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India’s National Health Policy: Nailing it right!

Jan 21, 2014

Rajendra Pratap Gupta, President, Disease Management Association of India speaks on the need for an effective National Health Policy and the aspects to be considered while framing it.

Rajendra Pratap Gupta

The need for planning and policy in health was felt about seven decades ago in British India, when a committee was appointed under Sir Joseph Bhore. The Bhore committee recommended the formation and execution of a ‘National Health Policy’ (NHP) in 1946 (Health Survey & Development Committee, Vol II - Bhore Committee, 1946, p. 410) . India has had only two National Health Policies till date; i.e. the National Health Policy 1983 and the National Health Policy 2002 - the first healthcare policy came after a gap of 37 years from Bhore committee recommendation.

Also, there are some learning from the past National Health Policies. The ‘National Health Policy’ did not adequately reflect ground realities. Despite the fact that the National Population Policy (NPP) 2000, the National Health Policy 2002, the Eleventh Five Year plan (2007-12 ) and the National Rural Health Mision (2007-12)- having laid down the goals for child health, the number of children dying < 5 years in 2000 was 2294000 and had reduced to 1696000 in 2010. But still, it is way too high.

‘Universal comprehensive primary healthcare services which was the goal of the National Health policy is far from being realised’……..NHP recommended the formulation of the medical education and a population policy , but this has not been done till today . (Voluntary Health Association of India, 1997, pp. 39,40)

Also, the earlier National Health Policies did not even have the word ‘chronic diseases’, and so clearly, the older policy documents are not relevant today.

The National Health Policy document of 1983 aimed at achieving ‘Health for all by the year 2000’ and emphasised universal provision of comprehensive primary care, community participation, decentralisation, increase in outreach services through domiciliary care and field camps, seek involvement of voluntary organisations, according priority to tribal, hilly and backward areas, promotion of family planning, supply of drinking water and sanitation, over hauling health manpower development, phasing out private practice amongst government doctors , integration of indigenous system of medicine in healthcare delivery, besides other issues.

NHP 2002 came out after 19 years of the first National Health Policy in 1983. The policy document accepted that some areas of NHP 1983 have yielded results, but in several other areas, the outcome has not been as expected!

NHP 2002 accepted that the mortality and morbidity were unacceptability high and such indices are an indication of the limited success of the public health system in meeting the preventive and curative needs of the general population.

The document dwells on problems like stagnancy of the public health funding, inequity in healthcare, health being the responsibility of states, shortfall in health infrastructure (as high as 58 per cent when disaggregated for CHCs) and accepted that the public health infrastructure was far from satisfactory.

NHP 2002 looked into the deficiency of health personnel, healthcare education, specialists in public health and family welfare, shortage of nursing personnel, use of generics, urban health, mental health, IEC, health research, enhancing the role of private sector, role of civil society, national disease surveillance network, scientific health statistics database, women’s health, medical ethics, quality standards for health foods, standards for paramedics, medical tourism, inter sectoral issues in health, population growth, increase in use of traditional/alternative systems of medicine, controlling the irrational use of drugs etc.

Click here to read the full article.

SOURCE: Financial Express

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