World Health Day 2025: Why India’s children must come first

One of the main pillars supporting the growth story of any country is how it ensures equitable access to healthcare for all—placing top priority on its children; and India is no exception. The idea of “Health for All” promotes healthcare as a non-negotiable entitlement to access basic services, regardless of a citizen’s socio-economic status, gender, or age. It stresses cross-sector cooperation at all levels to achieve better health outcomes, in alignment with global policies.

The COVID-19 pandemic underscored the need for a robust public health system that goes beyond service delivery. It taught us to examine public health through the lens of multidimensional poverty and malnutrition and highlighted the importance of having preparedness plans in place for future health emergencies.

National priorities: In line with SDGs and global commitments

To match global standards, India recalibrated its national health priorities in alignment with the Sustainable Development Goals (SDGs). The nation’s progress toward ending hunger is reflected in the rise of its SDG-2 Index score from 47 (in 2020-21) to 52 (in 2023-24). Similarly, the SDG-3 Index score (health and well-being) increased from 74 to 77 during the same period, reflecting improvements in health policy and implementation.

India’s support for global conventions reinforces its commitment to human rights, as enshrined in the Universal Declaration of Human Rights (UDHR, 1948, Articles 23 and 25) and the International Covenant on Economic, Social and Cultural Rights (1966, Articles 7, 11, and 12), which recognise health as a basic precondition for a decent standard of living. India also affirms its commitment to gender equality and children’s health through the Convention on the Elimination of All Forms of Discrimination Against Women (1979) and the Convention on the Rights of the Child (1989).

In India, various policy-level initiatives have been implemented to focus on the improvement of children's health, which are closely aligned with “Health for All” vision. India’s legal framework underscores its commitment to public health by protecting the healthcare rights of its citizens, particularly children. Article 21 guarantees the right to life and health, while Articles 38, 39, 42, 43, and 47—under the Directive Principles of State Policy—recommend that the state promote welfare and equitable healthcare.

The National Health Policies of 1983, 2002, and 2017, emphasising “Health for All,” prioritised child health, sanitation, nutrition, and safe drinking water.

Another significant policy instrument, the National Health Mission (NHM), aims to provide accessible and convenient health care to everyone, in particular vulnerable groups such as children. Based on the NHM, there are several special projects to prevent diseases and promote health in children. For example, the mission organises campaigns to improve immunisation rates, ensuring that children receive vaccines against fatal diseases such as polio, measles and hepatitis. By increasing the coverage of immunisation, the NHM helps to significantly reduce child mortality rates

The Right to Universal and Free Healthcare Bill (2019) and Rajasthan’s Right to Health Act (2022) are key legal provisions guaranteeing free healthcare access. Kerala’s Public Health Bill (2021, 2023) emphasises sanitation, while the National Food Security Act (2013, amended in 2023) enhances nutrition for children and mothers, promoting health equity.

The fundamental question: Why focus on children’s health?

Keeping children at the centre of the “Health for All” policy framework has deeper implications. India’s future depends on improving the lives of its most vulnerable populations. Prioritising children’s health not only addresses their immediate needs but also strengthens long-term national health indicators. Investing in children’s well-being improves overall health, reduces mortality, and builds human capital.

Early intervention for preventable diseases, malnutrition, and other health issues is essential for a healthier future. Tackling children’s health problems also helps break the cycle of intergenerational poverty and inequality. Childhood illnesses often lead to lifelong cognitive challenges, reduced educational attainment, and persistent socio-economic disadvantage. Policies promoting nutrition, clean water, sanitation, immunisation, and healthcare can reduce inequalities and enhance child well-being—while protecting children from emerging risks such as pollution and climate change. In doing so, these policies safeguard not only their health but also their future.

Current child health and nutrition scenario: What do the numbers say?

Data from the National Family Health Survey (NFHS-5) shows significant progress compared to the previous round (NFHS-4) in child health and nutrition indicators. A substantial 10-percentage-point increase in institutional births—a crucial factor in safer deliveries—brought the rate to 88.6 percent, nearing 100 per cent in Kerala, Goa, and Tamil Nadu.

Child vaccination coverage (for fully vaccinated children aged 12-23 months) rose by over 14 percentage points, reaching 76.4 per cent, with Odisha, Himachal Pradesh, and Tamil Nadu leading the way.

Antenatal care improved, with a 7-percentage-point rise in mothers receiving at least four visits, notably in Goa, Tamil Nadu, and Jammu & Kashmir. Postnatal care coverage increased by 16 percentage points, with Goa, Kerala, and Tamil Nadu excelling in care provided within 48 hours of delivery.

In terms of nutrition, stunting (for children under five) fell by three percentage points, and underweight prevalence declined by four percentage points. Wasting decreased slightly—from 21 per cent in 2015-16 to 19.3 per cent in 2019-21.

However, severe wasting in children under five worsened marginally, rising by 0.2 percentage points from 7.5 per cent to 7.7 per cent. Notably, the prevalence of overweight children under five increased by approximately four percentage points in Jammu & Kashmir, nearly five in Arunachal Pradesh, and six in Mizoram—raising concerns about childhood obesity. While these figures point to an overall improvement, they also highlight emerging challenges and regional disparities.

Setting priorities: Allocations in the Union Budget 2025-26

The government’s commitment is reflected in the Union Budget 2025-26. The key child health initiative—Flexible Pool (Reproductive and Child Health & Health System Strengthening), part of the National Health Programme and National Urban Health Mission—received an increased allocation of Rs 4,330 crore, up from Rs 4,153 crore in the previous fiscal year.

The allocation for Saksham Anganwadi and Poshan 2.0 saw a 3.6 percent rise, from Rs 18,020 crore in 2024-25 to Rs 18,666 crore in 2025-26. The budget for the PM POSHAN scheme also rose slightly, from Rs 12,467 crore to Rs 12,500 crore.

Strategic actions and the path ahead

While delivering services at citizens’ doorsteps is a path breaking goal, it cannot be achieved by the government alone. It requires a strong public-private partnership where civil society and non-profits play a unifying role. For over four and a half decades, CRY – Child Rights and You has worked closely with marginalised and underserved communities, along with local administrations, to ensure inclusive healthcare for mothers and children.

The government’s efforts to combat malnutrition and anaemia, run Vitamin A supplementation programmes, promote school health and wellness, and ensure the right to food are commendable. However, reaching the last-mile child requires a collective effort—where administration, policymakers, civil society, private sector partners, NGOs, and grassroots individuals work hand in hand to make India Ayushman in its truest sense.

Puja Marwaha is CEO, CRY – Child Rights and You

Views expressed are the author’s own and do not necessarily reflect those of Down To Earth