India releases National Health Policy, focus on primary care, district hospitals and non communicable diseases

The Indian government today released the national health policy with focus on primary care and wellness. The last

The Indian government today released the national health policy with focus on primary care and wellness. The last healthcare policy came out in 2002 and one can understand why health is often ignored in the national agenda of the country, with so many other issues taking precedence.

One of the key features of the national health policy released in 2017 is the focus on primary health and wellness.

 

With India spending less than 1.4 % of its GDP in health, it is no wonder than many of our public health parameters lag behind countries like Sri Lanka, Bangladesh and Nepal. Better ate than never looks like the government has addressed these and some others in their National Health Policy. Some of the key features based on my analysis of the policy are below

  • Focus on wellness and not sickness. Health Minister JP Nadda clearly spelt out the mandate for the policy to cover the non communicable diseases and focus on them, in addition to the continued focus on eradicating and managing the communicable diseases.
  • The policy acknowledges the role played by these non communicable diseases on the financial burden of the family. It is clearly observed that marriage of the girl child and health issues to family members are clearly the two main reasons for rural indebtedness. So hopefully this would really help the rural sector more in the coming years.

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  • The government clearly feels that the private healthcare sector needs to be watched and regulated. Earlier this year the government announced DPCO on devices like stents used in cardiac cases, something the industry feels might peg back the R & D and development of the sector in India.  In my opinion the private sector in healthcare is a soft target and focusing on them sometimes is a populist measure quiet evident from the actions of the West Bengal Chief Minister Mamata Bannerjee. Th greater ill in healthcare lies with the inefficiency and apathy with the government resources.
  • Emphasis on primary and secondary care to boost early detection, prevention and management of diseases.This would involve creating the infrastructure for screening defects, delays and deficiencies in children.
  • In the words of the minister what differentiates this policy from the previous ones is the disease elimination framework that this National Health Policy has established with timelines to achieve those goals. For example the policy has taken the target of elimination of Kala Azar and Filariasis by 2017. In my opinion this is a soft target, The National Vector Borne Disease Control Program had already sought to eliminate Filariasis by 2017 in an earlier announcement. Similarly for Kala Azar. At one time they were the scourge of the east and southern coasts. I have known many relatives affected by Filariasis in Madras, now Chennai in the 80’s. Today demons are Dengue and Chikungunya, I am not sure whats the plan to tackle them.
  • Elimination of TB by 2025 is an interesting target, Like we have written before TB is a social issue. No medical intervention can help unless the individual, gets good nutrition, coaching and employment to continue to sustain him or her self. If the government has taken this commitment I am sure they would have planned for social up-liftment and nutrition as part of the goal.

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  • Some other good targets are
    • Increasing the life expectancy from 67.5 today to 70 by 2025
    • Under 5 mortality reduction to 23 from 43.7 today by 2025
    • Infant mortality Rate down to 28 from 32.6 by 2019
  • There is a commitment to increase the number of beds per 1000 population to 2, from the current figure of .9. I am sure these are the ones at the district hospital level, which would see a big boost for the prevention and primary care in the rural India. Private sector hospital beds are expensive to put up and cost the hospital almost a crore according to Mr Vishal Bali at Medwell Ventures.
  • To implement all of these, there is going to be 66% increase in the spend on healthcare, mostly at the primary care level. There is going to be universal screening at the primary care level for Hypertension, Diabetes, Oral Cancer, Breast Cancer and Cervix Cancer. This would help the government also tackle Cardiac and chronic Kidney disease. Interestingly universal screening has started in 100 districts and this year it will be extended to 100 more districts.
  • Finally creation of a public health cadre across the country to facilitate this massive drive towards primary and preventive health. Now a similar scheme was launched by the Ghulam Nabi Azad ministry during the days of the UPA to train health workers to tackle key diseases.

To download the National Health Policy for 2017, please click the link here.

For a quick look on the health policy do look at this below

I will continue to look through the salient features of the policy, and cover it in subsequent posts in the website. As always comments and suggestions are welcome.

 

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