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SEMINAR
ON
PLANNING PROCESS
PRESENTED BY
RUSHIKESH .B PAWAR
CON PIMS (DU) LONI
PLANNING
Planning is a process of determining
the objectives of administrative
effort and devising the means
calculated to achieve them.
- Millet
PLANNING
Planning is a process of setting
formal guidelines and constraints
for the behavior of the firm.
-Assoff and Brundinhargh
NATIONAL HEALTH
PLANNING
National Health Planning has been
defined as the orderly process of
defining national health problems,
identifying unmet needs and surveying
the resources to meet them,
establishing priority goals that are
realistic and feasible and projecting
administrative action to accomplish
the purpose of the proposed Program.
NATIONAL DEVELOPMENT
PLANNING
 Definition
National development planning
has been defined as “continuous,
systematic, coordinated planning
for the investment of the resources
of a country in programmes.”
POLICY
 Policy is a system, which provides
the logical framework and
rationality of decision making for
the achievement of intended
objectives.
Purposes of Planning
 To match the limited resources with
many problems.
 To eliminate wasteful expenditure of
duplication of expenditure,
 To develop the best course of action
to accomplish a defined objectives.
 To improve the health services; and
 To meet the health needs and
demands of people.
GOAL OF PLANNING
PROCESS
A goal is usually described in terms of
 What is to be attained?
 The extent to which it is to be attained
 The population or section of the environment
involved.
 The geographic area in which the proposed
programme will operate and
 The length of time required for attaining the
goal.
Elements of goal in
planning process
 Action
 Limit
 Population
 Environment
 Geographic area
Planning element
 Objectives
 Policies
 Programmes
 Schedules
 Budget
Planning commission
The Planning commission consists of 7
members.
 Chairman - 1
 Deputy Chairman – 1
 Members – 5
Planning Division
 Programme advisory
 General Secretariat
 Technical division
Planning Process
1. Analysis of the health
situation
 The population its age and sex structure
 Statistic of morbidity and mortality
 The epidemiology and Geographical
distribution of different diseases
 Medical care facilities
 The technical manpower
 Training facilities available
 Attitudes and beliefs of the population toward
diseases, its cure and prevention.
Establishment of objectives
and goals
3. Assessment of
Resources
4. Fixing priorities
5. Write-up of formulated
plan
6. Programming and
implementation
 Definitions of Roles and Task.
 The selection, training, motivation,
supervision of the manpower.
 Organization and communication.
 Efficiency of individual institution
Ex. Hospital or Health Centers.
7. Monitoring
8. Evaluation
HEALTH PLANNING IN
INDIA
BHORE COMMITTEE
 Chairman - Sir Joseph Bhore, Appointment - 1946
 Recommendations –
 Integration of preventive and curative services at
all administrative level.
 Development of primary health centre in two
stages.
a) Short term measure ex. PHC should cater to
a population of 40,000 with a secondary health
centre to serve as a supervisory, coordinating
and referral institutions. For each PHC 2 MO, 4
PHN, 1 Staff Nurse (ANM) & 4 Trained Dais, 2
Sanitary Inspectors, 2 HA, 1 Pharmacist, 15
other four class employees were recommended.
BHORE COMMITTEE
b) Long term programme – 75 bedded
hospital for each 10 to 20 thousand population
and 650 bedded hospitals at regional level,
district hospitals with 2500 beds
recommended.
c) To prepare “social physician”, 3 months
training in preventive and social medicine.
MUDALIAR COMMITTEE
Chairman - Sir Mudaliar, Appointment – 1956 to 1961
Recommendations –
 Consolidation of first two Five Year Plans.
 Strengthening of the district hospital with
specialist services to serve as central base of
regional services.
 Regional organization in each state between the
head quarters organization and the district in
change of a Regional Deputy or Assistant
Directors – each to supervise 2 to 3 medical,
district medical and health officers.
MUDALIAR COMMITTEE
 Each primary health center not to serve
more than 40,000 population.
 To improve the quality of health care
provided by the PHC.
 Integration of medical and health
services
 Constitution of an all India Health
Service on the pattern of Indian
Administrative Service.
CHADAH COMMITTEE
 Chairman – Dr. M. S. Chadah, Appointment –
1963
 Recommendations –
In “Vigilance” operations through PHC at the block
level Ex. National Malaria Eradication
Programme. Monthly home visit, 10,000
populations to each one basic health worker
allocated (MPHW) and to look after additional
duties of collection of vital statistics, Family
planning given. The family planning health
assistance was to supervise 3 to 4 MPHW’s at
district level.
MUKERJI COMMITTEE
 Chairman – Shri. Mukerji,
Appointment – 1965
 Recommendations
- Separate staff for the family planning
programme recommended. The family
planning assistance were specified
their duties only in family planning.
Also recommended de link the malaria
activities and other activities from
family planning.
JUNGALWALA
COMMITTEE
 Chairman – Dr. N. Jungalwal, Appointment –
1967
 Recommendations
Integration and organization of personnel
- a) unified cadre
- b) Common seniority kept
- c) recognition of extra qualification,
- d) equal pay for equal work
- e) special pay for specialized work
- f) no private practice and
- g) good service conditions should be given
KARTAR SINGH
COMMITTEE
 Chairman – Kartar Singh, Appointment –
1973
 Recommendations –
- ANM designated as “female health worker”
All basic health workers and surveillance
workers, vaccinators, health education
assistant, &
- Family planning Health assistant replaced by
“Male health worker”.
- MPHW introduced in malaria maintenance
phase areas and smallpox controlled area.
- PHC population coverage increase up to
KARTAR SINGH
COMMITTEE
 PHC divided in 16 sub centers. Sub centers
have given 3000 to 3500 populations. Each
sub centre has provided 1 male and 1
female health worker. Then there should be
a each male health and female health
supervisor to supervise the work of 3 to 4
male/ female health worker.
 Lady health visitor designated as female
health supervisor.
 MO-PHC has overall charge of all
supervisors and all health workers.
 Accepted Kartar Singh Committees
recommendations by Govt. of India
RECOMMENDATIONS
SHRIVASTAV
COMMITTEE
 Chairman – Shrivastav, Appointment – 1975
 Recommendations
- To devise a suitable curriculum for training a
cadre of health assistants, So that they can
serve as a link between qualified MO &
MPHW.
- Suggested steps to improve medical
educational process emphasis given on
problems relevant to national requirements.
- Suggested to realize the above objectives
and matters.
SHRIVASTAV
COMMITTEE
 Creation of Banks of paraprofessional and
semi professional health workers formed
within the community itself. Ex. School
Teacher, Post Master, Gram-sevak to
provide simple promotive, preventive and
curative health services needed by the
community.
 Establishment of two cadres of health
workers namely MPHW and Health Assistant
between the community level workers and
Doctors at the PHC.
RECOMMENDATIONS
SHRIVASTAV COMMITTEE
 Development of referral services complex by
establishing from proper linkage between the
PHC and higher level referral and service
centre.
 Establish Medical and Health Education
Commission for planning and implementing the
reforms needed in health and medical education.
 Establishment of on the lines of university grand
commission.
 Work load of MPHW increase and area of
population increased by 5,000 population. Work
load of male and female health assistant’s
decrease.
