National population policy and National policy on AYUSH and plans (NURSING MANAGEMENT)

This PowerPoint presentation aims to delve into two critical health policies shaping the landscape of healthcare in our country: the National Population Policy and the National Policy on Ayush. With a focus on population management and the promotion of traditional Indian systems of medicine, these policies play pivotal roles in addressing various healthcare challenges and shaping the future of public health in India.

Topics contained:
1) INTRODUCTION
2) EVENTS IN NATIONAL POPULATION POLICY
3) OBJECTIVES
4) STRATEGIC THEMES
5) LEGISLATIVE AND PUBLIC SUPPORT MEASURES AND MEASURES FOR THE CREATION OF NEW STRUCTURES TO SUPPORT POPULATION STABILIZATOIN MEASURES

1. 1

2. NATIONAL POPULATION POLICY AND NATIONAL POLICY ON AYUSH AND PLANS By: Daksh M.Sc Nursing 2 nd year 2

3. INTRODUCTION Family is considered as basic unit of the society. It has been a usual social and fundamental process of marrying and building a family since the times are known . With this process, childbirth is also associated, a factor that plays a role in increasing population . India is the leading country in the world today, crossing China marginally in the population i.e. 142.80 crores whereas the population of China in 2023 has been recorded as 142.57 crores. 3

4. EVENTS IN NATIONAL POPULATION POLICY 1952 India launched a nationwide family planning program in 1952 for the first time in the world. It started with the establishment of a few clinics and the distribution of educational material. The emphasis shifted from a clinical approach to a more vigorous extension education approach for motivating people to adopt small family norms. In 1966, a separate family planning department was created in the Ministry of Health. 4

5. CONT’D . . . 1976 In 1976, India framed its first National Population Policy. It called for an increase in legal minimum age at marriage from 15 years to 18 years for females and from 18 years to 21 years for males. 5

6. CONT’D . . . 1977 The policy was revised and importance was given to the adoption of small family norms but only on a voluntary basis. Name of the program was changed to Family Welfare Programme . The policy endorsed the minimum age at marriage and birth rate target of 25 per 1000 population by 1984. 6

7. CONT’D . . . 1983 The National Health Policy fixed the goals for replacement levels of the Total Fertility Rate to be achieved by 2000 AD. There was no spectacular decline in the birth rate despite the concerted efforts. It was felt that if the annual increase of 15.5 million in population continued, India would overtake China by 2045 AD, posing a great threat to conserve resource endowment and the environment. The population of India was projected to be 1263.5 million by the year 2016.   7

8. CONT’D . . . The role of population stabilization in promoting sustainable development has been very well recognized. This is possible only by making reproductive health care universally accessible and affordable besides empowering women and enhancing employment and communication facilities. 8

9. CONT’D . . . 2000 The National Population Policy 2000 (NPP 2000) affirms the commitment of the government towards voluntary and informed choice and consent of citizens while availing of reproductive care services, and continuation of Target Free Approach in administering family planning services. 9

10. CONT’D . . . It provides a framework for advancing goals and prioritizing strategies to achieve net replacement levels of Total Fertility Rate (TFR) by 2010. It also offers a comprehensive package of reproductive and child health services by government, industry, voluntary and non-government sector working in partnership. TFR in 2023 has reached to the replacement level i.e. 2.1. Certain factors has played a role in this counting as increased access to family planning, improvements in women’s education and empowerment, socio- economic development, urbanization and social norms and economic factors. 10

11. OBJECTIVES Immediate: To address the unmet needs for contraception, health care infrastructure and health personnel and to provide integrated service delivery for basic reproductive and child health care.  Medium-term: To bring TFR to replacement levels by 2010, through vigorous implementation of intersectoral operational strategies. 11

12. CONT’D . . . Long-term: To achieve a stable population by 2045, at a level consistent with the requirement of sustainable economic growth, social development, and environmental protection. In pursuance of these objectives, the national sociodemographic goals to be achieved by 2010, have been formulated. 12

13. CONT’D . . . It has been stated in NPP 2000 that if it is fully implemented, the population of the country is expected to be 1,107 million in 2010 with a crude birth rate of 21, IMR 42 and TFR 2.1, instead of projected 1,162 million population. The population growth in India continues to be high on account of large size of population in the reproductive age group which was estimated to be 58% at the time of drafting NPP 2000India had 168 million eligible couples, of which 48% were effectively protected. 13

