Karnataka stands at a pivotal moment. In 2025, the government began decentralizing specialist care: a three-year plan links each district hospital with new trauma, cardiac and cancer units, bringing advanced treatment closer to remote communities.

Maternal health received urgent attention. After alarming reports of deaths in childbirth, Karnataka launched an ambitious “zero maternal mortality” campaign, equipping every hospital with obstetric emergency kits, nutrition/Vatsalya packs, and incentives, and stationing specialist obstetricians in high-risk taluks.

Preventive care was expanded through the Gruha Arogya programme, which reaches homes to screen adults for hypertension, diabetes, and other chronic diseases, and through new mobile health units that provide basic care in remote and underserved villages.

The government has redefined primary care as the central organizing principle and introduced evidence-based policies that originate at the grassroots level. New guidelines have been issued for mapping healthcare facilities, with strict criteria for upgrading Primary Health Centres (PHCs) to Community Health Centres (CHCs) based on factors such as distance, excessive travel times, or service gaps.

Additionally, PHCs will be strengthened by deploying more medical officers to enhance service delivery. Instead of program-by-program fixes, system-wide reforms were evident in 2025; extending the Arogya Sanjeevini cashless insurance scheme to all state employees, including contract workers.

A unified digital backbone was also rolled out. Hospital management systems are being installed at every district, taluk, and community centre, and a new NG-112 emergency network now coordinates about 1,270 ambulances for faster referrals.

On the regulatory side, Karnataka passed a tough amendment to the Drugs and Cosmetics Act to curb manufacture and sale of counterfeit medicines. It phased out in-hospital Jan Aushadhi outlets to facilitate supply of essential drugs free of cost through public pharmacies.

The government even innovated on social determinants. Karnataka became the first state to mandate paid menstrual leave for women workers. Under its Brain Health Initiative, more than a quarter of a million people were screened for neurological or mental disorders (32,630 treated), while district-level mental wellness centres were established.

Overall, Karnataka integrated evidence and equity into its health system, shifting governance focus from merely expanding programmes to prioritizing people’s needs. However, Karnataka faces growing risks from chronic illnesses and care gaps. For instance, the maternal mortality ratio of 57 per 100,000 is the highest in South India, a stark reminder of health inequity between rural and urban areas.

Vision 2026

Having the distinction of being the first state to pilot Universal Health Coverage (UHC), Karnataka’s reforms are fuelled towards achieving the goal of health for everyone.

The vehicle for this is a life course approach to health by creating policies and strengthening interventions that address health from before birth to old age.

Combining the primary healthcare and Life Course approaches to health can take transformative steps towards realizing UHC. The initial steps have been taken -- through the ‘zero mortality’ campaign, preventive adult care, Gruha Arogya, and enhanced insurance cover.

To reduce inequalities and enhance societal contribution, Karnataka’s integration of social and healthcare services across all age groups can serve as a role model for other states.

The government can consolidate and strengthen these initiatives by integrating them and creating a new ministry for public health that addresses both social and lifestyle determinants, a role currently held by the state’s development commissioner.

Call for action

A well-connected, well-staffed PHC with a fully functional continuum of care, including referrals, follow-ups, health exams, and chronic disease management could be the first step towards realizing UHC in 2026.

Reforms have paved the way. Now, political will is needed to achieve sustainable, life-course care in 2026. If realized, Karnataka’s model has the potential to offer global lessons in realizing UHC.