RECOMMENDATIONS
Rural health scheme 1997
 Under this scheme Shrivastav
Committee provided health care
through trained workers in the
community health centre was initiated
during 1977 to 1978. Steps were also
initiated
 For involvement of medical colleges
in the total health care of selected
PHC’s which the objectives of
reorienting medical education to the
needs of rural people.
Rural health scheme
1997
 Reorientation training of MPW in
the control of various
communicable disease programme
into unipurpose workers accepted
by the central council of health and
central family planning council in
1976.
Health for all by 2000AD-
Report of working group, 1981
 A working group on health was constituted
by the planning Commission in 1980 with
the secretary, Ministry of health and Family
Welfare, as its chairman, to identify in
programme terms, the goal for Health for
All by 2000 AD and to outline specific
programmes for the sixth Five Year plan.
Health for all by 2000AD-
Report of working group, 1981
 Setting out the broad approach to
health planning during the Sixth
Five year plan, had also evolved
specific indices and targets to be
achieved by the country by 2000
AD.
HEALTH SECTOR
PLANNING
 Water supply and sanitation
 Control of communicable diseases
 Medical education, training and
research
 Medical care including hospitals,
dispensaries and primary health
centers
 Public health services
 Family planning; and
Constraints in Health
Planning process
1 Low priority to health given by
political leaders and decision makers;
2 Low budget allocation to health;
3 Lack of adequate health information
system for planning, monitoring and
evaluation
4 Natural resistance to change;
5 Frequent change of government,
political and administrative staff and
planners
Constraints in Health
Planning process
6. Untrained personnel in Planning;
7. Traditional planning methods and not
need-based, cost-effective, team -based
and rational planning;
8. "Long Time" lag between planning and
implementation
9. Rigidity of budgeting, strategy, and
administrative procedures; and
10. Inadequate coordination of planning.
FIVE Year plans
OBJECTIVES
 Control or eradication of major
communicable diseases;
 Strengthening of the basic health
services through the establishment
of primary health centers and sub-
centre;
 Population control; and
 Development of manpower
resources.
10TH FIVE YEAR PLAN
(2002-2007)
Approach
 To improve and enhance the
quality of primary health care in
urban and rural areas.
 To improve efficiency of existing
health care infrastructure by
strengthening and improving
referral linkage.
10TH FIVE YEAR PLAN
(2002-2007)
Targets
 Reduction of poverty ratio by 5% points by
2007, and by 50% point by 2012.
 All children in school by 2003; all children
should complete 5 years of schooling by 2007.
 Reduction in gender gap in literacy and wage
rate by at least 50% by 2007.
 Reduction in decadal rate of population growth
between 2001 to 2011 to 16.2%.
10TH FIVE YEAR PLAN
(2002-2007)
Targets
 Increased in literacy rate to 75% within the
plan period.
 Reduction in infant mortality rate to 45 per
1000 live births by 2007 and 28 by 2012.
 Reduction of maternal mortality ratio to 2 per
1000 live births by 2007 and 1 by 2012.
 All villages to have sustained assess to
potable drinking water within the plan period.
Achievements during the past 55 years of plan
1st
Plan
1951-56
10th
Plan
2002-2007
1 Primary Health Centres 725 23,236 (Sep. 2005)
2 Subcentres NA 146,026
3 Community health centres - 3,346
4 Total beds (2002) 125,000 914,543
5 Medical Colleges 42 242
6 Annual admissions in
medical colleges
3,500 26,449
7 Dental colleges 7 205
8 Allopathic doctors 65,000 267,500
9 Nurses 18,500 865,135
10 ANMs 12,780 506,925
Achievements during the past 55 years of plan
1st
Plan
1951-56
10th
Plan
2002-2007
11 Health visitors 578 50,393
12 Health Workers (F) (in position) - 133,194
13 Health Workers (M) (in position) - 61,907
14 Block Extension Educator - 2,645
15 Health Assistant (M)
(in position)
- 20,181
16 Health Assistant (F)/LHV
(in position)
- 17,371
17 Village Health Guides (2002) - 3.23.lakh
NATIONAL HEALTH
POLICY 2002
 The Ministry of Health and Family
Welfare, Govt. of India, evolved a
National Health Policy in 1983
keeping in view the national
commitment to attain the goal of
Health for All by the year 2000.
NATIONAL HEALTH
POLICY- 2002
 OBJECTIVE
To achieve an acceptable
standard of good health amongst
the general population of the
country.
NATIONAL HEALTH
POLICY 2002
Approach
- To increase access to decentralized public
health system by establishing new
infrastructure in the existing institutions.
- Equitable access to health services across
the social and geographical expanse of
the country and
- Primacy will be given to preventive and
first line curative initiatives at the primary
health level
NATIONAL HEALTH
POLICY 2002
OBJECTIVES
 To achieve an acceptable standard of
good health amongst the general
population of the country;
 To increase access to the decentralized
public health system by establishing new
infrastructure in deficient areas, and by
upgrading the infrastructure in the
existing institutions;
NATIONAL HEALTH
POLICY 2002
Objectives
 To increase the aggregate public health
investment through a substantially increased
contribution by the Central Government;
 To strengthen the capacity of the public health
administration at the State level to render
effective service delivery;
 To ensuring a more equitable access to health
services across the social and geographical
expanse of the country
NATIONAL HEALTH
POLICY 2002
Objectives
 To enhance the contribution of the private
sector in providing health services for the
population group which can afford to pay
for services;
 To rationalize use of drugs within the
allopathic system; and
 To increase access to tried and tested
systems of traditional medicine.
INDICATOR 1951 1981 2004
Demographic Changes
Life Expectancy 36.7 54 66.90 (2001)
Crude Birth Rate (per 1000
population)
40.8 33.9 (SRS) 24.1
Crude Death Rate (per 1000
population)
25 12.5 (SRS) 7.5
IMR (per 1000 live births) 146 1I0 58
Couple Protection Rate (%) - 10.4 29 (2000)
Total Fertility Rate 6.0 - 3 (2003)
Achievements of India from the
Years -1951-2000
Indicator 1951 1981 2001
Epidemiological Shifts
Malaria (cases in Million) 75 2.7 2.0 (2001)
Leprosy (per 10,000) 38.1 57.3 3.7 (2001)
Small Pox (No. of Cases) >44887 Eradicated -
Guinea Worm NA >39792 Eradicated
Polio - 29709 265
Infrastructure
Sub-Centers 725 57363 137311 (2001)
Dispensaries & Hospitals 9209 23555 43322 (CBHI-96)
Beds (Private & Public) 117198 569495 870161 (CBHI-96)
Achievements of India from the
Years -1951-2000
Differences in Health Status
in India
Sector BPL(%)
IMR
1999(SRS)
<5MR
(NFHS-
II)
% of
Children
underweight
MMR
(per lack)
India 26.1 70 94.9 47 408
Rural 27.09 75 103.7 49.6 -
Urban 23.62 44 s63.1 38.4 -
Differences in Health Status among
States
Sector
BPL(
%)
IMR
1999(SR
S)
<5MR
(NFHS-
II)
% of
Children
underweight
MMR per lack
Better Performing States
Kerala 12.72 14 18.8 27 87
Maharashtra 25.02 48 58.1 50 135
Tamil Nadu 21.12 52 633 37 79
Low Performing State
Orrissa 47.15 97 104.4 54 498
Bihar 42.6 63 105.1 54 707
Rajasthan 15.28 81 114.9 51 607
UP 31.15 84 122.5 52 707
MP 37.43 90 137.6 55 498
Goals to be achieved by
2000-2015
 Year 2003
• Enhancement of legislation for regulating minimum standard
in Clinical Establishment Medical Institutions
 Year 2005
• Eradicate Poliomyelitis and Yaws
• Eliminate Leprosy
• Establish an integrated system of surveillance, National Health
Accounts and Health Statistics
• Increase State Sector Health spending from 5.5% to 7% of the
budget.
