National health policy.pptx

9/19/2023
mhaske m.s. 1
NATIONAL HEALTH POLICY
DR. Mhaske M.S.
background
 The govt. of India adopted national health
policy in 1983 it is a 17 page document with 20
paragraphs.
 New national health policy -2002 evolved
 The main objective of this policy is to achieve
an acceptable standard of good health
amongst the general population of country.
9/19/2023
mhaske m.s. 2
 The approach is to increase access to
decentralize public health system.
 To ensure more equitable assess to health
services
 The policy focusses on the diseases like AIDS,
Malaria, tuberculosis, blindness.
 Emphasis on rational use of drugs
9/19/2023
mhaske m.s. 3
Goals of NHP 2002
sr.no Goal year
1 Eradicate polio and yaws 2005
2 Eliminate leprosy 2005
3 Eliminate kala azar 2010
4 Eliminate lymphatic filariasis 2015
5 Achieve zero level growth of HIV/AIDS 2007
6 Reduce mortality by 50%n account ofTB,maleria
and other vector borne diseases
2010
7 Reduce prevalence of blindness to 0.5% 2010
9/19/2023
mhaske m.s. 4
Reduce IMR to 30/1000 and MMR to 100/lakh 2010
Reduce utilization of public health facilities from
current level of ,<20% to >75%
2010
Establish integrated system of surveillance
,national health accounts and health statistics
2005
Increase health expenditure by govt as % of GDP
from 0.9 to 2%
2010
Increase share of central grants to 25% 2010
Increase state sector health spendingf rom 5.5 to
7%
2005
Further increase to 8% of the budget 2010
9/19/2023
mhaske m.s. 5
What is not achieved
 IMR
 MMR
 TFR
 Health expanditure
9/19/2023
mhaske m.s. 6
National health policy 2017
9/19/2023
mhaske m.s. 7
Why ?
 1., the health priorities are changing. Although
maternal and child mortality have rapidly declined,
there is growing burden on account of non-
communicable diseases and some infectious
diseases.
 The second important change is the emergence of a
robust health care industry estimated to be growing
at double digit.
 The third change is the growing incidences of
catastrophic expenditure due to health care costs,
which are presently estimated to be one of the major
contributors to poverty.
 Fourth, a rising economic growth enables enhanced
fiscal capacity.Therefore, a new health policy
responsive to these contextual changes is required.
9/19/2023
mhaske m.s. 8
National health policy 2017
 The primary aim of the National Health Policy,
2017, is to inform, clarify, strengthen and
prioritize the role of the Government in shaping
health systems in all its dimensions- investments
in health, organization of healthcare services,
prevention of diseases and promotion of good
health through cross sectoral actions, access to
technologies, developing human resources,
encouraging medical pluralism, building
knowledge base, developing better financial
protection strategies, strengthening regulation
and health assurance.
9/19/2023
mhaske m.s. 9
National health policy 2017
 Goal
 The policy envisages as its goal the 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.
9/19/2023
mhaske m.s. 10
 The policy recognizes the pivotal importance
of Sustainable Development Goals (SDGs). An
indicative list of time bound quantitative
goals aligned to ongoing national efforts as
well as the global strategic directions is
detailed at the end of this section
9/19/2023
mhaske m.s. 11
Key Policy Principles
 I. Professionalism, Integrity and Ethics:The health
policy commits itself to the highest professional
standards, integrity and ethics to be maintained in the
entire system of health care
 2 delivery in the country, supported by a credible,
transparent and responsible regulatory environment.
 II. Equity: Reducing inequity would mean affirmative
action to reach the poorest. It would mean minimizing
disparity on account of gender, poverty, caste,
disability, other forms of social exclusion and
geographical barriers. It would imply greater
investments and financial protection for the poor who
suffer the largest burden of disease.
9/19/2023
mhaske m.s. 12
 III. Affordability: As costs of care
increases, affordability, as distinct from
equity, requires emphasis. Catastrophic
household health care expenditures
defined as health expenditure exceeding
10% of its total monthly consumption
expenditure or 40% of its monthly non-
food consumption expenditure, are
unacceptable.
9/19/2023
mhaske m.s. 13
Cont…
 IV. Universality: Prevention of exclusions on
social, economic or on grounds of current health
status. In this backdrop, systems and services
are envisaged to be designed to cater to the
entire population- including special groups.
