India's journey toward addressing its public health challenges stands at a crucial juncture. While significant advancements have been made across various sectors, persistent issues such as malnutrition and anaemia continue to pose considerable challenges for the nation’s future. The recent National Family Health Survey (NFHS-5) data suggests that while government efforts are critical, they need to be complemented by the active involvement of the private sector and other stakeholders. While Corporate Social Responsibility and other initiatives by private sector players constitute an important role, a comprehensive and sustainable solution to these large-scale public health challenges may lie in empowering a mass movement—a "Jan Andolan." It is only when critical issues are championed through a nationwide collective effort that it can significantly enhance India’s approach to health crises through the collective strength of its people.
India has a rich history of successful Jan Andolans who have driven significant public health and societal changes. The first and foremost in this is the hallmark Pulse Polio campaign. Led by the collective effort of governments, civil society and a strong network of frontline health workers, India was declared Polio-free in 2014 by WHO, three years after the last case of reported polio in the country. The Swachh Bharat Abhiyan is another example of how collective action can yield transformative results. Launched on October 2, 2014, with the goal of achieving Open Defecation Free (ODF) status in rural areas by 2019, the mission witnessed widespread participation. By the end of Phase I, all villages had declared themselves ODF by October 2, 2019. While the government's role was crucial in formulating policies and providing incentives for toilet construction, the real victory was in the behavioural shift among the population. This change, rooted in the collective embrace of cleanliness, demonstrated the power of Jan Andolan, where individuals across the nation actively participated in improving their communities’ hygiene and sanitation.
The COVID-19 pandemic provided another testament to the efficacy of Jan Andolans in public health. The government worked relentlessly to achieve comprehensive immunisation coverage, partnering with various stakeholders and employing innovative strategies to ensure vaccine delivery to the remotest corners of the country. As a result, over 220 crore doses were administered. Initial vaccine hesitancy, which stood at 60 per cent in January 2021, dropped to just 7 per cent by the time the second wave struck, highlighting the success of mass awareness campaigns. These campaigns, supported by community engagement, played a pivotal role in addressing vaccine hesitancy. A report by Ashoka University, "The Impact of COVID-19 on India’s Nonprofit Organisations," further highlighted how non-profits, leveraging their deep community ties, were instrumental in pandemic relief efforts.
Similarly, the ongoing battle against tuberculosis (TB) in India illustrates the potential of a societal approach that unites citizens and organisations in a Jan Andolan. The movement has seen the rise of Nikshay Mitras (supporters in the fight against TB), who have come together to ensure that no one is left behind in the fight against this deadly disease. This comprehensive approach, which includes community-driven efforts, underscores the importance of widespread participation in achieving public health goals.
The Poshan Abhiyan serves as another notable example of a Jan Andolan aimed at tackling malnutrition, one of India’s most critical public health challenges. While the NFHS-5 (2019-21) data shows some improvements in nutrition indicators for children under five years—such as a decrease in wasting from 21 per cent to 19.3 per cent, undernutrition from 35.7 per cent to 32.1 per cent, and stunting from 38.4 per cent to 35.5 per cent—these figures also highlight the vast amount of work still required. The success of Poshan Abhiyan depends heavily on Jan Bhagidari (people’s participation), similar to the successes seen in the Swachh Bharat and COVID-19 vaccination initiatives. Engaging the population at every level is essential for replicating these successes in the fight against malnutrition. The introduction of campaigns like Poshan Maah or National Nutrition Month in September each year allows for organizations and governments to come together and work towards a single-aimed focus of raising awareness about malnutrition and promote healthy nutrition behaviours among communities. It is in initiatives like this and others that the role of community-based organisations become indispensable. NGOs and Civil Society Organisations (CSOs), with their deep understanding of local contexts, play a critical role in in leading such Jan Andolans and bridging the gap between national objectives and on-the-ground implementation. The existing network of regionally tailored organisations across the length and breadth of the country, working with communities across the spectrum is essential for ensuring equitable resource distribution and addressing the specific needs of various communities. These organisations’ close connections with local populations enable them to implement behaviourally informed interventions (BIIs) that lead to impactful, lasting change.
India's pursuit of a Swasth Bharat (Healthy India) demonstrates that when people unite around shared goals and responsibilities, transformative change becomes achievable. The key to overcoming public health challenges like malnutrition lies in fostering Jan Bhagidari and cultivating a culture of collective effort at every level of society. By harnessing the power of the people through a Jan Andolan, India can unlock the potential for sustainable, large-scale improvements in public health.
, Dr Shaiwal Khandelwal, Associate Director, Thoracic Surgery, Max Super Speciality Hospital, Saket-2_20240918203538_original_image_41.webp)