• 1% of the total health budget for Medical Research
• Decentralization of implementation of public health Programs
Goals to be achieved by
2000-2015
Year 2007
• Achieve Zero level growth of HIV / AIDS.
Year 2010
• Eliminate Kala Azar .
• Reduce Mortality by 50% on account of TB,
Malaria and Other Vector & Water Borne
diseases
• Reduce Prevalence of Blindness to 0.5%.
• Reduce IMR to 30/1000 And MMR to 100/Lakh
• Increase utilization of public health facilities
from current level of <20 to >75%
Goals to be achieved by
2000-2015
Year 2010
• Increase health expenditure by
Government from the existing 0.9 % to
2.0% of GDP
• 2% of the total health budget for Medical
Research
• Increase share of Central grants to
constitute at least 25% of total health
spending
• Further increase of State Sector health
spending to 8%
Year 2015
National Health Policy
Prescriptions
 Financial Resources
 Equity
 Delivery of National Public Health
Programs
 The State of Public health Infrastructure
 Extending Public Health Services
 Role of Local Self-Government
Institutions
 Norms for Health Care Professional
National Health Policy
Prescriptions
 Health Research
 Education of Health Care
Professionals
 Need for Specialists in "Public Health"
& "Family Medicine”
 Nursing Personnel
 Urban Health
 Information, Education and
Communication
National Health Policy
Prescriptions
 National Disease Surveillance Network
 Health Statistics
 Women's Health
 Medical Ethics
 Enforcement of Quality Standards for Food
and Drugs
 Regulation of Standards in Paramedical
Disciplines
 Providing Medical Facilities to Users from
Overseas (Health Tourism)
 Impact of Globalization on the Health
Sector
Recent Development
 The Prime Minister has launched the
Public Health Foundation of India (PHFI),
to establish world-class public health
institutes to train professionals in the
field.
NATIONAL POPULATION
POLICY
 In April 1976 India formed its first- “National
Population Policy. It called for an increase in
the legal minimum age of marriage from 15 to
18 for females, and from 18 to 21 for males.
 Policy was modified in 1977. New policy
statement reiterated the importance of the
small family norm without compulsion and
changed the programme title to “Family
Welfare Programme”
 National Health Policy 2000” is the latest in
this series
NATIONAL POPULATION
POLICY 2000
OBJECTIVES
 To bring the TFR to replacement
levels by 2010.
Long term objective
 To achieve requirements of
suitable economic growth, social
development and environment
protection.
NATIONAL POPULATION POLICY
2000
1, Address the unmet needs for basic
reproductive and child health services,
supplies and infrastructure.
2. Make school education up to age 14 free
and compulsory, and reduce drop-outs at
primary and secondary school levels to
below 20 percent for both boys and girls.
3. Reduce infant mortality rate below 30 per
1000 live births
Socio-demographic Goals for 2010 are as follows
NATIONAL POPULATION POLICY
2000
4. Reduce maternal mortality rate below 100
per lack live births
5. Achieve universal immunization of children
against all vaccine preventable diseases
6.Promote delayed marriage for girls, not
earlier than age 18 and preferably after 20
years of age.
7. Achieve 80% institutional deliveries and
100% deliveries by trained persons.
Socio-demographic Goals for 2010 are as follows
NATIONAL POPULATION POLICY
2000
8. Achieve universal access to information /
counseling, and services for fertility
regulation and contraception with a wide
basket of choices.
9. Achieve 100 percent registration of births,
deaths, marriage and pregnancy.
10. Contain the spread of AIDS, and promote
greater integration between the
management of reproductive tract infections
(RTI) and sexually transmitted infections
(STI) and the National AIDS Control
Organization
Socio-demographic Goals for 2010 are as follows
NATIONAL POPULATION POLICY
2000
11. Prevent and control communicable
diseases.
12. Integrate Indian Systems of Medicine
(ISM) in the provision of reproductive and
child health services, and in reaching out to
households.
13. Promote vigorously the small family norm
to achieve replacement levels of TFR.
14. Bring about convergence in
implementation of related social sector
programmes so that family welfare becomes
Socio-demographic Goals for 2010 are as follows
NATIONAL POPULATION
POLICY 2000
It deals with-
 women education;
 empowering women for improved
health and nutrition;
 child survival and health;
 the unmet needs for family welfare
services;
Women education
Women empowerment
Small family norm
Child survival and health
Child Survival and Health
NATIONAL POPULATION
POLICY 2000
It deals with-
 health care for the under-served
population groups like slums,
 tribal community, hill area population
and displaces and migrant population;
 adolescent’s health and education;
 increased participation of men in
planned parenthood; and

Adolescent Health and
Education
Adolescent health
Increased participation of
men in planned parenthood
Family welfare services
State health policy
Maharashtra state
Maharashtra State Health
System
 35 Districts
 350 Talukas - approx.
 60,000 Multi Purpose Worker [MPW] - Female
Auxiliary Nurse Midwife [ANM]
 60,000 Multi Purpose Worker [MPW] - Male
 60,000 Health Assistant [HA] – Male Nurse
Midwife / Lady Health Visitor
 5,000 Doctors
 55,000 Anganwadi Worker [AWW] 1
Anganwadi worker serves about 250 families
or 1,000 people
STATE POPULATION
POLICY
(Maharashtra)
Declared on 8th March 2000 on the day of the International
women Day. The policy has following features -
 Two child family norm
 Prevention of child marriage.
 Prevention of misuse of Pre-natal Sex
Determination Act
 Implementation of Births, Deaths and Marriages
registration act
 Empowerment of Gram Panchayats
 Recognition to Health Institutions doing quality
work
 Steering Committee under Chairmanship of
Hon'ble Chief Minister to monitor the Population
Policy.
AIDS Awareness
 Rallies and Public gatherings were
organized involving the Miss World /Miss
Universe for addressing the Youth about
"knowing AIDS and Prevention"
 Skating from Mumbai - Kolhapur, Pune -
Kolhapur were organized to draw attention
of people for AIDS control measures
Health Programmes in
Maharashtra state
 Malaria case incidence has come down from
1,58,239 cases to 76,234 cases in 2001
compared to the previous year. Similarly,
Filaria cases have come down from 42,748
cases to 24,947 cases
 Record Cataract operations of 3,81,929
in1999-2000 and 4,59,721 in 2000-2001
were performed.