14. CONT’D . . . There was an estimated 20% unmet need for contraception which required urgent steps to make contraceptives more widely available, accessible and affordable especially in rural areas where around 74% of the population lived. Many of the 5.5 lakh villages had poor transport and communication linkages and basic health and reproductive health services were out of reach for them. 14

15. STRATEGIC THEMES Twelve strategic themes to achieve the sociodemographic goals for 2010 and suggested ways of implementation were:- Decentralized planning and program implementation Convergence of service delivery at village level Empowering women for improved health and nutrition Child health and survival Meeting unmet needs for family welfare services Underserved populations 15

16. CONT’D . . . Diverse health providers Collaboration with NGOs and private sector Mainstreaming Indian systems of medicine and homeopathy Contraceptive technology and research on RCH Provisions for older population Information, education and communication (IEC) 16

17. CONT’D . . . Decentralized planning and program implementation: •This would be done through Panchayati Raj Institutions i.e. village panchayats. •The panchayat committee will identify the area specific unmet needs of RCH and contraception and plan and provide services at the village level. •33% seats in panchayats are reserved for women the panchayats are expected to promote gender sensitive, multisectoral agenda for population stabilization. 17

18. CONT’D . . . 2) Convergence of service delivery at village level: •Village Self Help Groups are in existence through various schemes of the Department of Women and Child Development, Ministry of Rural Development, and Ministry of Environment and Forests. •Groups would be utilized along with ICDS which is poised to be universalized to organize and provide basic reproductive and child health services at the village level. •Regular meetings of these groups may provide the forum for basic MCH care besides information about micro-credit and thrift schemes. 18

19. CONT’D . . . 3) Empowering women for improved health and nutrition: •Women are to be empowered through increasing literacy, involvement in paid programmes , and improving communications, e.g. access to telephones. •Share power in the local bodies and panchayats. •More childcare centers in the village and urban slums will encourage female participation in paid employment, reduce school drop-out rates for girl children, and may promote school enrolment as well. 19

20. CONT’D . . . •Access to potable water supply, household gadgets, e.g. solar cookers, and schemes of social forestry to increase easy access to fodder and fuel wood would save women's time and consequently improve participation in development activities. •Improving access to primary MCH services, strengthening the referral network, ensuring transport at village, subcenter, and PHC level, access to health information, and quality abortion and family planning services should enable women to improve their health and that of their children. 20

21. CONT’D . . . 4) Child health and survival: •It has been observed there has not been a significant decline in infant mortality in recent years. Neonatal care would be accorded priority. •A National Technical Committee consisting of consultants in obstetrics, pediatrics (neonatologists), family health, medical research, public health, clinical practitioners, and statistics have been suggested. •The ongoing child survival and interventions would continue. 21

22. CONT’D . . . •It should help to improve the quality of neonatal care and provide suggestions for continuing education to all perinatal health care providers. •The need for improving the quality and coverage of routine immunization has been emphasized. 22

23. CONT’D . . . 5) Meeting unmet needs for family welfare services: •The health infrastructure at the village, subcentre , and primary health center needs to be energized, strengthened, and made publicly accountable. •Priority needs to be given to unmet needs for contraceptives, supplies, and equipment for integrated service delivery and mobility of service providers and patients for referral services. 23

24. CONT’D . . . 6) Underserved populations: •Groups like the population in slums, tribal areas, and adolescents are to be provided with comprehensive basic health and RCH services through better coordination with municipal bodies, NGOs, and private sector organizations. •Special focus would be on men in IEC campaigns for promoting their contribution to the adoption of small family norms by promoting non-scalpel vasectomies. •Emphasis is also to be given to enforcing the Child Marriage Act 1976 to avoid teenage pregnancies. •Adolescents would have access to health and nutrition services through ICDS. 24

25. CONT’D . . . 7) Diverse health providers: •Utilization of private practitioners by assigning them to provide RCH services for satellite populations of up to 5,000 each may be explored. •They will be given compensation for services. •The involvement of nonmedical fraternities, e.g. retired defense personnel and school teachers will be sought in counseling and advocacy. •The concepts and strategies of RCH and NPP will be included in the UG/PG curriculum. 25

