National health policy 2017.pptx

This ppt will explain the national health policy 2017, containing an introduction, history, etc.

1. National Health Policy-2017

2. Contents

3. DEFINITION Policy is statement which lays down the stated agreement of a government regarding the strategy and broad course of actions that will be taken to address a problem.

4. Policy Vs Programme & Legislation Policy Programme Legislation Vision Interventions Rights Values Resources Do’s & Don’ts Principles Budget Accountability Broad objectives Specific Punishment

5. History

6. Situational Analysis

7. Situational analysis

8. Situational Analysis

9. Situational analysis- Health industry

10. Health Expenditure in Selected Countries Year Total health expenditure per capita USD-2011 Total health expenditure as % of GDP-2011 Govt. Health expenditure as % of Total health expenditure India $62 3.8% 30.5% Thailand $214 4.1% 77.7% Sri Lanka $93 3.3% 42.1% China $274 5.1% 45.7% UK $3659 9.4% 82.8% Situational Analyses report-2017

11. Need for NHP 2017

12. Goal Attainment of the highest possible level of health and wellbeing for all at all ages, through a preventive and promotive health care orientation in all developmental policies, and universal access to good quality health care services without anyone having to face financial hardship as a consequence.

13. Key Policy Principles

14. Objectives

15. Health Status and Programme Impact INDICATOR TARGET YEAR Life Expectancy and healthy life Life Expectancy at birth 67.5 to 70 2025 regular tracking of DALY index 2022 Reduction of TFR 2.1 2025 Mortality by Age and/ or cause Under Five Mortality 23 2025 MMR 100 2020 IMR 28 2019 Neonatal mortality 16 2025 Still birth Single digit 2025 Reduction of disease prevalence/ incidence HIV/AIDS 90:90:90 2020

16. Health Systems Performance INDICATOR TARGET YEAR Coverage of health services Increase utilization of public health facilities by 50% 2025 skilled attendance at birth Above 90 % 2025 Fully immunized new-borns Above 90 % 2025 Meet need of family planning Above 90 % 2025 80% of known HTN & DM „controlled disease status‟ 2025 Cross sectoral goals related to health prevalence of current tobacco use To be reduced by 30 % 2025 prevalence of stunting of under-five children To be reduced by 40% 2025 Access to safe water and sanitation to all 2020 Reduction of occupational injury 2020

17. Health Systems strengthening INDICATOR TARGET YEAR Health finance Increase health expenditure by Government 1.15%- 2.5% of GDP 2025 Increase State sector health spending 8% OF THEIR BUDGET 2020 Health Infrastructure and Human Resource Ensure availability of paramedics and doctors as per Indian Public Health Standard (IPHS) norm in high priority districts 2020 Increase community health volunteers 2025 Establish primary and secondary care facility 2025 Health Management Information district-level electronic database establish registries for diseases of public health importance ******************************

18. Ensuring Adequate Investment

19. Preventive and Promotive Health SWASTH NAGRIK ABHIYAN

20. Organization of Public Health Care Delivery key policy shifts

21. Cont ….

22. National Health Programmes

23. Elicit developmental action of all sectors to support Maternal and Child survival. Strengthening of general health systems to prevent and manage maternal complications Ensure continuity of care and emergency services for maternal health. Address the social determinants through developmental action in all sectors. Accelerated achievement of neonatal mortality targets and “single digit” stillbirth rates District hospitals- screening and treatment of children Pre-emptive care School health programmes- health and hygiene – part of curriculum Expansion of scope of Reproductive and Sexual Health RMNCH+A services Child and Adolescent Health

24. Reducing micronutrient malnourishment. Augmentation of Micro nutrient supplementation, food fortification, screening for anemia and public awareness. Screening Intensify the present efforts ( IFA,vit -A, ORS,Calcium , Iodized salt etc. Effective integration of both nutrition-sensitive and nutrition-specific interventions for coordinated optimal results. Improve immunization coverage with quality and safety, improve vaccine security as per National Vaccine Policy 2011 Introduction of newer vaccines Success of Mission Indradhanush Intervention to address Malnutrition Universal immunization

25. For Integrated Disease Surveillance Programme- response of districts to the communicable disease priorities Active case detection Greater involvement of private sector supplemented by preventive and promotive action Access to free drugs Communicable diseases Control of tuberculosis

26. Focused interventions on the high-risk communities (MSM, Transgender, FSW, etc.) and prioritized geographies. Support care and treatment for people living with HIV/AIDS Proactive measures targeted towards elimination of leprosy from India by 2018 Control of HIV/AIDS Leprosy elimination

27. Changing treatment regimens of drug resistance in Malaria National Programme for prevention and control of Japanese Encephalitis (JE)/Acute Encephalitis Syndrome (AES) acceleration with inter-sectoral collaboration. Set-up a National Institute of Chronic Diseases including Trauma Integrated approach where screening for the most prevalent NCDs with secondary prevention Comprehensive primary health care network - specialist consultations + follow up at the primary level. Research Developing protocol for mainstreaming AYUSH -Integrated medical care. Geriatric care (Maintenance and Welfare of Parents and Senior Citizens Act, 2007) Public awareness to promote voluntary tissue and organ donation Vector Borne disease control Noncommunicable diseases

