NATIONAL HEALTH POLICY AND STATE HEALTH POLICY

1. HEALTH CARE POLICY NATIONAL AND STATE

2. CONCEPT OF HEALTH AND COMPREHENSIVE HEALTH CARE HEALTH CARE : “ Services provided to individuals or communities by the agents of health services or professionals for the purpose of promoting , maintaining, monitoring or restoring health .”

3. COMPREHENSIVE HEALTHCARE “The provision of integrated ,preventive ,curative and promotional health services from womb to tomb, to every individual residing in a defined geographical area”

4. HEALTH STRATEGIES Restructuring the health infrastructure.

5. HEALTH STRATEGIES Developing health Manpower , research and development.

6. NATIONAL HEALTH POLICY 1983 HISTORY Bhore committee: 1943 First evolution: 1983 Revised: 2002

7. ELEMENTS OF NATIONAL HEALTH POLCY IN INDIA Awareness Of Health Problems. Supply Of Safe Drinking Water And Basic Sanitation. Reduction Of Imbalance In Health Services Dynamic Health Management Information System.

8. ELEMENTS OF NATIONAL HEALTH POLCY IN INDIA [ contd ]……. Legislative Support . Combat widespread Malnutrition. Alternative methods of health care delivery system Use of low cost technologies. Coordination of different systems of medicine.

9. COMPONENTS OF HEALTH POLICY Socioeconomic policies Employment Elementary Education Integrated rural development. Population Control. Welfare of women and children .

10. GOALS OF HEALTH POLICY Acceptable standard of good health Increased access to decentralized public health system. Establishing new infrastructure Equitable access to health services Preventive and curative services. Emphasis rational use of drugs and target burden disease

11. NATIONAL POLICIES RELATED TO HEALTH

12. NATIONAL HEALTH POLICY- 2002

13. NATIONAL POPULATION POLICY-2000

14. NATIONAL AIDS PREVENTION AND CONTROL POLICY-2002

15. NATIONAL BLOOD POLICY- 2002

16. NATIONAL POLICY FOR THE EMPOWERMENT OF WOMEN-2001

17. NATIONAL POLICY AND CHARTER FOR CHILDREN -2003

18. NATIONAL YOUTH POLICY -2003

19. NATIONAL POLICY FOR OLD PERSON-1999

20. NATIONAL HEALTH RESEARCH POLICY (DRAFT)

21. NATIONAL POLICY ON EDUCATION

22. NATIONAL PHARMACEUTICAL POLICY

23. NATIONAL WATER POLICY

24. NATIONAL ENVIRONMENTAL POLICY-2006

25. NATIONAL HOUSING AND HABITAT POLICY -1998

26. PARTS OF NATIONAL HEALTH POLCY

27. PARTS OF NATIONAL HEALTH POLICY PARTS OF NATIONAL HEALTH POLICY Introductory

28. PARTS OF NATIONAL HEALTH POLICY Our Heritage

29. PARTS OF NATIONAL HEALTH POLICY Progress achieved

30. PARTS OF NATIONAL HEALTH POLICY The Existing Picture: High rate of population growth

31. 2. High mortality rate for women children and Infants

32. 3.Malnutrition

33. 4. High prevalence of Communicable and Non communicable diseases.

34. 5. Poor access to potable water supply and the basic sanitation

35. 6. Poverty

36. 7.Ignorance

37. 8. Adoption of Health manpower models

38. 9. Establishment of Curative centers.

39. 10.Emphasis on hospital based, cure oriented approach

40. 11.Failure to involve the community in the identification of health needs and priorities .

41. PARTS OF NATIONAL HEALTH POLICY Revised 20-point programme

42. PARTS OF NATIONAL HEALTH POLICY Population stabilization

43. PARTS OF NATIONAL HEALTH POLICY Medical and Health Education

44. PARTS OF NATIONAL HEALTH POLICY Need for providing primary health care Comprehensive primary healthcare Transfer of knowledge , skills and technologies Organized building Referral system Sanitary cum epidemiological stations

45. PARTS OF NATIONAL HEALTH POLICY Need for providing primary health care Location of curative centers Planned programmes Speciality and Super speciality care Well coordinated programmes. Priority wise services Adequate mobility of personnel

46. PARTS OF NATIONAL HEALTH POLICY Reorientation of Existing Health Personnel

47. PARTS OF NATIONAL HEALTH POLICY Private practice by Government Functionaries

48. PARTS OF NATIONAL HEALTH POLICY Practitioners of indigenous and other systems of medicine and their role in health care.

