national health policy

1. NATIONAL
HEALTH
POLICY
Presented by
Dr Shivakumara Aladakatti BAMS
2nd year PG Scholar
Dept of PG Studies in Shalya Tantra
JSS Ayurveda Medical College,
Mysore-570028

2. CONTENTS
1. INTRODUCTION
2. BASIC CONSIDERATIONS
3. HISTORY
4. NATIONAL HEALTH POLICY – 1983
5. NATIONAL HEALTH POLICY – 2002
6. NATIONAL HEALTH POLICY _ 2017
7. ORAL HEALTH POLICY ININDIA
8. CONCLUSION
9. REFERNCES
2

3. Kulkarni A.P, Baride J.P, Doke P.P, Mulay P.Y. Text book of Community Medicine. Ch-15 Health Care in India- Part A. 4th ed. Mumbai: Vora Medical Publications;2013.
India is drawing the world’s attention, not only because
of its population explosion but also because of its
health profile and
prevailing as well as emerging
profound political, economic and social
transformations.
Despite several growth orientated policies adopted by
the government, the widening economic, regional and
gender disparities are posing challenges for the health
sector.
3

4. National health programs are launched by
the government of India for control/ eradication
of communicable disease, environmental
sanitation, nutrition, population control and
rural health.
Kulkarni A.P, Baride J.P, Doke P.P, Mulay P.Y. Text book of Community Medicine. Ch-15 Health Care in India- Part A. 4th ed. Mumbai: Vora Medical Publications; 2013.
The National Health Policy reviews the improvement in
demographic trends, control of infectious diseases and
growth of infrastructure.
NHP 2002 envisages that by 2010 the public investment
in health would reach 2% of the GDP.
NHP 2017 envisages that by 2025 the public investment
in health would reach 2.5% of the GDP.
5

5. BASIC CONSIDERATIONS
Health is a state of complete physical, mental, and social
well-being and not merely the absence of disease or
infirmity(as given by WHO- 7 April 1948).
17
Peter S. Essentials of preventive and community dentistry. Ch-10 Health Care Delivery. 5th ed. New Delhi: Arya(Medi) Publishing House; 2013.

6. ORAL HEALTH
Peter S. Essentials of preventive and community dentistry. Ch-10 Health Care Delivery. 5th ed. New Delhi: Arya(Medi) Publishing House; 2013.
The World Health Organization defines oral health as
a “state of being free from chronic mouth and facial
pain, oral and throat cancer, oral sores, birth defects
such as cleft lip and palate, periodontal (gum)
disease, tooth decay and tooth loss, and other
diseases and disorders that affect the oral cavity”.
18

7. POLICY
 Course or principle of action adopted by theGovernment.
HEALTH POLICY
 Is an statement of an authority adopted by the Government or public
in order to improve the healthservices.
NATIONAL HEALTH POLICY
 It is an expression of goals for improving the health, the priorities
among these goals, and the main directions for attaining them for a
nation.
19

8. HISTORY
Health planning in India can be seen as pre and
post independence.
Health planning in India - Pre
independence
Health planning in India - Post
independence
7
Roy R, Saha I. Mahajan and Gupta Textbook of Preventive and Social Medicine. Part-IV Health Care and Services. 4th ed. New Delhi, Jaypee Brothers; 2013.

9. Health planning in India – Pre independence
1873- The Birth and
Death registrationAct
8
1825- QuarantineAct
(1st Public healthAct)
1880- VaccinationAct
1864- Public health
community
.
.
1886 – Plague
Commission
Act
Roy R, Saha I. Mahajan and Gupta Textbook of Preventive and Social Medicine. Part-IV Health Care and Services. 4th ed. New Delhi, Jaypee Brothers; 2013.

10. National health committees
Planning Commission
Five year plans
National Health Policy
Health planning in India -Post independence
11
Roy R, Saha I. Mahajan and Gupta Textbook of Preventive and Social Medicine. Part-IV Health Care and Services. 4th ed. New Delhi, Jaypee Brothers; 2013.

11. NATIONAL HEALTH POLICY – 1983
36

12. NHP-1983
37
The NHP-1983
policies which
circumstances
gave a general exposition of the
required recommendation in the
prevailing in the health sector.
NHP-1983, in a spirit of optimistic empathy for the
health needs of the people, particularly the poor and
underprivileged, had hoped to provide ‘Health for All
by the year 2000 AD’, through the universal provision
of comprehensive primary health care services.
Babu V.V.R.S. Review in Community Medicine. Ch-14 Public Health Administration and National Programmes. 2nd ed. Hyderabad: Paras Medical Books. 1996

13. NHP-1983
38
The noteworthy initiatives under that policy were:-
A phased, time-based bound program 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.
Roy R, Saha I. Mahajan and Gupta Textbook of Preventive and Social Medicine. Part-IV Health Care and Services. 4th ed. New Delhi, Jaypee Brothers; 2013.

