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NATIONAL HEALTH POLICY IN INDIA

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NATIONAL HEALTH POLICY IN INDIA DR. KANUPRIYA CHATURVEDI DR. KANUPRIYA DR. KANUPRIYA Medical ethics . NHP 2002 has recommended notifying a contemporary code of ... – PowerPoint PPT presentation

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Title: NATIONAL HEALTH POLICY IN INDIA


1
NATIONAL HEALTH POLICY ININDIA
  • DR. KANUPRIYA CHATURVEDI

2
National Health Policy 2002
  • Objectives
  • Achieving an acceptable standard of good health
    of Indian Population,
  • Decentralizing public health system by upgrading
    infrastructure in existing institutions,
  • Ensuring a more equitable access to health
    service across the social and geographical
    expanse of India.

3
NHP 2002, Objectives..
  • Enhancing the contribution of private sector in
    providing health service for people who can
    afford to pay.
  • Giving primacy for prevention and first line
    curative initiative.
  • Emphasizing rational use of drugs.
  • Increasing access to tried systems of Traditional
    Medicine

4
Goals NHP 2002
  • 1. Eradication of Polio Yaws 2005



  • 2. Elimination of Leprosy
    2005
  • 3. Elimination of Kala-azar 2010
  • 4. Elimination of lymphatic Filariasis 2015
  • 5. Achieve of Zero level growth 2007
  • of HIV/AIDS

5
Goals NHP 2002
  • 6.Reduction of mortality by 50 2010
  • on account of Tuberculosis,
    Malaria, Other vector and
    water borne Diseases
  • 7.Reduce prevalence of blindness 2010
  • to 0.5

6
Goals NHP 2002
  • 8. Reduction of IMR to 30/1000 2010
  • MMR to 100/lakh
  • 9. Increase utilisation of public
    2010
  • health facilities from current
  • level of lt20 to gt 75
  • 10. Establishment of an integrated 2007
  • system of surveillance,
  • National Health Accounts and
  • Health Statistics

7
Goals NHP 2002
  • 11.Increase health expenditure 2010
  • by government as a of
  • GDP from the existing
  • 0.9 to 2.0
  • 12. Increase share of Central 2010
  • grants to constitute at least
  • 25 of total health spending

8
Goals NHP 2002
  • 13. Increase State Sector 2005
  • Health spending from
  • 5.5 to 7 of the budget
  • 14. Further increase of 2010
  • State sector
  • Health spending
  • from 7 to 8

9
NHP-2002Policy prescriptions
10
Differentials in health status among rural/urban
India
11
Equity..
  • To overcome the social inequality, NHP 2002 has
    set an increased allocation of 55 total public
    health investment for the primary health sector,
    35 for secondary sector and 10 for tertiary
    sector.

12
Delivery of national public health programmes
  • NHP 2002 envisages the gradual convergence of all
    health programmes under a single field
    administration.
  • It suggests for a scientific designing of public
    health projects suited to the local situation.

13
Delivery of national public health programmes.
  • Training and reorientation of rural health staff
    and free hand to district administration to
    allocate the time of the rural health staff
    between the various programmes, depending on the
    local need is stressed.

14
Public health spending in select countries
Population with income of less than one dollar per day IMR /1000 Health expenditure to GDP Public expenditure on health to total health expenditure
India 44.2 70 5.2 17.3
China 18.5 31 2.7 24.9
Sri Lanka 6.6 16 3.0 45.4
UK - 6 5.8 96.9
USA - 7 13.7 44.1
15
Delivery of national public health programmes.
  • Therefore, the policy places reliance on
    strengthening of public health outcomes on
    equitable basis.
  • It recognises the need of user charge for
    secondary and tertiary public health care for
    those who can afford to pay.

16
Extending public health services
  • Expanding the pool of General Practitioners to
    include a cadres of licentiates including Indian
    systems of Medicine and Homoeopathy is
    recommended in the policy.
  • In order to provide trained manpower in under
    served areas it recommends contract employment.

17
Suggested norms for health personnel
Category of personnel Norms suggested Norms suggested
1 . Doctors 1 per 3,500 population
2. Nurses 1 per 5,000 population
3. Health worker female and male 1 per 5,000 population in plain area and 3000 population in tribal and hilly areas.
4. Trained dai 1per village 1per village
5. Health assistant (male and female 1 per 30,000 population in plain area and 20000 population in tribal and hilly areas.
6. Health assistant (male and female) provides supportive supervision to 6 health workers (male /female).
7. Pharmacists 1 per 10,000 population
8. Lab. technicians 1 per 10,000 population
18
Education of health care professionals
  • NHP 2002 recommends setting up of a Medical Grant
    Commission for funding new government
    medical/dental colleges.
  • It suggests for a need based, skill oriented
    syllabus with a more significant component of
    practical training.