 The prevalence of 14.7/10,000 of Leprosy
cases in 1991-92 has come down to 3.1 /
10,000.81
Health Programmes in
Maharashtra state
 The Mental Health Problems are being
given priority and 10 bedded wards are
being opened at every District Hospital
 Heart Surgeries had been the domain of
only urban areas and being costly were
beyond the reach of the poor. The issue
has been seriously taken up and facilities
are being extended to the District Hospitals
through "Jeevandai Yogana".
Integrated Population &
Development Project (I.P.D)
 Goals
 To enable individuals and couples to achieve
their personal reproductive intentions and to
ensure survival and development of their
children through delivery of quality reproductive
and child health services including family
planning.
 To improve the educational and social status of
women in project areas.
Project period- 1998-2002
Integrated Population &
Development Project (I.P.D)
 Objectives: 
 To improve access to essential package of quality
reproductive health services in project areas in
identified groups.
 To contribute to creating an enabling environment for
gender equity and equality, women's empowerment
and realisation of reproductive rights.
 To strengthen the capacities related to reproductive
and child health including family planning program,
project management in project areas.
Integrated Population &
Development Project (I.P.D)
Activities
 Training and infrastructure improvements
 Equipment supply
 Mobility support
 Group and Communication activities
 Panchayat and NGO activities
 Service Support
 Project Management
HEALTH PLAN OF
MAHARASHTRA
 
 An integrated approach to reduce
childhood mortality and morbidity
due to diarrhoea and dehydration;
Maharashtra, India 2005 – 2010
AYUSH
 The
Indian Systems of Medicine and Homoeo
(ISM&H) were given an independent
identity in the Ministry of Health and
Family Welfare in 1995 by creating a
separate Department, which was
renamed as
Department of Ayurveda, Yoga and Natu
(AYUSH) in November 2003
AYUSH
 Ayurveda, Siddha Unani and
Homoeopathy drugs are covered
under the purview of
Drugs and Cosmetics Act, 1940
 A separate National Policy on Indian
Systems of Medicine and
Homoeopathy is in place since
2002.
National Health Policy on
AYUSH
1. To promote good health and expand the outreach of health
care to our people, particularly those not provided with
health cover, through preventive, promotive and curative
interventions.
2. To improve the quality of teachers and clinicians by revising
curricula to contemporary relevance by creating model
institutions and Centres of Excellence and extending
assistance for creating infrastructural facilities.
3. To ensure affordable ISM&H services and drugs which are
safe and efficacious.
4. To facilitate availability of raw drugs which are authentic and
contain essential components as required under
pharmacopoeial standards to help improve quality of
drugs, for domestic consumption and export.
OBJECTIVES
National Health Policy on
AYUSH
5. To integrate ISM&H in the health care delivery
system and National Programmes and ensure
optimal use of the infrastructure of hospitals,
dispensaries and physicians.
6. To re-orient and prioritize research in ISM&H to
gradually validate therapy and drugs to address
in particular the chronic and new life style related
emerging diseases.
7.To create awareness about the strengths of these
systems in India and abroad and sensitize other
stakeholders and providers of health.
8.To provide full opportunity for the growth and
development of these systems and utilization of
their potential, strength and revival of their glory.
OBJECTIVES
National Health Policy on
AYUSH
1. Legislative measures would be taken to
check mushroom growth of substandard
colleges.
2. Course curricula would be reinforced to
raise the standards of medical training and
to equip trainees for utilization in national
health programs.
3.Priority would be accorded to research
covering clinical trials, pharmacology,
toxicology, standardization and study of
pharmaco-kinetics in respect of already
identified areas of strength.
STRATEGIES
National Health Policy on
AYUSH
4. The Medicinal Plants Board would
address all issues connected with
conservation and sustainable use of
medicinal plants leading to remunerative
farming, regulation of medicinal farms
and conservation of biodiversity.
5. Medicinal Plants Board would acquire
statutory status to be able to regulate
registration of farmers and cooperative
societies, transportation, marketing of
medicinal plants and proper procurement and
supply of pharmaceutical industry.
STRATEGIES
National Health Policy on
AYUSH
6. Protection of India’s traditional medicinal
knowledge would be undertaken through a
progressive creation of a Digital Library for each
system and eventually for codified knowledge
leading to innovation and good health outcomes.
7. Efforts would be made to integrate and
mainstream ISM&H in health care delivery
system and in National Programmes.
8. A range of options for utilization of ISM&H
manpower in the healthcare delivery system
would be developed by assigning specific goal
oriented role and responsibility to the ISM&H
work force.
STRATEGIES
National Health Policy on
AYUSH
9. up AYUSH health facilities.
10. Central Government would assist
allopathic hospitals to establish
Panchkarma and Ksharshutra facilities
for the treatment of neurological
disorders, musculo-skeletal problems as
well as ambulatory treatment of
bronchial asthma and dermatological
problems.
11. States would be encouraged to
consolidate the ISM&H infrastructure
and health services
STRATEGIES
National Health Policy on
AYUSH
12. Pharmacopoeial work related to
Ayurveda, Unani, Siddha and
Homoeopathy Drugs would be expedited
13. Industry would be encouraged to make
use of quality certification
14. Quality Control Centers would be set
up on regional basis to standardize the
in-process quality control of ISM
products and to modernize traditional
processes without changing the
concepts of ISM.
STRATEGIES
National Health Policy on
AYUSH
15. States would be advised and supported to
augment facilities for drug manufacture and
testing.
16. Operational use of ISM in Reproductive &
Child Health (RCH) would be encouraged in
eleven identified areas, where the Indian
systems of medicine would be useful for
antenatal, intra-natal, post-natal and
neonatal care.
17. North Eastern States, rich in flora and
fauna, would be supported to develop
infrastructure and awareness
STRATEGIES
National Health Policy on
AYUSH
18. Keeping in view the global interest in
understanding ISM concepts and practices,
modules will be formulated for introducing
Ayurveda and Yoga to medical schools and
institutions abroad and to expose medical
graduates.
19. Awareness programmes on the utility and
effectiveness of ISM&H would be launched
through the electronic and print media.
STRATEGIES
REFERENCES
 Basavanthappa B. T. Community Health Nursing Reprint
2001, Jaypee publication, Pp -585 – 669
 Gupta M.C.& Mahajan B.K.’ Text Book of Preventive and
Social Medicine; Jaypee Publication, Third Edition, Pp - 416
– 477, 454 – 460
 Koshore; National Health Programmes of India, 6th Edition,
Century Publication, Pp - 20 – 26, 362 – 377
 Park K. Essential of Community Health Nursing, 4th Edition,
Bhanot Publication, Pp -311 – 340
 Park K. Text Book of Preventive and Social Medicine 19th
Edition, Bhanot Publication Pp -346 – 378, 721 – 740 – 760
 Mary Lucita, “Nursing Practice and Public Health
Administration” published by ELSEVIER units 3 to 13.
 Basawanthappa BT, Nursing administration, Jaypee brothers
medical publishers (p) ltd 2004, edition 1st , Pp:43- 49, 258-
259
REFERENCES
 Bernhard LA, Walsh M: Leadership the key to the
professionalization of nursing. 3rd edition. Missouri: Mosby
publishers 1995, Pp:36- 47
 Marquis L.Bessiel, Leadership roles and management
functions in Nursing theory and application, Lippincott
Williams and Wilkins publications 2000 , edition 3rd , Pp:67-
73
 Marriner Ann, Guide to nursing management, Mosby
publishers 1988, edition 4th Pp: 29-31, 273- 274, 287.
