The document summarizes the key policies and objectives of the Indian public health system as outlined in its various five-year plans since the first plan in 1951-1956. Each subsequent plan aimed to expand health infrastructure like primary health centers and hospitals, control communicable diseases, improve family planning programs, and increase funding for public health initiatives. The plans emphasized developing rural health services, training health workers, implementing nationwide immunization and disease control campaigns, and working towards the goal of "Health for All" through primary care expansion and universal health coverage.

1. HEALTH IN FIVE YEAR PLANS
PRESENTED BY :-
Iqra Zeenat.
B.Sc,D.NA, M.Sc
Community Nursing
SKIMS SRINAGAR

2. INTRODUCTION
The Directive Principles of the State Policy, enshrined in the Constitution form the
social premises of planning in India (Gupta, 2002) The basic objective of planning in
India is ‗to initiate a process of development which will raise living standards and open
out to the people to provide new opportunities to lead a good life‘. Keeping this
objective, the public health policies in India were formulated through various five year
plans. The public health policies in India have come a long way since 1950s. In 1946,
the Health Survey and Development Committee, headed by Sir Joseph Bhore
recommended the establishment of a well-structured and comprehensive health
service with a sound primary health care infrastructure. This report not only provided
a historical landmark in the development of the public health system but also laid down
the blueprint of subsequent health planning and development in independent India
(Government of India, 1960).

4. FIRST PLAN (1951-1956)
The core of the public health policy enunciated in the first five year
plan was
1. provision of water-supply and sanitation;
2. control of malaria;
3. preventive health care of the rural population through health
units and mobile units;
4. health services for mothers and children;
5. education and training, and health education;
6. self-sufficiency in drugs and equipment; and
7. family planning and population control.

5. Contd…
During the First Five Year Plan (1951-56), 725 Primary
Health Centers (PHCs) were established. At the end of
First Five Year plan, there were 12600 hospitals and
dispensaries in the country and it was realized that the
country needed more health facilities and
infrastructure.

6. SECOND PLAN (1956-1961)
The specific objectives of the health policies during this plan were
a. establishment of institutional facilities to serve as a base from which
services can be rendered to the people both locally and in surrounding
territories;
b. development of technical manpower through appropriate training
programmes and employment of persons trained;
c. improvement of public health and institutional measures to control
communicable diseases
d. family planning and other supporting programmes for raising the
standard of health of the people. International agencies like the W.H.O.
and the U.N.I.C.E.F.

7. Contd…
There were 78 institutions teaching indigenous system of
medicine and 549 clinics in urban areas at the end of
Second Five Year Plan. In 1951, there were 8,600 hospitals
and dispensaries and about 1,13,000 beds in the country
which increased to 12,600 hospitals and dispensaries and
beds to 1,85,600 in 1960 .

8. THIRD PLAN (1961-1966)
1. The Third Plan aimed at controlling and eradication of communicable
diseases, providing curative and preventive health services in rural areas and
to augment the training programmes of medical and paramedical personnel.
Emphasis was also given to family planning.
2. Nation-wide control campaigns were initiated against small pox and
tuberculosis (Government of India, 1960).
3. The expenditure towards health sector during the third plan was Rs. 251
crores which is 2.9 per cent of the total budget.
4. As in the second plan, priority was given to water supply, sanitation, and
control of communicable diseases (226 crores / 2.63%). A sum of Rs. 25 crore
(0.29%) was invested towards family planning.

9. FOURTH PLAN (1969-1974)
1. The Fourth Plan ((1969-74) specially emphasized on better results of family planning
programmes. For this purpose, a committee on Multi-purpose workers under health and
family planning programme was appointed in 1972. The Committee suggested that new
trained multi- purpose health workers should be appointed to have more fruitful results
(Government of India, 1972).
2. The Nutrition Research Laboratories were converted into the National Institute of Nutrition
in 1969 and the Central Births and Deaths Registration Act was promulgated in the same
year.
3. The Central Council of Indian Medicine (Ayurveda, Unani and Siddha) was formed in 1971.
The Medical Termination of Pregnancy Bill was also passed by the Parliament in the same
year. The Central Council of Homeopathy was set up in 1973.
4. A sum of Rs. 613.5 crore was invested in the health sector during this plan period.

10. FIFTH PLAN (1974-1979)
• The Fifth Five Year Plan (1974-79) was based on two main issues. One of them was to realize
the failure of coercive method for family planning as family planning and nutrition were made
a component of ‘Minimum Needs Programme’ to attack poverty. But these programmes were
neglected due to declaration of emergency.
• The Water (Prevention and Control of Pollution) Act and The Cigarettes Regulation
(Production, Supply and Distribution) Act were enacted in 1974 and 1975 respectively. The
Integrated Child Development scheme was launched in 1975.
• The Central Council for Yoga and Naturopathy was established in 1976. The National Institute
of Health and Family Planning was formed and the Rural Health Scheme was launched in 1977.
• The Parliament approved the Child Marriage Restraint (Amendment) Bill fixing the minimum
age of marriage of 21 years for boys and 18 years for girls in 1978. (Goodhealthnyou.com,
2000).

