At the time of independence India’s health status was one of the worst in the world. the life expectancy at birth was estimated at 36.7 years in 1951. the infant mortality rate was high at 146 per 1000 in 1951. Poor socio-economic development opportunities coupled with deadly disease gift mortality rates very high. However the improve access of Healthcare service along with improved living conditions such as food supply, housing facilities, sanitation and hygiene, led to a gradual decline in deaths from infectious disease such as smallpox, malaria, pneumonia, tuberculosis, diarrhoea, poliomyelitis, typhoid, cholera and plague in the post independent India. Over a period of time both the life expectancy and other later indicator showed significant improvement.

According to the latest report the life expectancy has crossed 267 years.Though infant mortality rate (33 per 1000) and maternal mortality ratio (122 per 100000 live birth) have come down significantly since Independence it is still unacceptably high. Many diseases polio, Guinea worm disease, yaws and tetanus have been eradicated. If we look at the recent history there have been significant improvements in the overall health status specially in the last 20 years.The recent improvements in health care service can partially be attributed to the National Health Mission.
Presently, India is undergoing a health transition, Demographically as well as epidemiologically. Demographic transition is characterized by mortality decline, natural increase in population size, fertility decline, urbanization and population ageing.Whereas epidemiological transition can be characterized by Low mortality, high morbidity and by the double burden of communicable disease and non communicable disease (NCDs.). Though India still has heavy burden of communicable disease such as TB and malaria, and NCDs such as heart disease, cancer, diabetes chronic pulmonary disease and now the leading cause of death India Contributing to nearly 60% of death. Experts have argued that presently India suffers from the triple burden of disease communicable diseases. Non communicable disease and malnutrition. the recent report shows that more than one third of the world small malnutrition children live in India. in spite of government’s effort to address the malnutrition issue through massive new National level programs such as POSHAN Abhiyan, malnutrition still remains as one of the biggest development challenges in India.
Inadequate water, Sanitation and and hygiene (WASH) services have a ripple effect on almost everyone’s life.According to UNICEF just a few years ago in 2015 nearly half of India’s population of around 568 million people suffered the indignity of defecating in fileds, Forest, bodies of water or other public spaces due to lack of access to toilets.India alone accounted for 90% of the people in South Asia and half of the 1.2 billion people in the world that defecated in the open.2019 according to the latest estimate the number of people without access to toilet has reduced significantly by an estimated 450 million people. Tremendous achievement only possible because of the swachh Bharat mission(SBM) (clean India Campaign), Though the SBM is seen as big sucess by International Organisation suggest UNICEF its real impact on infant and child health is yet to be fully understood.
Health and nutritional statistics in India and elsewhere reflect social and economic inequities.Therefore it is important to bear in mind that the health and nutritional inequities in India for the exacerbated by the social inequities arising out of class, caste ‚religion and religion disparities. Many researchers has pointed out the evidence Association of Appallingly Low health status with poor, female gender, rural place of Residence, tribal ethnicity, scheduled caste (SC) and specific minority groups.
Types of Mission launched by Indian Government.

National Health Mission (NHM)
The National Health Mission (NHM) encompasses is to submission the National Rural Health Mission(NRHM) and the national Urban Health Mission(NUHM) . the main programmatic Components include health system strengthening ‚reproductive — maternal — neonatal child and Adolescent Health (RMNCH + A) and Communicable and non communicable Disease. The NHM envisages achivement of universal access to equitable , affordable and quality health cre services that are accountable
National Rural Health Mission
The National Rural Health Mission (NRHM) was launched by the Hon’ble prime minister on 12th April 2005, to provide accessible ‚affordable and quality health care to the rural population, especially the vulnerable groups . The union Cabinet vide its decision dated 1st May 2013,has approved the launch of National Urban Health Mission (NUHM) as a sub mission of an over arching National Health Mission (NHM), with National Rural health Mission (NRHM) being the other sub mission. Of National Health Mission.
NRHM seeks to provide equitable ‚affordable and quality health care to the rural population, especially the vulnerable groups. Under the NRHM , the Empowered Action Group (EAG) States as well as North Eastern states , Jammu and kashmir and Himachal Pradesh have been given special focus . the thrust of the mission is on establishing a fully functional , community owned ‚decentralised health delivery system with inter — sectoral convergence at all levels to ensure simultaneous action on a wide range of determinants of health such as water, sanitation, education , nutrition, social and gender equality . Institutional integration within the fragmented health sector was expected to provide a focus on outcomes ‚measured against Indian public Health Standard for all health facilities.
National Urban health Mission
The National urban Health Mission (NUHM) as a sub mission of National Health mission (NHM) has been approved by the cabinet on 1st May 2013.
NUHM Envisages to meet Healthcare needs of the Urban population with the focus on urban poor by making available to them essential Primary Health Care services and reducing their out of pocket expenses for treatment. This will be achieved by strengthening the existing Health Care Service Delivery System targeting the people living in slums and converging with various schemes related to why the determinant of health like drinking water, sanitation, school education etc. Implemented by Ministry of Urban Development, Housing and urban poverty alleviation, human resource development and women child development.