Professional Documents
Culture Documents
Dr. J.P. Majra Associate Professor Dept. of Community Medicine K.S. Hegde Medical Academy
Health policy of a Nation is its strategy for controlling and optimising the social uses of its health knowledge and health resources.
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India had its first national health policy in 1983 i.e. 36 years after independence.
Why ???
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Alma-Ata Declaration called on all the governments to formulate national health policies according to their own circumstances to launch and sustain primary health care as a part of national health system.
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The 30th World Health Assembly in May 1977 resolved The main social target of governments and WHO in the coming decades should be the attainment by all citizens of the world by the year 2000 AD of a level of health that will permit them to lead a socially and economically productive life.
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existing gross inequalities in the status of health of people particularly between developed and developing countries as well as within the countries is politically, socially and economically unacceptable.
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Alma-Ata Declaration called on all the governments to formulate national health policies according to their own circumstances to launch and sustain primary health care as a part of national health system.
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1. Equitable distribution
Some thing for all and most for those who need the most Bahujan hitae bahujan sukhae
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2. Community participation.
There must be a continuing effort to secure meaningful involvement of the community in the planning, implementation and maintenance of health services, besides maximum reliance on local resources such as manpower, money and materials.
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3.Intersectoral coordination
"primary health care involves in addition to the health sector, all related sectors and aspects of national and community development, in particular agriculture, animal husbandry, food, industry, education, housing, public works, communication and others sectors".
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4. Appropriate technology
"technology that is scientifically sound, adaptable to local needs, and acceptable to those who apply it and those for whom it is used, and that can be maintained by the people themselves in keeping with the principle of self reliance with the resources the community and country can afford"
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64 64
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62.4 63.4
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(%)
IMR 70 75 44
MMR 408 -
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BPL(%)
12.72 21.12
IMR
14 48 52
UFMR
18.8 58.1 63.3
MMR
87 135 79
90
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2. Elimination of Leprosy 3. Elimination of Kala-azar 4. Elimination of lymphatic Filariasis 5. Achieve of Zero level growth of HIV/AIDS www.similima.com
2010
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2010 2010
2007
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2010
2010
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2005
2010
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Financial resource
Increase in health sector expenditure to 6% of GDP, with 2% by public health investment by 2010 is recommended by the policy. Existing 15% of central government contribution is to be raised to 25% by 2010.
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Financial resource..
This will allow a good rise of current annual per capita public health expenditure of the country from Rs. 200/by ten-fold say around Rs. 2000/-.
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Equity
NHP 2002 has observed that the attainment of health indices has been very uneven across rural-urban divide, which can be seen from Tables
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47.0 49.6
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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.
10%
35%
55%
Primary
Secondary
Tertiary
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70 31 16 6 7
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1per 1 per
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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.
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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;
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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.
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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.
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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.
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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.
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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. It has suggested a national health accounts conforming to the source to users matrix.
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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.
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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.
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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.
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Impact of globalisation .
NHP 2002 has suggested synchronised implementation of National population policy and national health policy in improving health standard of the country. NHP 2002 focuses on building up credibility for the alternative systems of medicine through evidence based research and suggested a separate document.
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Summation
Crafting of a National Health Policy is a rare occasion. allow our dreams to mingle with ground realities.
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Summation
needs are enormous and the resources are limited health needs are also dynamic and keep changing over time. had to make hard choices between various priorities
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Summation
NHP 2002 has given a continuum to NHP 1983, where primary health care is adopted as the main strategy through
Decentralization Equity Private sector/indigenous system participation Rise in public investment
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Summation
The ultimate goal is achieving an acceptable standard of good health of people of India. The commitment of the service providers and an improved standard of governance is a prerequisite for the success of any health policy.
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miles to go before..
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