healthcare policy in india_final
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By:
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Health Policy of
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National Health Policy in India-
It is felt that an integrated, comprehensive approach towards development of medical education, research and health seto be established to serve the actual health needs and prioricountry.
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Alma-Ata Declaration -1978
Alma-Ata Declaration called on all the governments to formuhealth policies according to their own circumstances to launprimary health care as a part of national health system
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National Health Policy 2002
Objective : To achieve an acceptable standard of good heathe general population of the country
Launch of NRHM(National Rural Health Mission) in 2005
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Indian Health Policy: Vision
Health as a right for all citizens is the goal that the Ministry will
A comprehensive approach that encompasses individual hepublic health, sanitation, clean drinking water, access to fooknowledge of hygiene, and feeding practices.
To transform public health care into an accountable, accesaffordable system of quality services.
Convergence and development of public health systems anare responsive to the health needs and aspirations of the peo
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Indian Health Policy: Goals
To rise public spending on health from 1.2 per cent of GDP toof GDP, with improved arrangement for community financingpooling.
To undertake architectural correction of the health system toeffectively handle increased allocations and promote policiestrengthen public health management and service delivery i
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Structure of Indian Health Care
Different system of medicines1. Allopathy 2. Ayurvedic 3. Homoepathy
4. Unani 5. Siddha
Health Sector
1. Private Sector - mostly provides curative services
a. Not-for-profit Sector- NGOs, charitable institutions, trusts e
b. For-Profit Sector
2. Government Sectorprovides publicly financed and mana
promotive, preventive and curative health services
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Public Health Sector :
1 Central Government 2 State Government
3 Municipal 4 Local level bodies
National Health Policy : 3 Tier Structure
1. Primary Tier
a. Sub-Centre (SC) for a population of 3000-5000
b. Primary Health Centre (PHC) for 20000 to 30000 people
c. Community Health Centre (CHC) as referral centre for every fopopulation of 80,000 to 1.2 lakh
2. Secondary Tier - The district hospitals were to function as the seconhealth care, and as the primary tier for the urban population.
3. Tertiary Tier - The tertiary health care was to be provided by healt
urban areas which are well equipped with sophisticated diagnostic fa
Structure of Indian Health Care
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Structure of Ministry of Health anFamily Welfare
Department of Health and Family Welfare - responsible foimplementation of national level programmes for control of cand non- communicable diseases, hospitals and dispensarieseducation
Department of AYUSH - takes care of promotion of indigenmedicine such as Ayurveda, Homeo, Unani, Siddha and ongin indigenous medicine
Department of Health Researchmainly concerned with medical and health activities
Department of National AIDS Control Organization - responsiband implementation of programmes for prevention and cont
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Human Resources for Health
Shortage of human resources is a distressing feature of Indiaservices
Several initiative taken to overcome shortage of human resosector
1. Medical EducationNew Medical colleges, increase intake Colleges
2. Nursing Education
3. Para Medical Education
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Major Stakeholders In Health Care Syst
IndianHealthcare
System
Government
NonGovernment
Ministry ofHealth
Department ofHealth & Family
welfare
Department of
Health Research
Departm
AIDS C
Government In Ind
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Government as a Major Stakeho
Universal access to primary health care services for all sections of societ
Improving Maternal and child health
Focusing on population stabilisation in the country
Reducing overall disease burden of the society
Regulate health service delivery, and promote rational use of pharmac
Policy Formulation on issues relating to health and family welfare sectors Effective management of health institutions under the control of the hea
Welfare department.
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Public
Major health initiatives are taken for public
Access, Affordable & Quality
Universally available to all Citizens
HealthCare
Providers
Medical doctors
Dentists
Specialty practioners
HealthInsuranceProviders
Bajaj Allianz General InsuranceHSBC Health Insurance Provider
Apollo Insurance Provider
Business& Industry
Pharmaceutical Industries
Rising Health care cost leads to increased insurance cost forcing business financial burden
Non-Governmental Stakeholde
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Implementation & Achievement
National Rural Health Mission
Reproductive and child health programs
National Disease control programs
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Reproductive and child health
Janani Suraksha Yojna
a safe motherhood intervention for promoting institutional delive
number of beneficiaries has increased from 7.39 lakh in 2005-06 tcrore in 2010-11
JananiShishu Suraksha Karyakram
Provides free and cashless health care services to pregnant womhealth institutes
Mother and Child Tracking system
for Ante-Natal Care and immunisation
Annual Health Surveys
Covered 284 districts
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National Disease Control Progra
Communicable diseases
National TB Control Programme
National Vector Borne Disease Control Programme (provision of
insecticidal nets and rapid diagnostic kits)
HIV prevention and control
Leprosy
Lymphatic Filaria
Kala-azar
Acute encephalitis syndrome
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Non-communicable diseases