 Swansburg. C. Russell, Swansburg J. Richard, Introduction
to management and leadership for nurse managers, Jones
and Barlett publishers 2002, edition 3rd , Pp:68- 70
 Journal of Clinical Nursing 2000, 9(4) Pp:545-548
 Journal of Advance Nursing 1999, 30(6), Pp:1375-82
 www.biomedcentral. Com
 www. planning.com
Health planning PROCESS

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Health planning PROCESS

  • 2. PLANNING Planning is a process of determining the objectives of administrative effort and devising the means calculated to achieve them. - Millet
  • 3. PLANNING Planning is a process of setting formal guidelines and constraints for the behavior of the firm. -Assoff and Brundinhargh
  • 4. NATIONAL HEALTH PLANNING National Health Planning has been defined as the orderly process of defining national health problems, identifying unmet needs and surveying the resources to meet them, establishing priority goals that are realistic and feasible and projecting administrative action to accomplish the purpose of the proposed Program.
  • 5. NATIONAL DEVELOPMENT PLANNING  Definition National development planning has been defined as “continuous, systematic, coordinated planning for the investment of the resources of a country in programmes.”
  • 6. POLICY  Policy is a system, which provides the logical framework and rationality of decision making for the achievement of intended objectives.
  • 7. Purposes of Planning  To match the limited resources with many problems.  To eliminate wasteful expenditure of duplication of expenditure,  To develop the best course of action to accomplish a defined objectives.  To improve the health services; and  To meet the health needs and demands of people.
  • 8. GOAL OF PLANNING PROCESS A goal is usually described in terms of  What is to be attained?  The extent to which it is to be attained  The population or section of the environment involved.  The geographic area in which the proposed programme will operate and  The length of time required for attaining the goal.
  • 9. Elements of goal in planning process  Action  Limit  Population  Environment  Geographic area
  • 10.
  • 11. Planning element  Objectives  Policies  Programmes  Schedules  Budget
  • 12. Planning commission The Planning commission consists of 7 members.  Chairman - 1  Deputy Chairman – 1  Members – 5
  • 13. Planning Division  Programme advisory  General Secretariat  Technical division
  • 15. 1. Analysis of the health situation  The population its age and sex structure  Statistic of morbidity and mortality  The epidemiology and Geographical distribution of different diseases  Medical care facilities  The technical manpower  Training facilities available  Attitudes and beliefs of the population toward diseases, its cure and prevention.
  • 19. 5. Write-up of formulated plan
  • 20. 6. Programming and implementation  Definitions of Roles and Task.  The selection, training, motivation, supervision of the manpower.  Organization and communication.  Efficiency of individual institution Ex. Hospital or Health Centers.
  • 23.
  • 24.
  • 26. BHORE COMMITTEE  Chairman - Sir Joseph Bhore, Appointment - 1946  Recommendations –  Integration of preventive and curative services at all administrative level.  Development of primary health centre in two stages. a) Short term measure ex. PHC should cater to a population of 40,000 with a secondary health centre to serve as a supervisory, coordinating and referral institutions. For each PHC 2 MO, 4 PHN, 1 Staff Nurse (ANM) & 4 Trained Dais, 2 Sanitary Inspectors, 2 HA, 1 Pharmacist, 15 other four class employees were recommended.
  • 27. BHORE COMMITTEE b) Long term programme – 75 bedded hospital for each 10 to 20 thousand population and 650 bedded hospitals at regional level, district hospitals with 2500 beds recommended. c) To prepare “social physician”, 3 months training in preventive and social medicine.
  • 28. MUDALIAR COMMITTEE Chairman - Sir Mudaliar, Appointment – 1956 to 1961 Recommendations –  Consolidation of first two Five Year Plans.  Strengthening of the district hospital with specialist services to serve as central base of regional services.  Regional organization in each state between the head quarters organization and the district in change of a Regional Deputy or Assistant Directors – each to supervise 2 to 3 medical, district medical and health officers.
  • 29. MUDALIAR COMMITTEE  Each primary health center not to serve more than 40,000 population.  To improve the quality of health care provided by the PHC.  Integration of medical and health services  Constitution of an all India Health Service on the pattern of Indian Administrative Service.
  • 30. CHADAH COMMITTEE  Chairman – Dr. M. S. Chadah, Appointment – 1963  Recommendations – In “Vigilance” operations through PHC at the block level Ex. National Malaria Eradication Programme. Monthly home visit, 10,000 populations to each one basic health worker allocated (MPHW) and to look after additional duties of collection of vital statistics, Family planning given. The family planning health assistance was to supervise 3 to 4 MPHW’s at district level.
  • 31. MUKERJI COMMITTEE  Chairman – Shri. Mukerji, Appointment – 1965  Recommendations - Separate staff for the family planning programme recommended. The family planning assistance were specified their duties only in family planning. Also recommended de link the malaria activities and other activities from family planning.
  • 32. JUNGALWALA COMMITTEE  Chairman – Dr. N. Jungalwal, Appointment – 1967  Recommendations Integration and organization of personnel - a) unified cadre - b) Common seniority kept - c) recognition of extra qualification, - d) equal pay for equal work - e) special pay for specialized work - f) no private practice and - g) good service conditions should be given
  • 33. KARTAR SINGH COMMITTEE  Chairman – Kartar Singh, Appointment – 1973  Recommendations – - ANM designated as “female health worker” All basic health workers and surveillance workers, vaccinators, health education assistant, & - Family planning Health assistant replaced by “Male health worker”. - MPHW introduced in malaria maintenance phase areas and smallpox controlled area. - PHC population coverage increase up to
  • 34. KARTAR SINGH COMMITTEE  PHC divided in 16 sub centers. Sub centers have given 3000 to 3500 populations. Each sub centre has provided 1 male and 1 female health worker. Then there should be a each male health and female health supervisor to supervise the work of 3 to 4 male/ female health worker.  Lady health visitor designated as female health supervisor.  MO-PHC has overall charge of all supervisors and all health workers.  Accepted Kartar Singh Committees recommendations by Govt. of India RECOMMENDATIONS
  • 35. SHRIVASTAV COMMITTEE  Chairman – Shrivastav, Appointment – 1975  Recommendations - To devise a suitable curriculum for training a cadre of health assistants, So that they can serve as a link between qualified MO & MPHW. - Suggested steps to improve medical educational process emphasis given on problems relevant to national requirements. - Suggested to realize the above objectives and matters.
  • 36. SHRIVASTAV COMMITTEE  Creation of Banks of paraprofessional and semi professional health workers formed within the community itself. Ex. School Teacher, Post Master, Gram-sevak to provide simple promotive, preventive and curative health services needed by the community.  Establishment of two cadres of health workers namely MPHW and Health Assistant between the community level workers and Doctors at the PHC. RECOMMENDATIONS
  • 37. SHRIVASTAV COMMITTEE  Development of referral services complex by establishing from proper linkage between the PHC and higher level referral and service centre.  Establish Medical and Health Education Commission for planning and implementing the reforms needed in health and medical education.  Establishment of on the lines of university grand commission.  Work load of MPHW increase and area of population increased by 5,000 population. Work load of male and female health assistant’s decrease. RECOMMENDATIONS
  • 38. Rural health scheme 1997  Under this scheme Shrivastav Committee provided health care through trained workers in the community health centre was initiated during 1977 to 1978. Steps were also initiated  For involvement of medical colleges in the total health care of selected PHC’s which the objectives of reorienting medical education to the needs of rural people.
