UNIT 2 PHM - public health management and prevention of diseases.

Talks about the various diseases and the government initiatives / measures taken to prevent them .

1. UNIT 2

2. 1. Definition of Health Policy: Health policy refers to decisions, plans, and actions undertaken to achieve specific healthcare goals within a society. It serves as a guiding framework for health systems, ensuring accessibility, affordability, and quality of healthcare services.

3. Key Features:Addresses public health issues, healthcare access, and quality standards. Includes laws, regulations, funding mechanisms, and service delivery models Aims to improve population health and reduce health inequalities

4. Scope of Health Policy Health policy covers a wide range of health-related aspects, including: Healthcare Delivery – Hospital services, primary care, emergency responsePublic Health Initiatives – Immunization programs, disease prevention campaigns Health Financing – Insurance schemes (Ayushman Bharat, private health insurance) Regulation and Governance – Licensing of healthcare professionals, drug policies Technology and Innovation – Telemedicine, AI-driven diagnostics Environmental and Occupational Health – Policies on pollution control, workplace safety Health Equity and Inclusion – Addressing rural and tribal healthcare disparities

5. Types of Health Policy Types of Health Policy 1.Public Health Policy – Focuses on disease prevention, sanitation, and vaccinations Example: National Tuberculosis Elimination Program (NTEP) 2.Health Financing Policy – Determines how healthcare is funded Example: Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana (PM-JAY)

6. 3.Regulatory Policies – Governs medical practices, drug safety, and hospital standards Example: National Medical Commission (NMC) regulations. 4.Private Sector and Insurance Policies – Covers corporate health insurance and medical ethics Example: IRDAI regulations for private health insurance 5.Environmental and Occupational Health Policies – Focus on pollution control and workplace safety Example: The Factories Act (1948) regulating worker health and safety.

7. Pharmaceutical and Drug Policies – Regulate drug production, pricing, and availability Example: National List of Essential Medicines (NLEM)

8. India's National Health Policy (NHP) aims to improve the health and well-being of the country's citizens. The policy focuses on prevention, promotion, and access to healthcare services. It also seeks to reduce financial hardship for patients. Policy goals Universal access: The policy aims to provide universal access to quality healthcare services. Prevention: The policy aims to prevent diseases and promote good health. Financial protection: The policy aims to develop strategies to protect people from financial hardship. Regulation: The policy aims to strengthen regulation and health assurance.

9. Policy updates The NHP was first endorsed by the Parliament of India in 1983. It was updated in 2002 and again in 2017. The 2017 update built on the progress made since 2002.

10. Policy focus areas Non-communicable diseases: The policy focuses on the growing burden of non-communicable diseases. Healthcare industry: The policy focuses on the emerging healthcare industry. Healthcare costs: The policy focuses on reducing unsustainable healthcare costs. Special health needs: The policy focuses on the special health needs of tribal and socially vulnerable populations. Occupational health: The policy focuses on improving occupational health.

11. Evolution of Health Policy in India The evolution of health policy in India has been shaped by changing public health challenges, economic conditions, and global influences . It has progressed from basic healthcare provisions in the pre-independence era to universal health coverage and digital health transformation in recent years. 1. Pre-Independence Era (Before 1947) Health policies were limited and focused on epidemic control (e.g., cholera, plague). The Bhore Committee Report (1946) recommended a national healthcare system with free public healthcare . 2. Early Post-Independence (1947-1980s)

12. First National Health Policy (NHP-1983) was introduced, emphasizing rural healthcare and disease control . Family planning and immunization programs (e.g., Pulse Polio) were prioritized. Establishment of Primary Health Centers (PHCs) and Community Health Centers (CHCs) . 3. Economic Liberalization & Reforms (1990s-2010s) National Health Policy (NHP-2002) emphasized public-private partnerships (PPPs) . National Rural Health Mission (NRHM) 2005 expanded healthcare access in rural areas. Introduction of health insurance schemes (e.g., Rashtriya Swasthya Bima Yojana – RSBY).

13. 4. Modern Era (2017-Present) National Health Policy (NHP-2017) introduced universal healthcare, digital health, and preventive care . Ayushman Bharat (2018) launched the world’s largest health insurance scheme . Focus on telemedicine, AI in healthcare, and digital health records . COVID-19 response: Mass vaccination drives and Aarogya Setu app .

14. Methods to Assess the Need for Policy Development To ensure effective health policies, various assessment methods are used: Health Data Analysis Study disease burden, mortality rates, and healthcare access to identify public health needs. Example: National Family Health Survey (NFHS) data helps formulate maternal and child health policies. Stakeholder Consultations Engaging government bodies, healthcare professionals, and the public to identify priorities. Example: WHO-led consultations for pandemic preparedness policies. Cost-Benefit Analysis (CBA) Evaluates the financial feasibility and long-term impact of new policies. Example: Evaluating the economic impact of universal vaccination programs .

15. 4. Comparative Policy Analysis Studying successful health policies from other countries to apply best practices. Example: Learning from UK’s NHS for universal healthcare models . 5. Pilot Programs & Case Studies Implementing small-scale policy trials before nationwide rollout. Example: Testing digital health ID systems before full-scale implementation . 6.Public Opinion Surveys Understanding citizens’ needs, awareness, and acceptance of new policies. Example: Assessing rural populations' willingness to adopt digital health records . 7.Health Impact Assessment (HIA) Measures the potential effects of policy changes on population health. Example: Evaluating the impact of tobacco taxation on smoking rates . These assessment methods help develop data-driven, inclusive, and sustainable health policies that address national and global health challenges .

16. Public health varies significantly across rural, tribal, and urban areas due to differences in infrastructure, accessibility to healthcare services, socio-economic conditions, and cultural practices. Understanding these disparities is crucial for formulating effective health policies and interventions.

17. 1. Public Health in Rural Areas 1.1 Characteristics of Rural Public Health Rural areas often have limited healthcare facilities and fewer medical professionals . Higher dependency on primary health centers (PHCs), sub-centers, and community health centers (CHCs) . Long distances to healthcare facilities lead to delayed medical care and higher mortality rates . Limited access to specialized care such as oncology, cardiology, and maternal health services .

18. 1.2 Major Health Issues in Rural Areas Infectious diseases (e.g., tuberculosis, malaria, diarrheal diseases). Maternal and child health concerns (higher maternal and infant mortality rates). Malnutrition and undernutrition due to poverty and lack of awareness. Lack of sanitation and clean drinking water , increasing the risk of waterborne diseases. Non-communicable diseases (NCDs) like hypertension and diabetes are rising due to lifestyle changes.

19. 1.3 Challenges in Rural Healthcare Shortage of trained healthcare professionals due to migration to urban areas. Poor transportation and infrastructure , making emergency care difficult. Low health literacy , leading to the prevalence of traditional medicine and delayed medical care. Financial barriers —many rural families cannot afford healthcare expenses. Limited government funding and inefficient implementation of health programs.

20. 1.4 Government Initiatives for Rural Public Health National Rural Health Mission (NRHM) – Strengthening rural healthcare infrastructure. Ayushman Bharat – Provides health insurance to rural families. Janani Suraksha Yojana (JSY) – Encourages institutional deliveries to reduce maternal mortality. Mission Indradhanush – Improves immunization coverage among children. ASHA (Accredited Social Health Activist) Workers – Act as healthcare liaisons in rural areas.