Mapping political commitments: Analysing health priorities in Indian election manifestos

Abstract

Introduction: Political manifestos are crucial for communicating party visions and policy priorities during elections. In the health context, manifestos provide a lens to examine political commitment to addressing structural challenges in India. Despite India's position as the largest democracy and the fourth-largest economy, the healthcare system is inequitably distributed, disproportionately affecting vulnerable populations. This study aims to evaluate how national political parties prioritise health in their manifestos for the 18^th Lok Sabha elections, identifying patterns, gaps, and areas of focus.

Methodology: Manifestos from four national parties-Indian National Congress (INC), Bhartiya Janata Party (BJP), Communist Party of India-Marxist (CPI-M) and National People's Party (NPP)-were analyzed using content and conceptual analysis. Health-related statements were categorized into five themes: nature, area, focus, prevention levels, and management. Statements not aligned with predefined categories were grouped under new areas or focuses. Each category's emphasis was quantitatively assessed by counting and summing relevant terms. Inter-coder reliability was ensured through independent coding and discussion.

Results: The analysis identified one hundred and four health-related statements. INC emphasized Universal Health Coverage and workforce protection, while the BJP highlighted its achievements and program expansion. The CPI-M adopted a rights-based approach, focusing on equity and private-sector regulation. NPP presented a generalized vision, but lacked actionable strategies. Health infrastructure and traditional medicine featured across manifestos, yet governance, finance, and systemic reforms were largely neglected. Parties selectively addressed population-specific issues, with limited attention to tertiary care or research and development.

Discussion: Manifestos reflected the ideological leanings but revealed a low prioritization of systemic health reforms and governance. Short-term, delivery-based solutions dominate over long-term investments. Political and electoral calculations influence the framing of health policies, perpetuating inequities, and systemic inefficiencies.

Conclusion: India's political manifestos recognize health as important but fail to address systemic challenges. Greater political will and citizen engagement, is essential to elevate health as a governance priority, fostering universal health coverage and equity.

Keywords: Health; election; manifesto; political parties.

Figure 1

Interest Areas of National Political Parties (image generated from www.napkin.ai)