  • 39. Rural health scheme 1997  Reorientation training of MPW in the control of various communicable disease programme into unipurpose workers accepted by the central council of health and central family planning council in 1976.
  • 40. Health for all by 2000AD- Report of working group, 1981  A working group on health was constituted by the planning Commission in 1980 with the secretary, Ministry of health and Family Welfare, as its chairman, to identify in programme terms, the goal for Health for All by 2000 AD and to outline specific programmes for the sixth Five Year plan.
  • 41. Health for all by 2000AD- Report of working group, 1981  Setting out the broad approach to health planning during the Sixth Five year plan, had also evolved specific indices and targets to be achieved by the country by 2000 AD.
  • 42. HEALTH SECTOR PLANNING  Water supply and sanitation  Control of communicable diseases  Medical education, training and research  Medical care including hospitals, dispensaries and primary health centers  Public health services  Family planning; and
  • 43.
  • 44. Constraints in Health Planning process 1 Low priority to health given by political leaders and decision makers; 2 Low budget allocation to health; 3 Lack of adequate health information system for planning, monitoring and evaluation 4 Natural resistance to change; 5 Frequent change of government, political and administrative staff and planners
  • 45. Constraints in Health Planning process 6. Untrained personnel in Planning; 7. Traditional planning methods and not need-based, cost-effective, team -based and rational planning; 8. "Long Time" lag between planning and implementation 9. Rigidity of budgeting, strategy, and administrative procedures; and 10. Inadequate coordination of planning.
  • 46. FIVE Year plans OBJECTIVES  Control or eradication of major communicable diseases;  Strengthening of the basic health services through the establishment of primary health centers and sub- centre;  Population control; and  Development of manpower resources.
  • 47. 10TH FIVE YEAR PLAN (2002-2007) Approach  To improve and enhance the quality of primary health care in urban and rural areas.  To improve efficiency of existing health care infrastructure by strengthening and improving referral linkage.
  • 48. 10TH FIVE YEAR PLAN (2002-2007) Targets  Reduction of poverty ratio by 5% points by 2007, and by 50% point by 2012.  All children in school by 2003; all children should complete 5 years of schooling by 2007.  Reduction in gender gap in literacy and wage rate by at least 50% by 2007.  Reduction in decadal rate of population growth between 2001 to 2011 to 16.2%.
  • 49. 10TH FIVE YEAR PLAN (2002-2007) Targets  Increased in literacy rate to 75% within the plan period.  Reduction in infant mortality rate to 45 per 1000 live births by 2007 and 28 by 2012.  Reduction of maternal mortality ratio to 2 per 1000 live births by 2007 and 1 by 2012.  All villages to have sustained assess to potable drinking water within the plan period.
  • 50. Achievements during the past 55 years of plan 1st Plan 1951-56 10th Plan 2002-2007 1 Primary Health Centres 725 23,236 (Sep. 2005) 2 Subcentres NA 146,026 3 Community health centres - 3,346 4 Total beds (2002) 125,000 914,543 5 Medical Colleges 42 242 6 Annual admissions in medical colleges 3,500 26,449 7 Dental colleges 7 205 8 Allopathic doctors 65,000 267,500 9 Nurses 18,500 865,135 10 ANMs 12,780 506,925
  • 51. Achievements during the past 55 years of plan 1st Plan 1951-56 10th Plan 2002-2007 11 Health visitors 578 50,393 12 Health Workers (F) (in position) - 133,194 13 Health Workers (M) (in position) - 61,907 14 Block Extension Educator - 2,645 15 Health Assistant (M) (in position) - 20,181 16 Health Assistant (F)/LHV (in position) - 17,371 17 Village Health Guides (2002) - 3.23.lakh
  • 52.
  • 53. NATIONAL HEALTH POLICY 2002  The Ministry of Health and Family Welfare, Govt. of India, evolved a National Health Policy in 1983 keeping in view the national commitment to attain the goal of Health for All by the year 2000.
  • 54. NATIONAL HEALTH POLICY- 2002  OBJECTIVE To achieve an acceptable standard of good health amongst the general population of the country.
  • 55. NATIONAL HEALTH POLICY 2002 Approach - To increase access to decentralized public health system by establishing new infrastructure in the existing institutions. - Equitable access to health services across the social and geographical expanse of the country and - Primacy will be given to preventive and first line curative initiatives at the primary health level
  • 56. NATIONAL HEALTH POLICY 2002 OBJECTIVES  To achieve an acceptable standard of good health amongst the general population of the country;  To increase access to the decentralized public health system by establishing new infrastructure in deficient areas, and by upgrading the infrastructure in the existing institutions;
  • 57. NATIONAL HEALTH POLICY 2002 Objectives  To increase the aggregate public health investment through a substantially increased contribution by the Central Government;  To strengthen the capacity of the public health administration at the State level to render effective service delivery;  To ensuring a more equitable access to health services across the social and geographical expanse of the country
  • 58. NATIONAL HEALTH POLICY 2002 Objectives  To enhance the contribution of the private sector in providing health services for the population group which can afford to pay for services;  To rationalize use of drugs within the allopathic system; and  To increase access to tried and tested systems of traditional medicine.