49. PARTS OF NATIONAL HEALTH POLICY Problems requiring urgent attention Nutrition Prevention of food adulteration and maintenance of quality of drugs. 3. Water supply and Sanitation Environmental protection. Immunization program. Maternal and child health services. School health program Occupational health services.

50. PARTS OF NATIONAL HEALTH POLICY Health Education

51. PARTS OF NATIONAL HEALTH POLICY Management information System

52. PARTS OF NATIONAL HEALTH POLICY Medical Industry

53. PARTS OF NATIONAL HEALTH POLICY Health Insurance

54. PARTS OF NATIONAL HEALTH POLICY Health legislation

55. PARTS OF NATIONAL HEALTH POLICY Medical research:

56. PARTS OF NATIONAL HEALTH POLICY Inter sectoral cooperation

57. PARTS OF NATIONAL HEALTH POLICY Monitoring and review of progress

58. COMMENTS OF NATIONAL HEALTH POLICY Mentions about poverty alleviation and not about social justice. No program for Community Participation Totally silent about health budget Not integrated No emphasis to certain areas .

59. REVISED NATIONAL HEALTH POLICY (2002) OBJECTIVES : Achieve acceptable standard of Good Health Increase access to the decentralized public health system Ensure more equitable access to health services . Increase aggregate public health investment. Strengthen the capacity of public health administration.

60. REVISED NATIONAL HEALTH POLICY (2002) OBJECTIVES 6. Enhance the contribution of Private sector 7. Rationalize use of drugs within allopathic system. 8. Increase access to tried and tested systems of traditional medicine

61. INITIATIVES OF REVISED NATIONAL HEALTH POLICY A widespread network of comprehensive health care services. Intermediation through Health Volunteers. Referral System Speciality and Superspeciality services .

62. CURRENT SCENARIO OF OUR COUNTRY 1. Financial Resources : Low public health investment Declined GDP

63. CURRENT SCENARIO OF OUR COUNTRY 2. Equity Lack of equitable distribution of resources

64. CURRENT SCENARIO OF OUR COUNTRY Lack of flexibility of Public health infrastructure No permit for state to craft their own programmes Not need based. 3. Delivery of National Public Health Programme

65. CURRENT SCENARIO OF OUR COUNTRY 4. State of Public health infrastructure : Existing Public health infrastructure is not satisfactory. Based on an Objective assessment of the quality and efficiency of existing public health infrastructure .

66. CURRENT SCENARIO OF OUR COUNTRY 5. Extending public health Services Shortage of Medical power No incentive system is attempted so far, has induced private medical manpower

