Need to bridge gaps in human resources in health
sector stressed
PM LAUNCHES PUBLIC HEALTH FOUNDATION OF INDIA
The Prime Minister, Dr. Manmohan Singh emphasized the need
to bridge a major gap in our health education by training professionals in
disciplines that relate to health, such as economics, sociology, demography
and environment–in addition to management of diseases.
Speaking at a function here
today to launch the Public Health Foundation of India, he underlined the need
to develop a new cadre of professionals who are managers of health and not
just of diseases.
Referring to a major gap
in human resources in health sector, Dr. Singh declared that “Programmes
for the poor will degenerate into poor programmes, if these deficiencies are
not corrected.” “If we do not effectively upscale knowledge and skills of
our people and act purposefully to protect and promote their health, we run
the risk of wasting this precious human resource”, Dr. Singh said.
Asserting that good health
is an inalienable human right of every citizen of this country, the Prime
Minister pointed out that issues of health particularly
in developing countries have strong links with social, economic, environmental
and cultural factors. “They therefore
need responses that appreciate intersecting spaces”, he added.
Expressing concern over
the severe shortage of trained public health professionals with broad based
multi-disciplinary knowledge of the determinants of health, the Prime Minister
stressed the need to address the capacity gap among health personnel. “I look
forward to your public health schools helping us bridge this gap by training
people who can in turn build capacities at middle and senior management levels
in the Indian health system”, he added.
The Prime Minister urged
the Foundation to develop an Indian agenda both in academics and research.
“Many tropical diseases are under-researched and this institution could,
by harnessing the best technical expertise from all over the world break new
ground in the management of tropical diseases”, he said.
Dr. Singh stressed the importance
of revitalizing and strengthening departments of social
and preventive medicine in our medical colleges. He also highlighted the importance
of increasing health literacy among all sections of our people, undertaking
programmes in health education and assisting in community empowerment. “The
setting up of the Public Health Foundation of India presents an opportunity
to develop innovative models of public-private partnership in social sector
programmes”, Dr. Singh said.
The function was attended
by Dr. Amartya Sen, Dr Fleming, Director, Global Health Strategies, Shri Rajat Gupta, Sr.Partner Worldwide, McKinsey,
Dr. Anbumani Ramadoss, Union Minister of Health and Family Welfare, Shri Kapil
Sibal, Union Minister for Science
and Technology and Ocean Development, Mrs. Panabaka Lakshmi, Minister of State
for Health & Family Welfare and other public health professionals.
Following is the text of
Prime Minister’s speech on the occasion:
“It gives me great happiness
to be with you at the birth of the Public Health Foundation of India (PHFI).
I commend all those who have worked with passion and commitment to
create this Foundation. I wish you every success in this endeavour to galvanize
public health in India and to guide policy in the critical area of social
development.
The importance of public
health in India’s development cannot be over emphasized. Ours is a demographically
young country. The largest growing
demographic segment in India over the next two decades lies between 15 and
59 years. This provides a wide window
of opportunity to enhance national growth, provided we can productively deploy
this vast human resource. However,
this requires adequate investment in education and health; the two vital areas
of human resource development to which my friend Amartya Sen has so vigorously
drawn our attention over the years. If we do not effectively upscale knowledge and skills of our people
and act purposefully to protect and promote their health, we run the great
risk of wasting this precious human resource.
Good health is not merely
a developmental resource – it is an inalienable human right of every citizen
of this country. Every Indian has
the right to demand and obtain essential preventive, promotive, diagnostic
and curative health services. It is
the bounden duty of the Indian state as well as society at large to ensure
that this right is fully respected and adequately realized.
The management of health
has overly focused hitherto on clinical management of diseases and ignored
the larger social and economic context in which health is best managed. It has been aptly said that the conventional
understanding of malaria is that it is caused by a mosquito but if you widen the lens and ask
what facilitiates the mosquito, the
answer may be that we are living in an environmentally degraded space. Any further analysis would reveal that this
in turn may be the result of economic causes.
Therefore health issues need to be conceptualized in a framework that
understands these relationships, even though a specific disease itself can
be treated through a mixture of social and clinical management. Issues of health particularly in developing
countries have strong links with social, economic, environmental and cultural
factors. They therefore need responses
that appreciate intersecting spaces.
It is this understanding
of the intersecting spaces within which health policy needs to be located
that the initiative of the PHFI has posed before us. It seeks to bridge a very major gap in our health education by training
professionals in disciplines that relate to health, such as economics, sociology,
demography and environment in addition to management of diseases.
We need to develop a new cadre of professionals who are managers of
health and not just of diseases. We have good quality human resources in the
area of clinical management. But we
woefully lack public health managers. I
therefore commend the PHFI in taking this initiative to bridge a critical
gap in health education and in blazing a trail by setting up a series of public
health schools.
From what I see, we face
a major gap in human resources in health.
We have recently asked the Planning Commission to make an assessment
of the scenario of human resources for health.
This is important to address the wide inequalities in the provision
of services within India. While States
like Kerala, Tamil Nadu and Gujarat may have acceptable standards, there are
several states in the country which do not have even the minimum number of
institutions to turn out support staff for health care. There are also serious lacunae
in the capacity of the health sector to absorb and optimally utilize extra
financial resources. This gap must be filled, must be bridged to ensure effective
delivery of programmes. Programmes for the poor will degenerate into poor
programmes, if these deficiencies are not corrected in time.
