The Free Diagnostics Service Initiative (FDSI) is a scheme launched by the Government of India under the umbrella of the National Health Mission (NHM). The initiative was announced in the Union Budget 2014-15 and officially launched in July 2015 by the Ministry of Health and Family Welfare (MoHFW). It was created to address the high out-of-pocket expenditure (OOPE) on diagnostics, which was estimated to be around 10% of overall out-of-pocket health expenses, and to move towards the "Health for All" objective.
The scheme's core mechanism is the provision of a package of quality essential diagnostic services free of cost in all public health facilities, from the sub-center to the district hospital level. The MoHFW formulated the NHM Free Diagnostic Services guidelines, shared with States/UTs on July 2, 2015, to streamline processes and standards. The initiative operates through three key components: the Essential Pathology Initiative, the Tele-radiology initiative, and the provision of CT Scan Services at District Hospitals. States and Union Territories implement the scheme using in-house capacity, Public Private Partnership (PPP), or a Hybrid mode.
The FDSI is closely connected to the Free Drugs Service Initiative, as both were launched concurrently to reduce OOPE on healthcare. While the core concept of free diagnostics has remained, the scope of the scheme has been expanded since its launch. The initial guidelines provided an illustrative list of tests, such as 9 tests at the Sub Centre level and 57 tests at the District Hospital level. More recently, the guidelines recommend an expanded range of diagnostics, including 14 tests at Sub Centres and 134 tests at District Hospitals.