PUBLIC HEALTH POLICY IN INDIA
Although the National Health Policy (NHP) in India was not framed until 1983, India has built up a vast health infrastructure and initiated several national health programmes over last five decades in government, voluntary and private sectors under the guidance and direction of various committees (Bore, Mudaliar, Kartar Singh, Srivastava), the Constitution, the Planning Commission, the Central Council of Health and Family Welfare, and Consultative Committees attached to the Ministry of Health and Family Welfare.
The period after 1983 witnessed several major developments in the polices impacting the health sector - adoption of National Health Policy in 1983, 73 rd and 74 th Constitutional Amendments in 1992, National Nutrition Policy in 1993, National Health Policy in 2002, National Policy on Indian System of Medicine and Homeopathy in 2002, Drug Policy in 2002, introduction of Universal Health Insurance s chemes for the poor in 2003, and inclusion of health in Common Minimum Programme of the UPA Government in 2004.
The first National Health Policy in 1983 aimed to achieve the goal of Health for All' by 2000 AD, through the provision of comprehensive primary healthcare services. It stressed the creation of an infrastructure for primary healthcare; close co-ordination with health-related services and activities (like nutrition, drinking water supply and sanitation); the active involvement and participation of voluntary organisations; the provision of essential drugs and vaccines; qualitative improvement in health and family planning services; the provision of adequate training; and medical research aimed at the common health problems of the people.
The main objective of the revised National Health Policy, 2002 was to achieve an acceptable standard of good health among the general population of the country and has set goals to be achieved by the year 2015. The major policy prescriptions are as follows:
Increase public expendi-ture from 0.9 percent to 2 per cent by 2010.
Increase allocation of public health investment in the order of 55 per cent for the primary health sector; 35 per cent and 10 per cent to secondary and tertiary sectors respectively.
Gradual convergence of all health programmes, except the ones (such as TB, Malaria, HIV/AIDS, RCH), which need to be continued till moderate levels of prevalence are reached.
Need to levy user charges for certain secondary and tertiary public health services, for those who can afford to pay.
Mandatory two year rural posting before awarding the graduate medical degree.
Decentralising the implementation of health programmes to local self governing bodies by 2005.
Setting up of Medical Grants Commission for funding new Government Medical and Dental colleges.
Promoting public health discipline.
Establishing two-tier urban healthcare system - Primary Health Centre for a population of one lakh and Government General Hospital .
Increase in Government funded health research to a level of 2 per cent of the total health spending by 2010.
Appreciation of the role of private sector in health, and enactment of legislation by 2003 for regulating private clinical establishments.
Formulation of procedures for accreditation of public and private health facilities.
Co-option of NGOs in national disease control programmes.
Promotion of tele medicine in tertiary healthcare sector.
Full operationalisation of National Disease Surveillance Network by 2005.
Notification of contem-porary code of medical ethics by Medical Council of India.
Encouraging setting up of private insurance instruments to bring secondary and tertiary sectors into its purview.
Promotion of medical services for overseas users.
Encouragement and promotion of Indian System of Medicine.
Through the 73 rd and 74 th Constitutional Amendment Acts (1992), the local bodies (Municipalities and Panchayat) have been assigned 29 development activities, which have a direct and indirect bearing on health. These include health and sanitation (covering hospitals, PHCs and dispensaries), family welfare, drinking water, women and child development, the public distribution system and poverty alleviation programmes.
Source: World Health Organisation