1. Presented By. Arun Kumar.S.K IInd Year M.Sc.Nursing V.N.S.S College Of Nursing NATIONAL HEALTH POLICIES

3. INDIA Population 1,21,01,93,422. Males 62,37,24,248. Females 58,64,69,174. census 2011

4. DEFINITIONS HEALTH Health is a state of complete physical, mental & social wellbeing & not merely absence of disease or infirmity. ( WHO)

5. DEFINITIONS (cont…) POLICY Policy is a system, which provides logical framework & rationality of decision making for achievement of intended objectives.

6. DEFINITIONS (CONT..) HEALTH POLICY Health policy of a nation is its strategy for controlling and optimizing the social uses of its health knowledge and health resources

7. DEFINITIONS (CONT..) NATIONAL HEALTH POLICIES National health policies are the government’s mandate to shape, strengthen, support and sustain a health system where every citizen has access to readily available, qualitatively appropriate and adequately wide ranging health services at affordable costs

8. HEALTH POLICIES IN INDIA “ Health is not mainly an Issue of doctors, Social services and hospitals. It is an issue of social justice."

9. POLICIES BEFORE INDEPENDENCE There were no health policies as such for colonial India

11. POLICIES BEFORE INDEPENDENCE (CONT..) Death rates were high close to 30 to 40 per 1000 population; very high during major epidemics.

13. BASIC RECOMMENDATIONS OF THE BHORECOMMITTEE The Bhore Committee concentrated on preventive medicine and tried to link health with social justice.

14. BASIC RECOMMENDATIONS OF THE BHORECOMMITTEE (CONT..) Population based national net work

15. BASIC RECOMMENDATIONS OF THE BHORECOMMITTEE (CONT..) Sub-centers (SC-one for 20,000 population) Primary health center ( PHC-one for 1 lakh population) Secondary center , also called the referral center ( SHC-1 for each taluka or teshil) Specialized hospital with teaching facilities at the district level

16. BASIC RECOMMENDATIONS OF THE BHORECOMMITTEE (CONT..) Basic maternal care, family planning services, immunizations against small pox, cholera and plague, vector control for prevention of malaria and treatment of tuberculosis.

17. POLICIES AFTER INDEPENDENCE IN 1947 In 1950 according to the constitution of India, in the allocation of responsibilities between the center and the state, health became a state responsibility

18. POLICIES AFTER INDEPENDENCE IN 1947 (CONT..) In the initial setting up of the SC, CHCs, UNICEF provided assistance to the state and the central governments in the design and construction of buildings, providing vehicles to PHCs, and drugs and equipments

19. Many other Committees set up by followed up Bhore Committee Government of India. The Mudaliar Committee that gave its report in 1962 concentrated on medical education and development of training infrastructure for static medical units

20. OTHER COMMITTES The Shrivastav Committee that gave its report in 1975 urged the training of a cadre of health assistants to serve as links between qualified medical practitioners and multipurpose workers (e.g. school teachers, postmasters, gram-sevaks, etc.) Kartar Singh committee and Jungalwalla Committee to look into the specific issues of service delivery at different levels

21. Right to Health global movements Russia was the first country to give its citizens a constitutional right to all health services The French Constitution of 1946 guarantees to all... protection of health In 1965-66, the Social Legislation in the United States declared health a human right.

22. Right to Health global movements(Cont..) The 89th US Congress Medicare and Medicaid, and Comprehensive Health Planning from ‘the womb to the tomb'

23. The Joint WHO – UNICEF international conference in 1978 at Alma-Ata (USSR) Alma-Ata Declaration called on all the governments to formulate national health policies according to their own circumstances to launch and sustain primary health care as a part of national health system.

26. The Joint WHO – UNICEF international conference in 1978 at Alma-Ata ( USSR ) Declared that “ The existing gross inequalities in the status of health of people particularly between developed and developing countries as well as within the countries are politically, socially and economically unacceptable.”

27. The Alma-Ata conference called for acceptance of the WHO goal of HEALTH FOR ALL by 2000 AD and ‘Primary Health Care’ as a way to achieve Health For All. The Alma-Ata conference defined that “ Primary health care is essential health care made universally accessible to individuals and acceptable to them, through their full participation and at the cost the community and country can afford.” .

28. NATIONAL HEALTH POLICY 1983 The NHP, 1983, was the first attempt to synthesise recommendations of three important earlier committees, the Bhore Committee of 1946 (Government of India, 1946), the Mudaliar Committee of 1962 (Government of India, 1962), and the Shrivastav Committee of 1975 (Government of India, 1975, 1976) and the Alma Ata declaration of global demand of Health for All by 2000.

31. NHP 1983- Goal suggested/achieved 62.4 63.4 64 64 LIFE EXPECTANCY MALE FEMALE 9.4 10 UFMR 4 2 MMR 8.7 9 CDR 46 30 PNMR 70 60 IMR Achieved by 2000 Goal by 2000 Indicator

32. NHP 1983- Goal suggested/achieved 1.93 1.2 Growth rate 1.45 1 NRR 46.2% 60% CPR 26.1 21 CBR 26% 10% LBW Achieved by 2000 Goal by 2000 Indicator

33. NHP 1983- Goal suggested/achieved 82% 85% OPV 87% 85% DPT 83% 100% TT Pregnant 67.2% any ANC 100% AN Care 3.1 2.3 Family size Achieved by 2000 Goal by 2000 Indicator

34. NHP 1983- Goal suggested/achieved 56% 85% FULLY IMMUNIZED 82% 85% BCG Achieved by 2000 Goal by 2000 Indicator

35. National Health Policy 2002 Nearly twenty years after the first health policy, the II nd"National Health Policy -2002 (NHP 2002) was formulated and accepted by central government in September, 2002) and it closely followed on the heels of the National Population Policy 2000 (NPP 2000)

45. Financial Resource (CONT..) This will allow a good rise of current annual per capita public health expenditure of the country from Rs. 200/- by ten-fold say around Rs. 2000

46. Differentials in health status among rural/urban India

51. Public health spending in select countries 44.1% 13.7% 7 - USA 96.9% 5.8% 6 - UK 45.4% 3.0% 16 6.6 % Sri Lanka 24.9% 2.7% 31 18.5 % CHINA 17.3% 5.2% 70 44.2 % India Public expenditure on health to total health expenditure Health expenditure to GDP IMR /1000 Population with income of less than one dollar per day

61. Infant Mortality rates Infant Mortality Rate has dropped by three points from 53 during 2008 to 50 infant deaths per 1000 live births during 2009. The IMR for rural areas has dropped by three points from 58 to 55 infant deaths per 1000 live births The state Goa reported the lowesr IMR of 11, followed by Kerala 12 infant deaths per 1000 live births during 2009

77. Nursing personnel NHP 2002 recognizes acute shortage of nurses trained in superspeciality disciplines. It recommends increase of nursing personnel in public health delivery centres and establishment of training courses for superspecialities .

84. Enforcement of quality standard for food and drugs • NHP 2002 envisaged that Food and Drug administration be strengthened in terms of laboratory facilities and technical expertise

100. Health Research & Development • 2002 NHP noted the aggregate annual health expenditure of Rs. 80,000 crores and on research Rs. 1150 crores is quite low. •The policy envisages an increase in govt. funded health resources to a level of 1% total health spending by 2005 and upto 2% by 2010. •New therapeutic drugs and vaccines for tropical disease are given priority

124. conclusion miles to go before……..

127. This is just a beginning………………

128. THANKS . HAVE A NICE DAY .