  • 59. INDICATOR 1951 1981 2004 Demographic Changes Life Expectancy 36.7 54 66.90 (2001) Crude Birth Rate (per 1000 population) 40.8 33.9 (SRS) 24.1 Crude Death Rate (per 1000 population) 25 12.5 (SRS) 7.5 IMR (per 1000 live births) 146 1I0 58 Couple Protection Rate (%) - 10.4 29 (2000) Total Fertility Rate 6.0 - 3 (2003) Achievements of India from the Years -1951-2000
  • 60. Indicator 1951 1981 2001 Epidemiological Shifts Malaria (cases in Million) 75 2.7 2.0 (2001) Leprosy (per 10,000) 38.1 57.3 3.7 (2001) Small Pox (No. of Cases) >44887 Eradicated - Guinea Worm NA >39792 Eradicated Polio - 29709 265 Infrastructure Sub-Centers 725 57363 137311 (2001) Dispensaries & Hospitals 9209 23555 43322 (CBHI-96) Beds (Private & Public) 117198 569495 870161 (CBHI-96) Achievements of India from the Years -1951-2000
  • 61. Differences in Health Status in India Sector BPL(%) IMR 1999(SRS) <5MR (NFHS- II) % of Children underweight MMR (per lack) India 26.1 70 94.9 47 408 Rural 27.09 75 103.7 49.6 - Urban 23.62 44 s63.1 38.4 -
  • 62. Differences in Health Status among States Sector BPL( %) IMR 1999(SR S) <5MR (NFHS- II) % of Children underweight MMR per lack Better Performing States Kerala 12.72 14 18.8 27 87 Maharashtra 25.02 48 58.1 50 135 Tamil Nadu 21.12 52 633 37 79 Low Performing State Orrissa 47.15 97 104.4 54 498 Bihar 42.6 63 105.1 54 707 Rajasthan 15.28 81 114.9 51 607 UP 31.15 84 122.5 52 707 MP 37.43 90 137.6 55 498
  • 63. Goals to be achieved by 2000-2015  Year 2003 • Enhancement of legislation for regulating minimum standard in Clinical Establishment Medical Institutions  Year 2005 • Eradicate Poliomyelitis and Yaws • Eliminate Leprosy • Establish an integrated system of surveillance, National Health Accounts and Health Statistics • Increase State Sector Health spending from 5.5% to 7% of the budget. • 1% of the total health budget for Medical Research • Decentralization of implementation of public health Programs
  • 64. Goals to be achieved by 2000-2015 Year 2007 • Achieve Zero level growth of HIV / AIDS. Year 2010 • Eliminate Kala Azar . • Reduce Mortality by 50% on account of TB, Malaria and Other Vector & Water Borne diseases • Reduce Prevalence of Blindness to 0.5%. • Reduce IMR to 30/1000 And MMR to 100/Lakh • Increase utilization of public health facilities from current level of <20 to >75%
  • 65. Goals to be achieved by 2000-2015 Year 2010 • Increase health expenditure by Government from the existing 0.9 % to 2.0% of GDP • 2% of the total health budget for Medical Research • Increase share of Central grants to constitute at least 25% of total health spending • Further increase of State Sector health spending to 8% Year 2015
  • 66. National Health Policy Prescriptions  Financial Resources  Equity  Delivery of National Public Health Programs  The State of Public health Infrastructure  Extending Public Health Services  Role of Local Self-Government Institutions  Norms for Health Care Professional
  • 67. National Health Policy Prescriptions  Health Research  Education of Health Care Professionals  Need for Specialists in "Public Health" & "Family Medicine”  Nursing Personnel  Urban Health  Information, Education and Communication
  • 68. National Health Policy Prescriptions  National Disease Surveillance Network  Health Statistics  Women's Health  Medical Ethics  Enforcement of Quality Standards for Food and Drugs  Regulation of Standards in Paramedical Disciplines  Providing Medical Facilities to Users from Overseas (Health Tourism)  Impact of Globalization on the Health Sector
  • 69. Recent Development  The Prime Minister has launched the Public Health Foundation of India (PHFI), to establish world-class public health institutes to train professionals in the field.
  • 70.
  • 71.
  • 72. NATIONAL POPULATION POLICY  In April 1976 India formed its first- “National Population Policy. It called for an increase in the legal minimum age of marriage from 15 to 18 for females, and from 18 to 21 for males.  Policy was modified in 1977. New policy statement reiterated the importance of the small family norm without compulsion and changed the programme title to “Family Welfare Programme”  National Health Policy 2000” is the latest in this series
  • 73. NATIONAL POPULATION POLICY 2000 OBJECTIVES  To bring the TFR to replacement levels by 2010. Long term objective  To achieve requirements of suitable economic growth, social development and environment protection.
  • 74. NATIONAL POPULATION POLICY 2000 1, Address the unmet needs for basic reproductive and child health services, supplies and infrastructure. 2. Make school education up to age 14 free and compulsory, and reduce drop-outs at primary and secondary school levels to below 20 percent for both boys and girls. 3. Reduce infant mortality rate below 30 per 1000 live births Socio-demographic Goals for 2010 are as follows
  • 75. NATIONAL POPULATION POLICY 2000 4. Reduce maternal mortality rate below 100 per lack live births 5. Achieve universal immunization of children against all vaccine preventable diseases 6.Promote delayed marriage for girls, not earlier than age 18 and preferably after 20 years of age. 7. Achieve 80% institutional deliveries and 100% deliveries by trained persons. Socio-demographic Goals for 2010 are as follows
  • 76. NATIONAL POPULATION POLICY 2000 8. Achieve universal access to information / counseling, and services for fertility regulation and contraception with a wide basket of choices. 9. Achieve 100 percent registration of births, deaths, marriage and pregnancy. 10. Contain the spread of AIDS, and promote greater integration between the management of reproductive tract infections (RTI) and sexually transmitted infections (STI) and the National AIDS Control Organization Socio-demographic Goals for 2010 are as follows
  • 77. NATIONAL POPULATION POLICY 2000 11. Prevent and control communicable diseases. 12. Integrate Indian Systems of Medicine (ISM) in the provision of reproductive and child health services, and in reaching out to households. 13. Promote vigorously the small family norm to achieve replacement levels of TFR. 14. Bring about convergence in implementation of related social sector programmes so that family welfare becomes Socio-demographic Goals for 2010 are as follows
  • 78.
  • 79. NATIONAL POPULATION POLICY 2000 It deals with-  women education;  empowering women for improved health and nutrition;  child survival and health;  the unmet needs for family welfare services;
  • 85. NATIONAL POPULATION POLICY 2000 It deals with-  health care for the under-served population groups like slums,  tribal community, hill area population and displaces and migrant population;  adolescent’s health and education;  increased participation of men in planned parenthood; and 
  • 88. Increased participation of men in planned parenthood
  • 92. Maharashtra State Health System  35 Districts  350 Talukas - approx.  60,000 Multi Purpose Worker [MPW] - Female Auxiliary Nurse Midwife [ANM]  60,000 Multi Purpose Worker [MPW] - Male  60,000 Health Assistant [HA] – Male Nurse Midwife / Lady Health Visitor  5,000 Doctors  55,000 Anganwadi Worker [AWW] 1 Anganwadi worker serves about 250 families or 1,000 people
  • 93. STATE POPULATION POLICY (Maharashtra) Declared on 8th March 2000 on the day of the International women Day. The policy has following features -  Two child family norm  Prevention of child marriage.  Prevention of misuse of Pre-natal Sex Determination Act  Implementation of Births, Deaths and Marriages registration act  Empowerment of Gram Panchayats  Recognition to Health Institutions doing quality work  Steering Committee under Chairmanship of Hon'ble Chief Minister to monitor the Population Policy.
  • 94. AIDS Awareness  Rallies and Public gatherings were organized involving the Miss World /Miss Universe for addressing the Youth about "knowing AIDS and Prevention"  Skating from Mumbai - Kolhapur, Pune - Kolhapur were organized to draw attention of people for AIDS control measures
  • 95. Health Programmes in Maharashtra state  Malaria case incidence has come down from 1,58,239 cases to 76,234 cases in 2001 compared to the previous year. Similarly, Filaria cases have come down from 42,748 cases to 24,947 cases  Record Cataract operations of 3,81,929 in1999-2000 and 4,59,721 in 2000-2001 were performed.  The prevalence of 14.7/10,000 of Leprosy cases in 1991-92 has come down to 3.1 / 10,000.81
  • 96. Health Programmes in Maharashtra state  The Mental Health Problems are being given priority and 10 bedded wards are being opened at every District Hospital  Heart Surgeries had been the domain of only urban areas and being costly were beyond the reach of the poor. The issue has been seriously taken up and facilities are being extended to the District Hospitals through "Jeevandai Yogana".
