Social Sectors in India: Health and Education for RBI Grade B ESI

Last updated: 2026-11-11 · MockMentor

"Social Sectors in India: Health and Education" is part of the Social Structure in India unit of the RBI Grade B Phase 2 Economic and Social Issues (ESI) syllabus. Health and education decide whether India's large young population becomes a productive workforce, and whether growth reduces poverty for good. Questions ask about public spending, malnutrition, the quality of schooling, the reach of health insurance and the reforms of the National Education Policy 2020.

In one line: India has made large gains in life expectancy, immunisation, school enrolment and access to health insurance, but low public spending, malnutrition, weak learning outcomes and high out-of-pocket costs still hold back human capital.

Basic concepts

• Health: "a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity", as defined by the World Health Organization (WHO).
• Primary, secondary and tertiary care: primary care is basic care close to the community; secondary care is in district and sub-district hospitals; tertiary care is specialised care in large hospitals.
• Out-of-pocket expenditure (OOPE): money that households pay directly for health care, not covered by insurance or the government.
• Universal Health Coverage (UHC): access for all people to quality health services without financial hardship.
• Stunting, wasting and underweight: low height for age (chronic malnutrition), low weight for height (acute malnutrition) and low weight for age.
• Gross Enrolment Ratio (GER): enrolment at a level of education as a percentage of the population of the official age group for that level.
• Learning outcomes: what students actually know and can do, as opposed to years spent in school.

Why in News?

1. In 2024, Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PM-JAY) was extended to all citizens aged 70 and above, irrespective of income, with cover of ₹5 lakh a year.
2. The Union Budget 2026-27 announced training of 1 lakh allied health professionals over five years, five regional medical hubs, NIMHANS-2 in north India and one girls' hostel in every district.
3. The SRS put India's Infant Mortality Rate at 25 per 1,000 live births in 2023 and the Maternal Mortality Ratio at 88 per 1 lakh live births in 2021-23.

Health

Why health matters

Good health is valuable in itself and is also a driver of growth: healthy workers are more productive, healthy children learn better, and lower health costs protect households from poverty. Illness and medical bills are among the most common reasons families fall back into poverty in India.

Health in the Constitution

Health is mainly a State subject (public health and sanitation, hospitals and dispensaries are in the State List), while medical education, population control and family planning, and the prevention of the spread of infectious diseases between states are in the Concurrent List. Article 21 (right to life), as interpreted by the courts, includes the right to health. Article 47 directs the state to raise the level of nutrition and the standard of living and to improve public health.

The health care system

The private sector provides most outpatient care and a large share of hospital care, especially in cities. Public spending on health by the Centre and states together has been about 2% of GDP, below the National Health Policy target of 2.5%. The share of out-of-pocket spending in total health expenditure has fallen but remains high, at about two-fifths.

Achievements

Key findings of NFHS-5 (2019-21)

Challenges in health

1. Low public spending and a shortage of doctors, nurses and specialists, especially in rural areas.
2. High out-of-pocket costs, which push families into debt.
3. The double burden of disease: infectious diseases such as tuberculosis alongside a rise in non-communicable diseases (diabetes, hypertension, cancer, heart disease), which now cause most deaths.
4. Malnutrition and anaemia.
5. Weak primary care, leading to overcrowding in tertiary hospitals.
6. Mental health: a large treatment gap and few professionals.
7. Uneven quality and regulation of private care.
8. Regional disparities, with states such as Kerala and Tamil Nadu far ahead of Uttar Pradesh, Bihar and Madhya Pradesh.

National Health Policy, 2017

Main health schemes

Malnutrition and government interventions

Malnutrition includes undernutrition (stunting, wasting, underweight), micronutrient deficiencies (anaemia) and overweight and obesity, which are rising. Its causes include poor maternal nutrition, early marriage and pregnancy, inadequate breastfeeding and complementary feeding, lack of dietary diversity, infections from poor sanitation, and poverty.

