Developing a regional typology for precision public health using a methodological framework applied to India

Abstract Background National health programmes often apply uniform strategies that overlook regional variation in disease burden and ecological context. This paper introduces a planning framework that enables subnational health systems to design precision public health strategies aligned with local epidemiology and risk profiles. Methods The paper presents a three-step typology method that is well-suited for both practitioners and academicians to use: (1) classify regions based on relative disease prevalence, (2) contextualise with ecological heat mapping, and (3) align evidence-informed strategies across key intervention domains. The method was applied to high blood glucose (HBG) and hypertension (HTN) data from India, using 12 ecological indicators and a synthesis of over 160 peer-reviewed studies to guide strategy development. Results The framework produced four distinct quadrant profiles, each with tailored public health strategies across five domains (cultural evolution of health, One Health, social determinants, public health services, and healthcare delivery) and two enabling inputs (comparative case studies and implementation pathways). The approach was applied to Indian states, but the method is generalisable to other low- and middle-income countries (LMICs) with decentralised health systems. Conclusion This typological planning framework provides a practical, data-driven tool for precision public health at the subnational level. It enables national and regional planners to account for local variation while designing scalable, adaptive strategies. The framework is suitable for LMICs and adaptable to a range of health system challenges beyond Non-Communicable Diseases (NCDs) such as diabetes and hypertension. Highlights Introduces a replicable method for subnational public health strategy planning Combines disease prevalence classification with ecological heat mappingCombines disease prevalence classification with ecological heat mapping Demonstrates application to HTN and HBG in Indian states Produces tailored strategies across five domains and two enabling inputs Supports adaptive NCD planning in decentralised LMIC health systems