26. CONT’D . . . 8) Collaboration with NGOs and the private sector: This would be sought for increasing clinic outlets, and mobile clinics and encouraging self-help groups for efficient service delivery at the village level. Industry and corporate sectors may help to strengthen management information systems at PHC and sub-center level in the seven most deficient states by offering electronic data entry machines. Industries with 100 workers may provide preventive RCH care to their own employees. NGO collaboration may be sought in IEC, advocacy, and social marketing of contraception. 26

27. CONT’D . . . 9) Mainstreaming Indian systems of medicine and homeopathy: •The indigenous systems of medicine have provided effective remedies for centuries. •The feasibility of utilizing services of institutionally qualified practitioners of ISM & H after appropriate training in RCH needs to be explored. •They may help to fill up the manpower gaps at the village, sub-center, and PHC levels. •The ISM & H institutions, hospitals, and dispensaries may be utilized for the RCH Programme . 27

28. CONT’D . . . 10) Contraceptive technology and research on RCH: •This would be supported by the government by encouraging medical and social science research, and demographic and behavioral science research in consultation with ICMR and the network of academic and research institutions. •A constant review and evaluation of the community needs assessment approach will be pursued. •Newly emerging contraceptive technology will be reviewed with the aim of including in the program. 28

29. CONT’D . . . 11) Provisions for older population: •Promoting old age care and support for persons aged 60 years and above will reduce the incentive to have large families for this. •Under National Policy on Older Persons, there is a plan to sensitize, train, and equip rural and urban health institutions to provide geriatric care and encourage NGOs to design schemes to make the elderly economically self-reliant. •Tax benefits may be explored to encourage children to look after their aged parents. 29

30. CONT’D . . . 12) Information, education and communication (IEC): •Family welfare messages to be clear, focused and disseminated everywhere including far flung areas. •Massive national campaign on population-related issues to be undertaken through mutually supportive strategy by both Department of Family Welfare and Education using folk media, public address system, public media, artists, popular film personalities, politicians, etc. •Local bodies and NGOs may be supported for interactive and participatory IEC activities. 30

31. legislative and public support measures and measures for the creation of new structures to support population stabilization measures. These measures are Legislation Public support 31

32. CONT’D . . . Legislation: The 42nd constitutional amendment which freezes the Lok Sabha and Rajya Sabha seats till 2000 based on the 1971 census, has been extended up to 2026. Public support: Demonstration of strong support for the small family norm, as well as a personal example by political, community, business, professional, and religious leaders, media and film stars, sports personalities, and opinion makers, will enhance its acceptance throughout society. The government will actively enlist their support in concrete ways. 32

33. CONT’D . . . NEW STRUCTURES The NPP 2000 is to be largely implemented and managed at the panchayat and Nagar Palika levels in coordination with the concerned state/ UT administration. The planning and implementation of NPP 2000 will require multisectoral coordination. 33

34. CONT’D . . . The following structures have been recommended in order to achieve objective coordination at various levels: 34

35. CONT’D . . . 1) National commission on population: In line with the recommendations of NPP, a National Commission on Population has been constituted on 11th, May 2000. It is presided over by the Prime Minister and has Chief Ministers of all states/UTS, Central Minister of Health and Family Welfare, other concerned central ministries and departments reputed demographers, public health professionals and NGOs as members. The Deputy Chairman of Planning Commission is its Vice Chairman. The commission is to oversee and review implementation of the policy. 35

36. CONT’D . . . At its inaugural meeting the Prime Minister announced formation of Empowered Action Group (EAG) to prepare area specific programmes with special emphasis on eight states that have been lagging behind in containing population growth to manageable limits. It was also proposed establishment of National Population Stabilisation Fund ( Jansankhya Sthirata Kosh ) to provide a window for transferring money from national voluntary sources to specifically aid projects designed to contribute to population stabilisation . In January 2003, Prime Minister himself held meeting with the Chief Ministers of Bihar, Uttar Pradesh, Madhya Pradesh and Rajasthan to review their family planning programmes and motivate them to intensify their action for population stabilisation . 36

