NATIONAL HEALTH POLICY AND STATE HEALTH POLICY

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HEALTH CARE POLICY

NATIONAL AND STATE

CONCEPT OF HEALTH AND COMPREHENSIVE HEALTH CARE

HEALTH CARE: “Services provided to individuals or communities by the agents of health services or professionals for the purpose of promoting , maintaining, monitoring or restoring health.”

COMPREHENSIVE HEALTHCARE

“The provision of

integrated ,preventive ,cu

rative and promotional

health services from

womb to tomb, to every

individual residing in a

defined geographical

area”

HEALTH STRATEGIES

Restructuring the health infrastructure.

HEALTH STRATEGIES

Developing health Manpower , research and development.

NATIONAL HEALTH POLICY 1983

HISTORY

Bhore committee: 1943

First evolution: 1983

Revised: 2002

ELEMENTS OF NATIONAL HEALTH POLCY IN INDIA Awareness Of Health Problems.

Supply Of Safe Drinking Water And Basic Sanitation.

Reduction Of Imbalance In Health Services

Dynamic Health Management Information

System.

ELEMENTS OF NATIONAL HEALTH POLCY IN INDIA [contd]…….

Legislative Support.

Combat widespread Malnutrition.

Alternative methods of health care delivery system

Use of low cost technologies.

Coordination of different systems of medicine.

COMPONENTS OF HEALTH POLICY

Socioeconomic policies

Employment

Elementary Education

Integrated rural development.

Population Control.

Welfare of women and children.

GOALS OF HEALTH POLICY Acceptable standard of good health Increased access to decentralized public health

system.Establishing new infrastructureEquitable access to health servicesPreventive and curative services.Emphasis rational use of drugs and target burden

disease

NATIONAL POLICIES RELATED TO HEALTH

NATIONAL HEALTH POLICY- 2002

NATIONAL POPULATION POLICY-2000

NATIONAL AIDS PREVENTION AND CONTROL POLICY-2002

NATIONAL BLOOD POLICY- 2002

NATIONAL POLICY FOR THE EMPOWERMENT OF WOMEN-2001

NATIONAL POLICY AND CHARTER FOR CHILDREN -2003

NATIONAL YOUTH POLICY -2003

NATIONAL POLICY FOR OLD PERSON-1999

NATIONAL HEALTH RESEARCH POLICY (DRAFT)

NATIONAL POLICY ON EDUCATION

NATIONAL PHARMACEUTICAL POLICY

NATIONAL WATER POLICY

NATIONAL ENVIRONMENTAL POLICY-2006

NATIONAL HOUSING AND HABITAT POLICY -1998

PARTS OF NATIONAL HEALTH POLCY

PARTS OF NATIONAL HEALTH POLICY

Introductory

Our Heritage

Progress achieved

The Existing Picture:1. High rate of population growth

2. High mortality rate for women children and Infants

3.Malnutrition

4. High prevalence of Communicable and Non communicable diseases.

5. Poor access to potable water supply and the basic sanitation

6. Poverty

7.Ignorance

8. Adoption of Health manpower models

9. Establishment of Curative centers.

10.Emphasis on hospital based, cure oriented approach

11.Failure to involve the community in the identification of health needs and priorities.

Revised 20-point programme

Population stabilization

Medical and Health Education

Need for providing primary health care• Comprehensive primary healthcare• Transfer of knowledge , skills and technologies• Organized building• Referral system• Sanitary cum epidemiological stations

Need for providing primary health care• Location of curative centers• Planned programmes• Speciality and Super speciality care• Well coordinated programmes.• Priority wise services• Adequate mobility of personnel

Reorientation of Existing Health Personnel

PARTS OF NATIONAL HEALTH POLICYPrivate practice by Government Functionaries

Practitioners of indigenous and other systems of medicine and their role in health care.

Problems requiring urgent attention1. Nutrition2. Prevention of food adulteration and maintenance of quality of drugs.3. Water supply and Sanitation4. Environmental protection.5. Immunization program.6. Maternal and child health services.7. School health program8. Occupational health services.

Health Education

Management information System

Medical Industry

Health Insurance

Health legislation

Medical research:

Inter sectoral cooperation

Monitoring and review of progress

COMMENTS OF NATIONAL HEALTH POLICY

Mentions about poverty alleviation and not

about social justice.

No program for Community Participation

Totally silent about health budget

Not integrated

No emphasis to certain areas.