19
Education of health care professionals..
  • The need for inclusion of contemporary medical
    research and geriatric concern and creation of
    additional PG seats in deficient specialities are
    specified.

20
Need for specialists in 'public health' and
'family medicine'
  • For discharging public health responsibilities in
    the country NHP 2002 recommends specialisation in
    the disciplines of Public Health and Family
    Medicine
  • where medical doctors, public health engineers,
    microbiologists and other natural science
    specialists can take up the course.

21
Nursing personnel
  • NHP 2002 recognises acute shortage of nurses
    trained in superspeciality disciplines.
  • It recommends increase of nursing personnel in
    public health delivery centres and establishment
    of training courses for superspecialities.

22
Urban health
  • Migration has resulted in urban growth which is
    likely to go up to 33.
  • It anticipates rising vehicle density which lead
    to serious accidents.
  • In this direction, 2002 NHP has recommended an
    urban primary health care structure as under

23
Urban health
  • First Tier-
  • Primary centre cover 1 Lakh population
  • It functions as OPD facilities.
  • It provides essential drugs.
  • It will carry out national health programmes.

24
Urban health
  • Second Tier-
  • General Hospital a referral to primary centre
    provides the care.
  • The policy recommends a fully equipped hub-spoke
    trauma care network to reduce accident mortality.

25
Mental health
  • Decentralised mental health service for diagnosis
    and treatment by general duty medical staff is
    recommended.
  • It also recommends securing the human rights of
    mentally sick.

26
Information Education and Communication
  • NHP 2002 has suggested interpersonal
    communication by folk and traditional media to
    bring about behavioural change.

27
Information Education and Communication.
  • School children are covered for promotion of
    health seeking behaviour, which is expected to be
    the most cost effective intervention where health
    awareness extends to family and further to future
    generation.

28
Health research
  • 2002 NHP noted the aggregate annual health
    expenditure of Rs. 80,000 crores and on
    research Rs. 1150 crores is quite low.
  • The policy envisages an increase in govt. funded
    health resources to a level of 1 total health
    spending by 2005 and upto 2 by 2010.
  • New therapeutic drugs and vaccines for tropical
    disease are given priority.

29
Role of private sector
  • The policy welcomes the participation of the
    private sector in all areas of health activities
    primary, secondary and tertiary health care
    services
  • but recommended regularitory and accreditation of
    private sector for the conduct of clinical
    practice.

30
Role of private sector..
  • It has suggested a social health insurance scheme
    for health service to the needy.
  • It urges standard protocols in day-to-day
    practice by health professionals.
  • It recommends tele-medicine in tertiary care
    services.

31
Health statistics
  • NHP 2002 has recommended full baseline estimate
    of tuberculosis, malaria and blindness by 2005,
    and
  • In the long run for cardiovascular diseases,
    cancer, diabetes, accidents, hepatitis and G.E.

32
Women's health
  • After recognising the catalytic role of empowered
    women in improving the overall health standard of
    the country, NHP 2002 has recommended to meet the
    specific requirement of women in a more
    comprehensive manner.

33
Medical ethics
  • In India we have guidelines on professional
    medical ethics since 1960.
  • This is revised in 2001.
  • Government of India has emphasised the importance
    of moral and religious dilemma.

34
Medical ethics.
  • NHP 2002 has recommended notifying a contemporary
    code of ethics, which is to be rigorously
    implemented by Medical Council of India.
  • The Policy has specified the need for a vigilant
    watch on gene manipulation and stem cell research.

35
Enforcement of quality standard for food and
drugs
  • NHP 2002 envisaged that Food and Drug
    administration be strengthened in terms of
    laboratory facilities and technical expertise.

36
Regulation of standards in paramedical disciplines
  • More and more training institutions have come up
    recently under paramedical board which do not
    have regulation or monitoring.
  • Hence, establishment of Statutory Professional
    Council for paramedical discipline is recommended.

37
Environmental and occupational health
  • Government has noted the ambient environment
    condition like unsafe drinking water, unhygienic
    sanitation and air pollution.
  • Child labour and substandard working conditions
    are causing occupational linked ailments.

38
Environmental and occupational health.
  • NHP 2002 has suggested for an independent state
    policy and programme for environment apart from
    periodic health screening for high risk
    associated occupation.
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