37. CONT’D . . . • It has been decided to hold such meetings on a regular basis. • Government of India has further categorised States as per the TFR level in - very high- focus (more than or equal to 3.0), - high-focus (more than 2.1 and less than 3.0) - non- high focus (less than or equal to 2.1). 37

38. CONT’D . . . 2) State/UT commission on population: • Each state/UT may consider having state/UT commission on population on similar lines as at centre . • It will be presided over by the Chief Minister. 38

39. CONT’D . . . 3) Coordination cell in planning commission: • This will look for intersectoral coordination between ministries for enhancing performance especially in states/UTs with adverse demographic and human development. 39

40. CONT’D . . . 4) Technology mission in department of family welfare: • This will provide technological support in respect of the design and monitoring of projects and programs for RCH and IEC to enhance performance. 40

41. FUNDING The programs, projects and schemes premised on the goals and objectives of NPP 2000 will be adequately funded in view of their central importance to the national development. Preventive and promotive services, e.g. immunization and contraception will be continued to be subsidized. Priority in allocation of funds will be given to improve health care infrastructure of peripheral health centers and village level. 41

42. CONT’D . . . Gaps in the manpower will be reduced through redeployment and referral linkage will be improved. The annual budget of Department of Family Welfare has been recommended to be doubled to address shortfall in unmet needs for health care infrastructure, services and supplies. 42

43. PROMOTIONAL AND MOTIVATIONAL MEASURES FOR ADOPTION OF THE SMALL FAMILY NORM The following promotional and motivational measures will be undertaken: i . - Panchayats and Zila Parishads will be rewarded and honored for exemplary performance in universalizing the small family norm, achieving reductions in infant mortality and birth rates, and promoting literacy with the completion of primary schooling. 43

44. CONT’D . . . ii. - The Balika Samridhi Yojana run by the Department of Women and Child Development, to promote survival and care of the girl child will continue. - Under the scheme a cash gift of 500 is awarded at the birth of the girl child of birth order 1 or 2 . - Subsequently scholarship is given at various stages of schooling up to class X. The benefit is available to BPL families. 44

45. CONT’D . . . iii. - Maternity Benefit Scheme run by the Department of Rural Development will continue. - A cash incentive of 500 is awarded to mothers who have their first child after 19 years of age, for birth of the first or second child only. - Disbursement of the cash award will in future be linked to compliance with antenatal checkup, institutional delivery by trained birth by attendant, registration of birth and BCG immunization. 45

46. CONT’D . . . iv. A Family Welfare linked Health Insurance Plan will be established. Couples below the poverty line, who undergo sterilization with not more than two living children, would become eligible (along with children) for health (for hospitalization) insurance not exceeding 5,000, and a personal accident insurance cover for the spouse undergoing sterilization. 46

47. CONT’D . . . v. - Couples below poverty line, who marry after the legal age of marriage, register the marriage, have their first child after the mother reaches the age of 21, accept the small family norm and adopt a terminal method after the birth of the second child, will be rewarded. 47

48. CONT’D . . . vi. A revolving fund will be set up for income generation activities by village level self-help groups, who provide community level health care services. 48

49. CONT’D . . . Other promotional and motivational measures include: 1) Making available wider choice of contraceptives, making products and services affordable through innovative social marketing schemes, expansion and strengthening of abortion services. 2) Provision of soft loans to local entrepreneurs at village level to run ambulance services for referral support. 3) Soft loans to ANMs to ensure their mobility have been recommended. 49

50. CONT’D . . . 4) Increased vocational training schemes for girls and opening of creches and child care centres in rural areas and urban slums to facilitate participation of women in paid employment. 5) Pre-Natal Diagnostic Techniques Act, 1994 and Child Marriage Restraint Act, 1976 will be strictly enforced. 6) Population freeze at 1971 census levels has been recommended to be extended up to 2026, so as to provide incentive to states to pursue the agenda for population stabilisation . 50

