust infrastructure investment is key to effective healthcare delivery. Innovations such as modular health units, online health portals, mobile clinics and telemedicine hubs provide immediate solutions to accessibility challenges, while permanent facilities are being built.
In addition to improving access, digital tools are revolutionising healthcare governance. Initiatives like Ayushman Bharat Digital Mission (ABDM) led by the National Health Authority (NHA), have demonstrated impressive outcomes in Uttar Pradesh and Bihar. The integration of the Command-and-Control Centre have equipped healthcare workers with actionable data, enhancing transparency, and improving care delivery. Technologies such as health data systems like Accessible Medical Records vis Integrated technology (AMRIT) facilitate online monitoring of patient health, integrating point-of-care testing to help workers make faster, more informed decisions.
Programs like Niramay II, a partnership between NHM and Cisco, has strengthened the ABDM ecosystem in Assam enabling early detections of 34,000 presumptive tuberculosis cases and facilitating 64,000 institutional deliveries, ensuring continuum of care.
The commitment to holistic, inclusive healthcare—rooted in empathy and driven by innovation— holds the potential to bridge the rural-urban divide and ensure that no one is left behind on India’s path to 100. In rural India, where healthcare challenges are most acute, solutions must be as multifaceted as the issues themselves. By building a skilled, compassionate healthcare workforce supported by robust infrastructure and empowered through partnerships, we can create a rural health system that is equitable and sustainable —laying the foundation for a prosperous and inclusive Viksit Bharat.
The writer is Vice chairperson, Piramal Group.
This article was first published on 23 January 2025, on FinancialExpress