CSR for health, hunger, sanitation and drinking water

Yes: CSR money can pay for health care, nutrition, sanitation and safe drinking water, because item (i) of Schedule VII covers all four. It is one of the broadest items in the list, and after education it receives more CSR money than any other area.

Schedule VII is the list in the Companies Act, 2013 of the activities CSR money can be spent on. This guide, for CSR teams and for NGOs designing projects, explains what its first item says, which projects clearly qualify, how the Ministry of Corporate Affairs (MCA) has settled the grey areas, what never counts and what good practice looks like. For all thirteen items in one table, see Schedule VII at a glance.

What item (i) says

In plain words, the item has four strands:

• Hunger, poverty and malnutrition: food and nutrition support, especially for young children, adolescent girls and pregnant and breastfeeding women.
• Health care, including preventive care: primary and maternal care, screening and treatment, eye care, mental health, palliative care, training health workers, and health buildings and equipment.
• Sanitation: toilets, menstrual hygiene, handwashing and managing solid and liquid waste.
• Safe drinking water: purification, supply, water testing and protecting sources.

The MCA answers common questions on CSR in a set of frequently asked questions (General Circular 14/2021, 25 August 2021), cited here as “FAQ” and a number. They are the Ministry’s reading of the law rather than law, but companies and auditors rely on them. FAQ 3.13 says Schedule VII “must be interpreted liberally to capture the essence of the subjects”, so an activity needn’t be named word for word: community mental health or menstrual hygiene for schoolgirls sit comfortably within health care and sanitation.

How much CSR goes to health, nutrition, sanitation and water

The National CSR Portal sorts spending into about 29 “development sectors”. They aren’t Schedule VII items, but five of them map onto item (i).

Together these lines came to ₹9,227.60 crore in 2023-24, about 26% of the ₹34,908.75 crore companies spent on CSR that year. Health care’s share has fallen since the COVID-19 years, from 29.7% of all CSR in 2021-22 to 20.5% in 2023-24. The figures come from filings up to 31 March 2025 (PIB, 25 March 2026), and late filings keep revising them: see India’s CSR in numbers.

Projects that clearly qualify

Water projects often overlap with items (iv) and (x), so tag each project with the item that best describes its main purpose, and agree the tag with your partner.

Grey areas, and how the FAQs settle them

Clinics and camps that employees also use

Rule 2(1)(d)(iv) of the CSR Rules excludes activities benefiting the company’s employees. FAQ 4.2 draws the line: an activity “designed exclusively for the benefit of employees” doesn’t count, but one designed for the public still counts when employees and their families are “incidental beneficiaries”. A clinic near the factory that serves the whole village qualifies even if workers’ families use it. An occupational health centre inside the plant doesn’t.

Medicines and products from the company’s own stock

Section 135(5) requires a company to spend, so FAQ 3.12 says “CSR contribution cannot be in kind and monetized”. A drug maker can’t hand over its own medicines and book their value as CSR, and a consumer goods company can’t count soap from its warehouse. Buying medicines or supplies for a project is spending, and it counts.

Branding on health camps

FAQ 4.3 says CSR should run “in a project or programme mode rather than as a one-off event”, though brand building “as a collateral benefit” is fine. A year-round screening programme with the company’s name on the van qualifies. A single branded camp at a marketing event looks like sponsorship, which Rule 2(1)(d)(v) excludes.

Working with government hospitals and health centres

FAQ 3.17 says CSR “should not be interpreted as a source of financing the resource gaps in Government Schemes”, though a board may run similar activities independently. Companies can equip a primary health centre, train its staff or run outreach that brings patients to it, agreed in writing with the health department. Paying salaries for sanctioned posts the state hasn’t filled is the gap-filling the FAQ warns against. See CSR and government schemes.