51. CONT’D . . . 7) Though less than the population policy goal of 80%, institutional deliveries have increased to 78.9% and 81.4% deliveries were safe deliveries" Infant mortality Rate (IMR) has declined to 34 in 2017." 8) Rapid progress towards the goal of bringing IMR to less than 30 requires measures for reduction of Neonatal Mortality Rate, which constitutes about two third of IMR and gearing up of efforts at providing the package of services for children under RMNCH+A programme to all. 9) Decadal Growth Rate of population has declined from 21.34% (1991-2001) to 17.64% (2001-2011). 51

52. CONT’D . . . 10) Maternal Mortality Ratio (MMR) which stagnated at 400-500 per lakh live births in the last two decades of 20th century, has of late started declining and reached 167 as per the data from SRS 2013,12 which is still far off from the goal of less than 100 maternal deaths per lakh live births. 11) Such a steep fall of 3.7 percentage points has occurred for the first time and is an encouraging sign. 12) Census 2011 has also shown decline in population growth rates in the EAG states. 52

53. CONT’D . . . 14) Total Fertility Rate has declined to 2.2 in 2016." However, the country is still far from the goal of replacement levels of fertility, which was to be achieved by 2010. 15) Also a population of 1210.2 million (census 2011) is much higher than projected population of 1,107 million in 2010 if NPP were to be fully implemented. 53

54. NATIONAL POLICY ON AYUSH 54

55. Department of Indian Systems of Medicine and Homeopathy (ISM & H) was given an independent identity in March 1995 in the Ministry of Health and Family Welfare ( MoHFW ) by creating a separate department, which was renamed as the Department of Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy (AYUSH) in November 2003. Sowa Riga, a Tibetan system of medicine similar to Ayurveda, was also introduced under AYUSH. A separate Ministry of AYUSH was formed on November 9, 2014, to develop and propagate the ISM. 55

56. The objective of setting a separate ministry: • to upgrade education standards of ISM • to strengthen research institutions • to develop various schemes for promotion, cultivation, and regeneration of medicinal plants to develop drugs standards. 56

57. CONT’D . . . The first International Yoga day was celebrated on June 21, 2015, and the Union Ministry of AYUSH launched Mission Madhumeha on the occasion of the first National Ayurveda Day on October 28, 2016. The November 2003 policy on AYUSH is in place since 2002. Keeping in mind many developments, its importance, and amendment in Acts, the Ministry of AYUSH is drafting a new policy on AYUSH. 57

58. MAIN OBJECTIVES OF AYUSH POLICY 2002 The main objectives of AYUSH 2002 are listed below: 1) To promote good health by expanding the outreach of AYUSH healthcare through preventive, promotive, mitigating, and curative interventions. 2) To improve the teaching and clinical standards of teachers and clinicians. 3) To ensure affordable and efficacious AYUSH services and drugs. 4) To integrate AYUSH into the healthcare delivery system and national health programs. 58

59. CONT’D . . . 5) To improve the quality of drugs for domestic consumption and export. 6) To sensitize people at national and international levels, other stakeholders, and providers of health regarding AYUSH. 7) To develop and utilize these systems. 59

60. STRATEGIES/THRUST AREAS OF POLICY Education and research Medicinal plants Intellectual property rights and patents Integration of ISM & H and national health programmes Drug standardization and quality control ISM industry Revitalization to local/folk health traditions and home remedy kits Veterinarv medicine Operational use of ISM in Reproductive and Child Health (RCH) services Finance, administration, and development of ISM sector Medical tourism Intersectoral cooperation Exposing both foreien and Indian modern graduates to ISM Building awareness 60

61. CONT’D . . . 1.) Education and research • Developing regulation to establish new colleges and to start new courses. • Establishment of model colleges and center of excellence or national institutes. • Curriculum revision. •Setting up separate regulatory council for Yoga and naturopathy. • Compulsory reorientation programs for physicians and teachers. 61

62. CONT’D . . . • Development of vocational training programs for homemakers, dais, nurses, dietitians, etc. • Separate entrance examination for undergraduate courses at the state level and unified admission test for postgraduate (PG) courses in Ayurveda and Unani medicine. • Setting up an accreditation system at the central level. • Strengthening studies based on clinical trials and other priority areas. 62

