National Health Policy of 1983, 2002 and 2017

An presentation on National Health Policy, whose initiation taken during 1983 committed to attain the goal of Health for all by the year 2000AD and further matters added from to time considering present scenario.

1. NATIONAL HEATH POLICY PRESENTED BY NIRUPAMA MISHRA, [ M.Sc (N)- CHN Speciality ] TUTOR, CON VIMSAR, BURLA

2. INTRODUCTION TO NHP 1983 National health policy (NHP) is a statement , outlined by GoI as a blue print for further action. It aims at the elimination of poverty, illiteracy, ill health, ignorance and inequality. In view of the commitment made by GoI to achieve the global, social target Health For All by 2000 AD, an expert committee appointed by the planning commission submitted the report in 1981, about assessing the health status of the country, in terms of various indicator, which became the basis or root of national health policy. NHP was finalized by the Ministry of Health and Family Welfare in 1982, with the goal HFA by 2000 AD and NHP was approved in August 1983

3. Cont …… NHP-1983, in a spirit of optimistic empathy for the health needs of the people, particularly the poor and underprivileged, had hoped to provide ‘Health for All by 2000 AD through the comprehensive Primary Health Care Services. That is a way to achieve H ealth for All.

4. PRIORITY AREAS OF THE POLICY Small family norm Improvement of maternal and child health Immunization programme Improvement of nutritional status Provision of safe water supply and sanitation Environmental protection School health programme Occupational health Prevention of food adulteration Maintenance of quality of drugs

5. OTHER STRATEGIES OF NHP 1983 Prohibition of private practice by Govt. Doctors, in a phased manner. Exploitation of the services by the practitioners of AYUSH. Promotion of herbal gardening and health industry to increase the production of drugs. Promotion of basic and applied research. Establishment of inter sectoral coordination. Training of all categories of medical personnel. Universal adult literacy education.

6. NATIONAL HEALTH POLICY 2002 Because of the certain comments and criticism, the policy was revised by Ministry of Health and Family Welfare, in the year 2002 as “New National Health Policy- 2002”. NHP 1983 was perceived to achieve HFA by 2000 AD through universal provision of PHCs, not visualizing enormous resources necessitated to achieve the goal. Contrastingly NHP 2002 is projected as a realistic document based on conceptual and operational framework.

7. OBJECTIVES OF NHP 2002

8. GOALS OF NHP 2002 Goals of NHP – 2002, to be achieved by 2005- 2015 are:- DISEASE YEAR Eradication of poliomyelitis and yaws 2005 Elimination of leprosy 2005 Elimination of Kala-azar 2010 Elimination of lymphatic filariasis 2015 Achieve zero level growth of HIV/ AIDS 2007 Reduce mortality by 50% on account of TB, malaria and other water borne and vector borne diseases 2010 Reduce prevalence of blindness to 0.5% 2010 Reduce IMR to 30/ 1000 LB and MMR to 1/ 1000 LB ( i.e 100/ 1 lakh LB) 2010 Increase utilization of public health facilities from current level of <20 to >75% 2010 Establish an integrated system of surveillance, health statistics and health accounting by 2005

9. NHP 2017 The National Health Policy of 1983 and the National Health Policy of 2002 have served well in guiding the approach for the health sector. The current context has however changed in four major ways. 1. Health priorities are changing. Although maternal and child mortality have rapidly declined, there is growing burden on account of non-communicable diseases and some infectious diseases . 2. E mergence of a robust health care industry estimated to be growing at double digit. 3. G rowing incidences of catastrophic expenditure due to health care costs, which are presently estimated to be one of the major contributors to poverty. 4. A rising economic growth enables enhanced fiscal capacity. Therefore, a new health policy responsive to these contextual changes is required. The National Health Policy, 2017 seeks to reach everyone in a comprehensive integrated way to move towards wellness.  It aims at achieving universal health coverage and delivering quality health care services to all at affordable cost.

10. GOAL OF NHP 2017 To attain the highest possible level of health and well-being 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. This would be achieved through:- I ncreasing access I mproving quality and L owering the cost of healthcare delivery.

11. OBJECTIVES OF NHP 2017 Improve health status through concerted policy action in all sectors and expand preventive, promotive, curative, palliative and rehabilitative services provided through the public health sector with focus on quality.

12. SPECIFIC QUANTITATIVE GOALS AND OBJECTIVES OF NHP 2017 1. Health Status and Programme Impact A. Life Expectancy and healthy life B. Mortality by Age and/ or cause Life Expectancy at birth from 67.5 to 70 2025 TFR to 2.1 at national and sub-national level 2025 Under Five Mortality to 23 2025 MMR from current levels to 100 2020 IMR rate to 28 2019 Neo-natal mortality to 16 and Still birth rate to “single digit” 2025

13. Cont ….. C. Reduction of disease prevalence/ incidence Achieve global target of 2020 which is also termed as target of 90:90:90, for HIV/AIDS i.e. Achieve and maintain elimination status of Leprosy by 2018, Kala-Azar by 2017 and Lymphatic Filariasis in endemic pockets by 2017. To achieve and maintain a cure rate of >85% in new sputum positive patients for TB and reduce incidence of new cases, to reach elimination status by 2025. To reduce the prevalence of blindness to 0.25/ 1000 by 2025 and disease burden by one third from current levels. To reduce premature mortality from cardiovascular diseases, cancer, diabetes or chronic respiratory diseases by 25% by 2025.

14. 2 . Health Systems Performance A. Coverage of Health Services Increase utilization of public health facilities by 50% from current levels by 2025. Antenatal care coverage to be sustained above 90% and skilled attendance at birth above 90% by 2025. More than 90% of the newborn are fully immunized by one year of age by 2025. Meet need of family planning above 90% at national and sub national level by 2025. 80% of known hypertensive and diabetic individuals at household level maintain "controlled disease status" by 2025. B. Cross Sectoral goals related to health Relative reduction in prevalence of current tobacco use by 15% by 2020 and 30% by 2025. Reduction of 40% in prevalence of stunting of under-five children by 2025. Access to safe water and sanitation to all by 2020 . National / State level tracking of selected health behavior .

15. 3. Health Systems strengthening A. Health finance Increase health expenditure by Government as a percentage of GDP from the existing 1.1 5 % to 2.5 % by 2025. Increase State sector health spending to > 8% of their budget by 2020. Decrease in proportion of households facing catastrophic health expenditure from the current levels by 25%, by 2025. B. Health Infrastructure and Human Resource Ensure availability of paramedics and doctors as per Indian Public Health Standard (IPHS) norm in high priority districts by 2020. C. Health Management Information Ensure district - level electronic database of information on health system components by 2020. Strengthen the health surveillance system and establish registries for diseases of public health importance by 2020 .

16. 4. Policy thrust A. Ensuring Adequate Investment  - The policy proposes a potentially achievable target of raising public health expenditure to 2.5% of the GDP in a time bound manner. B. Preventive and Promotive Health  - The policy identifies coordinated action on seven priority areas for improving the environment for health: The Swachh Bharat Abhiyan Balanced, healthy diets and regular exercises. Addressing tobacco, alcohol and substance abuse Yatri Suraksha – preventing deaths due to rail an d road traffic accidents Nirbhaya Nari – action against gender violence Reduced stress and improved safety in the work place Reducing indoor and outdoor air pollution C. Organization of Public Health Care Delivery  - The policy proposes seven key policy shifts in organizing health care services.

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