The
Cabinet has approved the National Health Policy 2017. Itis a huge milestone in
the history of health sector in the country. The Health Ministry has formulated
the National Health Policy 2017, under the guidance of the Hon. Prime Minister
Shri Narendra Modiji. The last National Health Policy was framed in 2002. So, this
policy has come after a gap of 15 years to address the current and emerging
challenges necessitated by the changing socio-economic, technological and
epidemiological landscape.
The
Government of India adopted a highly participative and consultative approach in
policy formulation process. The Draft National Health Policy was placed it
public domain on 30th December, 2014. Over 5000 suggestions were
received. This was followed by consultations with the State Governments and
other stakeholders for further fine tuning of the policy. The policy was placed
before the Central Council for Health & Family Welfare, the apex policy
making body and was unanimously endorsed by it.
The
policy informs and prioritizes the role of the Government in shaping health
systems in all its dimensions- investment in health, organization and financing
of healthcare services, prevention of diseases and promotion of good health
through cross-sectoral action, access to technologies, developing human
resources, encouraging medical pluralism, building the knowledge base required
for better health, financial protection strategies and regulation and
progressive assurance for health. The policy is aimed at reaching healthcare in
an assured manner to all, particularly the underserved and underprivileged.
The
policy aims for attainment of the highest possible level
of health and well-being for all at all ages, through a preventive and
promotive health care orientation in all developmental policies, and universal
access to good quality health care services without anyone having to face
financial hardship as a consequence. This would be achieved through increasing
access, improving quality and lowering the cost of healthcare delivery.The
broad principles of the Policy are centered on professionalism, integrity and
ethics, equity, affordability, universality, patient centered and quality of
care, accountability and pluralism.
The
policy seeks to move away from Sick- Care to Wellness, with thrust on
prevention and health promotion. While the policy seeks to reorient and
strengthen the public health systems, it also looks afresh at strategic
purchasing from the private sector and leveraging their strengths to achieve
national health goals. The policy looks at stronger partnership with the
private sector.
As
a crucial component, the Policy proposes raising public health
expenditure to 2.5% of the GDP in a time bound manner. The
Policy advocates a progressively incremental assurance-based approach. It
envisages providing larger package of assured comprehensive primary health care
through the ‘Health and Wellness Centers’ and denotes important change from
very selective to comprehensive primary health care package which includes care
for major NCDs, mental health, geriatric health care, palliative care and
rehabilitative care services. It advocates allocating major proportion
(two-thirds or more) of resources to primary care. It
aims to ensure availability of 2 beds per 1000 population distributed in a
manner to enable access within golden hour. In order to provide
access and financial protection, it proposes free drugs, free diagnostics and
free emergency and essential healthcare services in all public hospitals.
The
Policy has also assigned specific quantitative targets aimed at reduction of
disease prevalence/incidence under 3 broad components viz.(a)health status and
programme impact, (b) health system performance and (c) health systems
strengthening, aligned to the policy objectives. Some
key targets that the policy seeks to achieve are -
1.
Life Expectancy and healthy life
a. Increase
Life Expectancy at birth from 67.5 to 70 by 2025.
b. Establish
regular tracking of Disability Adjusted Life Years (DALY) Index as a measure of
burden of disease and its trends by major categories by 2022.
c. Reduction
of TFR to 2.1 at national and sub-national level by 2025.
2.
Mortality by Age and/ or cause
a. Reduce
Under Five Mortality to 23 by 2025 and MMR from current levels to 100 by 2020.
b. Reduce
infant mortality rate to 28 by 2019.
c. Reduce
neo-natal mortality to 16 and still birth rate to “single digit” by 2025.
3.
Reduction of disease prevalence/ incidence
a. Achieve
global target of 2020 which is also termed as target of 90:90:90, for HIV/AIDS
i. e,- 90% of all people living with HIV know their HIV status, - 90% of all
people diagnosed with HIV infection receive sustained antiretroviral therapy
and 90% of all people receiving antiretroviral therapy will have viral
suppression.
b. Achieve
and maintain elimination status of Leprosy by 2018, Kala-Azar by 2017 and
Lymphatic Filariasis in endemic pockets by 2017.
c. To
achieve and maintain a cure rate of >85% in new sputum positive patients for
TB and reduce incidence of new cases, to reach elimination status by 2025.
d. To
reduce the prevalence of blindness to 0.25/ 1000 by 2025 and disease burden by
one third from current levels.
e. To
reduce premature mortality from cardiovascular diseases, cancer, diabetes or
chronic respiratory diseases by 25% by 2025.
This
policy focuses on tackling the emerging challenge of non-communicable diseases.
It supports an integrated approach where screening for the most prevalent NCDs
with secondary prevention would make a significant impact on reduction of
morbidity and preventable mortality.
The
policy envisages a three dimensional integration of AYUSH systems encompassing
cross referrals, co-location and integrative practices across systems of
medicines. This has a huge potential for effective prevention
and therapy,that is safe and cost-effective. Yoga would be
introduced much more widely in school and work places as part of promotion of
good health.
To
improve and strengthen the regulatory environment, the policy seeks putting in
place systems for setting standards and ensuring quality of health care. The
policy is patient centric and empowers the patient for resolution of all their
problems. The policy also looks at reforms in the existing regulatory systems
both for easing manufacturing of drugs and device s, to promote Make in India,
as also for reforming medical education. The policy, has at its centre, the
person, who seeks and needs medical care.
The
policy advocates development of cadre of mid-level service providers, nurse
practitioners, public health cadre to improve availability of appropriate
health human resource.
The
policy also seeks to address health security and make in India for drugs and
devices. It also seeks to align other policies for medical devices and
equipment with public health goals.
The
policy envisages a time-bound Implementation Framework with clear deliverables
and milestones to achieve the policy goals.
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MV