63. CONT’D . . . 2. Medicinal plants • Statutory status for the Medicinal Plants Board to regulate the registration of farmers and cooperative societies, transportation, marketing, procurement, and supply to the pharmaceutical industry. • Establishment of an export authority. • Focus on research studies of particular areas such as reproductive system of plants, distribution, and storage. • Research and development on rare and endangered plants. 63

64. CONT’D . . . 3. Intellectual property rights and patents • Creation of a digital library for each system to protect traditional medical knowledge. • Addressing relevant international fora regarding the need for sharing benefits to the custodian of knowledge and compensation to originators. • Setting up of a sui generis system to provide an incentive to grassroots' innovators to disclose knowledge. 64

65. CONT’D . . . 4. Integration of ISM & H and national health programmes • Integration and the mainstream of ISM & H in health-care delivery system and vertical national health programmes • Modification of laws about the practice of modern medicine by ISM practitioners - Upgradation of referral ISM hospitals • Setting up of specialty centers at primary health center (PHC) and district hospitals, and also Panchkarma and Ksharsutra facilities for treating various disorders in allopathic specialty hospitals with the assistance of the central government. 65

66. CONT’D . . . • Consolidation of infrastructure and raising salary and status of ISM practitioners at the state levels. 66

67. CONT’D . . . 5. Drug standardization and quality control • Time target of 2005 to complete all pharmacopeia work related to all systems of medicine through an activation mechanism • Introduction of quality certification scheme for batch-by-batch testing by industry, and financial support for obtaining ISO 9000 certification by ISM • Creating new legislation for neutraceuticals and food supplements not covered under drug and food licensing, respectively. 67

68. CONT’D . . . • Setting up quality control centers or recognition on regional basis • Amendment of Drugs and Cosmetics Act. 68

69. CONT’D . . . 6. ISM industry ● Priority industry status to ISM industry as a green industry ● Framing guidelines for patents, proprietary medicines, etc. 69

70. CONT’D . . . 7. Revitalization to local/folk health traditions and home remedy kits • Identification, reinforcement, validation, and propagation of folk health traditions related to birth attendants, herbal healers, etc. • Implementation of a scheme to identify medicines to be included in the home remedy kits. 70

71. CONT’D . . . 8. Veterinarv medicine • The inclusion of homeopathic medicines for treatment of animals under Drugs and Cosmetics Act. 71

72. CONT’D . . . 9. Operational use of ISM in Reproductive and Child Health (RCH) services • Use of Unani and homeopathic drugs in addition to Ayurveda drugs. 72

73. CONT’D . . . 10. Finance, administration, and development of ISM sector • Raising the ISM share in the overall health plan • Establishing separate directorates of ISM and autonomy to ISM sector • Developing utilization of medicinal plants, the setting of dispensaries, need-based teaching institution in North East and other states, which are rich in medicinal flora and fauna. 73

74. CONT’D . . . 11. Medical tourism • Promotion of Panchkarma and Yoga in hotels and through road shows • Development of ISM parks and scheme for accreditation of Panchkarma and Yoga facilities. 74

75. CONT’D . . . 12. Intersectoral cooperation • Linking with other departments such as cultural tourism and railways for promotion and propagation • Schemes for the production and sale of medicinal plant products • Exploring the introduction of ISM in the school curriculum, and encouraging naturopathy diets and yogic exercises in schools, colleges, and offices. 75

76. CONT’D . . . 13. Exposing both foreien and Indian modern graduates to ISM • Development of modules and courses on Avurveda and Yoga in medical colleges and institutions • Provision of scholarshins for PG and doctorate scholars for researching ISM. 76

77. CONT’D . . . 14. Building awareness • Launching of electronic and print media programs on the utility and effectiveness of ISM • Special incentive schemes for colleges and students, especially of management and science courses to work and for innovative ideas to provide awareness • Utilizing services from NGOs • Allocation of budget for Information Education and Communication (IC) on healthy lifestyles and preventive health. 77

78. NATIONAL AYUSH MISSION National AYUSH Mission (NAM) was launched in the 12th plan to implement the participation of states and UTs, with the aim to improve planning, supervision, and monitoring of various schemes under it. 78

79. OBJECTIVES • Promote the AYUSH system by upgrading its hospitals and dispensaries and improving facilities at various levels of health-care delivery systems. • Strengthen AYUSH educational system by upgrading and setting these institutions including drug testing labs at state levels. • Facilitate quality control of Allopathic, Siddha, Unani, and Homeopathic (ASU&H) drugs by its enforcement mechanisms. 79

