2. INTRODUCTION
One of the objective of Eleventh Five Year plan is to provide good
health for people, especially the poor and the underprivileged.
The strong link between poverty and ill health need to be
recognized.
High health care costs can lead exacerbation of poverty.
We need to transform public health care into an accountable
accessible and affordable system of quality services.
3. AYUSH
Since Independence, india has built up a vast Health infrastructure and health personnel
at primary, secondary and tertiary care in public health , voluntary and private sectors .
For producing skilled human resources, a number of medical and paramedical
institutions including Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy
(AYUSH) institution have been set up.
The major thrust in Allopathic as well as AYUSH will be given to the following areas:
• Improving diagnosis, treatment delivery, and development of new tools for the diagnosis
and treatment
• Integrating disease control programmes within primary health care system
• Cost effectiveness analysis of different regimen for prevention and treatment of diseases
• Quality of lab-diagnosis, lab related factors, periodic training, adequacy of reagents, kits and
good microscopy.
• Delayed diagnosis: community factors, surveillance factors, lab factors, and health system
factors
• Up gradation of drug delivery system: surveillance mechanisms
• Research on poor drug compliance rate: community, social, educational, ethnic, cultural, and
health system factors
• Research on social determinants of health, health care seeking, and the epidemiological web
5. Time-Bound Goals for the Eleventh
• Reducing Maternal Mortality Ratio (MMR) to 1 per 1000 live births.
• Reducing Infant Mortality Rate (IMR) to 28 per 1000 live births.
• Reducing Total Fertility Rate (TFR) to 2.1.
• Providing clean drinking water for all by 2009 and ensuring no slip-
backs.
• Reducing malnutrition among children of age group 0–3 to half its
present level.
• Reducing anaemia among women and girls by 50%.
• Raising the sex ratio for age group 0–6 to 935 by 2011–12 and 950 by
2016–17.
6. Enhancing efforts at disease reduction
Launching new initiatives (Rabies, Fluorosis,
Leptospirosis)
Focusing on excluded/neglected areas
Taking care of the Older persons.
Reducing Disability and integrating disabled
Providing humane Mental Health services.
Providing Oral Health services.
Providing focus to Health System and Bio-Medical research
Increasing focus on Health Human Resources
Improving Medical, Paramedical, Nursing, and
Dental education, and availability.
AYUSH education and utilization
Reintroducing licentiate course in medicine
Improving Health Equity
NRHM
NUHM
Increasing Survival
Reducing Infant and Child mortality.
Reducing Maternal mortality
Sex ratio
Decentralizing governance
Increasing the role of NGOs
Protecting the poor from health expenditures
Creating mechanisms for Health Insurance.
Establishing e- Health
Adapting IT for governance (HMIS)
Increasing role of telemedicine
Thrust areas to be pursued during the Eleventh year plan are summarized below:
7. • Promote access to improved health care at household level through the female health activist (ASHA).
• Health Plan for each village through Village Health Committee of the Panchayat.
• Integrate vertical health and family welfare Programmes at national, State, and district levels.
• Technical Support to National, State, and District Health Missions for Public Health Management.
• Formulate transparent policies for deployment and career development of Human Resources for health.
• Promote non-profit sector particularly in underserved areas
STRATEGIES OF HEALTH SECTOR
10. Sarva Swassthya Abhiyan
NRHM has been launched for meeting health needs of
all age groups and to reduce disease burden across
rural India.NUHM will be launched to mmet the unmet
needs of the urban population (28.6 crore in 2001 and
35.7 crore in 2011). As per the 2001 Census, 4.26 crore
lived in urban slums spread over 640 towns and cities.
The number is growing. NUHM based on health
insurance and PPP will provide integrated health
service delivery to the urban poor. Initially, thefocus
will be on urban slums. NUHM will be aligned with
NRHM and existing urban schemes.Besides, Sarva
Swasthya Abhiyan aims for inclusive growth by finding
solutions for strengthening health services and
focusing on neglected areas and groups.
JANANI SURAKSHA YOJANA (JSY)
The JSY scheme is meant to promote institutional
delivery, it has to take two critical factors into account,
one being that India does not have the institutional
capacity (International Institute of Population Sciences
[IIPS], 2003) to receive the 26 million women giving
birth each year, and the other being that around half of
all maternal deaths occur outside of delivery, during
pregnancy, abortions, and postpartum complications.
If institutions are preoccupied with handling the huge
numbers of normal childbirths, there will be inevitable
neglect of life-threatening complications faced by
women. They will be compelled to vacate beds in the
shortest time. Consequently, complications during
pregnancy and after childbirth will not be given
attention. Second, JSY money sometimes does not
reach hospitals on time, and as a result, poor women
and their families do not receive the promised money.
11. DRAWBACKS OF HEALTH SECTOR
1. Centralized planning instead of decentralized planning and using
locally relevant strategies.
2. Inflexible financing and limited scope for innovations.
3. No prescribed standards of quality.
4. Inability of system to mobilize action in areas of safe water,
sanitation, hygiene, and nutrition (key determinants of health in the
context of our country)—lack of convergence.
5. Inadequate provision of human resources