Education

Why education matters

Education raises individual earnings, productivity and health, improves citizenship and social mobility, and is the strongest tool against inequality. Girls' education in particular lowers child mortality, delays marriage, reduces fertility and improves the nutrition and schooling of the next generation.

Constitutional provisions

Right of Children to Free and Compulsory Education Act, 2009

State of school education

India has achieved near-universal enrolment at the elementary level, and girls' enrolment is on a par with boys'. The main problem is learning. Surveys by government (the National Achievement Survey and its successor, PARAKH Rashtriya Sarvekshan) and independent groups (the Annual Status of Education Report, ASER) have found that a large share of children in primary classes cannot read a simple text or do basic arithmetic at the level expected for their grade, though there was a recovery after the pandemic learning loss.

Other problems include dropouts at the secondary level, teacher shortages and absenteeism, many small single-teacher schools, poor infrastructure in some states, and the fast growth of private schools of uneven quality.

Secondary and higher education

The GER in higher education was about 28% in 2021-22 according to the All India Survey on Higher Education (AISHE), up from about 20% a decade earlier, with women's enrolment now slightly higher than men's. India's higher education system is one of the largest in the world, with over 1,100 universities and over 40,000 colleges. Indian institutions have climbed in global rankings such as the QS World University Rankings and the Times Higher Education rankings, but very few are among the world's top 100. Problems include poor quality in many colleges, faculty shortages, low research output, outdated curricula and a weak link with employers.

Regulation

The NEP 2020 proposes a single Higher Education Commission of India to replace the UGC, AICTE and NCTE, with separate verticals for regulation, accreditation, funding and standards.

Education policies

National Education Policy 2020

1. New school structure of 5+3+3+4: foundational (ages 3 to 8, including three years of pre-school), preparatory (8 to 11), middle (11 to 14) and secondary (14 to 18).
2. Foundational literacy and numeracy for all by Class 3, through the NIPUN Bharat mission.
3. Mother tongue or regional language as the medium of instruction at least up to Class 5, wherever possible.
4. Vocational education and internships from Class 6.
5. Board exams made easier and more focused on core skills, with an option of taking them twice a year.
6. A National Assessment Centre, PARAKH, to set assessment standards.
7. GER in higher education of 50% by 2035.
8. Multidisciplinary undergraduate programmes of four years with multiple entry and exit, and an Academic Bank of Credits.
9. A National Research Foundation (set up under the Anusandhan National Research Foundation Act, 2023).
10. Public spending on education to reach 6% of GDP.
11. Entry of top foreign universities into India, several of which have since set up campuses.

Challenges common to both sectors

• Low public spending: around 2% of GDP on health and about 4% to 4.5% on education (Centre and states together), below the targets of 2.5% and 6%.
• Shortage and uneven distribution of skilled staff: doctors, nurses and teachers.
• Quality and accountability problems in public services.
• Inequality between states, between rural and urban areas, and between social groups.
• Weak data and monitoring of outcomes.

Way forward

• Raise public spending on health and education steadily towards policy targets, with a focus on primary care and foundational learning.
• Strengthen primary health care and the referral system, and cut out-of-pocket costs through wider insurance and free medicines and diagnostics.
• Tackle malnutrition through convergence of nutrition, sanitation, water and women's education.
• Focus school reform on learning outcomes, teacher training and regular assessment.
• Improve the quality of higher education and research, and link skills to jobs.
• Use digital tools, such as telemedicine and digital learning, while closing the digital divide.

Possible exam and interview questions

1. Despite progress, India's health outcomes lag behind those of countries at similar income levels. Analyse the reasons and suggest reforms. (420 words)
2. "India has solved the problem of access to school, but not of learning." Discuss with reference to the National Education Policy 2020. (620 words)
3. What are the main findings of NFHS-5 on malnutrition, and what has the government done to address it?
4. Evaluate the performance of Ayushman Bharat PM-JAY.
5. Interview: Should health care be made a fundamental right in India?

Related reading: human development, demographic trends, and gender issues.

More in ESI

• National Income
• Human Development
• Poverty
• Employment
• Sustainable Development

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