National Health Policy and Health Committees Dr Pracheth

National Health Policy and Health Committees Dr. Pracheth R

Outline • Five Year Plans • National Health Policy • Committees

Five Year Plans • Conceived to re-build rural India • Lay foundations: industrial progress, balanced development • Recognized “health”

Twelfth Five Year Plan (2012 -2017) • Universal Health Coverage • Outcome indicators: üReduce IMR to 25 üReduce MMR to 100 üReduce TFR to 2. 1 üControl undernutrition : <5 years üPrevent anaemia (15 -49 years): 28% üPrevent, reduce NCDs

Focus areas • Access to services • Special services to vulnerable • Train professionals • Universal Health Coverage: üIncrease budget: health üAccess to medicines üCommunity participation üDrug regulation üRegulation medical practice

Niti Aayog • National Institution for Transforming India • Replace Planning Commission

National Health Policy-2002 • MOHFW: National Health Policy: 1983 - Health For All 2000 • Revised: 2002 • Acceptable standard of good health • Equitable access • Rational use of drugs

Goals • 2005: ü Eradicate polio üEliminate leprosy üIncrease state sector health spending: 5. 5% to 7% of budget

Goals • 2007: üAchieve zero growth of HIV/AIDS • 2010: üEliminate Kala Azar üReduce mortality by 50%: TB, malaria üReduce blindness: 0. 5% üReduce IMR, MMR • 2015: Eliminate lymphatic filariasis

Health Planning in India • Guidelines: many Committees • Appointed by GOI: review existing health situation, recommend measures

Sir Joseph Bhore

Bhore Committee, 1946 • In 1943: Health Survey and Development Committee • Met regularly for 2 years: submitted report in 1946. • “ If nation’s health built: health programmepreventive health work. ”

Recommendations • Integration of preventive +curative services • Development of Primary Health Centres: üShort term : 40, 000 üLong term: 75 bedded hospital-10 to 20, 000 • 3 months training: Preventive and Social Medicine- “Social Physicians”.

AL Mudaliar

Mudaliar Committee, 1962 • In 1959: Health Survey and Planning Committee • Quality of services : PHCs inadequate • Strengthen existing PHCs

Recommendations • Consolidate advances : first 2 five year plans • Strengthen District Hospitals: specialists • Each PHC not more than 40, 000 • Improve quality in PHC • Integrate medical and health services • All India Health Services

Chadah Committee, 1963 • In 1963, appointed: Dr. MS Chadah- DGHS: study National Malaria Eradication Programme. • Monthly home visits: health workers • One per 10, 000 • 1 Multipurpose worker: family planning, malaria. • Family Planning Health Assistants: supervise 3 -4 health workers.

Mukerji Committee, 1965 • Realized: basic health workers- not function effectively as multipurpose workers • So, malaria operations suffered • Work of family planning programme suffered • Committee 1965: set up • Separate staff: family planning only • Delink malaria from family planning

Mukerji Committee, 1966 • States: difficulty- burden of Health Programmes • Paucity of funds • Basic Health Service : PHC level

Jungalwalla Committee, 1967 • Committee on integration of health services • Defined integrated health services: ü Service : unified approach for all problems üMedical care for sick, health programmes : unified manner

Jungalwalla Committee, 1967 • Main steps: üUnified cadre üCommon seniority üRecognize extra qualifications üEqual pay for equal work üSpecial pay for specialized work üNo private practice

Kartar Singh Committee, 1973. • Committee on Multipurpose Workers under Health and Family Planning Objectives: • Structure of integrated services • Feasibility: multipurpose workers and training

Recommendations • Auxillary Nurse Midwives: Female Health Workers • Multipurpose workers: areas- malaria is maintenance , smallpox controlled • One PHC: 50, 000

Recommendations • Each PHC: 16 sub-centres (3, 000 -5, 000) • Each sub-centre: male, female health workers • Male Health Supervisor: 3 -4 male health workers • Doctor in PHC : overall charge of supervisors

Shrivastav Committee, 1975 • Group on Medical Education and Support Manpower Objectives: • Curriculum of training of health assistants • Suggest steps: improve existing medical education

Recommendations • Create para-professional and semi-professional health workers from community (school teachers, postmasters) • Establish 2 cadres of health workers: üMultipurpose health workers üHealth assistants • Develop referral linkages • Establish Medical and Health education Commission

Rural health scheme, 1977 • Recommendations: üInvolve Medical Colleges health care of PHCs üTrain multipurpose workers on communicable diseases

Questions • National Health Policy 2002 • Bhore Committee recommendations • Shrivasthav Committee • 12 th Five Year Plan

Summary • Bhore Committee: Primary Health Centres • Mudaliar: integrate medical+health care • Chadah: malaria, health workers • Mukerjee: separate malaria, family planning • Jungalwala: integrate health services • Srivastava: medical education, health workers

Portion for upcoming exam 6 th Term- 2013 Batch • NCDs • Demography and Family Planning • Mental Health • Disaster Management • Preventive Obstetrics • Health Committees

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