REVISED NATIONAL HEALTH POLICY (2002)

OBJECTIVES:

1. Achieve acceptable standard of Good Health

2. Increase access to the decentralized public health system

3. Ensure more equitable access to health services .

4. Increase aggregate public health investment.

5. Strengthen the capacity of public health administration.

REVISED NATIONAL HEALTH POLICY (2002)

OBJECTIVES

6. Enhance the contribution of Private sector

7. Rationalize use of drugs within allopathic system.

8. Increase access to tried and tested systems of

traditional medicine

INITIATIVES OF REVISED NATIONAL HEALTH POLICY

1. A widespread network of comprehensive

health care services.

2. Intermediation through Health Volunteers.

3. Referral System

4. Speciality and Superspeciality services.

CURRENT SCENARIO OF OUR COUNTRY

1. Financial Resources:

Low public health investment

Declined GDP

2. Equity

Lack of equitable distribution of resources

Lack of flexibility of Public health infrastructure

No permit for state to craft their own

programmes

Not need based.

3. Delivery of National Public Health Programme

4. State of Public health infrastructure:

Existing Public health infrastructure is not satisfactory.

Based on an Objective assessment of the quality and efficiency of existing public health infrastructure.

5. Extending public health Services

Shortage of Medical power

No incentive system is attempted so far, has induced private

medical manpower

6. Role of Local Self- government institutions

7. Medical Education

8. Need for specialists in ‘Public health’ and ‘Family Medicine’

9. Urban Health

10.Mental Health

11. I E C

Information

Education

Communication

12. Medical Research

Limited to ICMR

13.Role of the Private Sector

14. Role of Civil society

15.National Disease surveillance Network

16. Health Statistics

17. Women’s Health

18. Medical ethics

19. Enforcement of Quality standards for food and Drugs

20. Regulation of Standards in Para medical disciplines.

21. Occupational Health

22. Providing Medical facilities to users from Overseas

23. Impact of Globalization on the health sector

24. Non Health Determinants

25. Population Growths and Health Standards

26. Alternative Systems of Medicine

DEMOGRAPHIC trends of National health policy

Population : 1.21 billionGrowth rate: 1.51%Birth rate : 20.22 birth / 1000 population Death rate : 7.4 death /1000 population Life expectancy: 68.89 years

SWOT ANALYSIS OF NATIONAL HEALTH POLICY

Strengths: Identified deficiencies of the policy. Advancement of technology and proven

public health strategies Commitment to enhance the budget on

health expenditure

Weakness

Lack of Monitoring and Evaluation

Lack of Government Expenditure on

Public Health

Gap in Situation analysis and problem

prescription

Opportunities

Move ahead in Health through Health PolicySupportive environment and absence of obvious threat

of water and unrest etc. Policy initiative will provide a new impetus to the

development of Health Sector

Threats:

Health Tourism

STATE HEALTH POLICY

OBJECTIVES OF STATE HEALTH POLICY 2013

PEOPLE

Information

Financing

Human Resources

Medicines and Technologies

Service Delivery

Governance

KERALACURRENT SCENARIO

2. HEALTH FINANCING

• Budget allocation: From NRHM Fund.

3.SOCIAL DETERMINANTS OF HEALTH

Water Supply

• Increased reclamation of wetlands and Water

bodies• Increased Pollution

Sanitation

• Problems of Toilet construction in water

logged areas.• Absence of appropriate models in areas of water

scarcity.• Sanitary toilets without Septic Tank

Solid and Liquid waste Management system

• Accumulation of Plastic waste

• Issue of Thin Plastic Bags

• Ecological degradation

• Contamination of Water bodies

• Misuse of Pesticides

Climate Change and Public Health

• Challenges to control of infectious

Diseases.

• Seasonal changes in the availability of

Fresh water.

• Regional drop in Food Production

• Rising Sea level

Other Social Determinants of Health

• Food and Nutrition

• Regular Employment

• Housing

• Women empowerment

4. Managing Emerging and Re emerging Diseases

5. Non- Communicable Diseases

• 50% of Total Deaths – between the age group

of 30-60• 27% Adult males and 19% Adult

females are diabetic.• Kerala – “ Diabetic Capital of

India.”

5. Non- Communicable Diseases Contd……….

Introduction of NPCDCS Introduction of “Amrutham

Arogyam” [ NCD Control Programme]

6.CANCER CARE- EARLY DETECTION AND PREVENTION

• Cancer treatment is limited.

• Kerala reports nearly 35,000

new registrations

• Nearly 1 lakh patients are under

treatment every year

7. WOMEN’S HEALTH

8. MATERNAL HEALTH

9. CHILD HEALTH

• IMR of Kerala is 12/1000• Achieve universal immunisation• Nutritional Monitoring• Organisation of New born Screening

programmes

10.ADOLESCENT HEALTH[ARSH]

WIFS- Weekly Iron and Folic acid Supplementation programme

AFHCs – Hospital based Adolescent Friendly Clinics

11. SCHOOL HEALTH

• Implementation of modified School Health programme.

