Comparing health systems in Australia and India through the WHO Framework: a narrative review

Australia and India, despite shared democratic values and commitments to health equity, operate vastly different health systems. Understanding these differences through a structured framework enables identification of opportunities for mutual learning and system improvement. This review aims at comparing and contrasting the health systems of Australia and India using the World Health Organization (WHO) Health System Framework, highlighting their respective strengths, weaknesses, and sustainability challenges. This narrative-based comparative review applied the WHO Health System Framework, encompassing six building blocks: (1) health workforce, (2) service delivery, (3) health information systems, (4) access to essential medicines and technologies, (5) health financing, and (6) leadership and governance. Literature was sourced from PubMed, Scopus, Google Scholar, and official databases (WHO, AIHW, MOHFW, etc.) with publications from 2007 to 2025. Australia’s health system is characterized by universal coverage via Medicare, robust data infrastructure, regulated workforce planning, and strong financial risk protection. However, it faces challenges in equitable service distribution, fiscal sustainability, and funding inefficiencies. In contrast, India’s system grapples with underfunding, workforce shortages, and high out-of-pocket expenses. Yet, it exhibits innovations in low-cost care, community-based models (e.g., ASHA), frugal technologies, and expanding insurance schemes like PM-JAY. Both systems face issues of aging populations, geographic inequity, and sustainability. Australia and India represent contrasting models -- one resource-rich and structured, the other resource-constrained but adaptive. Australia can learn from India’s cost-effective service innovations, while India may adopt Australia’s regulatory rigor and universal coverage design. Cross-learning offers potential for strengthening global health systems facing diverse challenges.