According to the National Family Health Survey (NFHS-5), more than half of Indian women of reproductive age are anaemic (International Institute for Population Sciences (IIPS) & ICF, 2021). Anaemia is not a minor medical issue; it is strongly associated with fatigue, diminished physical stamina, and reduced cognitive function. The World Bank (2021) estimates that productivity losses from anaemia alone may cost India up to 2% of its GDP annually. High rates of maternal morbidity and inadequate access to NCD care further compound this problem, resulting in absenteeism, reduced labour force participation, and premature exit from the workforce.
The intergenerational effects are equally profound. Research shows that children born to malnourished or unhealthy mothers face higher risks of low birth weight, stunting, impaired cognitive development, and lower schooling attainment. These early disadvantages translate into poorer productivity and lower earnings in adulthood, perpetuating a cycle of lost human capital. Thus, women’s health deficits do not merely limit current economic output—they compromise the very foundation of India’s future workforce.
If India is serious about achieving its economic aspirations, it cannot afford to treat women’s health as peripheral or discretionary spending. Initiatives like SNSPA are welcome signals, but they must be embedded within a broader understanding that investments in women’s health are productive capital investments. Just as roads and digital networks are planned and financed with an eye to economic returns, so too should women’s health programmes be budgeted and evaluated for their impact on productivity, labour market participation, and long-term growth.
This calls for a critical re-examination of how women’s health is positioned within India’s policy and economic discourse. Robust action on anaemia, maternal health, NCDs, and intergenerational nutrition must be seen not simply as welfare interventions but as strategic levers for inclusive and sustainable economic development.
When we speak of infrastructure, most people imagine highways, ports, or power grids—the tangible assets that fuel economic activity. These investments are not ends in themselves; they are enablers, reducing transaction costs, enhancing efficiency, and expanding productive potential. Yet the same logic applies to the health of a nation’s people, especially its women. Women’s health is not just a private matter or a welfare concern—it is economic infrastructure, foundational to productivity, resilience, and long-term growth.
The case for this reframing is both intuitive and evidence-based. Women comprise nearly half of India’s potential workforce and are the primary caregivers and nurturers of the next generation. Their health status, therefore, determines not only their own ability to contribute economically but also the human capital trajectory of the entire country. Neglecting women’s health is akin to neglecting the maintenance of a highway—over time, inefficiencies mount, bottlenecks emerge, and growth slows.
Extending this analogy reveals three interlinked channels through which women’s health functions as infrastructure:
* Labour supply and productivity.
Healthy women are more likely to enter, remain in, and thrive within the workforce. Conversely, chronic conditions such as anaemia, reproductive health issues, and non-communicable diseases undermine both participation and performance. The cost is not only in absenteeism but also in “presenteeism,” where women are physically present at work but unable to perform at full capacity. India’s burden is particularly stark: NFHS-5 data show that over half of women of reproductive age are anaemic, a condition linked to fatigue, diminished stamina, and impaired cognitive functioning. The consequence is reduced productivity in agriculture, manufacturing, and services alike—a silent but significant drag on GDP.
* Human capital formation across generations.
Women’s health is not only about the present—it shapes the future. Research in developmental science demonstrates that maternal nutrition and health during pregnancy have enduring effects on children’s outcomes, from birth weight to cognitive ability. Malnourished or anaemic mothers are more likely to give birth to children who are stunted, underweight, or cognitively disadvantaged. These disadvantages persist through lower schooling attainment, reduced skills, and weaker labour market outcomes in adulthood. In effect, poor maternal health perpetuates a cycle of lost productivity and entrenched poverty—while healthier mothers set the foundation for a more skilled and competitive workforce.
* Fiscal and household stability.
The economic costs of poor health ripple far beyond the clinic. Preventive healthcare reduces the need for expensive late-stage treatments, lowering public expenditure and household out-of-pocket costs. Conversely, when women face chronic or untreated illnesses, households often absorb the burden through catastrophic spending, asset depletion, or foregone investments in education and entrepreneurship. Thus, investing in women’s health is not only an act of social justice but a fiscal strategy—one that protects families from economic shocks and strengthens national economic resilience.
This framing is increasingly recognised at the global level. The World Bank’s landmark World Development Report 1993concluded that investments in health can generate returns exceeding many traditional infrastructure projects (World Bank, 1993). More recent estimates show that every $1 spent on health interventions yields economic returns of up to $9 through enhanced productivity and reduced costs. The McKinsey Global Institute has calculated that advancing women’s equality—including better health outcomes—could add $12 trillion to global GDP by 2025. UN Women (2022) further underscores that women’s health is the “hidden engine” of sustainable development, directly tied to progress on multiple Sustainable Development Goals.
In sum, treating women’s health as peripheral is a costly miscalculation. If India continues to think of “infrastructure” narrowly as concrete and steel, it risks undermining the most fundamental infrastructure of all: Human potential. Roads and ports may connect markets, but it is healthy women who connect generations, sustain households, and power economies.
The theoretical link between women’s health and economic growth becomes strikingly real when we examine data from India. The National Family Health Survey (NFHS-5) paints a stark picture: nearly 57% of women aged 15–49 are anaemic. This is not just a clinical statistic—it represents a daily struggle with fatigue, reduced stamina, and impaired cognitive performance, all of which directly curtail productivity in both paid work and unpaid caregiving roles. At a macro level, such widespread anaemia translates into a significant drag on economic output, particularly in labour-intensive sectors.
