Syllabus: GS-III: Inclusive Growth

Why in the News?

India has entered the top 100 in the global SDG Index 2025, ranking 99th out of 167 countries with a score of about 67/100, up from 109th in 2024. However, despite this overall improvement, health-related goals under SDG-3 lag behind. 

More About the News

• According to recent data (e.g., NFHS-5, various national health surveys), India is not on track to meet several critical targets by 2030—such as:
  •  Reducing maternal mortality, neonatal deaths, achieving full immunisation, reducing non-communicable disease burden, and ensuring universal health coverage.
• This context makes it essential to examine where India is performing well, where it is falling short, and what steps are needed to accelerate progress on SDG-3.

About Sustainable Development Goals (SDGs)

• • The SDGs are 17 globally agreed goals as part of the 2030 Agenda, adopted in 2015 by the UN, to address global challenges like poverty, health, inequality, climate change, etc.
  • Adopted in September 2015 at the United Nations Sustainable Development Summit in New York.
  • Form part of the 2030 Agenda for Sustainable Development.
  • Aim: To achieve peace and prosperity for people and the planet by 2030 through 17 goals and 169 targets.
    • Balances economic growth, social inclusion, and environmental sustainability.

• Historical Background: Follow-up to Millennium Development Goals (MDGs, 2000–2015).

• SDGs are broader, universal, and inclusive, applying to all countries (developed and developing).

• Core Principles:

• Leave No One Behind → inclusive growth and equity.

• Universality → applicable to all nations, not just developing ones.

• Integration → interconnected goals, requiring holistic approaches.

• Partnership → global cooperation between governments, civil society, and private sector.

• Monitoring: Global monitoring by the UN High-Level Political Forum (HLPF).

• Indicators set by the UN Statistical Commission (232 indicators).

• Countries present progress via Voluntary National Reviews (VNRs).

• In India → NITI Aayog monitors progress through the SDG India Index.

• Supporting Agreements:

• Addis Ababa Action Agenda (2015): financing framework for SDGs.

• Paris Agreement (2015): climate action supports SDG-13.

• Sendai Framework for Disaster Risk Reduction (2015–2030): aligns with resilience goals.

About the SDG Index

• The SDG Index and Dashboard is an annual assessment by the Sustainable Development Solutions Network (SDSN) / UN that ranks countries based on their performance across all 17 goals.
• India’s latest global ranking is 99th out of 167 countries in 2025, with a score of ~67.0.
• Among the SDGs, sectors such as access to electricity, sanitation, and some indicators of basic education show relatively better performance. 
• But in health (SDG-3), there are multiple lagging indicators.

SDG-3 and India’s Performance

What is SDG-3?

• Good Health and Well-Being: ensure healthy lives and promote well-being for all at all ages. 
• Key targets include reducing maternal mortality ratio (MMR), neonatal and under-5 mortality, ending epidemics (AIDS, TB, malaria), universal health coverage (UHC), reducing non-communicable diseases, etc.
  

India’s current performance (key indicators & gaps):

• Infant Mortality Rate (IMR) and Maternal Mortality Ratio (MMR): While there has been steady decline, current rates are still above the targets set for 2030. NFHS-5 shows improvements but pace is inadequate.
• Neonatal mortality remains high; reductions have occurred but not at a pace enough to meet targets.
• Antenatal care, clean cooking fuels, health insurance coverage: significant gaps persist. Many households lack full antenatal care, many still use polluting cooking fuels, and health insurance penetration remains low.
• Disease burden: Non-communicable diseases (NCDs) are rising. Also, communicable diseases, TB, malaria, etc., still burden many regions. Disparities exist across states, rural-urban, socio-economic groups.

Why Is India Behind Its SDG-3 Targets?

• Slow Pace vs. High Targets: Health improvements need accelerated rates; many indicators require steeper decline than current trends.
• Health Infrastructure Gaps: Insufficient primary health centres, shortage of skilled health workers, low availability of specialized care in rural & remote areas.
• Socio-economic & Inequality Barriers: Income inequality, gender gaps, caste/tribal marginalization; many rural areas do not have access to good healthcare facilities.
• Behavioural & Social Determinants: Poor nutrition, sanitation, hygiene, clean cooking fuel usage; lifestyle factors contributing to NCDs.
• Financial Barriers: Out-of-pocket health expenditure remains high, pushing vulnerable households into poverty. Insurance coverage is not universal.
• Public Health Emergencies and Disruptions: COVID-19, pandemics, supply chain disruptions, climate change events (heat waves, floods) disrupt progress.
  

Steps Taken to Improve India’s Performance in SDG-3

• National Health Policy, 2017: Sets targets for reducing MMR, IMR, increasing health coverage.
• Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana (AB-PMJAY): Health insurance cover for poorer sections for secondary and tertiary care.
• National Rural Health Mission / National Health Mission (NHM): Upgrading primary health centres, maternal and child health programmes, immunisation.
• Swachh Bharat, Jal Jeevan Mission: Improving sanitation, safe drinking water, which impacts health.
• Nutrition programmes: POSHAN Abhiyaan, Integrated Child Development Services (ICDS) for early childhood nutrition.
• Innovations & Technology: Telemedicine, mHealth, digital health IDs, expansion of health infrastructure under PM Awas Yojana and other schemes in rural areas.
  

Challenges in Achieving SDG-3

• State-level disparities: Some states (Kerala, Tamil Nadu) perform well; many others in central and north India lag behind.
• Shortage of human resources: Doctors, nurses, midwives per capita are below required thresholds in many rural districts.
• Funding constraints: Public health expenditure as % of GDP is low (~1-1.5%), less than global averages.
• Weak Data Systems: Delay in data availability, under-reporting, lack of real-time monitoring.
• Urban health challenges: Slums, informal settlements with poor living conditions, air pollution, etc.
• Rise of lifestyle diseases: NCDs require long-term management and public awareness, which is still weak.
  

Way Forward

• Increase health expenditure: Raise public health spending (target at least 2.5-3% of GDP) and ensure efficient utilisation.
• Strengthen primary healthcare: Make PHCs and sub-centres stronger, better staffed, better equipped.
• Focus on preventive health & social determinants: Nutrition, sanitation, clean fuel, health education.
• Universal Health Coverage: Expand insurance coverage, make health services affordable.
• State-specific strategies: Tailor interventions based on state and district health index; share best practices.
• Improved data and monitoring: Strengthen health information systems, use NFHS, SRS, incorporate digital tools.
• Public-private partnerships: Engage private sector in service delivery in remote areas, ensure regulatory oversight.
• Promote Health Workforce Development: Train more doctors, midwives; incentives for rural health workers.
  

Conclusion

India has made important but uneven strides toward achieving SDG-3. The global SDG Index ranking crossing into the top 100 is encouraging, yet health indicators show critical gaps remain. Bold investments, focused policy action, stronger state delivery, and greater social inclusion are essential. If India does not dramatically step up progress, many of the health-related SDG targets will remain unmet by 2030, with serious human and economic costs.

Mains Practice Question

1. “India has entered the top 100 in the global SDG Index, but its performance on SDG-3 remains mixed, especially on maternal and child health, non-communicable diseases, and universal health coverage. Critically examine the reasons behind this lag. What reforms and strategies should India adopt to accelerate progress on SDG-3 by 2030?” (250 words / 15 marks)

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