 V. Patient Centered & Quality of Care: Gender
sensitive, effective, safe, and convenient
healthcare services to be provided with dignity
and confidentiality.There is need to evolve and
disseminate standards and guidelines for all
levels of facilities and a system to ensure that
the quality of healthcare is not compromised.
9/19/2023
mhaske m.s. 14
cont…
 VI. Accountability: Financial and performance
accountability, transparency in decision
making, and elimination of corruption in
health care systems, both in public and
private.
 VII. Inclusive Partnerships: A multistakeholder
approach with partnership & participation of
all non-health ministries and communities.
This approach would include partnerships with
academic institutions, not for profit agencies,
and health care industry as well.
9/19/2023
mhaske m.s. 15
Cont…
 VIII. Pluralism: Patients who so choose and
when appropriate, would have access to
AYUSH care providers based on
documented and validated local, home and
community based practices.These
systems, inter alia, would also have
Government support in research and
supervision to develop and enrich their
contribution to meeting the national health
goals and objectives through integrative
practices.
9/19/2023
mhaske m.s. 16
 IX. Decentralization: Decentralisation of
decision making to a level as is consistent with
practical considerations and institutional
capacity. Community participation in health
planning processes, to be promoted side by
side.
 X. Dynamism and Adaptiveness: constantly
improving dynamic organization of health care
based on new knowledge and evidence with
learning from the communities and from
national and international knowledge partners
is designed.
9/19/2023
mhaske m.s. 17
Specific Quantitative Goals and
Objectives:
 2.4 The indicative, quantitative goals and
objectives are outlined under three broad
components viz.
 (a) health status and programme impact,
 (b) health systems performance and
 (c) health system strengthening.These
goals and objectives are aligned to achieve
sustainable development in health sector in
keeping with the policy thrust.
9/19/2023
mhaske m.s. 18
Health Status and Programme Impact
 a. Increase Life Expectancy at birth from
67.5 to 70 by 2025.
 b. Establish regular tracking of Disability
Adjusted LifeYears (DALY) Index as a
measure of burden of disease and its trends
by major categories by 2022.
 c. Reduction ofTFR to 2.1 at national and
sub-national level by 2025.
9/19/2023
mhaske m.s. 19
 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.
9/19/2023
mhaske m.s. 20
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.
9/19/2023
mhaske m.s. 21
 c.To achieve and maintain a cure rate of >85% in
new sputum positive patients forTB 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.
9/19/2023
mhaske m.s. 22
2.4.2 Health Systems
Performance
 Coverage of Health Services
 a. Increase utilization of public health
facilities by 50% from current levels by 2025.
 b. Antenatal care coverage to be sustained
above 90% and skilled attendance at birth
above 90% by 2025.
 c. More than 90% of the newborn are fully
immunized by one year of age by 2025.
9/19/2023
mhaske m.s. 23
 d. Meet need of family planning above 90%
at national and sub national level by 2025.
 e. 80% of known hypertensive and diabetic
individuals at household level maintain
„controlled disease status‟ by 2025.
9/19/2023
mhaske m.s. 24
Cross Sectoral goals related to
health
 a. Relative reduction in prevalence of current
tobacco use by 15% by 2020 and 30% by 2025.
 b. Reduction of 40% in prevalence of stunting
of under-five children by 2025.
 c. Access to safe water and sanitation to all by
2020 (Swachh Bharat Mission).
9/19/2023
mhaske m.s. 25
 d. Reduction of occupational injury by half
from current levels of 334 per lakh agricultural
workers by 2020.
 e. National/ State level tracking of selected
health behaviour.
9/19/2023
mhaske m.s. 26
Health Systems strengthening
 Health finance
 a. Increase health expenditure by
Government as a percentage >of GDP from
the existing 1.15% to 2.5 % by 2025.
 b. Increase State sector health spending to
8% of their budget by 2020.
 c. Decrease in proportion of households
facing catastrophic health expenditure from
the current levels by 25%, by 2025.
9/19/2023
mhaske m.s. 27
Health Infrastructure and Human
Resource
 a. Ensure availability of paramedics and
doctors as per Indian Public Health Standard
(IPHS) norm in high priority districts by 2020.
 b. Increase community health volunteers to
population ratio as per IPHS norm, in high
priority districts by 2025.
 c. Establish primary and secondary care
facility as per norms in high priority districts
(population as well as time to reach norms)
by 2025.