80. CONT’D . . . • Maintain the availability of raw materials for preparing. • ASU&H drugs by adopting better agricultural practices and setting up clusters through various methods. • Develop infrastructure for entrepreneurs. 80

81. COMPONENTS/ACTIVITIES 1. Mandatory component: Mandatory component includes activities related to AYUSH services, its institutions, the medicinal plants of ASU&H, and quality control of the related drugs. 2. Flexible component: The flexible component includes various activities such as wellness centers, telemedicine, sports medicine, IC, research and development, innovations such as public-private partnership, interest subsidy for private institutions, reimbursement, voluntary certification, and market promotion. 81

82. STRUCTURE/MECHANISM At national level: At the national level, NAM has a governing body and an appraisal committee. A National Mission Directorate is a governing body that is headed by the secretary of AYUSH, a chairperson with eight members including the member secretary of different departments, and may include experts as co-opted members with the approval of the chairperson. Its main role is to approve the State Annual Action Plan (SAAP) recommended by the appraisal committee. 82

83. CONT’D . . . The appraisal committee constitutes the ioint secretary in charge of NAM as a chairperson with eight other members including the secretary member and may also include experts as co-opted members. The main role of this committee is to appraise and submit SAAP to the governing body for approval. 83

84. CONT’D . . . 2. At state level: At the state level, NAM possesses a governing body and an executive body. The State AYUSH Mission Society is the governing body that is headed by the chief secretary, a chairperson with nine members including member secretary, and also experts as co-opted members with the approval of the chairperson. Its main role is to overview the system, review its policies and program implementation, work on requirements, and approve SAAP. 84

85. CONT’D . . . The executive body headed by the principal secretary/ secretary in charge of AYUSH/ H&FW as a chairperson and also comprise the vice-chairperson and eight members including the member secretary of different departments and may include experts as co-opted members with the approval of the chairperson. Its main role is to prepare and execute SAAP and administration of society, follow the decision made by the governing body, implement, review, monitor, account, etc. 85

86. Program Management Units Program Management Units (PMUs) are setup at both national and state levels. It comprises management and technical staff. The function of PMUs is to give technical assistance to NAM for its implementation. 86

87. Monitoring and Evaluating Cells Health Management Information System (HMIS) is setup at the center/state for concurrent monitoring and evaluation. It is proposed to have three HMIS managers at the national level and one HMIS at the state level. 87

88. RESEARCH INPUT Title: The utilization of systematic review evidence in formulating India’s National Health Programme guidelines between 2007 and 2021. Author: Rajwar Eti , Pundir Prachi et. al. Journal: Health Policy and Planning Publish: 2023 Aim: Reviewed the use of systematic review evidence in framing National Health Programme (NHP) guidelines in India. 88

89. CONT’D . . . Conclusion: This paper focuses on the use of systematic review evidence in formulating public health policies for NHPs in India and the overall evolution of the evidence policy system in India. The first essential component for use of research evidence is access to that evidence. India made an important step forward in 2017 when a new licensing agreement gave its students, practitioners, researchers and patients access to the systematic reviews for research addressing healthcare interventions through the Cochrane Library (Cochrane, 2017). The second essential component is decision-makers with skills to access and make sense of evidence (such as critical appraisal training programmes ). The third essential component is fostering changes to decision-making structures and processes. 89

90. REFERENCES 1. Banerjee Batati . DK Taneja's Health Policies Programmes in India. Fifth Edition. Jaypee Publication. 2. Vati Jogindra . Principales and Practices of Nursing Management & administration of B.sc and M.sc Nursing. Second Edition. Jaypee Publication 3. https://main.mohfw.gov.in/sites/default/files/26953755641410949469%20%281%29.pdf 4. https://indianexpress.com/article/india/india-population-up-un-sowp-report-life-expectancy-fertility-rate-8564123/ 5. https://timesofindia.indiatimes.com/india/world-population-day-indias-drastic-fall-in-tfr-reveals-population-boom-thing-of-past/articleshow/101664334.cms?from=mdr 90