National Programme of Prevention & Control of Cancer, Diabete
Cardiovascular Diseases & Stroke Programme (NPCDCS)
National Mental Health Programme
Programme for Prevention of Burn Injuries
The National Programme for the Health Care for the Elderly
National Disease Control Progra
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National Disease Control Progra
Pradhan mantri swasthya suraksha yojana
Construction of six AIIMS like institutes
Upgrading of 13 medical institutes
Medical education
4442 MBBS seats and 2398 Post Graduate seats were added to th
in the recognized colleges
Legislations
Clinical Establishments Bill, 2010
Cigarettes and Other Tobacco Products (Packaging and Labelin
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Progress on Key Indicators
Demographics & Mortality Scenario
1. Population & Avg. Annual Exponential Growth Rate (AAEGR)
Population of 1.21 Billion (17.5 % of worlds population)
Rural: 68.84% & Urban: 31.16%
AAEGR dropped from 1.97% to 1.64%
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Progress on Key Indicators
Demographics & Mortality Scenario
2. Sex Ratio
Haryana: 830 girls per 1000 boys
Punjab: 846 girls per 1000 boys
J&K: 859 girls per 1000 boys
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Progress on Key Indicators
Demographics & Mortality Scenario
3. Life expectancy at birth
Currently close to 65, increased from 63.5 in 2006-10
Decrease in death rate
Improvement in quality of health services
Kerala: 74 years while in Bihar, Assam, Madhya Pradesh, Uttar Prades
4. Total Fertility Rate
Average number of children that would be born to a woman over he
Indias TFR is at 2.5
Bihar, Madhya Pradesh, Rajasthan, Uttar Pradesh, Meghalaya & D&Nthan 3
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Progress on Key Indicators
Demographics & Mortality Scenario
5. Crude Birth Rate
No. of births per 1000 people per year
29.5 births per 1000 population in 1991 to 22.1 births per 1000 populatio
Rural: 23.7 & Urban: 18.00
Highest: Uttar Pradesh (28.3) & Lowest: Goa (13.2)
6. Crude Death Rate
No. of deaths per 1000 people per year
9.8 deaths per 1000 population in 1991 to 7.2 deaths per 1000 popula
Rural: 7.7 & Urban: 5.8
Highest: Odisha (7.8) & Lowest: Nagaland (3.6)
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Progress on Key Indicators
Demographics & Mortality Scenario
7. Maternal Mortality Rate
The ratio of the number of maternaldeaths per 100,000 live births during agiven time-period
Has reduced from 254 in 2004-06 to 212in 2007-09
Lowest: Kerala & Tamil Nadu ( Less than100 ) & Highest: Assam (390)
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Progress on Key Indicators
Demographics & Mortality Scenario
8. Infant Mortality Rate
Higher in females (49) than males (46)
Urban: 31 & Rural: 51
Best performing state: Kerala (13)
9. Child Mortality Rate
Rural: 14.9 & Urban: 7.8
Highest: Madhya Pradesh (20)
Lowest: Kerala (2.9)
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Progress on Key Indicators
Reproductive & Child Health (RCH)
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Progress on Key Indicators
Disease Burden
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Progress on Key Indicators
Disease Burden
Communicable Diseases
Up Trends Down Trends
Dengue, Chikungunya Polio
Cholera O139 Tuberculosis
Japanese Encephalatis Neonatal Tetan
Leptospirosis Measles
Emerging: Influenza A H5N1 Eradicated: Small Pox
Emerging: Influenza A PandemicH1N1
Eradicated: Yaws, Guin
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Progress on Key Indicators
Disease Burden
Non-communicable Diseases
1. National Cancer Control Program (NCCP)
2. National Mental Health Program (NMHP)
3. National Program for Health Care of Elderly (NPHCE)
4. National Tobacco Control Program (NTCP)
5. National Program for Prevention & Control of Deafness (NPPCD)
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Global Comparison
Indicators US India China
Annual Population GrowthRate 0.9% 1.31% 0.47%
Percentage of expenditurespent by Govt. on the
healthcare 17.6% of GDP 4.1% of GDP 7% of GDP
Gross National Income per
Capita 50,120 USD 1,530 USD 9,210 USD
Sex Ratio 952 per 1000 males 940 per 1000 males 926 per 1000 mal
Life Expectancy 77.97 65 73.49
Infant Mortality Rate 5.9 per 1,000 44 15.2
Maternal Mortality Rate9.1 maternal deathsper 100,000 live births 200
37 maternal deatper 100,000 live bi
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Global Comparison
Indicators US India China
Total Fertility Rate1.89 births per
woman 2.59 births per woman1.58 births per
woman
Most Prevalant Diseases
ArthritisDiabetes MellitusCoronary Heart
DiseaseChronic ObstructivePulmonary Disease
dengue fever,hepatitis, tuberculosis,
malaria andpneumonia
Tuberculosis,Hepatitis A, typh
fever
Crude Birth Rate 13 per 1,000 people 22 12 Crude Death Rate 8 per 1,000 people 8 7
No. of doctors (per 1000 ppl) 2.4 0.6 1.8
No. of nurses (per 1000 ppl) 9.8 1 1.7
No. of hospital beds (per 1000ppl) 3 0.9 3.8
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Suggestions
Central and State Governments
Protect poor against ill health and exploitation
Promote social health insurance
Scale up financial resources
Improve management and accountability of public health servic
Ensure quality improvement through standards and accreditatio
Strengthen the base of the pyramid
Further improvements in tax benefit plans, import duty concessio
of medical devices
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Suggestions
Corporate Sector
Widen the scope of CSR activities
Develop mechanisms of cross subsidising the poor through earni
sections
Provide hub and spoke model for both treatment and diagnostic
Encourage provision locum medical staff wherever required
Take on responsibility of medical education
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Suggestions
Non government and non profit sector
Enter into mutually beneficial partnerships with the corporate an
sectors
Academic and Research institutions
Medical colleges should facilitate updating technical knowledg
Bio-medical research organizations should be keen to improving
technology Contributions by Public health and management training instituti
management institutions
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Thank You
Stay Healthy!
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