The healthcare system in India and the healthcare system in Russia represent two of the world’s most extensive public health frameworks. Each evolved through different historical paths, yet both pursue the same ultimate goal: delivering affordable, accessible, and quality care to every citizen.
Comparing India’s and Russia’s healthcare systems helps us understand how these two large nations manage public health for millions with diverse needs. Two nations, two mechanisms, but one shared mission: healthier lives for all.
Healthcare System Structure in India
India’s healthcare system resembles a layered pyramid, starting from grassroots outreach and rising to advanced tertiary hospitals. It blends strong community involvement, growing infrastructure, and rapid digital health expansion.
India’s health delivery begins where the people live, right in their communities.
1. ASHA Workers
At the base of the healthcare system in India are the ASHA workers, Accredited Social Health Activists. They link families to the public health system, support immunisation, maternal care, family planning, and basic health education.
ASHAs serve as the crucial human bridge between households and health facilities.
2. Health and Wellness Centres (HWCs)
HWCs sit above ASHAs, led mainly by ANMs or trained nurses. They provide preventive, promotive, and simple curative services. HWCs conduct NCD screening, counselling, and manage day-to-day illnesses.
These centres symbolise India’s commitment to strengthening comprehensive primary healthcare.
Healthy communities lay the foundation for a healthier nation.
3. Primary Health Centres (PHCs)
PHCs, supervised by Medical Officers, offer primary medical care in rural regions. They handle OPD services, minor emergencies, vaccinations, and essential diagnostic needs.
PHCs remain the central pillar of India’s rural healthcare system.
4. Community Health Centres (CHCs)
CHCs offer specialist support, medicine, paediatrics, surgery, and obstetrics. As referral centres for PHCs, they manage more complicated conditions.
CHCs reinforce India’s secondary healthcare tier.
5. District Hospitals
District hospitals provide a wider range of speciality services, advanced diagnostics, and emergency care to the whole district population.
They deliver critical care to large and diverse communities.
6. Tertiary Care Hospitals
India’s tertiary network includes medical colleges, super-speciality hospitals, and leading centres like AIIMS. They manage complex diseases, organ failures, major surgeries, and advanced medical interventions.
When health conditions grow complicated, tertiary hospitals become the defining support system.
Healthcare System in Russia
Russia’s healthcare system is predominantly government-driven, built on the Semashko model emphasises universal access and state-led administration. Although reformed over time, it maintains a centralised character.
Russia follows one guiding principle: healthcare for every citizen, across every region.
1. Feldshers & Rural Health Posts
Primary care in rural Russia starts with feldshers, mid-level medical practitioners who diagnose, treat common illnesses, support maternal care, and stabilise emergencies.
Rural health posts parallel India’s HWCs but grant fieldworkers greater clinical authority.
2. Polyclinics
A hallmark of Russia’s healthcare structure is the polyclinic system—one location providing GP services, specialist consultations, imaging, diagnostics, and preventive care.
Polyclinics minimise fragmentation by offering most outpatient services under one roof.
One facility. Many services. Complete care.
3. District Hospitals
Russia’s district hospitals deliver inpatient care, emergency services, surgeries, chronic disease management, and referrals from polyclinics or rural posts—similar to India’s district hospital model.
4. Regional & Federal Hospitals
Regional hospitals provide advanced specialist care, while federal hospitals and national medical research centres form the apex of Russia’s system, comparable to India’s AIIMS-level institutions.
They manage rare diseases, high-risk surgeries, and research-driven treatments.
Russia’s top-tier hospitals reflect expertise, precision, and advanced medical capabilities.
India vs Russia Healthcare System: Key Differences
Examining India’s vs Russia’s healthcare system highlights distinctions in structure, funding, and healthcare delivery models.
Primary Care
- India depends on a community-driven model with ASHAs and ANMs.
- Russia emphasises feldshers and polyclinics, offering integrated outpatient care in one setting.
Government Role
- India operates with a public–private mix.
- Russia’s system remains largely state-funded and state-guided.
Insurance Coverage
- India’s Ayushman Bharat has expanded coverage, yet out-of-pocket costs remain significant.
- Russia’s Mandatory Health Insurance (MHI) covers nearly all citizens with minimal direct expense.
Workforce Distribution
- India experiences shortages of doctors in rural regions.
- Russia counters this with its trained feldsher workforce.
Accessibility
- India faces an uneven distribution of facilities.
- Russia maintains a structured referral chain but struggles in remote northern territories.
Different approaches, different hurdles, yet both strive toward universal access.
Strengths of India
India excels in community outreach, digital health scaling, rapid medical education expansion, and robust national health programmes.
Its ASHA network is among the world’s largest community health forces.
Strengths of Russia
Russia benefits from integrated polyclinics, consistent government support, and rural health posts that ensure services even in far-flung areas.
Russia also maintains favourable medical staff-to-population ratios.
Challenges in India
India continues to face rural–urban gaps, specialist shortages, high out-of-pocket spending, and rising rates of non-communicable diseases.
India’s issue is not capability—but distribution.
Challenges in Russia
Russia struggles with an ageing population, bureaucratic processes, limited funding in remote regions, and slow modernisation.
Ageing population and increasing costs, Russia is under pressure to adapt.
Comparing the healthcare system in India vs Russia shows how both countries tackle the universal challenge of providing healthcare to millions. India stands strong with its community-focused model and innovations, while Russia shines in its centralised and integrated service design.
Both countries can learn from one another, India from Russia’s polyclinic efficiency, and Russia from India’s community-level ASHA and HWC outreach.
Two nations. Two systems. Unlimited possibilities for progress.
By studying India vs Russia healthcare system models, policymakers can create stronger, more resilient, and more patient-centred health systems for the future.