National Health Policy Of India

depicted object health constitution Of IndiaThe guinea pig health Policy of 1983 was announced during the Sixth mean period. The National Health Policy (NHP) in light of the Directive Principles of the constitution of India recommends universal joint, comprehensive primary wellness oversee services which argon relevant to the actual needs and priorities of the community at a cost which people can afford (MoHFW, 1983, 3-4).It recommended the giving medication of a nationwide network of epidemiological stations that would facilitate the integration of various wellness interventions.It site up targets for achievement that were primarily demographic in nature.The NHP 1983 stated that India is committed to attaining the goal of Health for all by the Year AD 2000, through the universal provision of comprehensive primary health care services. This goal was in line with the 1978 Alma-Ata conference of the WHO.Some of the policy initiatives come outlined in the NHP-1983 feed y ielded results, while, in several another(prenominal) areas, the outcome has not been as expected.National Health Policy of India 2002The results of the 1983 policy have been mixed. The to the highest degree noteworthy initiative under this policy was a phased, time-bound programme for setting up a well dispersed network of comprehensive primary healthcare services. However the financial resources and common health administrative capacity which it was possible to marshal, was far short of that necessary to achieve such an ambitious and holistic goal. The outcomes have been far less than targets as NHP 1983 was a set of broad-based macro-level recommendations spanning not and the health sector, precisely also sectors associated with other contributors such as water depict, sanitation, environment, nutrition, etc. to the health status of the universe of discourse. thereof against the preceding(prenominal) backdrop the existing health policy was modified in 2002 and the Nati onal health policy 2002 was formulated. The National Health Policy 2002 re revolutionarys its commitment to expeditiously control communicable complaints, eliminate a few and hold the rest in a time-bound manner. Some of the time bound goal this policy expects to achieve are shown in the table below terminalTarget DatesEradicate polio and yaws2005 extend leprosy2005Eliminate kala-azar2010Eliminate lymphatic filariasis2015Achieve zero level growth of human immunodeficiency virus/AIDS2007 constrict mortality by 50% on account of tuberculosis, malaria and other vector and water-borne diseases2010Reduce prevalence of cecity to 0.5% 20102010Reduce infant mortality rate to 30/ c0 and maternal mortality rate to 100/1000002010Increase utilization of globe health facilities from current level of 75%2010Establish an merged system of surveillance, interior(a) health accounts and health statistics2005Increase health expenditure by organisation as a % of GDP from the existing 0.9% to 2%20 10Increase share of Central grants to constitute at to the low degree 25% of total health spending2010Increase state sector health spending (from 5.5% to 7% of budget)2005Further increase state sector health spending to 8% of budget2010In this canvas we analyse the national health policy by addressing the following questionsHave the tasks enlisted in the 2002 NHP been fulfilled as desired?Did the 2002 NHP capablely reflect the ground realities in health care provision?And lastly, what are the gaps in national health policy formulation and what is the road ahead for the health policy of the country?Achievements of the NHP 2002India achieved the lowest ever polio transmission levels in 2010, especially during the high transmission season. Also a exquisite decline was seen in number of polio cases reported with only 633 polio cases reported in November 2010 compared to 633 cases in 2009Adult HIV prevalence at national level has declined from 0.41% in 2000 to 0.31% in 2009. The es timated number of new annual HIV infections has declined by more than 50% over the past decade. According to data from National AIDS Control Organization, there has been an overall reduction in adult HIV prevalence and HIV incidence (new infections) in India.Leprosy Prevalence Rate has been further muffled to 0.71/10,000 2010. 32 State/UTs (except Bihar, Chhattisgarh and Dadra Nagar Haveli) have achieved excreting by March 2010. Similar progress of elimination has also been in 81% of districts and 77% of button up PHC in the country.TB mortality in the country has reduced from over 42/hundred thousand population in 1990 to 23/lakh population in 2009 as per the WHO world-wide report 2010. As per the WHO global TB report, 2010 the prevalence of TB in the country has reduced from 338/lakh population in 1990 to 249/lakh population by the year 2009.Problems not addressed by NHP 2002NHP 2002 completely omits the imagination of comprehensive and universal healthcare. The policy thu s departs from the fundamental concept of the NHP 1983 and the Alma Ata Declaration. By its silence, the NHP 2002 provides a framework for the dismantling of the entire concept of primary healthcare. Importantly, the section on policy prescriptions in the NHP 2002 is silent on the content of the primary healthcare system.Despite the increase financial resources dedicated to health care the country continues to struggle in creating sufficient healthcare infrastructure. The government estimated there was a shortage of 4,803 primary health centres and 2,653 community health centres in 2006. According to a study conducted by the Confederation of Indian Industry, the formal healthcare system reaches only about 50% of the total population. India is also desperately short of doctors, with only 645,825, or 0.6 per 1,000 people, in 2004, consort to the World Health Organisation (WHO).Even though the NHP 2002 plans to raise earthly concern health investment to 2% of GDP, the target is far less than the WHO recommended target of 5%.The policy does admit grave deficiencies in the health sector and notes how only 20 