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HEALTH CARE REFORMS
Health care reform is a general rubric used for discussing major health policy creation or changes—for the most part, governmental policy that affects health care delivery in a given place.
OBJECTIVES ,[object Object]
Expand the array of health care providers
Improve the access to health care specialists
Improve the quality of health care
Give more care to citizens
Decrease the cost of health care,[object Object]
EVOLUTION OF HEALTH CARE CHANGES
MEDICINE IN ANTIQUITY. DAWN OF SCIENTIFIC MEDICINE MODERN MEDICINE
MEDICINE IN ANTIQUITY. In ancient times, health and illness were interpreted in a cosmological and anthropological perspective. Medicine was dominated by magical and religious beliefs which were an integral part of ancient cultures and civilizations.
1. PRIMITIVE MEDICINE ,[object Object]
Primitive medicine frequently performed a type of brain surgery that we today call trephination.  Trephination was done by using stone instruments to bore or grind holes in the skull,[object Object]
2. TRIO INDIAN MEDICINE
[object Object],The practicals fields of Ayurveda are divided into eight sections or branches. These sections are: internal medicinal, surgery, cranial organo medicine, pediatrics, toxicology, rejuvenating remedy, aprodisiac remedy and spiritual healing. These eight sections are called "AstangaAyurveda.
                                                                                                                                                  
[object Object],The Siddha medicine is a form of south Indian Tamil traditional medicine and part of the trio Indian medicines - ayurveda, siddha and unani. This system of medicine was popular in ancient India. The system is believed to be developed by the 18 siddhas in the south called siddhar.
[object Object],Unani-tibb or Unani Medicine its origin to Greece. It was the Greek philosopher - Physician Hippocrates (460-377 BC) who freed Medicine from the realm of susperstition and magic, and gave it the status of Science. The theoretical framework of Unani Medicine is based on the teachings of Hippocrates
[object Object],[object Object]
[object Object],[object Object]
[object Object],[object Object]
[object Object],The Greeks taught men to think in terms of why and how. The medical historian, Douglas Guthrie has reminded us of the legend that Hygiea was worshipped as the goddess of health and Panacea as the goddess of medicine. Panacea and Hygiea gave rise to dynasties of healers (curative medicine) and hygienists (preventive medicine) with different philosophies. Greatest physician in Greek medicine was Hippocrates who is often called as the father of medicine.
[object Object],[object Object]
[object Object]
Sanitary awakening
Rise of public health
Germ theory of disease
Birth of preventive medicine,[object Object]
GERM THEORY
GERM THEORY OF DISEASE-LOUIS PASTEUR
III. MODERN MEDICINE ,[object Object]
Preventive medicine
Social medicine,[object Object]
Health promotional phase(1920-1960)
Social engineering phase.
Health for all phase,[object Object]
1. COMPREHENSIVE CARE
The Bhore committee (1946)defined comprehensive health care as the following criteria.  Provide adequate preventive, curative and promotive health services. Be as close to the beneficiaries as possible. Widest cooperation between the people, the service and the profession.  Is available to all irrespective of their ability to pay Look after specifically the vulnerable and weaker sections of the community. Create and maintain healthy environment both in home as well as working places.
2. BASIC HEALTH SERVICES.
A basic health service is understood to be a network of coordinated, peripheral and intermediate health units capable of performing effectively a selected group of functions essential to the health of an area and assuring the availability of competent personnel and auxiliary personnel to perform these functions.
3. PRIMARY HEALTH CARE
[object Object]
The Alma-Ata international conference gave primary health care a wider meaning Primary health care is essential health care made universally accessible to individuals and acceptable to them , through their full participation and at a cost the community and country can afford. ,[object Object]
Community participation.
Inter sectoral coordination
Appropriate technology,[object Object],[object Object]
In 1978, Alma Ata international conference on Primary health care reaffirmed Health for all as the major social goals of the Governments and stated that the best approach to achieve the goal  of HFA is by providing primary health care, especially to the vast majority of underserved rural areas.
In 1981, a global strategy for HFA  was evolved by WHO. The global strategy provides a global framework that is broad enough to apply to all Member states ,[object Object]
ISSUES IN HEALTH CARE REFORMS.
1. UNEQUAL DISTRIBUTION OF HEALTHCARE RESOURCES INDIA.
[object Object]
The ratio of doctors to population in rural areas is almost six times lower than that in the urban population.
Per capita expenditure on public health is seven times lower in rural areas, compared to government health spending for urban areas. ,[object Object]
In a recent survey it was noticed that only 38% of all PHCs have all the essential manpower and only 31% have all the essential supplies (defined as 60% of critical inputs), with only 3% of PHCs having 80% of all critical inputs.,[object Object]
Only five other countries in the world are worse off than India regarding public health spending (Burundi, Myanmar, Pakistan, Sudan, Cambodia).  As a result of this dismal and unequal spending on public health, the infrastructure of health system itself is becoming ineffective. ,[object Object]
[object Object]
Socio-economic distance
Gender distance,[object Object]
Urban residents are extremely vulnerable to macroeconomic shocks that undermine their earning capacity and lead to substitution towards less nutritious, cheaper foods.

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