Hospitals, equipment and ambulances

Buildings, machines and vehicles are capital assets. Since 22 January 2021, Rule 7(4) has required them to be held by a Section 8 company, registered public trust or registered society with charitable objects and a CSR registration number, by the project’s beneficiaries as self-help groups, collectives or entities, or by a public authority such as a state health department, never by the company that paid. Transfer costs count (FAQ 3.6), and once an ongoing project ends the board may fund its operation and maintenance as a separate project (FAQ 6.1). See capital assets in CSR.

Pandemics and health emergencies

For COVID-19, General Circular 10/2020 (23 March 2020) made spending eligible under items (i) and (xii), health care and disaster management, and Circulars 05/2021 and 09/2021 added makeshift hospitals, oxygen plants and medical equipment. Circular 15/2020 (10 April 2020) said the PM CARES Fund qualified, and so did contributions to State Disaster Management Authorities under item (xii), but chief ministers’ or state relief funds didn’t, and nor did wages paid to a company’s own workers during the lockdown. The answers were written for the pandemic, but they show how the Ministry reads items (i) and (xii) together in an emergency.

What doesn’t count

Our guide to what doesn’t count as CSR covers each exclusion in full. In health, the common ones are:

• Health benefits for the company’s own staff, such as medical insurance, a staff clinic or annual check-ups.
• Anything another law already requires, such as first-aid and occupational health arrangements at its own workplaces, or treating its own waste and effluent (Rule 2(1)(d)(vi)).
• The company’s normal business: a hospital group’s paid services, an insurer’s policies, a drug maker’s trials of its own products. A temporary exception for COVID-19 vaccine, drug and device research ended after 2022-23.
• Goods in kind at a notional value (FAQ 3.12), and employees’ volunteering hours, which “cannot be monetized” (FAQ 3.18).
• Contributions to funds not named in Schedule VII, including state health or relief funds (FAQ 3.16). The Swachh Bharat Kosh is named, so it counts.
• Anything outside India.

Good practice: need, partners and what to measure

Start from the data

The National Family Health Survey (NFHS) is the starting point for nutrition and maternal and child health. NFHS-6, conducted in 2023-24 across 715 districts, found that stunting among children under five fell from 35.5% to 29.3% since NFHS-5 (2019-21), and severe wasting from 7.7% to 5.2%. Underweight barely moved, from 32.1% to 31.8%, and institutional deliveries rose from 88.6% to 90.6% (PIB, 29 May 2026). Use figures for your own districts, which can differ widely from the national average. For water and sanitation, the Jal Jeevan Mission and the Swachh Bharat Mission (Grameen) publish village-level progress. See needs assessment for combining data with what communities say.

Work with the public system

Projects that strengthen anganwadi centres, ASHAs and primary health centres, rather than building a parallel service, tend to last. Some national programmes invite this directly: the Ni-kshay Mitra initiative, launched on 9 September 2022 under the Pradhan Mantri TB Mukt Bharat Abhiyaan, asks companies, NGOs and individuals to give people on TB treatment extra diagnostic, nutritional and vocational support (PIB, 9 September 2022). For water and toilets, village water and sanitation committees and gram panchayats are the natural partners.

Measure outcomes, not camps

See choosing indicators for setting targets and breaking results down by gender, age and location. And budget for running costs, from nurses and medicines to filters and repairs: put the plan for handing over to the health department, the panchayat or a user committee in the agreement from the start.

For NGOs

• Show the need with numbers: district NFHS figures, health centre records or your own baseline survey.
• Be eligible before you apply: the right legal form and income-tax registrations, a CSR registration number on Form CSR-1 and, unless a company or a government set you up, at least three years’ record of similar work. See Form CSR-1 and how NGOs can get CSR funding.
• Protect patients: qualified staff, any registration your state requires for clinics, private records and no photographs without consent (see consent, photos and dignity).
• Agree who holds equipment and who pays for upkeep before anything is bought.
• Report outcomes and problems honestly. Money released to you counts as the company’s spending only once you have used it (FAQ 7.4).

To go deeper, take the Academy’s CSR Essentials and The SDGs and India courses.