9/19/2023
mhaske m.s. 28
Health Management Information
 a. Ensure district-level electronic database of
information on health system components by
2020.
 b. Strengthen the health surveillance system
and establish registries for diseases of public
health importance by 2020.
 c. Establish federated integrated health
information architecture, Health Information
Exchanges and National Health Information
Network by 2025.
9/19/2023
mhaske m.s. 29
9/19/2023
mhaske m.s. 30
NATIONAL POPULATION POLICY
Dr. Mhaske M.S.
NPP- 2000
 Refers to policies intended to decrease birth
rate or growth rate.
 In April 1976 India formed its first national
population policy .
 It increased minimum legal age for marriage
 15 to 18 for females and 18 to 21 yrs for
males.
 This policy was modified in 1977 this
reiterated the statement of small family
norm.
9/19/2023
mhaske m.s. 31
 Then national health policy 1983 had set goal
of NRR of 1 by 2000
 NPP 2000 is the latest in series reinforces the
target free approach
 It also deals with women education , women
nutrition, child survival, unmet need for
family planning, health of unserved , tribal ,
hilly area ,adolescent health, increased
participation of men in planned parenthood
and collaboration with NGO
9/19/2023
mhaske m.s. 32
Sociodemographic goals of NPP
 1.address the unmet need for basic RCH services
 2.make school education upto age of 14 free
 3.reduce IMR to 30/1000 live births
 4. reduce MMR to below 100per 100000 live
births
 Achieve universal immunization of children
againstVPD
 Achieve 80% hospital deliveries and 100%
deliveries by trained person.
9/19/2023
mhaske m.s. 33
 Achieve universal access to counselling and
services for fertility regulation.
 Achieve 100% registration to births, deaths,
marriage and pregnancy.
 Contain the spread of AIDS
 Prevent and control communicable diseases.
 Integrate Ism in RCH
 Promote small family norm to achieve
replacement levels ofTFR
 Convergence of social sector .
9/19/2023
mhaske m.s. 34
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mhaske m.s. 35
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National health policy.pptx

  • 1. 9/19/2023 mhaske m.s. 1 NATIONAL HEALTH POLICY DR. Mhaske M.S.
  • 2. background  The govt. of India adopted national health policy in 1983 it is a 17 page document with 20 paragraphs.  New national health policy -2002 evolved  The main objective of this policy is to achieve an acceptable standard of good health amongst the general population of country. 9/19/2023 mhaske m.s. 2
  • 3.  The approach is to increase access to decentralize public health system.  To ensure more equitable assess to health services  The policy focusses on the diseases like AIDS, Malaria, tuberculosis, blindness.  Emphasis on rational use of drugs 9/19/2023 mhaske m.s. 3
  • 4. Goals of NHP 2002 sr.no Goal year 1 Eradicate polio and yaws 2005 2 Eliminate leprosy 2005 3 Eliminate kala azar 2010 4 Eliminate lymphatic filariasis 2015 5 Achieve zero level growth of HIV/AIDS 2007 6 Reduce mortality by 50%n account ofTB,maleria and other vector borne diseases 2010 7 Reduce prevalence of blindness to 0.5% 2010 9/19/2023 mhaske m.s. 4
  • 5. Reduce IMR to 30/1000 and MMR to 100/lakh 2010 Reduce utilization of public health facilities from current level of ,<20% to >75% 2010 Establish integrated system of surveillance ,national health accounts and health statistics 2005 Increase health expenditure by govt as % of GDP from 0.9 to 2% 2010 Increase share of central grants to 25% 2010 Increase state sector health spendingf rom 5.5 to 7% 2005 Further increase to 8% of the budget 2010 9/19/2023 mhaske m.s. 5
  • 6. What is not achieved  IMR  MMR  TFR  Health expanditure 9/19/2023 mhaske m.s. 6
  • 7. National health policy 2017 9/19/2023 mhaske m.s. 7
  • 8. Why ?  1., the health priorities are changing. Although maternal and child mortality have rapidly declined, there is growing burden on account of non- communicable diseases and some infectious diseases.  The second important change is the emergence of a robust health care industry estimated to be growing at double digit.  The third change is the growing incidences of catastrophic expenditure due to health care costs, which are presently estimated to be one of the major contributors to poverty.  Fourth, a rising economic growth enables enhanced fiscal capacity.Therefore, a new health policy responsive to these contextual changes is required. 9/19/2023 mhaske m.s. 8