• Vision of a School: “ That constantly strengthens its capacity as a healthy setting for living and Working………………’’

12. HEALTH PROBLEMS OF ELDERLY

• Present elderly population( above 60 years) is 12% and is expected to cross 25% by 2050

• Geriatric friendly Hospitals• Palliative care policy in Kerala (2008)• 700 palliative care units are

established with PHC.• 250 Palliative Care Unit Attached

with Community Based Organizations

13. MENTAL HEALTH PROBLEMS:

14. HEALTH OF VULNERABLE SECTIONS

AND HEALTH INFRASTRUCTURE IN

KERALA

OVERVIEW OF HEALTH SERVICE SYSTEM OF THE STATE

• Tertiary care

• Secondary care Institutions

• Primary health center

• Sub -center

Tertiary Care:

Secondary care Institutions

Primary Health centers

Sub -centers

5500 ANMs

3500 JHI

5403 Sub centers

• Emergency medical services and management of trauma.

MEDICAL ESTABLISHMENT BILL 2013

HUMAN RESOURCE POLICY IN HEALTH

NURSING CARE AND NURSING EDUCATION

TREATENT PROTOCOLS, REFERRAL PROTOCOLS AND MANAGEMENT GUIDELINES

DATA MANAGEMENT SYSTEM

DECENTRALIZATION AND HEALTH

PRIVATE SECTOR

PLAN OF ACTION

DETERMINANTS OF HEALTH CARE

• Clean drinking water

• Sanitation facilities

• Solid waste management policy and plan of action

• Poverty

ENFORCEMENT OF REGULATIONS FOR GOOD HEALTH

• Food safety

• Public health act

• Reorganization of Government Health systems:

• Primary Health centers• Community Health centers• Taluk Head quarters Hospital• District/ General Hospitals.• Medical College Hospitals

• OTHER SPECIALISED AREAS

o Public health cadre and Health protection Agency

o Communicable Disease Surveillance And Execution Of Control Measures”

o Non Communicable Disease Control

o Community Mental Health Care and Services.

o Measures for reducing the Road traffic accidents other trauma and developing systemic trauma care services

• Construction of an “Act force System” , involving police.

o Strengthening Laboratory Network in the State:

o AYURVEDA

Research and Documentation

o AYURVEDA

Quality Assurance

o AYURVEDA

Support to Manufacturing

o AYURVEDA

Awareness regarding the Benefits of Ayurveda

HOMEOPATHY

• In 1928, The Maharaja of Travancore acknowledged Homoeopathy as an acceptable system of treatment.

• Homeopathic health care services:

1. 31 Homeopathic Hospitals.

2. 611 Homeopathic Dispensaries

3. 348 NRHM Homeo Dispensaries

4. 29 Dispensaries at SC/ST dominant areas.

HOMEOPATHY

o ESI: 13 Dispensaries and 1 Hospital

o Seethalayam

o Ayushman bhava

o Jyothir gamaya

o Chethana

ORAL HEALTH

FUTURE DEVELOPMENTS

Quality up gradation in health sector

Universal Health Coverage

CONCLUSION

BIBLIOGRAPHY

Text books:

Gupta M.C, Mahajan B.K . Textbook of preventive and Social medicine:(3rd ed).New delhi : Jaypee Medical Brothers pvt.ltd; 2003

Keshav Swarnkar. Community Health Nursing: Includes behavioural sciences and personal hygiene: (2nd ed). Indore: N.R Brothers publishers Pvt.ltd:2006

Mary Lucita. Nursing: Practice and public health administration, current concepts and trends: Newdelhi: Elsevier India pvt.ltd; 2004

Park.K. Textbook of preventive and social medicine;(16th ed): Indore;Banarasi Bhanot Brothers; 2007

BIBLIOGRAPHY

Government Document:

Kerala Health care policy 2013. Department of Health and family welfare; 2013.Online Database

Chaukar D.A, Walvekar RR, Das A.K, Deshpande MS,Pai. P.S, Chaturvedi . P, Kakade A, D’cruz A.K; Quality of life in head and neck Cancer Survivors: A cross sectional study. [Internet]. 2009 May-June [ cited 2009June];30(3): 176-80; Available from pubmed , http;//:en://www.ncbi.nlm.nib.gov/pubmed]

Website:

www.slideshare.chantal .net.com www.pubmed.com www.wikipedia.com