67. CURRENT SCENARIO OF OUR COUNTRY 6. Role of Local Self- government institutions

68. CURRENT SCENARIO OF OUR COUNTRY 7. Medical Education

69. CURRENT SCENARIO OF OUR COUNTRY Need for specialists in ‘Public health’ and ‘Family Medicine’

70. CURRENT SCENARIO OF OUR COUNTRY 9. Urban Health

71. CURRENT SCENARIO OF OUR COUNTRY 10.Mental Health

72. CURRENT SCENARIO OF OUR COUNTRY 11. I E C Information Education Communication

73. CURRENT SCENARIO OF OUR COUNTRY 12. Medical Research Limited to ICMR

74. CURRENT SCENARIO OF OUR COUNTRY 13.Role of the Private Sector

75. CURRENT SCENARIO OF OUR COUNTRY 14. Role of Civil society

76. CURRENT SCENARIO OF OUR COUNTRY 15.National Disease surveillance Network

77. CURRENT SCENARIO OF OUR COUNTRY 16. Health Statistics

78. CURRENT SCENARIO OF OUR COUNTRY 17. Women’s Health

79. CURRENT SCENARIO OF OUR COUNTRY 18. Medical ethics

80. CURRENT SCENARIO OF OUR COUNTRY 19. Enforcement of Quality standards for food and Drugs

81. CURRENT SCENARIO OF OUR COUNTRY 20. Regulation of Standards in Para medical disciplines.

82. CURRENT SCENARIO OF OUR COUNTRY 21. Occupational Health

83. CURRENT SCENARIO OF OUR COUNTRY 22. Providing Medical facilities to users from Overseas

84. CURRENT SCENARIO OF OUR COUNTRY 23. Impact of Globalization on the health sector

85. CURRENT SCENARIO OF OUR COUNTRY 24. Non Health Determinants

86. CURRENT SCENARIO OF OUR COUNTRY 25. Population Growths and Health Standards

87. CURRENT SCENARIO OF OUR COUNTRY 26. Alternative Systems of Medicine

88. DEMOGRAPHIC trends of National health policy Population : 1.21 billion Growth rate: 1.51% Birth rate : 20.22 birth / 1000 population Death rate : 7.4 death /1000 population Life expectancy: 68.89 years

89. SWOT ANALYSIS OF NATIONAL HEALTH POLICY Strengths: Identified deficiencies of the policy. Advancement of technology and proven public health strategies Commitment to enhance the budget on health expenditure

90. SWOT ANALYSIS OF NATIONAL HEALTH POLICY Weakness Lack of Monitoring and Evaluation Lack of Government Expenditure on Public Health Gap in Situation analysis and problem prescription

91. SWOT ANALYSIS OF NATIONAL HEALTH POLICY Opportunities Move ahead in Health through Health Policy Supportive environment and absence of obvious threat of water and unrest etc. Policy initiative will provide a new impetus to the development of Health Sector

92. SWOT ANALYSIS OF NATIONAL HEALTH POLICY Threats: Health Tourism

93. STATE HEALTH POLICY

94. OBJECTIVES OF STATE HEALTH POLICY 2013

95. KERALA CURRENT SCENARIO

96. 2. HEALTH FINANCING Budget allocation: From NRHM Fund .

97. 3.SOCIAL DETERMINANTS OF HEALTH

98. Water Supply Increased reclamation of wetlands and Water bodies Increased Pollution

99. Sanitation Problems of Toilet construction in water logged areas. Absence of appropriate models in areas of water scarcity. Sanitary toilets without Septic Tank

100. Solid and Liquid waste Management system Accumulation of Plastic waste Issue of Thin Plastic Bags Ecological degradation Contamination of Water bodies Misuse of Pesticides

101. Climate Change and Public Health Challenges to control of infectious Diseases. Seasonal changes in the availability of Fresh water. Regional drop in Food Production Rising Sea level

102. Other Social Determinants of Health

103. Other Social Determinants of Health Food and Nutrition

104. Other Social Determinants of Health Regular Employment

105. Other Social Determinants of Health Housing

106. Other Social Determinants of Health Women empowerment

107. 4. Managing Emerging and Re emerging Diseases

108. 5. Non- Communicable Diseases 50% of Total Deaths – between the age group of 30-60 27% Adult males and 19% Adult females are diabetic. Kerala – “ Diabetic Capital of India.”

109. 5. Non- Communicable Diseases Contd ………. Introduction of NPCDCS Introduction of “ Amrutham Arogyam ” [ NCD Control Programme ]

110. 6.CANCER CARE- EARLY DETECTION AND PREVENTION Cancer treatment is limited. Kerala reports nearly 35,000 new registrations Nearly 1 lakh patients are under treatment every year

111. 7. WOMEN’S HEALTH

112. 8. MATERNAL HEALTH

113. 9. CHILD HEALTH IMR of Kerala is 12/1000 Achieve universal immunisation Nutritional Monitoring Organisation of New born Screening programmes

114. 10.ADOLESCENT HEALTH [ARSH] WIFS - Weekly Iron and Folic acid Supplementation programme AFHCs – Hospital based Adolescent Friendly Clinics

115. 11. SCHOOL HEALTH Implementation of modified School Health programme . Vision of a School: “ That constantly strengthens its capacity as a healthy setting for living and Working………………’’

116. 12. HEALTH PROBLEMS OF ELDERLY Present elderly population ( above 60 years) is 12% and is expected to cross 25% by 2050 Geriatric friendly Hospitals Palliative care policy in Kerala (2008) 700 palliative care units are established with PHC . 250 Palliative Care Unit Attached with Community Based Organizations