India has made important strides in reducing maternal mortality ratios, with a decline of over 70% since 2000. Yet, progress is uneven, and gaps in the quality and comprehensiveness of maternal care remain troubling. While antenatal care (ANC) contact rates are relatively high, far fewer women actually receive the full package of recommended ANC services—blood pressure monitoring, iron supplementation, nutrition counselling, and institutional delivery support (MoHFW, 2022). This disparity is particularly acute in poorer states and among low-income households. Ironically, it is precisely these women—those whose economic contribution could most transform family and community well-being—who enter motherhood with the greatest health vulnerabilities, perpetuating cycles of disadvantage.
At the same time, India is confronting a silent but rising epidemic of non-communicable diseases (NCDs) among women. Conditions such as cardiovascular disease, diabetes, and cancer are being detected late, in part because women often prioritise the health of their families over their own and face structural barriers in accessing timely care. These illnesses impose a dual economic burden: they limit women’s own productive years and simultaneously place heavy caregiving responsibilities on other women in the household, further constraining female labour force participation.
Labour market statistics reflect these health shocks vividly. National Sample Survey Office (NSSO) data show sharp declines in female labour force participation (LFPR) coinciding with childbearing years. This is not just a matter of social expectations—it reflects the intense physical toll of pregnancy and childbirth, inadequate postnatal health support, and the near absence of affordable childcare infrastructure. These barriers often keep women out of the workforce for years, creating a “productivity penalty” that stretches across decades.
The burdens of ill health are not evenly distributed. Rural, tribal, and low-income women face the highest rates of anaemia and maternal morbidity, alongside limited access to healthcare facilities. For instance, anaemia prevalence among tribal women often exceeds national averages by double digits, reflecting compounding nutritional deficits and health care barriers. These women are disproportionately concentrated in agriculture and informal sectors, where each day of missed work directly reduces household income and food security. In such settings, a woman’s illness is not just an individual health issue but a community-level economic shock.
Taken together, the evidence makes a compelling case: India’s persistently low female LFPR cannot be understood only through the lens of social norms or gender roles. Beneath those cultural explanations lies a deeper structural crisis of women’s health. The overwhelming prevalence of anaemia, incomplete maternal care, and the growing burden of NCDs act as physiological barriers to economic engagement. Unless addressed, these barriers will continue to suppress labour supply, erode human capital, and lock the poorest communities into cycles of vulnerability.
The evidence makes one point unmistakably clear: Women’s health cannot remain on the periphery of social welfare—it must be repositioned at the very core of India’s economic growth strategy. This requires rethinking not only how programmes are designed and funded, but also how their outcomes are measured and understood.
First, budgeting and ownership must transform. Women’s health cannot be left solely to the ministry of health and family welfare. Institutions like the ministry of finance and NITI Aayog should co-own these initiatives, embedding them within the country’s growth agenda. Reframing interventions—whether tackling anaemia, expanding breast cancer screening, or strengthening maternal healthcare—as growth-enabling investments allows them to be treated like physical infrastructure projects such as highways or digital networks. Such a framing makes the case for larger, more protected budget allocations and shifts the conversation from discretionary welfare spending to capital expenditure that drives productivity.
Second, measurement and accountability frameworks need upgrading. Evaluating women’s health interventions purely on biomedical outcomes misses their wider economic impact. Expanding program evaluations to include metrics such as workdays lost due to illness, female labour force participation at district levels, and catastrophic health expenditure reduction would reveal the broader return on investment. Evidence from other contexts shows that healthier populations contribute to higher labour supply, better educational attainment, and long-term GDP growth. Embedding such economic indicators into monitoring frameworks can strengthen political buy-in and ensure sustained policy attention.
Third, programmatic integration is critical. Current interventions often remain siloed—nutrition programs separated from maternal health, or NCD screening detached from reproductive care. A consolidated “women’s economic health” portfolio could strategically link adolescent nutrition, safe motherhood, and NCD prevention. This life-course approach recognises that health deficits at any stage—whether adolescent anaemia or undiagnosed diabetes in midlife—compound into long-term productivity losses.
Finally, an equity-focused targeting strategy will yield the highest economic returns. Resources should be directed to districts with the poorest health and lowest female labour participation indicators, particularly rural and tribal areas. Investing in these populations unlocks the economic potential of historically excluded groups and fosters inclusive growth. By prioritising equity, India ensures that the growth dividend of healthier women is not just larger, but also more fairly
The central insight is simple yet transformative: a nation’s economic infrastructure is incomplete without healthy women. India’s persistently low female labour force participation and high burden of women’s ill-health underscore that physiological barriers, not just social norms, constrain growth. Anaemia, incomplete maternal healthcare, and rising NCDs are not only health issues but structural bottlenecks to productivity.
If India is serious about its $5 trillion economy ambition, neglecting women’s health risks squandering its demographic dividend. A workforce weakened by anaemia and a future generation shaped by maternal malnutrition cannot drive the growth engine the country envisions.
Campaigns such as Swasth Nari, Shashakt Parivar Abhiyan need to be championed not as welfare gestures but as strategic growth initiatives. Investing in women’s health is investing in the indispensable human infrastructure—the “roads and bridges” of a productive economy—that will carry India toward prosperity. The dividend from such investment goes beyond health: it is stronger human capital, higher productivity, and a more inclusive and equitable society.
As Amartya Sen argued, development is freedom—and ensuring women’s health is among the most powerful freedoms that can unlock growth.
This article is authored by Dr Vishal Jani, head of research, Practo.
