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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
PARTS OF NATIONAL HEALTH POLICY
Introductory
PARTS OF NATIONAL HEALTH POLICY
Our Heritage
PARTS OF NATIONAL HEALTH POLICY
Progress achieved
PARTS OF NATIONAL HEALTH POLICY
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.
PARTS OF NATIONAL HEALTH POLICY
Revised 20-point programme
PARTS OF NATIONAL HEALTH POLICY
Population stabilization
PARTS OF NATIONAL HEALTH POLICY
Medical and Health Education
PARTS OF NATIONAL HEALTH POLICY
Need for providing primary health care• Comprehensive primary healthcare• Transfer of knowledge , skills and technologies• Organized building• Referral system• Sanitary cum epidemiological stations
PARTS OF NATIONAL HEALTH POLICY
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
PARTS OF NATIONAL HEALTH POLICY
Reorientation of Existing Health Personnel
PARTS OF NATIONAL HEALTH POLICYPrivate practice by Government Functionaries
PARTS OF NATIONAL HEALTH POLICY
Practitioners of indigenous and other systems of medicine and their role in health care.
PARTS OF NATIONAL HEALTH POLICY
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.
PARTS OF NATIONAL HEALTH POLICY
Health Education
PARTS OF NATIONAL HEALTH POLICY
Management information System
PARTS OF NATIONAL HEALTH POLICY
Medical Industry
PARTS OF NATIONAL HEALTH POLICY
Health Insurance
PARTS OF NATIONAL HEALTH POLICY
Health legislation
PARTS OF NATIONAL HEALTH POLICY
Medical research:
PARTS OF NATIONAL HEALTH POLICY
Inter sectoral cooperation
PARTS OF NATIONAL HEALTH POLICY
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
CURRENT SCENARIO OF OUR COUNTRY
2. Equity
Lack of equitable distribution of resources
CURRENT SCENARIO OF OUR COUNTRY
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
CURRENT SCENARIO OF OUR COUNTRY
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.
CURRENT SCENARIO OF OUR COUNTRY
5. Extending public health Services
Shortage of Medical power
No incentive system is attempted so far, has induced private
medical manpower
CURRENT SCENARIO OF OUR COUNTRY
6. Role of Local Self- government institutions
CURRENT SCENARIO OF OUR COUNTRY
7. Medical Education
CURRENT SCENARIO OF OUR COUNTRY
8. Need for specialists in ‘Public health’ and ‘Family Medicine’
CURRENT SCENARIO OF OUR COUNTRY
9. Urban Health
CURRENT SCENARIO OF OUR COUNTRY
10.Mental Health
CURRENT SCENARIO OF OUR COUNTRY
11. I E C
Information
Education
Communication
CURRENT SCENARIO OF OUR COUNTRY
12. Medical Research
Limited to ICMR
CURRENT SCENARIO OF OUR COUNTRY
13.Role of the Private Sector
CURRENT SCENARIO OF OUR COUNTRY
14. Role of Civil society
CURRENT SCENARIO OF OUR COUNTRY
15.National Disease surveillance Network
CURRENT SCENARIO OF OUR COUNTRY
16. Health Statistics
CURRENT SCENARIO OF OUR COUNTRY
17. Women’s Health
CURRENT SCENARIO OF OUR COUNTRY
18. Medical ethics
CURRENT SCENARIO OF OUR COUNTRY
19. Enforcement of Quality standards for food and Drugs
CURRENT SCENARIO OF OUR COUNTRY
20. Regulation of Standards in Para medical disciplines.
CURRENT SCENARIO OF OUR COUNTRY
21. Occupational Health
CURRENT SCENARIO OF OUR COUNTRY
22. Providing Medical facilities to users from Overseas
CURRENT SCENARIO OF OUR COUNTRY
23. Impact of Globalization on the health sector
CURRENT SCENARIO OF OUR COUNTRY
24. Non Health Determinants
CURRENT SCENARIO OF OUR COUNTRY
25. Population Growths and Health Standards
CURRENT SCENARIO OF OUR COUNTRY
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
SWOT ANALYSIS OF NATIONAL HEALTH POLICY
Weakness
Lack of Monitoring and Evaluation
Lack of Government Expenditure on
Public Health
Gap in Situation analysis and problem
prescription
SWOT ANALYSIS OF NATIONAL HEALTH POLICY
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
SWOT ANALYSIS OF NATIONAL HEALTH POLICY
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
Other Social Determinants of Health
• Food and Nutrition
Other Social Determinants of Health
• Regular Employment
Other Social Determinants of Health
• Housing
Other Social Determinants of Health
• 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
DETERMINANTS OF HEALTH CARE
• Sanitation facilities
DETERMINANTS OF HEALTH CARE
• Solid waste management policy and plan of action
DETERMINANTS OF HEALTH CARE
• 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
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
SSSS
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