  • 97. Integrated Population & Development Project (I.P.D)  Goals  To enable individuals and couples to achieve their personal reproductive intentions and to ensure survival and development of their children through delivery of quality reproductive and child health services including family planning.  To improve the educational and social status of women in project areas. Project period- 1998-2002
  • 98. Integrated Population & Development Project (I.P.D)  Objectives:   To improve access to essential package of quality reproductive health services in project areas in identified groups.  To contribute to creating an enabling environment for gender equity and equality, women's empowerment and realisation of reproductive rights.  To strengthen the capacities related to reproductive and child health including family planning program, project management in project areas.
  • 99. Integrated Population & Development Project (I.P.D) Activities  Training and infrastructure improvements  Equipment supply  Mobility support  Group and Communication activities  Panchayat and NGO activities  Service Support  Project Management
  • 100. HEALTH PLAN OF MAHARASHTRA    An integrated approach to reduce childhood mortality and morbidity due to diarrhoea and dehydration; Maharashtra, India 2005 – 2010
  • 101. AYUSH  The Indian Systems of Medicine and Homoeo (ISM&H) were given an independent identity in the Ministry of Health and Family Welfare in 1995 by creating a separate Department, which was renamed as Department of Ayurveda, Yoga and Natu (AYUSH) in November 2003
  • 102. AYUSH  Ayurveda, Siddha Unani and Homoeopathy drugs are covered under the purview of Drugs and Cosmetics Act, 1940  A separate National Policy on Indian Systems of Medicine and Homoeopathy is in place since 2002.
  • 103. National Health Policy on AYUSH 1. To promote good health and expand the outreach of health care to our people, particularly those not provided with health cover, through preventive, promotive and curative interventions. 2. To improve the quality of teachers and clinicians by revising curricula to contemporary relevance by creating model institutions and Centres of Excellence and extending assistance for creating infrastructural facilities. 3. To ensure affordable ISM&H services and drugs which are safe and efficacious. 4. To facilitate availability of raw drugs which are authentic and contain essential components as required under pharmacopoeial standards to help improve quality of drugs, for domestic consumption and export. OBJECTIVES
  • 104. National Health Policy on AYUSH 5. To integrate ISM&H in the health care delivery system and National Programmes and ensure optimal use of the infrastructure of hospitals, dispensaries and physicians. 6. To re-orient and prioritize research in ISM&H to gradually validate therapy and drugs to address in particular the chronic and new life style related emerging diseases. 7.To create awareness about the strengths of these systems in India and abroad and sensitize other stakeholders and providers of health. 8.To provide full opportunity for the growth and development of these systems and utilization of their potential, strength and revival of their glory. OBJECTIVES
  • 105. National Health Policy on AYUSH 1. Legislative measures would be taken to check mushroom growth of substandard colleges. 2. Course curricula would be reinforced to raise the standards of medical training and to equip trainees for utilization in national health programs. 3.Priority would be accorded to research covering clinical trials, pharmacology, toxicology, standardization and study of pharmaco-kinetics in respect of already identified areas of strength. STRATEGIES
  • 106. National Health Policy on AYUSH 4. The Medicinal Plants Board would address all issues connected with conservation and sustainable use of medicinal plants leading to remunerative farming, regulation of medicinal farms and conservation of biodiversity. 5. Medicinal Plants Board would acquire statutory status to be able to regulate registration of farmers and cooperative societies, transportation, marketing of medicinal plants and proper procurement and supply of pharmaceutical industry. STRATEGIES
  • 107. National Health Policy on AYUSH 6. Protection of India’s traditional medicinal knowledge would be undertaken through a progressive creation of a Digital Library for each system and eventually for codified knowledge leading to innovation and good health outcomes. 7. Efforts would be made to integrate and mainstream ISM&H in health care delivery system and in National Programmes. 8. A range of options for utilization of ISM&H manpower in the healthcare delivery system would be developed by assigning specific goal oriented role and responsibility to the ISM&H work force. STRATEGIES
  • 108. National Health Policy on AYUSH 9. up AYUSH health facilities. 10. Central Government would assist allopathic hospitals to establish Panchkarma and Ksharshutra facilities for the treatment of neurological disorders, musculo-skeletal problems as well as ambulatory treatment of bronchial asthma and dermatological problems. 11. States would be encouraged to consolidate the ISM&H infrastructure and health services STRATEGIES
  • 109. National Health Policy on AYUSH 12. Pharmacopoeial work related to Ayurveda, Unani, Siddha and Homoeopathy Drugs would be expedited 13. Industry would be encouraged to make use of quality certification 14. Quality Control Centers would be set up on regional basis to standardize the in-process quality control of ISM products and to modernize traditional processes without changing the concepts of ISM. STRATEGIES
  • 110. National Health Policy on AYUSH 15. States would be advised and supported to augment facilities for drug manufacture and testing. 16. Operational use of ISM in Reproductive & Child Health (RCH) would be encouraged in eleven identified areas, where the Indian systems of medicine would be useful for antenatal, intra-natal, post-natal and neonatal care. 17. North Eastern States, rich in flora and fauna, would be supported to develop infrastructure and awareness STRATEGIES
  • 111. National Health Policy on AYUSH 18. Keeping in view the global interest in understanding ISM concepts and practices, modules will be formulated for introducing Ayurveda and Yoga to medical schools and institutions abroad and to expose medical graduates. 19. Awareness programmes on the utility and effectiveness of ISM&H would be launched through the electronic and print media. STRATEGIES
  • 112. REFERENCES  Basavanthappa B. T. Community Health Nursing Reprint 2001, Jaypee publication, Pp -585 – 669  Gupta M.C.& Mahajan B.K.’ Text Book of Preventive and Social Medicine; Jaypee Publication, Third Edition, Pp - 416 – 477, 454 – 460  Koshore; National Health Programmes of India, 6th Edition, Century Publication, Pp - 20 – 26, 362 – 377  Park K. Essential of Community Health Nursing, 4th Edition, Bhanot Publication, Pp -311 – 340  Park K. Text Book of Preventive and Social Medicine 19th Edition, Bhanot Publication Pp -346 – 378, 721 – 740 – 760  Mary Lucita, “Nursing Practice and Public Health Administration” published by ELSEVIER units 3 to 13.  Basawanthappa BT, Nursing administration, Jaypee brothers medical publishers (p) ltd 2004, edition 1st , Pp:43- 49, 258- 259
  • 113. REFERENCES  Bernhard LA, Walsh M: Leadership the key to the professionalization of nursing. 3rd edition. Missouri: Mosby publishers 1995, Pp:36- 47  Marquis L.Bessiel, Leadership roles and management functions in Nursing theory and application, Lippincott Williams and Wilkins publications 2000 , edition 3rd , Pp:67- 73  Marriner Ann, Guide to nursing management, Mosby publishers 1988, edition 4th Pp: 29-31, 273- 274, 287.  Swansburg. C. Russell, Swansburg J. Richard, Introduction to management and leadership for nurse managers, Jones and Barlett publishers 2002, edition 3rd , Pp:68- 70  Journal of Clinical Nursing 2000, 9(4) Pp:545-548  Journal of Advance Nursing 1999, 30(6), Pp:1375-82  www.biomedcentral. Com  www. planning.com