Union Budget | Big numbers, small gains for women

The Budget 2026-2027 comes at a pivotal moment in India’s demographic trajectory. Recent projections show that fertility is declining, population ageing is accelerating, and the country’s window for reaping the demographic dividend is rapidly narrowing.

At the same time, women’s health, safety, and agency remain chronically underfunded. A women-led development approach is essential — not only to enable individuals to realise their potential and participate fully in the economy, but also to achieve the government’s stated goal of a Viksit Bharat by 2047. The upcoming Budget is, therefore, a make-or-break moment: a chance to fiscally prioritise India’s women and girls, not as a matter of charity, but as a strategic investment in the country’s future.

It is impossible to tell India’s public health story without confronting the persistent underinvestment that continues to shape women’s lives. On paper, allocations for child and reproductive health have increased, but headline gains mask deeper structural weaknesses. The Flexible Pool for Reproductive and Child Health and Health System Strengthening rose from Rs 13,937 crore in 2022-2023 to Rs 18,741.2 crore in 2025-2026. Yet on the ground, thousands of Auxiliary Nurse Midwives and nearly 10 lakh ASHA workers remain overburdened — carrying the weight of maternal care, immunisation, counselling, and follow-up, with little financial security, safety, or training. As a result, many women, particularly in rural areas, receive care that is episodic and crisis-driven rather than continuous, supportive, and preventive.

Even when we look specifically at reproductive health spending, the numbers conceal more than they reveal. Allocations for social marketing and the free distribution of contraceptives rose from Rs 110 crore in 2022-2023 to Rs 226.88 crore in 2025-2026; this increase remains modest in real terms. Chronic underinvestment shows up in the absence of adolescent-friendly services, poor availability of spacing methods, and limited access to quality counselling. While national projections indicate declining fertility, this trend is far from uniform. Stark inter-regional disparities mean unintended pregnancies persist, women’s reproductive choices remain constrained, and unsafe abortions are still distressingly common.

The Lancet Citizens’ Commission on Reimagining India’s Health System, of which this author was a commissioner, conducted a nationwide survey in 2022-2023 that produced telling results. While public healthcare remains the main source of care for most households — with 65 per cent preferring public facilities for outpatient services and 73 per cent for inpatient care — only 28 per cent report feeling financially protected against health-related expenses. Women bear the brunt of this gap: they are more likely to delay care, absorb rising household debt, and shoulder the burden of unpaid caregiving, especially given abysmal male involvement in household work. Chronic underinvestment in women’s health, therefore, is not merely a fiscal failure; it is a democratic one.

Responses to domestic violence are where the gap between need and investment is most stark. Funding for safety-related programmes has been volatile: allocations for Safe City Projects rose from Rs 520.04 crore in 2022-2023 to Rs 1,300.1 crore in 2023-2024, before collapsing to around Rs 214 crore in both 2024-2025 and 2025-2026. In 2025-2026, safety and crisis support together account for just 0.89 per cent of the total gender budget — down from 2.23 per cent in 2022-2023 — despite mounting evidence that domestic violence has increased in the post-pandemic years. Counselling services, one-stop crisis centres, and shelter homes require sustained, predictable funding. Gender-based violence in India is systemic and pervasive, yet it still fails to be treated as a public health issue.

India’s community health workforce sits at the core of these systems. Between 2005 and 2023, community action mechanisms expanded across more than 2.3 lakh villages, 145 cities, and 450 districts, with over 50,000 health officials trained in community engagement — underscoring the potential of decentralised, participatory health systems. Yet the backbone of this effort — ASHAs and ANMs — continues to work under precarious conditions, marked by low and irregular compensation, safety risks, and limited professional recognition. If women-led development is to move beyond rhetoric, this workforce must be strengthened through fair remuneration, continuous training, and safe, dignified working conditions.

At first glance, India’s gender budget numbers appear encouraging. Total gender-related expenditure rose from Rs 1.43 lakh-crore in 2020-2021 to Rs 4.49 lakh-crore in 2025-2026. Yet only 23.5 per cent of this allocation goes to Part A programmes that directly target women, down from 39.4 per cent in 2023-2024. The bulk of spending sits in Part B programmes, where women are one among many beneficiaries and outcomes are far harder to identify and track.

All of this is unfolding against the backdrop of rapid demographic change. India’s working-age population is projected to peak in 2031, even as uneven fertility decline creates sharply divergent local realities that centralised policy responses struggle to address. A Budget that fails to strengthen women’s health systems will ultimately undermine both gender equality and India’s broader development ambitions. These investments in women’s health and well-being, safety, economic participation, and skilling should not be framed as welfare, but as the repayment of a long-overdue debt to those who hold the key to India’s prosperity.

Poonam Muttreja is Executive Director, Population Foundation of India. X: @Letstransform.

(Disclaimer: The views expressed above are the author's own. They do not necessarily reflect the views of DH)