We must also address the
capacity gap among health professionals. The skewed distribution of specializations
among our doctors is also a concern. There is a severe shortage of trained public health professionals
with broad based multi-disciplinary knowledge of the determinants of health.
Such deficiencies are more acute within our public health services sector,
and this generates a more severe impact than deficiencies in clinical medicine.
They complicate the task of managing public health programmes. Such lacunae
also impose an additional burden on medical doctors, who are trained primarily
as clinical care providers. All of
these problems have resulted in the suboptimal performance of major health
programmes. We need therefore public health professionals
equipped with expertise and managerial skills to design and deliver health
programmes at the national level and down to the village level. We must also provide relevant training to enhance
the capabilities of health care providers involved in public health activities.
Apart from these lacunae,
there is also the realm of future opportunities. India faces the possibility
of becoming a global destination for cheap and high quality health care. The demographic contrast between a young India
and an aging world gives us an opportunity to train professionals at different
levels to meet the needs of the emerging global care industry. These issues have not come on the policy radar
because of the absence of institutes like public health schools which would
have tracked such issues.
Our Government is sensitive
to these issues. Quite apart from an unprecedented increase in budgetary allocations,
we have tried to make architectural corrections in our programmes to see health
in a holistic framework through the National Rural Health Mission. The Mission
will not only seek to reduce inequities in health in rural areas, it is also
designed to greatly improve access to essential health services and to enhance
citizens’ control over healthcare planning. We are trying to move away from
over centralized management of health care to decentralized management through
the development of district plans. These will not only address management
of diseases but also the determinants of health care such as safe water, sanitation
and nutrition. This major agenda can be effectively implemented only with adequate
planning capacity at the district level. I therefore look forward to your public health schools helping us
bridge this gap by training people who can in turn build capacities at middle
and senior management levels in the Indian health care system.
I would also like you to
develop an Indian agenda both in academics and research. Many tropical diseases are under- researched
and this institution could, by harnessing the best technical expertise from
all over the world break new ground in the management of tropical diseases. A research agenda responds to the Indian condition
would also emerge, I sincerely hope.
I am happy that the Public
Health Foundation of India has many of these issues on its agenda. I hope
the public health professionals you train will help transform the state of
our public health services. From
my own personal observations, in many areas of social development, our problem
is not a lack of ideas. On the contrary, institutions have failed to deliver.
I therefore hope the PHFI will also invest in capacity-building in existing
public health institutions across the country. We also need to revitalize
and strengthen departments of social and preventive medicine in our medical
colleges. We have a rich legacy in this area, but of late, we have neglected
this aspect. Your efforts will help invigorate our health services and contribute
to the success of health programmes.
Apart from insititutional
work, it is necessary to make capacity building programmes transcend training
public health professionals. We need
to enhance health literacy among all sections of our people. Every citizen
of India can contribute to public health through measures to protect individual
health as well as by acting to promote societal health. We must empower people
to become effective agents for the promotion of personal and public health.
I hope your Foundation will also undertake programmes in health education
and assist in community empowerment in this vital area.
The setting up of the Public
Health Foundation of India presents a unique opportunity to develop innovative
models of public-private partnership in major social sector programmes. Such
partnership can help blend the commitment of government with the operational
efficiency of not-for-profit private groups. There are many noteworthy examples
of the latter, such as Dr. Devi Shetty’s hospitals, Dr V. Shantha’s Cancer
Institute in Chennai and many other examples can also be given. Regrettably,
on the whole, the record of the private sector in health care provisioning
in India has not been as good as one had hoped for, even though it is the
dominant source of health care provisioning. We are all familiar with reports
of unethical practices, including commissions given in return for referral
and diagnostic work. We must have appropriate measures to tackle these maladies.
In this context, I congratulate
the corporates who have contributed to this laudable effort. I hope others
will also follow suit with their generous support. It
is heartening to see that support is also being offered to this initiative
by several international academic institutions of high repute and by corporate
houses and corporate philanthropists from other countries. Such inspired support
as part of a public private partnership is indeed heartwarming. We also hope
that our State Governments will find it beneficial to partner your initiative
to introduce greater levels of expertise into their public health system.
You can also assist our States by mobilizing resources to build capacity to
strengthen public health in a sustainable manner.
I am very happy that this
initiative has come up in the public-private partnership. I applaud the splendid spirit of international
cooperation that underlies this cooperative effort. I am confident that the
institutions established by the foundation would build bridges with other
institutions in many countries, to collaboratively share knowledge and collectively
shape the future of global public health. I would like to congratulate and
thank all donors who have graciously contributed to this noble effort.
Dreaming together and working together is an idea that has now begun
to work in many parts of the world. With these words, I wish your initiative
all success. I congratulate Shri Rajat Gupta for the efforts
that he has made to give concrete shape to this idea. I look forward to receiving
reports of your steady progress in helping us improve the quality of life
of our citizens.”
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YSR/DS/HK/LV
(Release ID :16832)