11. SIXTH PLAN (1980-1985)
• Sixth Five Year Plan is also referred to as the Janata Government Plan and it was
revolutionary since it marked a change from the Nehruvian model of Five Year
Plans. The government of India adopted the National Health Policy in 1983
which reiterated India's commitment to attain "Health for All by 2000 A.D",
• Health Care Programmes were restructured and reoriented towards this policy.
Priority was given to extension and expansion of the rural health infrastructure
through a network of community health centres, primary health centres and
subcentres, on a liberalized population norm.
• The family welfare programme was integrated with the Health programme,
especially Maternal and Child Health (Government of India, 1981). The total
investment in the health sector during the sixth plan was Rs. 3412.2 crores

12. SEVENTH PLAN (1985-1990)
• The core objective of health policy in the seventh plan was laid on preventive and promotive
aspects and on organising effective and efficient health services which were comprehensive in
nature, easily and widely available, freely accessible, and generally affordable by the people.
• This plan takes note of ‘Health for all by 2000 A.D.’ To achieve this goal, Primary Health
Centres were taken as the main instruments of action. The voluntary organizations and local
bodies were encouraged to undertake the responsibility of family welfare and primary health
care services. The special schemes were introduced for assisting private medical care centres
for family planning work. The emphasis was laid on Maternity and Child Health programmes
by supporting non-governmental organizations, village health committees, private health
services and women organizations (Barn & Nandy, 2008).
• A worldwide "safe motherhood" campaign, National Diabetes Control, and the National
AIDS Control Programmes were initiated in 1987 and the Mental Health Act was also passed
in the same year. The total expenditure on Health Sector was Rs. 6809 (3.11%) crores.

13. EIGHTH PLAN (1992-1997)
• Health and population control were listed as two of the six priority
objectives during the eighth plan period. Emphases were laid on
provision of safe drinking water and primary health care facilities,
including immunization, accessibility to all the villages and the entire
population, and complete elimination of scavenging.
• The Transplantation of Human Organs Bill was passed in the year 1994
• The Persons with Disabilities (Equal Opportunities, Protection of Rights
and Full Participation) Act passed was in 1995.
• The total outlay for the health sector during this plan period was Rs.
14082.2 crores.

14. NINTH PLAN (1997-2002)
• In the Ninth Five Year Plan (1997-2002), Reproduction and Child Health (RCH)
programmes were given special attention. During this plan, greater emphasis was
provided on primary health care, and provision of safe drinking water.
• Emphasis was also given to provide integrated preventive, promotive, curative and
rehabilitative services for communicable, non-communicable and nutrition related
health problems . These programmes also got some external funding, mainly from
World Bank.
• In 2002, Government of India introduced the National Health Policy (NHP). The
main objective of the NHP-2002 was to achieve an acceptable standard of good health
among the general population of the country and set goals to be achieved by the year
2015.
• a sum of Rs. 20402 crore was allotted for the health sector during this plan.

15. TENTH PLAN (2002-2007)
The major focus in the tenth plan was to improve the efficiency of the existing health
care system, quality of care, logistics of supplies of drugs and diagnostics and
promotion of the rational use of drugs.
The tenth plan also proposed three major initiatives in the health sector. They are: (i)
redesigning the Universal Health Insurance scheme introduced in 2003 to make it
exclusive for below poverty level people with a reduced premium, (ii) introduction of
Group Health Insurance scheme for members of Self Help Groups and Credit Link
Groups at a premium of Rs 120 per person for an insurance cover of Rs 10000, and (iii)
exemption of income tax for hospitals working in rural areas (W.H.O., 2006).
The total sum of Rs. 37878 crore was allotted towards the Health Sector during this plan
period.

16. ELEVENTH PLAN (2007-2012)
• The Eleventh Five Year Plan provides an opportunity to restructure policies to
achieve a New Vision based on faster, broad-based, and inclusive growth.
• The objectives for health sector aims (i) to achieve good health for people,
especially the poor and the underprivileged by focusing on individual health care,
public health, sanitation, clean drinking water, access to food, and knowledge of
hygiene, and feeding practices; (ii) to facilitate convergence and development of
public health systems and services that are responsive to health needs and
aspirations of people and (iii) to give special attention to the health of
marginalized groups like adolescent girls, women of all ages, children below the
age of three, older persons, disabled, and primitive tribal groups.
• A Sum of Rs. Rs 136147.00 crore was earmarked for the health sector.

17. TWELFTHYEAR PLAN (2012–2017)
• The Strategy of this plan was Strengthening of public sector health care Substantially
increase in health care expenditure, efficient Financial and managerial systems,
Coordinated delivery of services, Cooperation between the public and private sector,
Expansion of skilled human resource, Prescription drugs reforms, Effective regulation
through a Public Health Cadre, Pilots on Universal Health Care
• 12th Plan goals was to Reduce Maternal Mortality from 212 to 100 , Reduce IMR from
44 to 25, Reduce underweight children below 3 years from 40% to 23% , Increase
child sex ratio from 914 to 950, Reduce levels of anaemia among women from 55%
to 28%, Reduce Total Fertility Rate from 2.5 to 2.1. Reduce poor households' out-of-
pocket expenditure on health
• The Planning Commission had approved a total outlay of ₹ 1.93 trillion for the NHM
and ₹2.69 trillion for the health department for the 12th Plan.

18. Thank you