14. Small pox and guinea worm disease
have been eradicated from india
Polio is on the verge of being
eradicated
Leprosy, kala azar and filariasis are
expected to b eliminated in future.

15. DRAWBACKS:
It does not speak about social injustice- an essential
prerequisite for Health forAll.
No definite program – to promote community
participation in health.
No mention - health budget
Does not emphasis on –
 accident prevention,
 geriatric care
 Non- communicable disease like obesity, coronary heart
disease
 Disease related to use of tobacco, alcohol, drugs, etc.
NHP-1983
42
Babu V.V.R.S. Review in Community Medicine. Ch-14 Public Health Administration and National Programmes. 2nd ed. Hyderabad: Paras Medical Books. 1996

16. NATIONAL HEALTH POLICY –2002
44

17. NHP-1983 served the purpose for some time but over
the years the health scene of the country changed.
New challenges could not be addressed within the
framework of that policy- it necessitated a revision.
The government of India initiated the process by holding
wide ranging deliberations involving central and state
governments, voluntary organizations and the central
council of health and family welfare.
Dhaar GM. Robbani I. Foundations of Community Medicine. Ch 55- HEALTH CARE IN THE INDIAN CONTEXT. 1st ed. Elsevier;2006.
46
INTRODUCTION – NHP 2002

18. NHP 2002
Dhaar GM. Robbani I. Foundations of Community Medicine. Ch 55- HEALTH CARE IN THE INDIAN CONTEXT. 1st ed. Elsevier;2006.
A draft of national health policy was formulated and
circulated for eliciting comments from responsible
sources.
A final shape was given to the policy and was eventually
approved by the cabinet and launched as NATIONAL
HEALTH POLICY – 2001.
47

19. The policy aims 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.
However, from a global perspective India’s public
spending on health is extremely low.
Dhaar GM. Robbani I. Foundations of Community Medicine. Ch 55- HEALTH CARE IN THE INDIAN CONTEXT. 1st ed. Elsevier;2006.
NHP-2002
48
NHP 2002

20.  NHP, 1983 is perceived as an idealistic document mainly
addressed to achieve health for all by the year 2000
 NHP, 2002 is realistic document based on a conceptional
and operational framework that is consistent with the
socio-economic realties prevailing in India.
Roy R, Saha I. Mahajan and Gupta Textbook of Preventive and Social Medicine. Part-IV Health Care and Services. 4th ed. New Delhi, Jaypee Brothers; 2013.
NHP-2002
RELEV
ANCE OF NATIONAL
HEALTH POLICY:

21. OBJECTIVES OF THE POLICY
Toachieve
decentralization of
health services.
Tostrengthen
and upgrade the
health care
infrastructure.
T
oemphasize
primary level of
health care.
Topromote
rational use of
drugs.
T
oensure
equitable access
to health services.
T
oincrease
primary health
investment.
T
oenhance
private sector
participation.
It also specifies a time frame for the achievement of various goals
NHP-2002
56

22. DRAWBACKS:
Kumar A, Gupta S. Health Infrastructure in India: Critical Analysis of Policy Gaps in the Indian Healthcare Delivery. Vivekananda International Foundation . 2012
Not much attention is paid to child, adolescent, Geriatrics
health, gender (women), domestic violence.
Ignored areas-
 Lack of govt.expenditure,Resource generation &
allocation,
 Management of work force,
 Substance abuse management
.
1
16

23. Methodology of strengthening
healthcare & functioning of health
workers is not specified, creating
“Paramedical Doctors”. Promoting
QUACKERY.
Literacy & its investment is not
specified.
Problem of population is not
answered properly.
School education has not yielded
desired results.
1
17
Kumar A, Gupta S. Health Infrastructure in India: Critical Analysis of Policy Gaps in the Indian Healthcare Delivery. Vivekananda International Foundation . 2012

24. National Health Policy - 2017
120

25. Need for National Health Policy 2017
122
• Burden of non-coomunicable diseases.
•Emergence of robust health care industry
•Increased health care cost
•Increases financial capacity

26. KEY FEATURES OF NEW HEALTH
POLICY ,2017
PREVENTIVE
AND
PROMOTIVE
HEALTH CARE
UNIVERSAL
ACCESSTO
QUALITY
HEALTH
SERVICES
AFFORDABLE
COST

27. POLICY THRUST:
 Increased health expenditure by govt. from
existing 1.15% to 2.5% GDP by 2025.
Increased state sector health spending to more
than 8% of their budget by2020.
Decrease in proportion of households facing
catastrophic health expenditure from current
levels by 25% by 2025.