28. Provisions of the National Mental Health Policy 2014 Increase creation of specialists to work in public systems Strengthen mental health services at primary level Leverage digital technology in a context where access to qualified psychiatrists is difficult Camp based services  Any day of the week / A fixed day Increase the proportion of male sterilization <5%  30% and if possible much higher. Mental health Population stabilization

29. Other areas Women’s health & Gender based violence Supportive Supervision Emergency Care and Disaster Preparedness Mainstreaming the Potential of AYUSH Tertiary care Services

30. 6. Human Resources for Health Medical Education Attracting and Retaining Doctors in Remote Areas Specialist Attraction and Retention Mid-Level Service Providers Nursing Education ASHA Paramedical Skills Public Health Management Cadre Human Resource Governance and leadership development Other areas

31. Other areas Financing of Health Care (National health account system) Purchasing of Healthcare Services Collaboration with Non-Government Sector/Engagement with private sector Capacity building Skill Development programmes Corporate Social Responsibility (CSR) Mental healthcare programmes Disaster Management Strategic Purchasing as Stewardship Enhancing accessibility in private sector Role in Immunization Disease Surveillance Tissue and organ transplantations Make in India Health Information System Incentivising Private Sector

32. Other areas 9. Regulatory Framework Professional Education Regulation Regulation of Clinical Establishments Food Safety Drug Regulation Medical Devices Regulation Clinical Trial Regulation Pricing- Drugs, Medical Devices and Equipment 10. Vaccine safety 11.Medical Technologies 12. Public Procurement 13. Availability of Drugs and Medical Devices 14. Aligning other policies for medical devices and equipment with public health goals 15. Improving Public Sector Capacity for Manufacturing Essential Drugs and Vaccines

33. Other areas 16. Anti-microbial resistance 17. Health Technology Assessment 18. Digital Health Technology Eco – System Application of Digital Health Leveraging Digital Tools for AYUSH 18. Health surveys 19. Health Research Strengthening Knowledge for Health: Drug Innovation & Discovery Development of Information Databases Research Collaboration 20. Governance Role of Centre & State Role of Panchayati Raj Institutions Improving Accountability 21. Legal Framework for Health Care and Health Pathway 22. Implementation Framework and Way Forward

34. Let’s go Deep into the reality

35. Are the objectives achievable?

36. Quantitative objectives INDICATOR TARGET By YEAR LATEST DATA Life expectancy at birth 67.5 to 70 2025 69.6 (2019- World bank data) Reduction of TFR 2.1 2025 2 (2019-NFHS 5) Under five mortality 23 2025 42 (2019 NFHS 5) MMR 100 2020 103 (2019 SRS DATA-2019) IMR 28 2019 30 (2019-NFHS 5) Neonatal mortality 16 2025 25(2019-NFHS 5) Still birth Single digit 2025 13.9(2019 WHO report) HIV/AIDS 90:90:90 2020 77:65:55(2021-UNAIDS report) Increase utilization of public health facilities by 50% 2025 Prevalence of current tobacco use To be reduced by 30 % (32.2-2015-world Bank Data) 2025 27.2%(2019) Prevalence of stunting of under-five children To be reduced by 40% (38%-NFHS 4) 2025 35.5%(NFHS 5) Increase health expenditure by government 1.15%- 2.5% of GDP 2025 Increase state sector health spending 8% OF THEIR BUDGET 2020

37. Ref: NFHS-5 Report Targets Year 23 2025 28 2019 16 2025

38. Ref: MoHFW /National Health Estimates 2018-19 report launch/12 Sept 2022/4

39. Is National health policy ambitious?

40. Will it be possible to achieve universal health coverage by 2030?

41. Health financing being neglected (GHE is 1.4% of GDP) National health policy 2017: Can it lead to achievement of sustainable development goals?

42. Sri Lanka - 3.25% Bangladesh - 3.7% Pakistan - 2.8% India -1.4% South-East Asian region countries Government health expenditure (% of GDP)

43. Year Total health expenditure per capita Total health expenditure as % of GDP Govt. Health expenditure as % of Total health expenditure 2015 $62 3.9% 30.5% 2019 $63.75 3.01% 32.79% Health Outcomes and Health expenditures in India World bank data-2019

44. Health financing being neglected (GHE is 1.4% of GDP) Need to relook our strategies to reduce maternal and child mortality National health policy 2017: Can it lead to achievement of sustainable development goals?

45. Ref: Annual report 2021-22 and Sample Registration System (SRS) special bulletin on maternal mortality in India (2017-19

46. Ref: According to the latest Sample Registration System (SRS) special bulletin on maternal mortality in India (2017-19), brought out by the office of the Registrar General of India.

