Health-Seeking Behaviour in India: NSO 80th Round Survey Key Findings & Trends

The findings from the National Statistical Office 80th Round Health Survey indicate a significant improvement in healthcare access, driven by government interventions, expansion of public health services, and wider insurance coverage.

• The National Statistical Office survey covered 1.39 lakh households (76,296 rural; 63,436 urban), providing robust insights into healthcare access, affordability, and utilisation.

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Key Trends of  National Statistical Office 80th Round Health Survey

• Rising Reported Ailment (PPRA): Health-seeking behaviour in India is improving as the proportion of the population reported ailing (PPRA) in 2025 nearly doubled in 2017-18 from 6.8% to 12.2% in rural areas, and 9.1% to 14.9% in urban areas.
• Surge in Health Insurance Coverage: Expansion in coverage under government health insurance and financing schemes rose more than threefold  increasing from 12.9% to 45.5% in rural areas, and 8.9% to 31.8% in urban areas. 

• Increased Utilisation of Public Healthcare: In response to rising demand, the utilisation of public healthcare facilities has strengthened, particularly for outpatient care in rural areas, where utilisation has increased from 33% to 35%. 
  • Government Approach: This improvement is attributable to the expansion of comprehensive primary healthcare services, with an emphasis on preventive, promotive, and early diagnostic care, supported by the availability of free drugs and diagnostics. 
• Enhanced Financial Risk Protection: Financial risk protection has expanded significantly with the rapid scaling up of Government-financed health insurance coverage, including under Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana (PM-JAY) and various State schemes. 
  • Expansion in Insurance Coverage: Percentage of population covered under these Government Health Financed/Insurance Schemes in the country has notably increased from 12.9% to 45.5% in rural areas and from 8.9% to 31.8% in urban areas, representing more than a threefold expansion. 
• Improvement in Maternal Health Outcomes: The survey also highlights continued progress in maternal and child health outcomes, with institutional deliveries increasing from 90.5% in 2017-18 to 95.6% in 2025 in rural areas and from 96.1% to 97.8% in urban areas during the same time period. 
  • Government Approach: This reflects sustained efforts to promote safe motherhood and strengthen access to quality maternal healthcare services by the Government through schemes including Quality Assurance, Janani Suraksha Yojana (JSY), Janani Shishu Suraksha Karyakaram (JSSK), Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA). 
• Dominance of Public Facilities in Rural Deliveries: The survey further mentions that nearly two-third (66.8%) of rural deliveries occur in Government Health facilities, while it is 47% (nearly half) for the urban deliveries.
• Long-Term Rise in Public Facility Usage: The NSO survey also reveals the increasing trend towards utilisation of public health facilities over the last three rounds. 
  • It shows that where in 2014 around 28% of the rural population headed to public facilities for outpatient care, the same has surged to 35% in 2025.  

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Drivers of Improved Health-Seeking Behaviour

• Enhanced Public Health Investment: Enhanced budgetary allocations have enabled significant expansion of healthcare infrastructure across primary, secondary, and tertiary levels, strengthened human resources, and supported the scaling up of key initiatives focused on preventive, promotive, and curative care 

• Epidemiological Transition: A shift from infectious diseases to non-communicable diseases (NCDs) such as diabetes and cardiovascular conditions reflects improved disease control and changing lifestyle patterns.
• Effective Government Interventions: Sustained Information, Education and Communication (IEC) efforts, intersectoral convergence through platforms like Village Health Sanitation and Nutrition Committee, and large-scale screening at primary and community levels have strengthened early detection and awareness.
• Improved Availability of Free Drugs and Diagnostics: Provision of essential medicines and diagnostic services at public facilities has reduced out-of-pocket expenditure and increased trust in public healthcare. 

