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Background: Developing countries, including India, face similar problems in implementation of health programs and thus have shown poor progress on the Millennium Development Goals. Many of these countries are also facing epidemiological transition and facing a dual disease pattern, which leads to increasing burden on the limited resources, leading to program failure. This review is undertaken to look at the possible reasons for program failure focusing on India. Methods and Findings: A SWOT (Strengths, Weakness, Opportunities and Threats) has been undertaken to review the National Health Programs in India. Any program's inadequacy in achieving its goal can be attributed to one or more of the following: (1) Technical insufficiency, (2) Administrative inanity and (3) Operational incapacity. Even a single distraction of any of these determinants can be enough deterrent causing program-failure. Poor communication about benefits of health due to lack of awareness, poor use of healthcare informatics, insufficient management training, lack of financial resources and limited collaboration with other healthcare organizations were found to lead to program failure. Conclusions: Poverty mitigation, reduction of inequalities, health care financing, strengthening of public health information system, health education and communication, positive life style changes are some of the important domains on which the success of a program depends.