National health policy

1. INTRODUCTION
HEALTH: A state of complete physical, mental and social well being
and not merely the absence of disease or infirmity.
POLICY: Policy is a system, which provides the logical framework
and rationality of decision making for the achievements
HEALTH POLICY: Health policy of a nation is its strategy for
controlling and optimizing the social uses of its health knowledge of
intended objectives.

2. • Health Policy defines a vision for the future which in turn
helps to establish targets and points of reference for the
short and medium term. It outlines priorities and the
expected roles of different groups and it builds consensus
and informs people.

3. Need of National Health Policy
• Notwithstanding the improved access to health services, there still
remain challenges such as -
• The low numbers of pregnant women who are delivered deliveries by
skilled attendants
• high neonatal mortality
• TB prevalence and incidence is still a challenge
• possible threat of resurgence of malaria due to cross border transmission

4. • emergence and/or re-emergence of vector-borne diseases.
• Other sector challenges are an increasing prevalence of non-communicable
diseases and injuries
• double burden of communicable and non-communicable diseases
• progressive technological advancement in health
These challenges led to a high demand for appropriately skilled health personnel
and supply of funding that is outstripped by current and potential demands

5. Goals of National Health Policy
• In response to these challenges in the coming decades, the health sector will strive to
attain the following strategic policy goals:
Significantly reduce the burden of early childhood illness and improve maternal and child
health/development.
 Control communicable diseases with an aim of reducing them to a non-public health
problem.
 Prevent, control and manage non-communicable diseases.
 Strengthen cross cutting health programmes.

6. Enhance efficiency, equity and quality of service delivery through
health systems development.
Improve effectiveness of governance of the health system.
Introduce a health-financing scheme that protects people from
catastrophic expenditures and ensures sustainability of the system.
Strengthen sector planning and monitoring capability.

7. National Health Policy 1983
• The Ministry of Health & Family Welfare, Government of
India, evolved a National Health Policy in 1983 keeping in
view the national commitment to attain the goal of Health for
all by the year 2000.

8. Cont….
• The policy lays stress on preventive, promotive, public health and
rehabilitation aspects of healthcare.
• The policy stresses the need of establishing comprehensive primary health
care services to reach the population in the remote area of the country.
• India had its first national health policy in 1983 i.e. 36 years after
independence
• India had its first national health policy in 1983 i.e. 36 years after
independence

9. Objectives of NHP 1983
• A phased, time-bound programme for setting up a well-dispersed
network of comprehensive primary health care services, linked with
extension and health education, designed in the context of the ground
reality that elementary health problems can be resolved by the people
themselves.
• Intermediation through ‘Health volunteers’ having appropriate
knowledge, simple skills and requisite technologies.

10. • Establishment of a well worked out referral system to ensure that
patient load at the higher levels of the hierarchy is not needlessly
burdened by those who can be treated at the decentralized level.
• An integrated net-work of evenly spread speciality and super-
speciality services; encouragement of such facilities through
private investments for patients who can pay, so that the draw on
the Government’s facilities is limited to those entitled to free use.

11. Salient features of the 1983 Health policy
• It was critical of the curative-oriented western model of health care
• Emphasized a preventive, promotive and rehabilitative primary health care
approach
• Recommended a decentralized system of health care, the key features of
which were low cost, deprofessionalisation (use of volunteers and
paramedics), & community participation,
• expansion of the private curative sector which would help reduce the
government's burden

12. Indicators to Achieve Health For All
• Reduction of Infant Mortality Rate from 125 to below 60
• Reduction of Maternal Mortality Rate from 4.5 to below 2
• To raise life expectancy at birth from 52.6 to 64
• To reduce Crude Death Rate from 14 to 9 5.
• To reduce Crude Birth Rate from 35 to 21 6.
• To achieve a Net Reproductive Rate of 1 7.
• To provide portable water to the entire rural population