28. Policy Principles:
– Equity
– Universality
– Patient Centered & Quality of Care
– Inclusive Partnerships
– Pluralism(AYUSH)
– Subsidiarity
– Accountability
– Professionalism, Integrity and Ethics
– Learning and AdaptiveSystem
– Affordability
129

29. Policy Directions
 Ensuring Adequate Investment
 Preventive and Promotive Health
 Organization of Public Health Care Delivery
 Primary Care Services & Continuity of Care
 Secondary Care Services
 Reorienting Public Hospitals
 Closing Gaps in Infrastructure and Human Resource/Skill
 Urban Health Care
 National Health Programs: RCH, Communicable Diseases, Non-
Communicable Diseases, Mental Health, Emergency Care and
Disaster preparedness
131

30. The policy identifies coordinated action on seven prioirity
areas for improving the environment for health :
 Swachh BharatAbhiyan (2nd Oct.2014 )
132

31.  Balanced and Healthy diets(through Anganwadi centres and
schools) and regular exercises.
 Adressing tobacco ,alcohol and substance abuse.

32.  Reducing stress and improved safety in the work place.
 Reducing indoor and outdoor air pollution.
 Yatri Suraksha –preventing deaths due to rail and road traffic
 accidents
 Nirbhaya Nari – action against gender voilence

33.  Swasth NagrikAbhiyan(social movement for health)
 Greater emphasis on school health and SCHOOL NOON
MEAL PROGRAMME
133

34.  More support to ASHA workers(in palliative care,
Community Mental Health, and in Village Health
Sanitation and Nutrition Committees)
 Yoga promotion at work place, schools and in the community

35. The National Oral Health Policy has been formulated
by the “Dental Council of India” through the inputs of
two national workshops organized in 1991 and 1994
at Delhi and Mysore.
NATIONAL ORAL HEALTH
POLICY
143
Peter S. Essentials of preventive and community dentistry. Ch-10 Health Care Delivery. 5th ed. New Delhi: Arya(Medi) Publishing House; 2013

36. CONCLUSION
172
Public health has effectively remained a low
priority for the Indian state in terms of financing
and political attention.
Contributed to the slow and inadequate
improvement of health of the population.
Replacing the current unhealthy and inequitable socio-
economic system, by one that is far more just, humane
and healthy, in the world of tomorrow is essential.

38. REFERENCES

39. REFERENCES
1.Peter S. Essentials of preventive and community
dentistry. Ch-10 Health Care Delivery. 5th ed. New Delhi:
Arya(Medi) Publishing House; 2013.
2.Scheutz AM. India’s Healthcare System – Overview and
Quality Improvements. Direct response. 2013:04.
3.Chandra S, Chandra S. Textbook of Community
Dentistry. Ch-9 Oral Health Policy of Government of India.
1st ed. New Delhi: Jaypee Brothers Medical Publishers;
2000.
176

40. 4.Dhaar GM. Robbani I. Foundations of Community
Medicine. Chapter 55- HEALTH CARE IN THE INDIAN
CONTEXT. 1st ed. Elsevier; 2006.
5.Gangolli LV, Duggal R, Shukla A. Review of Healthcare
In India. SECTION 2- PUBLIC HEALTH POLICIES AND
PROGRAMMES. Mumbai: Centre for Enquiry into Health
and Allied Themes;2005.
6.SATHE P
.V., SATHE A.P., Epidemiology and
Management for Health Care for All. Ch-2 Health for All
by 2000 A.D. 2nd ed. Mumbai: Popular Prakshan PVT
Limited; 1997.
REFERENCES
177

41. REFERENCES
7.Banerjee SR. Community and Social Pediatrics. Ch-6
Cild Health Care- The challenges for the Next Decade. Ist
ed. New Delhi: Jaypee Brothers Medical Publishers; 1995.
8.Suryakantha AH. Community Medicine with Recent
Advances. Ch- 39 National Health Policy. 3rd ed. New
Delhi: Jaypee Brothers Medical Publishers; 2014.
9.Babu V.V.R.S. Review in Community Medicine. Ch-14
Public Health Administration and National Programmes.
2nd ed. Hyderabad: Paras Medical Books. 1996
178

42. REFERENCES
10.Kulkarni A.P, Baride J.P, Doke P
.P
,Mulay P
.Y
.Text book
of Community Medicine. Ch-15 Health Care in India- Part
A. 4th ed. Mumbai: Vora Medical Publications; 2013.
11.Roy R, Saha I. Mahajan and Gupta Textbook of
Preventive and Social Medicine. Part-IV Health Care and
Services. 4th ed. New Delhi, Jaypee Brothers; 2013.
12.Kumar A, Gupta S. Health Infrastructure in India: Critical
Analysis of Policy Gaps in the Indian Healthcare Delivery.
Vivekananda International Foundation; 2012.

43. 13.http://www.mohp.gov.np/english/files/new_publi
cations/9-2-National-Oral-Health-Policy.pdf.Last
acessed 11/06/2014.
14.http://cphe.files.wordpress.com/2009/10/karnat
aka-state-integrated-health-policy-2001.pdf.last
acessed on 11/7/014 .
REFERNCES

44. 181