  • 9. National health policy 2017  The primary aim of the National Health Policy, 2017, is to inform, clarify, strengthen and prioritize the role of the Government in shaping health systems in all its dimensions- investments in health, organization of healthcare services, prevention of diseases and promotion of good health through cross sectoral actions, access to technologies, developing human resources, encouraging medical pluralism, building knowledge base, developing better financial protection strategies, strengthening regulation and health assurance. 9/19/2023 mhaske m.s. 9
  • 10. National health policy 2017  Goal  The policy envisages as its goal the 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. 9/19/2023 mhaske m.s. 10
  • 11.  The policy recognizes the pivotal importance of Sustainable Development Goals (SDGs). An indicative list of time bound quantitative goals aligned to ongoing national efforts as well as the global strategic directions is detailed at the end of this section 9/19/2023 mhaske m.s. 11
  • 12. Key Policy Principles  I. Professionalism, Integrity and Ethics:The health policy commits itself to the highest professional standards, integrity and ethics to be maintained in the entire system of health care  2 delivery in the country, supported by a credible, transparent and responsible regulatory environment.  II. Equity: Reducing inequity would mean affirmative action to reach the poorest. It would mean minimizing disparity on account of gender, poverty, caste, disability, other forms of social exclusion and geographical barriers. It would imply greater investments and financial protection for the poor who suffer the largest burden of disease. 9/19/2023 mhaske m.s. 12
  • 13.  III. Affordability: As costs of care increases, affordability, as distinct from equity, requires emphasis. Catastrophic household health care expenditures defined as health expenditure exceeding 10% of its total monthly consumption expenditure or 40% of its monthly non- food consumption expenditure, are unacceptable. 9/19/2023 mhaske m.s. 13
  • 14. Cont…  IV. Universality: Prevention of exclusions on social, economic or on grounds of current health status. In this backdrop, systems and services are envisaged to be designed to cater to the entire population- including special groups.  V. Patient Centered & Quality of Care: Gender sensitive, effective, safe, and convenient healthcare services to be provided with dignity and confidentiality.There is need to evolve and disseminate standards and guidelines for all levels of facilities and a system to ensure that the quality of healthcare is not compromised. 9/19/2023 mhaske m.s. 14
  • 15. cont…  VI. Accountability: Financial and performance accountability, transparency in decision making, and elimination of corruption in health care systems, both in public and private.  VII. Inclusive Partnerships: A multistakeholder approach with partnership & participation of all non-health ministries and communities. This approach would include partnerships with academic institutions, not for profit agencies, and health care industry as well. 9/19/2023 mhaske m.s. 15
  • 16. Cont…  VIII. Pluralism: Patients who so choose and when appropriate, would have access to AYUSH care providers based on documented and validated local, home and community based practices.These systems, inter alia, would also have Government support in research and supervision to develop and enrich their contribution to meeting the national health goals and objectives through integrative practices. 9/19/2023 mhaske m.s. 16
  • 17.  IX. Decentralization: Decentralisation of decision making to a level as is consistent with practical considerations and institutional capacity. Community participation in health planning processes, to be promoted side by side.  X. Dynamism and Adaptiveness: constantly improving dynamic organization of health care based on new knowledge and evidence with learning from the communities and from national and international knowledge partners is designed. 9/19/2023 mhaske m.s. 17
  • 18. Specific Quantitative Goals and Objectives:  2.4 The indicative, quantitative goals and objectives are outlined under three broad components viz.  (a) health status and programme impact,  (b) health systems performance and  (c) health system strengthening.These goals and objectives are aligned to achieve sustainable development in health sector in keeping with the policy thrust. 9/19/2023 mhaske m.s. 18