13. Factors interfering with the progress
towards Health For All
• Insufficient political commitment to the implementation of health of all
• Failures to achieve equity in access to all primary health care elements
• The continuing low status of women
• Slow socio-economic development
• Difficulty in achieving intersectoral action for health
• Unbalanced distribution of and weak support for human resources

14. • Widespread inadequacy of health promotion activities
• Weak health information sysytem and no baseline data
• Pollution, poor food, safety and lack of water supply and sanitation
• Rapid demographic and epidemiological changes
• Inappropriate use of and allocation of resources , high cost
technology
• Natural and Man made disasters

15. NATIONAL HEALTHPOLICY-2002
• A revised health policy for achieving better health care and unmet goals has
been brought out by government of India- National Health Policy 2002.
• According to this revised policy, government and health professionals are
obligated to render good health care to the society.
• Optimizing the use of health service to a large group rather than a small
group is a foreseen event by the NHP2002.
• Inclusion of social policies adds to the credit of the revised NHP 2002

16. Main Objectives Of NATIONAL HEALTH
POLICY-2002
• To achieve and acceptable standard of good health among the
general population of the country
• The approach would be increase access to decentralize public health
system by establishing new infrastructure in the existing institutes
• Ensure equitable access to health services across the social and
geographical expanse of the country

17. • Primacy will be given to preventive and first line curative
initiatives at primary health level
• Focus on those diseases which are principally contributing to
disease burden such a Malaria, Blindness etc
• Emphasis will be laid on rational use of drugs within the
allopathic system

18. Key Strategies of NHP 2002
• Primary Health Care Approach
• Decentralized public health system
• Convergence of all health programme under single field umbrella
• Strengthening and extending public health services
• Enhanced contribution of private and NGO sector in health care
delivery.
• Increase in public spending for health care.

19. POLICY Key Components
• Financial Resources, Equity
• Delivery Of National Public Health Programs
• The state of public health infrastructure, Extending public health
service
• Role of local self- Government Institutions , Norms of Health
care Professional
• Indian Medical council Act and IndianNursing Council Act

20. • Education of Health care Professional
• Need for specialists in 'Public Health' and 'Family
Medicine’
• Use of Generic drugs
• Urban health: Urban Community Health Centre
• Mental health
• Women's health

21. Goals of NHP 2002 By The Year to Be
Achieved
• Eliminate Lymphatic Filariasis by the year of 2015
• Eliminate Kala – Azar by the year of 2010
• Eliminate malaria and vector and water borne diseases by the year of 2010
• Reduce prevalence of blindness to 0.5% by the year of 2010
• Reduce IMR to 30/1000 and MMR to 100/1 Lakh by the year of 2010
• Increase utilization of public health facilities current level of 75 % by the year of 2010
• Increase health expenditure by government as a % of GDP from the existing 0.9 % to 2
% by the year of 2010

22. • Increase share of central grants to constitute at least 25% of total health spending
by the year of 2010
• Further increase to 8 % of the budget by the year of 2010
• Achieve zero level growth of HIV / AIDS by the year of 2007
• Eradicate Polio & Yaws by the year of 2005
• Eliminate Leprosy by the year of 2005
• Establish an integrated system of surveillance, National health accounts & Health
statistics by the year of 2005
• Increase state sector health spending from 5.5 % to 7 % of the budget by the year
of 2005

23. National Health Policy, 2017
• NHP 2017 builds on the progress made since the last NHP
2002.
• The developments have been captured in the document
“Backdrop to National Health Policy 2017 Analyses”,
Ministry of Health and Family Welfare, Government of India

24. Need of The National Health Policy, 2017
The National Health Policy of 1983 and the National Health Policy of 2002
have served well in guiding the approach for the health sector in the Five-
Year Plans. The current context has however changed in four major ways.
• First, the health priorities are changing. Although maternal and child
mortality have rapidly declined, there is growing burden on account of
non communicable diseases and some infectious diseases.
• The second important change is the emergence of a robust health care
industry estimated to be growing at double digit.