117. 13. MENTAL HEALTH PROBLEMS :

118. 14. HEALTH OF VULNERABLE SECTIONS AND HEALTH INFRASTRUCTURE IN KERALA

119. OVERVIEW OF HEALTH SERVICE SYSTEM OF THE STATE Tertiary care Secondary care Institutions Primary health center Sub -center

120. Tertiary Care:

121. Secondary care Institutions

122. Primary Health centers

123. Sub -centers 5500 ANMs 3500 JHI 5403 Sub centers

124. Emergency medical services and management of trauma.

125. MEDICAL ESTABLISHMENT BILL 2013

126. HUMAN RESOURCE POLICY IN HEALTH

127. NURSING CARE AND NURSING EDUCATION

128. TREATENT PROTOCOLS, REFERRAL PROTOCOLS AND MANAGEMENT GUIDELINES

129. DATA MANAGEMENT SYSTEM

130. DECENTRALIZATION AND HEALTH

131. PRIVATE SECTOR

132. PLAN OF ACTION

133. DETERMINANTS OF HEALTH CARE Clean drinking water

134. DETERMINANTS OF HEALTH CARE Sanitation facilities

135. DETERMINANTS OF HEALTH CARE Solid waste management policy and plan of action

136. DETERMINANTS OF HEALTH CARE Poverty

137. ENFORCEMENT OF REGULATIONS FOR GOOD HEALTH

138. Food safety

139. Public health act

140. Reorganization of Government Health systems : Primary Health centers Community Health centers Taluk Head quarters Hospital District/ General Hospitals. Medical College Hospitals

141. OTHER SPECIALISED AREAS Public health cadre and Health protection Agency

142. Communicable Disease Surveillance And Execution Of Control Measures ”

143. Non Communicable Disease Control

144. Community Mental Health Care and Services.

145. Measures for reducing the Road traffic accidents other trauma and developing systemic trauma care services Construction of an “Act force System” , involving police.

146. Strengthening Laboratory Network in the State :

147. AYURVEDA

148. AYURVEDA Research and Documentation

149. AYURVEDA Quality Assurance

150. AYURVEDA Support to Manufacturing

151. AYURVEDA Awareness regarding the Benefits of Ayurveda

152. HOMEOPATHY In 1928, The Maharaja of Travancore acknowledged Homoeopathy as an acceptable system of treatment. Homeopathic health care services : 31 Homeopathic Hospitals. 611 Homeopathic Dispensaries 348 NRHM Homeo Dispensaries 29 Dispensaries at SC/ST dominant areas.

153. HOMEOPATHY ESI: 13 Dispensaries and 1 Hospital Seethalayam Ayushman bhava Jyothir gamaya Chethana

154. ORAL HEALTH

155. FUTURE DEVELOPMENTS Quality up gradation in health sector Universal Health Coverage

156. SSSS CONCLUSION

157. BIBLIOGRAPHY Text books: Gupta M.C, Mahajan B.K . Textbook of preventive and Social medicine:(3 rd ed ).New delhi : Jaypee Medical Brothers pvt.ltd ; 2003 Keshav Swarnkar . Community Health Nursing: Includes behavioural sciences and personal hygiene: (2 nd ed ). Indore: N.R Brothers publishers Pvt.ltd:2006 Mary Lucita . Nursing: Practice and public health administration, current concepts and trends: Newdelhi : Elsevier India pvt.ltd ; 2004   Park.K . Textbook of preventive and social medicine;(16 th ed ): Indore;Banarasi Bhanot Brothers; 2007  

158. BIBLIOGRAPHY Government Document:   Kerala Health care policy 2013. Department of Health and family welfare; 2013 . Online Database Chaukar D.A, Walvekar RR, Das A.K, Deshpande MS,Pai . P.S, Chaturvedi . P, Kakade A, D’cruz A.K; Quality of life in head and neck Cancer Survivors: A cross sectional study. [Internet]. 2009 May-June [ cited 2009June];30(3): 176-80; Available from pubmed , http;//:en://www.ncbi.nlm.nib.gov/pubmed]   Website: www.slideshare.chantal .net.com www.pubmed.com www.wikipedia.com