  • 19. Health Status and Programme Impact  a. Increase Life Expectancy at birth from 67.5 to 70 by 2025.  b. Establish regular tracking of Disability Adjusted LifeYears (DALY) Index as a measure of burden of disease and its trends by major categories by 2022.  c. Reduction ofTFR to 2.1 at national and sub-national level by 2025. 9/19/2023 mhaske m.s. 19
  • 20.  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. 9/19/2023 mhaske m.s. 20
  • 21. 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. 9/19/2023 mhaske m.s. 21
  • 22.  c.To achieve and maintain a cure rate of >85% in new sputum positive patients forTB 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. 9/19/2023 mhaske m.s. 22
  • 23. 2.4.2 Health Systems Performance  Coverage of Health Services  a. Increase utilization of public health facilities by 50% from current levels by 2025.  b. Antenatal care coverage to be sustained above 90% and skilled attendance at birth above 90% by 2025.  c. More than 90% of the newborn are fully immunized by one year of age by 2025. 9/19/2023 mhaske m.s. 23
  • 24.  d. Meet need of family planning above 90% at national and sub national level by 2025.  e. 80% of known hypertensive and diabetic individuals at household level maintain „controlled disease status‟ by 2025. 9/19/2023 mhaske m.s. 24
  • 25. Cross Sectoral goals related to health  a. Relative reduction in prevalence of current tobacco use by 15% by 2020 and 30% by 2025.  b. Reduction of 40% in prevalence of stunting of under-five children by 2025.  c. Access to safe water and sanitation to all by 2020 (Swachh Bharat Mission). 9/19/2023 mhaske m.s. 25
  • 26.  d. Reduction of occupational injury by half from current levels of 334 per lakh agricultural workers by 2020.  e. National/ State level tracking of selected health behaviour. 9/19/2023 mhaske m.s. 26
  • 27. Health Systems strengthening  Health finance  a. Increase health expenditure by Government as a percentage >of GDP from the existing 1.15% to 2.5 % by 2025.  b. Increase State sector health spending to 8% of their budget by 2020.  c. Decrease in proportion of households facing catastrophic health expenditure from the current levels by 25%, by 2025. 9/19/2023 mhaske m.s. 27
  • 28. Health Infrastructure and Human Resource  a. Ensure availability of paramedics and doctors as per Indian Public Health Standard (IPHS) norm in high priority districts by 2020.  b. Increase community health volunteers to population ratio as per IPHS norm, in high priority districts by 2025.  c. Establish primary and secondary care facility as per norms in high priority districts (population as well as time to reach norms) by 2025. 9/19/2023 mhaske m.s. 28
  • 29. Health Management Information  a. Ensure district-level electronic database of information on health system components by 2020.  b. Strengthen the health surveillance system and establish registries for diseases of public health importance by 2020.  c. Establish federated integrated health information architecture, Health Information Exchanges and National Health Information Network by 2025. 9/19/2023 mhaske m.s. 29
  • 30. 9/19/2023 mhaske m.s. 30 NATIONAL POPULATION POLICY Dr. Mhaske M.S.
  • 31. NPP- 2000  Refers to policies intended to decrease birth rate or growth rate.  In April 1976 India formed its first national population policy .  It increased minimum legal age for marriage  15 to 18 for females and 18 to 21 yrs for males.  This policy was modified in 1977 this reiterated the statement of small family norm. 9/19/2023 mhaske m.s. 31
  • 32.  Then national health policy 1983 had set goal of NRR of 1 by 2000  NPP 2000 is the latest in series reinforces the target free approach  It also deals with women education , women nutrition, child survival, unmet need for family planning, health of unserved , tribal , hilly area ,adolescent health, increased participation of men in planned parenthood and collaboration with NGO 9/19/2023 mhaske m.s. 32
  • 33. Sociodemographic goals of NPP  1.address the unmet need for basic RCH services  2.make school education upto age of 14 free  3.reduce IMR to 30/1000 live births  4. reduce MMR to below 100per 100000 live births  Achieve universal immunization of children againstVPD  Achieve 80% hospital deliveries and 100% deliveries by trained person. 9/19/2023 mhaske m.s. 33
  • 34.  Achieve universal access to counselling and services for fertility regulation.  Achieve 100% registration to births, deaths, marriage and pregnancy.  Contain the spread of AIDS  Prevent and control communicable diseases.  Integrate Ism in RCH  Promote small family norm to achieve replacement levels ofTFR  Convergence of social sector . 9/19/2023 mhaske m.s. 34