47. Health financing being neglected (GHE is 1.4% of GDP) Need to relook our strategies to reduce maternal and child mortality Over reliance on private sector National health policy 2017: Can it lead to achievement of sustainable development goals?

48. Household social consumption in India: Health NSS 75th round (July, 2017 – June, 2018) [Internet]. [cited 2022 Oct 8]. Available from: https://pib.gov.in/newsite/PrintRelease.aspx?relid=194918 Utilization of public and private hospitals in inpatient and outpatient healthcare

49. Comparison of per episode treatment cost (INR) in Public and Private Facilities Hospitals Treatment cost Inpatient Treatment cost outpatient Public 4451.9 331.4 Private 31845.4 1062.2 Charitable/Trust/NGO 24452.4 732.4 Household social consumption in India: Health NSS 75th round (July, 2017 – June, 2018) [Internet]. [cited 2022 Oct 8]. Available from: https://pib.gov.in/newsite/PrintRelease.aspx?relid=194918

50. Health financing being neglected (GHE is 1.4% of GDP) Need to relook our strategies to reduce maternal and child mortality Over reliance on private sector Uniform health insurance system for the country is the need of the hour National health policy 2017: Can it lead to achievement of sustainable development goals?

51. Out of pocket expenditure 54.78% (2019) 10%

52. Health financing being neglected (GHE is 1.4% of GDP) Need to relook our strategies to reduce maternal and child mortality Over reliance on private sector Uniform health insurance system for the country is the need of the hour Inequities & Inter and intra State variations. National health policy 2017: Can it lead to achievement of sustainable development goals?

53. Ref: NFHS-5 Report

54. NHP -2017 Low targets?

55. Country Life expectancy at Birth India 66 Thailand 75 Sri Lanka 75 Brazil 74 China 75 Russia 69 South Africa 59 USA 79 UK 81 Germany 82 France 82 Norway 82 Denmark 80 Japan 84 Life expectancy at birth in different countries Ref: Situational analysis-2017

56. Is it a mirror image of previous policies?

57. Indicators NHP 2002 target (year) ( MoHFW , 2002) NHP 2017 target (year)  ( MoHFW , 2017) Current status (year) Maternal mortality ratio 100 (2010) 100 (2020) 113 (2016–2018) Leprosy Elimination by 2005 Elimination by 2018 8.38 new cases detected per 100 000 population (2019) Kala-azar Elimination by 2010 Elimination by 2017 Reported cases: 1967, deaths: 6 (2020) Lymphatic filariasis Elimination by 2015 Elimination by 2017 (in endemic pockets) Average microfilaria rate (2014): 0.44% Public spending on health 2% of GDP (2010) 2.5% of GDP (2025) 1.2% GDP (2016– 2017) Increase state sector health spending 8% of budget by 2010 8% of budget by 2020 6.3% of total revenue expenditure (20192020) Srivastava S, Karan AK, Bhan N, Mukhopadhya I, World Health Organization. India: health system review. Health Systems in Transition. 2022;11(1).

58. Any mention of pandemic?

59. NHP-17 & Covid-19

60. What happened during Covid-19 pandemic? Main target of NHP 2017 Universalization of health care “Health in All approach” Private healthcare system Vs Public health care system

61. Private healthcare system during Covid 19

62. Public healthcare system during covid-19

63. Ref: Center For Disease Dynamics, Economics & Policy report ( 20 April 2020) and National Health Profile 2019

64. Where the policy is lagging behind? What can be done to achieve the targets by 2030? What should be added in future policies?

65. References National health policy -2017 report ( MoHFW ) National health policy- 2002 ( MoHFW ) Situational analysis-Backdrop to the nationalhealth policy-2017 Kaur H, Rathi SK. National Health Policies in Practice: An Explorative Analysis for India. Journal of Health Management. 2019 Sep;21(3):372-82. Sundararaman T. National Health Policy 2017: a cautious welcome. Indian Journal of Medical Ethics. 2017 Apr 4;2(2):69-71. Sharma S, Singh M, Pal R, Ranjan R, Pal S, Ghosh A. National Health Policy 2017: Can it lead to achievement of sustainable development goals. Al Ameen J Med Sci. 2018;11(1):4-11 Gupta RK, Kumari R. National health policy 2017: an overview. JK Science. 2017 Jul 1;19(3):135-6. Grover A, Singh RB. Health policy, programmes and initiatives. InUrban Health and Wellbeing 2020 (pp. 251-266). Springer, Singapore. Gauttam P, Patel N, Singh B, Kaur J, Chattu VK, Jakovljevic M. Public health policy of India and COVID-19: Diagnosis and prognosis of the combating response. Sustainability. 2021 Mar 19;13(6):3415. Srivastava S, Karan AK, Bhan N, Mukhopadhya I, World Health Organization. India: health system review. Health Systems in Transition. 2022;11(1). Annual report-2021-22 NFHS-5 data