India Must Build a Holistic Care System

UPSC Syllabus: Gs Paper 2- Issues relating to development and management of Social Sector/Services relating to Health.

Introduction

India’s development strategy has prioritised highways, metro lines, electrification and digital platforms, but care remains an under-recognised foundation of growth. Without affordable services, families, especially women, bear unpaid work and lose economic opportunities. With an ageing population and rising demand for caregivers, India must connect childcare, eldercare, disability support and healthcare through an accessible, quality, adequately funded care system to advance inclusive development and Viksit Bharat 2047.

Understanding the Holistic Care System

1. Holistic Care System: It is a broader framework that connects childcare, eldercare, disability support and healthcare to meet people’s care needs throughout life.
2. Holistic Healthcare: It is an approach that addresses a person’s physical, mental and social well-being through preventive, promotive, curative, rehabilitative and palliative care.
3. Relationship Between the Two: Holistic healthcare is one component of a holistic care system, which also includes wider caregiving services and support for families and caregivers.
4. Person-Centred Approach: Care should respond to individual needs and support people’s dignity, well-being and participation through accessible and quality services.
5. Shared Responsibility: Care requires coordinated efforts by governments, communities, workplaces, families and trained caregivers rather than placing the burden mainly on women.

Significance of the Care Economy for India’s Development

1. Women’s Employment Opportunities: Affordable childcare can reduce caregiving barriers and allow more women to pursue employment, leisure and participation in public life.
2. Unpaid Care Burden: The Time Use Survey 2024 found that 41% of women aged 15–59 provided unpaid care, averaging 140 minutes daily.
3. Women’s Labour Force Participation: The Periodic Labour Force Survey 2025 found that 44.4% of women outside the labour force cited childcare and homemaking as their main reason for staying out.
4. Economic Growth: Recognising care as productive economic activity can strengthen women’s participation and connect care provision with India’s broader development strategy.
5. Employment Generation: Rising global demand for caregivers offers skill-based employment opportunities for lakhs of Indian youth, requiring suitable training models.
6. Ageing Population: India’s growing elderly population will increase demand for accessible care services, making long-term care planning increasingly important.
7. Social Inclusion: Affordable care services can improve access to support for children, senior citizens and persons with disabilities, strengthening their participation and well-being.
8. Healthier Population: Preventive and community-based healthcare can help address chronic conditions and support healthier, longer and more balanced lives.

India’s Existing Care Infrastructure and Policy Framework

1. Early Childhood Care and Nutrition: The Anganwadi network, strengthened through Saksham Anganwadi and POSHAN 2.0, provides an important foundation for early childhood care and nutrition.
2. Childcare and Child Protection: Palna under Mission Shakti supports crèche services, while Mission Vatsalya addresses child protection needs.
3. Eldercare and Disability Support: Social security provisions and support measures for senior citizens and persons with disabilities address care needs beyond early childhood.
4. Healthcare Infrastructure and Access: Hundreds of new medical colleges have strengthened health infrastructure, while Ayushman Bharat wellness centres have extended access to health services in villages.
5. Emergency Healthcare Infrastructure: The Union Budget 2026–27 proposed establishing emergency and trauma care centres in district hospitals to increase emergency and trauma care capacity by 50%.
6. Digital Healthcare: The Ayushman Bharat Digital Mission (ABDM) and Ayushman Bharat Health Account (ABHA) support interoperable digital health records and a more integrated healthcare ecosystem.
7. Telemedicine Services: Telemedicine has improved healthcare access in remote areas, but simpler user experiences and greater public awareness remain necessary.

Key Challenges in Building a Holistic Care System

1. Fragmented Governance: Care programmes operate across ministries without a common framework, creating service gaps between childcare, eldercare and other support services.
2. Inadequate Childcare Coverage: The United Nations Development Programme (UNDP) estimates that 9–10 million women in low-income urban households need childcare, indicating substantial unmet demand.
3. Eldercare Service Gaps: 24% of older persons face limitations in daily activities, while national data on care service availability and coverage remain limited.
4. Inadequate Care Infrastructure: Some crèches close before factory shifts end, while existing schemes may not adequately address eldercare needs.
5. Undervalued Care Workforce: Anganwadi workers, home-based caregivers and domestic workers often face inadequate remuneration or honorary employment arrangements.
6. Weak Professional Recognition: Limited standards, certification, social protection and career pathways prevent care work from receiving adequate recognition as skilled and paid employment.
7. Inadequate Financing: Care is often budgeted as welfare expenditure rather than investment in economic and social development, limiting its recognition in growth planning.
8. Gendered Caregiving Norms: Workplace policies often assume that caregiving is women’s responsibility, restricting their employment opportunities and reinforcing unequal care responsibilities.

Way Forward

1. National-Level Coordination: NITI Aayog’s *Reimagining Care: Strategies for Empowering Caregivers in Viksit Bharat@2047* proposes a National Caregiving Council to strengthen coordination.
2. National Care Economy Mission: The Ministry of Social Justice and Empowerment’s May 2026 national workshop discussed a proposed mission with inter-ministerial governance, aligned financing and shared data.
3. State-Level Care Roadmaps: States should map demographic trends, care needs and existing services, identify gaps and prepare costed plans with clear responsibilities.
4. Sustainable Financing: Governments should align financing across programmes and recognise care services as essential development investments, not merely welfare expenditure.
5. Professional Care Workforce: Introduce clear standards, certification, decent working conditions, social protection and career pathways to recognise caregiving as skilled and paid work.
6. Gender-Sensitive Workplace Policies: Consider statutory paid paternity leave in the private sector, as recommended by the Economic Advisory Council to the Prime Minister (EAC-PM).
7. Outcome-Based Emergency Care: Strengthen coordination among hospitals, ambulance networks and government programmes through digital technologies, real-time monitoring, implementation research and continuous skilling of emergency care personnel.
8. Preventive and Holistic Healthcare: Promote community-based prevention, health awareness and lifestyle interventions, while integrating appropriate medical care to address chronic conditions and improve well-being.
9. Technology-Enabled Healthcare: Use artificial intelligence (AI), machine learning (ML) and digital health infrastructure to improve healthcare efficiency, quality, interoperability and continuity of health records.
10. Mental Health Awareness: Promote supportive environments in workplaces and educational institutions to address stress, burnout and students’ mental health needs.
11. Global Policy Learning: Colombia’s 2025 National Care Policy coordinates 34 government entities; Brazil’s national policy and plan use inter-ministerial committees, while Nepal’s care mapping informed funding for care pilots.
12. Women-Led Care Enterprises: Support women-led childcare enterprises through government partnerships, including initiatives involving the Ministry of Housing and Urban Affairs and the Women Entrepreneurship Platform.
13. International Collaboration: UNDP and UN Women’s Transform Care initiative, operating in more than 50 countries, support care mapping, workforce skilling and childcare enterprise development.

Conclusion

India must treat care as essential social and economic infrastructure for Viksit Bharat 2047. Connecting existing programmes, closing coverage gaps, financing services and improving care workers’ conditions can make support more accessible and reliable. A coordinated care system can widen women’s opportunities, create skilled jobs and improve well-being across people’s lives.

Question for practice:

Discuss the significance of a holistic care system for India’s inclusive development and the key challenges in building an integrated and sustainable care economy.

Source: The Hindu