Capacity building for Family Medicine in India to strengthen comprehensive primary care and district health systems

Capacity Building for Family Medicine

Abstract

Background: India’s health system is attempting to expand comprehensive, life-course primary care through Ayushman Arogya Mandirs while also strengthening secondary care at community, sub-district, and district levels. However, the clinical workforce required to deliver continuity, comprehensiveness, gatekeeping, rational referrals, and integrated care across levels remains underdeveloped. Family Medicine has been recognised in Indian policy for decades and is explicitly supported in the National Health Policy 2017 and reflected in IPHS 2022, yet formal training capacity remains small. Methodology: A focused narrative review and policy analysis were undertaken using official Indian policy and programme documents, current public dashboards, WHO primary care guidance, and recent peer-reviewed studies on Family Medicine in India. Priority sources included the National Health Policy 2017, Indian Public Health Standards 2022, the Ayushman Arogya Mandir portal, the NBEMS accreditation portal, and the 2025 national survey of family physicians in India. Results: India had 186,188 functional Ayushman Arogya Mandirs as of 4 June 2026. These facilities are expected to deliver 12 comprehensive service packages, including NCD care, mental health, elderly and palliative care, and first-level emergency/trauma care. IPHS 2022 includes Family Medicine in CHC service and human resources for health configurations and recommends phased public-system deployment as numbers rise. Nonetheless, recent evidence indicates that in 2023, only 39 accredited private institutions offered DNB Family Medicine, only 110 DNB-FM seats were available nationally, and only seven government medical colleges offered MD Family Medicine. Surveyed family physicians in India worked across public and private sectors and across system levels, with substantial involvement in rural practice, emergency care, inpatient care, home visits, palliative care, and telemedicine. Conclusion: Family Medicine is therefore not a peripheral speciality add-on; it is the clinical architecture needed for India’s comprehensive primary care platform and district health-system redesign to function efficiently. A national capacity-building strategy should combine undergraduate exposure, MD/DNB expansion, faculty development, in-service GP upskilling, structured deployment at CHC/FRU/SDH/DH levels, digital training, accreditation reform, financing incentives, and outcome-oriented monitoring