per cent of the population seeks OPD services and is forced to turn to private clinics. It also admits the collapse of the primary healthcare system and acknowledges the poor coverage of womens health and prevention of infant mortality. Ironically, its prescriptions function to address the problems or offer solutions.The policy calls for providing incentives to the private sector to move to the primary healthcare system. However, the do it in urban centres has been discouraging. The incentives in terms of subsidised land, water, electricity and duty-free import facility doled out to high-profile private medical centres and hospitals in the urban areas has seen little benefit for the poor. Very few of these hospitals conform to the authorization provision of free medical care to the population below the poverty line or the backlog of a certain percentage of their beds for the poor.Recommendations and conclusionAlthough the Indian economy had high growth rates in recent years (94% in 2005-06 and 96% in 2006-07, with a consistent 70% growth rate even during the period of global economic slowdown), according to the Human maturement Index India is ranked 134 among 182 countries. Indias economic transformation does not seem to have produced tangible improvements in the health of the nation, and the recognition that improvement in health contributes to accelerated economic growth has not led to sufficient investment in or improved the efficiency of health care.The NHP 2002 fails to check the growing influence of the private sector in the health care system. The private sector grew in an uncoordinated manner, to become the neglect option for healthcare in many cases. In an unregulated environment, neither the private sector nor the public sector provided an assurance of quality or access. The increasing dependence on the private secto r, in profit to very weak regulation and corruption, has led to a huge increase in health-care costs in the country.Considering the above scenario the new healthcare policy or any other healthcare plan of the government should focus mainly on achieving the following objectives in the period of next 10 years tick off the reach and quality of health services to all in IndiaReduce the financial burden of health care on individualsEmpower people to take care of their health and hold the health-care system accountable.Thus the new policy should again focus on the goal of universal health care which was mentioned in the NHP 1983, but was sidelined in the NHP 2002.Strategic plan to achieve healthcare goalsIn this section we briefly plow the goals that are desired to be achieved by the new healthcare policy framework and proposed strategies to achieve these goals.Goal Integrate private and public health-care delivery systemsStrategiesAll health-care institutions and practitioners should be required to register with a national health regulatory agency and make this information available on the internet.Define a sensible mix of public and private health-care services to enhance complementarities, and invest in further development of public health-care services including health promotion and prevention services.Goal construct a universal health-care fund and reduce the cost of health careStrategiesIncrease the proportion of gross domestic product as public health expenditureMerge all existing health insurance funds (eg, Rashtriya Swasthya Bima Yojna, Arogyasri) with this fund give heavy taxes on harmful products such as tobacco products, alcohol, and foods of low nutritional value, and allocate most revenue to health careDefine the costs of all essential and emergency health-care interventions, and finance a package of care that is based on diseases that should be prioritised and cost-effective interventionsNegotiate prices with providers, including caps, for diffe rent services on the basis of the cost of the care packagesInvest in health promotion and early recognition of diseaseGoal Increase the numbers, diversity, and distribution of human health resourcesStrategiesEstablish an autonomous organisation to govern the supply of a full range of health workers, from accredited social health activists to doctors to health administratorsStrengthen the fiber of community health workers with clearly defi ned skills, adequate remuneration, and career pathsEncourage postings in rural or other underserved areas through increased salaries and other incentives such as provision of education to childrenEstablish the Indian Health Service for careers in government health careAll senior personnel in the Ministry of Health should be required to have public health trainingPromote the creation of medical and care for colleges in underserved districtsGoal Promote evidence-based health-care practicesStrategiesEstablish an autonomous organisation to set guidel ines for care practices in the unified National Health SystemMonitor and regulate the use of practices that are not based on evidenceStrengthen capacities of health and non-health policy makers to recognise the importance of this approachIncrease resources for priority health researchImplement and act on the findings of district and national health surveillance and information systems, and move on assessmentsGoal Promote rational use of drugs and technologyStrategiesPromote use of generic drugs through a wide network of pharmacies for generic drugs, with at least one in each block fling incentives by pharmaceutical and medical technology companies to practitioners or consumer groupsNegotiate bulk purchasing for patented drugs chance on the best use of information technology that is being developed for the health systemGoal Create a decentralised governance structure that responds to local anaesthetic needs and is accountableStrategiesCreate systems for accountability of local hea lth-care services to fully empowered civil society groupsProvide flexibility and expertise in districts and subdistricts to plan local health-care management plansMonitor and promote equity, efficiency, effectiveness, and accountability in the health-care system