Conceptualization of Public Health in India: An Evolutionary Perspective

Abstract

Public health is a wider and a complex concept. It is concerned with the health of the population. The very notion of what constitutes ‘public’ in public health has been subject to different interpretations across time and contexts. This paper traces the evolution of public health conceptualization in India through five distinct phases from independence to present. It examines conceptual transformations that have shaped governance approaches and continue to influence contemporary challenges.

Through historical analysis, the study identifies transformations: from nation-building focus (1947-1983) to pragmatic private sector accommodation (1983-1990) which was followed by market-dominated approaches during liberalization (1990-2005), rights-based reconceptualization (2005-2020), and emergency governance and digital surveillance during COVID-19 (2020-present). It was found that each phase added new perspective in previous ones rather than replacing them. As a result, contemporary framework involves contradictory principles such as market mechanisms alongside rights discourse, universal coverage with targeted programs, and digital surveillance amid privacy concerns. The COVID-19 pandemic governance highlighted the limitations of existing legal frameworks and introduced unprecedented dimensions of inter-sectoral coordination and digital health governance. It concludes that public health conceptualization is not merely a technical exercise but also addresses questions about state capacity, citizen rights, federal governance, and the relationship between individual and collective welfare. It reflected deeper tensions about state authority, federal governance, and individual versus collective welfare which needs coherent approach to reconcile accumulated contradictions while maintaining crisis adaptability.