The document summarizes healthcare reforms in India and their implementation. It discusses the key components of the health system and health sector reforms. Major reforms included reorganizing and restructuring the existing healthcare system, involving communities in health system delivery, establishing a health management information system, and focusing on quality of care. Key national health missions addressed in the reforms were the National Rural Health Mission and National Urban Health Mission. Five Year Plans from the 8th to 12th Plans shifted policies to encourage private sector initiatives, prioritize primary healthcare, address issues of equity, and work towards universal health coverage. Effective health sector reforms require increased public spending on health, regulating the private sector, risk pooling, and strengthening health management information systems.

1. Healthcare Reforms in India and Its
Implementations
SUBMITTED TO PRESENTED BY
Dr Ranu Sharma Oshin Raj
HOD (MBA Department) MBA (HM) 1st year
Poornima University Poornima University

2. Introduction
 Health system means “The combination of resources, organization finances and
management culminates in the delivery of the heath service to the population.”
 The key institutional component of the health system are:-
• State government
• Healthcare provider
• Resource institutes
• Insurance companies
• Consumers or population

3. Health Sector Reforms
 According to WHO, HSR is a sustain process of fundamental change in policy and
institutional arrangement guide by government and designed to improve the functioning
and performance of health system and ultimately the health status of the population.
 HSR component are:-
• Equity
• Effectiveness
• Efficiency
• Quality
• Sustainability
• Defining priority
• Refining policies

4. Types of Reform
1. Changes of financing matter
2. Changes in health system organization and management
3. Public sector reform

5. Challenges to Reform
1. Unclear power of reform responsibility
2. Health insurers want more control and less spending
3. Doctor wants more freedom
4. Minister wants quick changes
5. Health specialist focus on health promotion

6. Health Reform Cycle
Problem
Identification
Identify the
cause
Develop
option
Decide
What to
Do?
Policy
Decision
Evaluation
Ethics
Politics

7. Health Sector Reforms in India
 Health sector reforms have come centre stage since 1980s essentially from
the public system. By 1990s the process had taken concrete shape.
 In India HSR, broadly covers the following area:
1. Reorganization and restructuring existing healthcare system
2. Involving Community in Health System Delivery
3. Health Management Information System
4. Quality of Care

8. Eighth Five Year Plan (1992-1997)
 Concept of free medical care was revoked.
 Ensured commitment for free subsidised care for needy BPL category
population.
 Promote social welfare measure like improved healthcare sanitation.
 Check the population growth by creating mass awareness program.
 Private sector promotion.

9. Ninth Five Year Plan (1997-2002)
 Convergence and involvement of public private health care provider.
 Establishment of Panchayat Raj Institution in planning and monitoring
healthcare program.
 Emphasis on basic infrastructural facilities like safe drinking water, PHC.
 Inter sectoral coordination and utilisation of local and community
resources.

10. Tenth Five Year Plan (2002-2007)
 Focused on primary, secondary and tertiary health care level.
 Emphasis on equity and financial healthcare.
 Social health insurance for BPL population under universal insurance
scheme.
 Human resources development.
 Focuses on public private partnership.
 Quality Assurance

11. Policy Shift in Five Year Plans
9th plan
• Free medical care revoked
• Encouraged initiatives with private sector
10th plan
• Profit/ non- profit NGOs in healthcare sector
• Inter-sectoral coordination of health programmes
• Panchayat Raj Institution in planning and controlling.
11th plan
• Address issues of equity

12. National Rural Health Mission
 Health care is now one of the thrust area for the Government of India.
 Government of India focus on increasing the expenditure in health sector,
with main focus on primary healthcare for current level of 0.9% of GDP to
2-3% of GDP.
 NRHM is the main vehicle for giving the effect from April 2005.

13. National Urban Health Mission
 NUHM (2005-2007) launched by the Government of India in 2005 has a
sub-mission on basic services for the urban poor covering 60 cities in
India.
 Focuses on need of the urban poor people population has constituted a task
force on urban health to recommend strategies for improving health.
 NGO involvement
 Integration of AYUSH

14. Eleventh Five Year Plan (2007-2012)
 To achieve good health for the poor and under privilege group.
 Reducing MMR to 100/ lakh life birth.
 Reducing IMR to 28/1000 live birth.
 Reducing malnutrition among children aged group 0-3 years to half.
 HSR areas:-
• Decentralization
• Human resources
• Health Management Informatics System
• Public Private Partnership
• Communication
• Quality Assurance

15. Twelfth Five Year Plan (2012-2017)
 Universal Health Coverage (UHC)
 Expansion and Strenthing Public Private Sector
 Mandatory practices of clinical treatment system
 Grievance Rederessal System
 Health Financing
 Health Regulation extended and clinical establishment act 2012

16. Effective Health Sector Reform
Effective
HSR
Taxation
Regulation of
private sector
Risk pooling
Strengthing of
HMIS social
audits
Increase public
spending on
Health
Incentive
system to
states