Interlinkages of Health Seeking Behavior in

• Governance:
  • Link with Human Capital Formation:
    • Healthy individuals contribute to higher productivity, better learning outcomes, and economic growth.
    • Early diagnosis and timely treatment reduce long-term morbidity, improving workforce participation.
    • It complements investments in education and nutrition, forming the backbone of human capital.
• Progress toward Universal Health Coverage (UHC)
  • • Universal Health Coverage ensures:
    • Access to quality healthcare services
    • Financial protection from catastrophic expenditure
  • Increased reporting of ailments (PPRA) indicates:
    • Better awareness and diagnosis
    • Reduced hidden morbidity
• Sustainable Development Goals (SDGs)
  • SDG 3: Good Health and Well-being
    • Encourages timely diagnosis and treatment, reducing morbidity and mortality.
    • Promotes preventive healthcare practices such as immunisation, screening, and maternal care.
    • Higher utilisation of public health services improves service delivery efficiency and health outcomes.
    • Strengthens progress toward Universal Health Coverage (UHC) by ensuring access to essential services.
  • SDG 1: No Poverty (via Reduced Out-of-Pocket Expenditure – OOPE)
    • Improved health-seeking behaviour, especially through public facilities, reduces catastrophic health expenditure.
    • Expansion of government insurance schemes lowers financial vulnerability of households.
    • Prevents households from falling into the poverty trap due to medical expenses.
    • Supports economic stability by safeguarding income and savings of vulnerable populations.

Challenges in India’s Health-Seeking Behaviour

• Persistent High Out-of-Pocket Expenditure (OOPE): Despite improvements, private healthcare continues to impose a heavy financial burden, especially for specialised treatments, leading to catastrophic expenditure for many households.
• Urban–Rural and Inter-State Disparities: Significant inequalities persist in healthcare access, infrastructure, and quality across regions, with rural and backward states lagging behind.
• Rising Burden of Non-Communicable Diseases (NCDs): Increasing prevalence of diabetes and cardiovascular diseases requires long-term, costly care, straining both households and the public health system.
• Quality and Capacity Constraints in Public Healthcare: Issues such as overcrowding, shortage of specialists, and uneven quality of services reduce efficiency and patient satisfaction.
• Overdependence on Private Sector for Advanced Care: Tertiary and specialised care is still dominated by private providers, limiting equitable access despite insurance coverage.
• Low Health Awareness in Marginalised Sections: Socio-cultural barriers, gender norms, and low health literacy continue to delay timely healthcare seeking in vulnerable populations.
• Fragmented Health Governance: Lack of coordination among Centre, States, and local bodies affects effective implementation of health policies and schemes.

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Way Forward

• Strengthen Primary Healthcare System: Expand and upgrade Health and Wellness Centres to provide comprehensive preventive and curative services at the grassroots level.
  • Example: Scaling up Ayushman Bharat HWCs for NCD screening and early diagnosis.
• Enhance Public Health Financing: Increase government health expenditure towards the target of 2.5% of GDP to improve infrastructure, workforce, and service quality.
• Improve Quality of Public Healthcare: Standardise treatment protocols and strengthen quality assurance mechanisms.
  • Expansion of Quality Assurance initiatives in district hospitals.
• Regulate Private Healthcare Costs: Ensure transparency in pricing and promote standard treatment guidelines to reduce exploitation.
  • Price caps under insurance schemes like Ayushman Bharat Pradhan Mantri Jan Arogya Yojana.
• Focus on NCD Prevention and Management: Promote lifestyle changes, regular screening, and community-based interventions.
  • Population-based screening for hypertension and diabetes at primary care level.
• Leverage Digital Health Technologies: Use telemedicine, electronic health records, and digital platforms to improve access and continuity of care.
• Strengthen Community Participation and Awareness: Enhance IEC campaigns and utilise grassroots institutions like Village Health Sanitation and Nutrition Committee for behaviour change and early healthcare seeking.

Conclusion

Health-seeking behaviour serves as a bridge between constitutional ideals and ground-level outcomes, reflecting how effectively governance translates the right to health into accessible, affordable, and equitable healthcare for all.

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