National Health Policy

A National Health Policy was last formulated in 1983, and since then there have been marked changes in the determinant factors relating to the health sector. Some of the policy initiatives outlined in the NHP-1983 have yielded results, while, in several other areas, the outcome has not been as expected. The policy gave a general exposition of the policies which required recommendation in the circumstances then prevailing in the health sector.

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 the year 2000 AD’, through the universal provision of comprehensive primary health care services. In retrospect, it is observed that the financial resources and public health administrative capacity which it was possible to marshal, was far short of that necessary to achieve such an ambitious and holistic goal.

Against this backdrop, NHP-2002 was approved by the Government which is hoped to consistent with the realistic expectations about financial resources, and about the likely increase in Public Health administrative capacity.

Objectives

The main objective of this policy is to achieve an acceptable standard of good health amongst the general population of the country. The approach would be to increase access to the decentralized public health system by establishing new infrastructure in deficient areas, and by upgrading the infrastructure in the existing institutions.

Overriding importance would be given to ensuring a more equitable access to health services across the social and geographical expanse of the country. Emphasis will be given to increasing the aggregate public health investment through a substantially increased contribution by the Central Government. It is expected that this initiative will strengthen the capacity of the public health administration at the State level to render effective service delivery.

The contribution of the private sector in providing health services would be much enhanced, particularly for the population group which can afford to pay for services. Primacy will be given to preventive and first-line curative initiatives at the primary health level through increased sectoral share of allocation. Emphasis will be laid on rational use of drugs within the allopathic system.

Increased access to tried and tested systems of traditional medicine will be ensured. Within these broad objectives, NHP-2002 seeks to achieve the time-bound goals mentioned below.

Goals to be Achieved By 2000-2015 

• Eradicate Polio and Yaws: 2005
• Eliminate Leprosy: 2005
• Eliminate Kala Azar: 2010
• Eliminate Lymphatic Filariasis: 2015
• Achieve Zero level growth of HIV/AIDS: 2007
• Reduce Mortality by 50% on account of TB, Malaria and Other Vector and Water Borne diseases: 2010
• Reduce Prevalence of Blindness to 0.5%: 2010
• Reduce IMR to 30/1000 And MMR to 100/Lakh: 2010
• Increase utilization of public health facilities from current Level of <20 to >75%: 2010
• Establish an integrated system of surveillance, National Health Accounts and Health Statistics: 2005
• Increase health expenditure by Government as a % of GDP from the existing 0.9 % to 2.0%: 2010
• Increase share of Central grants to Constitute at least 25% of total health spending: 2010
• Increase State Sector Health spending from 5.5% to 7% of the budget: 2005
• Further increase to 8% : 2010

Policy Prescriptions

• Taking into account the gap in health care facilities, it is planned, under the policy to increase health sector expenditure to 6 per cent of GDP, with 2 per cent of GDP being contributed as public health investment, by the year 2010
• NHP-2002 sets out an increased allocation of 55 per cent of the total public health investment for the primary health sector; the secondary and tertiary health sectors being targeted for 35 per cent and 10 per cent respectively
• This policy envisages a key role for the Central Government in designing national programmes with the active participation of the State Governments
• NHP-2002 envisages the gradual convergence of all health programmes under a single field administration. Vertical programmes for control of major diseases like TB, Malaria, HIV/AIDS, as also the RCH and Universal Immunization Programmes, would need to be continued till moderate levels of prevalence are reached
• The Policy envisages kick-starting the revival of the Primary Health System by providing some essential drugs under Central Government funding through the decentralised health system
• It is expected that the provisioning of essential drugs at the public health service centres will create a demand for other professional services from the local population, which, in turn, will boost the general revival of activities in these service centres
• This policy envisages that, in the context of the availability and spread of allopathic graduates in their jurisdiction, State Governments would consider the need for expanding the pool of medical practitioners to include a cadre of licentiates of medical practice, as also practitioners of Indian Systems of Medicine and Homoeopathy
• Simple services/procedures can be provided by such practitioners even outside their disciplines, as part of the basic primary health services in under-served areas
• NHP-2002 lays great emphasis upon the implementation of public health programmes through local self-government institutions
• In order to ameliorate the problems being faced on account of the uneven spread of medical and dental colleges in various parts of the country, this policy envisages the setting up of a Medical Grants Commission for funding new Government Medical and Dental Colleges in different parts of the country
• This Policy emphasizes the need for basing treatment regimens, in both the public and private domain, on a limited number of essential drugs of a generic nature. This is a prerequisite for cost-effective public health care
• The National Programme for Universal Immunization against Preventable Diseases requires to be assured of an uninterrupted supply of vaccines at an affordable price
• NHP-2002 envisages the setting up of an organised urban primary health care structure. Since the physical features of urban settings are different from those in rural areas, the policy envisages the adoption of appropriate population norms for the urban public health infrastructure
• NHP – 2002 envisages a network of decentralised mental health services for ameliorating the more common categories of disorders
• This Policy envisages an increase in Government-funded health research to a level of 1 per cent of the total health spending by 2005; and thereafter, up to 2 percent by 2010.