25. • The third change is the growing incidences of catastrophic
expenditure due to health care costs, which are presently estimated to
be one of the major contributors to poverty.
• Fourth, a rising economic growth enables enhanced fiscal capacity.
Therefore, a new health policy responsive to these conte required. The
National Health Policy, 2017 seeks to reach everyone in a
comprehensive integrated way to move towards wellness. It aims at
achieving universal health coverage and delivering quality health care
services to all at affordable

26. Primary Aim of National Health
Policy, 2017
• To inform, clarify, strengthen and prioritize the role of government in
shaping health systems an all its dimensions
• Investments in health, organization of health care services,
• Prevention of diseases
• Promotion of good health through cross sectoral actions,
• Access to technologies,

27. • Developing human resources,
• Encouraging medical pluralism,
• Building knowledge base,
• Developing better financial protection strategies,
• Strengthening regulation and health assurance

28. Goal of National Health Policy, 2017
• Attainment of the highest possible level of health and wellbeing for all at all ages,
through a preventive and promotive health care
• Orientation in all developmental policies
• Universal access to good quality health care services without anyone having to
face financial hardship as a consequence. This would be achieved through
increasing access, improving quality and lowering the cost of healthcare delivery.
• The policy recognizes the pivotal importance of sustainable development goals
(sdgs)

29. Key Policy Principles of The National
Health Policy, 2017
• Professionalism, integrity and ethics
• Equity
• Affordability
• Universality
• Patient centered & quality of care

30. • Accountability
• Inclusive partnerships
• Pluralism
• Decentralization

31. Objectives of The National Health Policy,
2017
• Improve health status through concerted policy action in all
sectors
• Expand preventive, promotive, curative, palliative and
rehabilitative services provided through the public health
sector with focus on quality.

32. Goals-By The Year to Be Achieved
•Life Expectancy And Healthy Life
1. Increase Life Expectancy at birth from 67.5 to 70 by the year
2005
2. Establish regular tracking of Disability Adjusted Life
3. . Reduction of TFR to 2.1 at national and sub national level
by the year of 2025

33. • Mortality by Age And/ Or Cause
1. Reduce Under Five Mortality to 23 by the year of 2025
2. MMR from current levels to 100 by the year of 2020
3. Reduce infant mortality rate to 28 by the year of 2019
4. Reduce neo-natal mortality to 16 and still “single digit” by
the year of 2025

34. Reduction of Disease Prevalence/ Incidence
• Achieve global target of 2020 which is also termed as target of 90:90:90, for
HIV/AIDS i.e.
90% of all people living with HIV know the
90% of all people diagnosed with HIV infection receive sustained
antiretroviral therapy
90% of all people receiving antiretroviral therapy will have viral
suppression
• Achieve and maintain elimination status of Leprosy by the year of 2018

35. • Achieve and maintain elimination status of Kala and Lymphatic Filariasis in
endemic pockets by the year of 2017
• To achieve and maintain a cure rate of >85% in new sputum positive patients
for TB and reduce incidence of new cases, to reach elimination status by the
year of 2025
• To reduce the prevalence of blindness to 0.25/ 1000 and disease burden by one
third from current level by the year of 2025
• To reduce premature mortality from cardiovascular diseases, cancer, diabetes
or chronic respiratory diseases by 25% by the year of 2025

36. • Coverage of Health Services
• Increase utilization of public health facilities by 50% from current levels by
the year of 2025
• Antenatal care coverage to be sustained above 90% and skilled attendance
at birth above 90% by the year of 2025
• More than 90% of the newborn are fully immunized by one year of age by
the year of 2025
• Meet need of family planning above 90% at national and sub national level
by the year of 2025
• 80% of known hypertensive and diabetic individuals at household level
maintain, controlled disease status by the year of 2025

37. • Cross Sectoral Goals Related To
Health
• Relative reduction in prevalence of current tobacco use by 15% by
2020 and 30% by 2025
• Reduction of 40% in prevalence of stunting of under five children by
the year of 2025
• Access to safe water and sanitation to all (swachh bharat mission) by
the year of 2020
• Reduction of occupational injury by half from current levels of 334
per lakh agricultural workers by the year of 2020
• National/ state level tracking of selected health behavior

38. • Health Finance
• Increase health expenditure by Government as a percentage of
GDP from the existing 1.15% to 2.5 % by the year of 2025
• Increase State sector health spending to > 8% of their budget by
the year of 2020
• Decrease in proportion of households facing catastrophic health
expenditure from the current levels by 25% by the year of 2025

39. • Health Infrastructure and Human
Resource
• Ensure availability of paramedics and doctors as per Indian Public
Health Standard (IPHS) norm in high priority districts by the year of
2020
• Increase community health volunteers to population ratio as per IPHS
norm in high priority districts by the year of 2025
• Establish primary and secondary care facility as per norms in high
priority districts by the year of 2025

40. • Health Management Information
• Ensure district-level electronic database of information on health
system components by the year of 2020.
• Strengthen the health surveillance system and establish registries
for diseases of public health importance by the year of 2020
• Establish federated integrated health information architecture,
Health information exchanges and National Health Information
Network by the year of 2025.

41. • National Health Policy 2017
• NHP-2017 also identifies seven priority areas for improving
the environment for health. These priority areas needing
coordinated action include:
• 1. The Swachh Bharat Abhiyan
• 2. Balanced, healthy diets and regular exercises.
• 3. Addressing tobacco, alcohol and substance abuse

42. • 4. Yatri Suraksha - preventing deaths due to rail and
road traffic accidents
• 5. Nirbhaya Nari -action against gender violence
• 6. Reduced stress and improved safety in the work place
• 7. Reducing indoor and outdoor air pollution

43. • Health Programme
• Reproductive, Maternal, Neonatal, Child and Adolescent
health
• Janani Shishu Suraksha Karyakaram (JSSK)
• Rashtriya Kishor Swasthya Karyakram(RKSK)
• Rashtriya Bal Swasthya Karyakram (RBSK)
• Mission Indradhanush

44. • Janani Suraksha Yojana (JSY)
• Pradhan Mantri Surakshit Matritva Abhiyan
(PMSMA)
• Navjaat Shishu Suraksha Karyakram (NSSK)
• National Programme for Family planning

45. • National Nutritional Programmes
• National Iodine Deficiency Disorders Control
Programme
• MAA (Mothers’ Absolute Affection) Programme for
Infant and Young Child Feeding
• National Programme for Prevention and Control of
Fluorosis (NPPCF)

46. • National Iron Plus Initiative for Anaemia Control
• National Vitamin A prophylaxis programme
• Integrated Child Development Services (ICDS)
• Mid-Day Meal Programme

47. • Communicable diseases control
Programme
• Integrated Disease Surveillance Programme(IDSP)
• Revised National Tuberculosis Control Programme(RNTCP)
• National Leprosy Eradication Programme(NLEP)
• National Vector Borne Disease Control Programme
• National AIDS Control Programme(NACP)

48. • Pulse Polio Programme
• National Viral Hepatitis Control Program
• National Rabies Control Programme
• National Programme on Containment of Anti-
Microbial Resistance (AMR)

49. • Non-communicable diseases
• National Tobacco Control Programme(NTCP)
• National Programme for Prevention and Control of Cancer, Diabetes,
Cardiovascular Diseases & Stroke (NPCDCS)
• National Programme for Control Treatment of Occupational Diseases
• National Programme for Prevention and Control of Deafness
(NPPCD)

50. • National Mental Health Programme
• National Programme for Control of Blindness& Visual impairment
• Pradhan Mantri National Dialysis Programme
• National Programme for the Health Care for the Elderly (NPHCE)
• National Programme for Prevention & Management of Burn
Injuries (NPPMBI)

51. • Health system strengthening programs
• Ayushman Bharat Yojana
• Pradhan Mantri Swasthya Suraksha Yojana (PMSSY)
• Laqshya’ programme (Labour Room Quality Improvement
Initiative)
• National Health Mission