NATIONAL HEALTH POLICY

 THE GOVERNMENT OF INDIA ADOPTED A

NATIONAL HEALTH POLICY IN AUGUST 1983.

 THE POLICY IS A 17 PAGE DOCUMENT

CONSISTING OF 20 PARAS AND AN APPENDIX
SETTING THE GOALS FOR HEALTH AND
FAMILY WELFARE PROGRAMME.
NHP 1983
 INDIA IS ONE OF THE COUNTRIES WHICH HAS
SIGNED THE ALMA ATA DECLARATION. IT IS
THEREFORE, COMMITED TO THE GOAL OF
HEALTH FOR ALL BY THE YEAR 2000.

 IN ORDER TO REACH THE GOAL THE

GOVERNMENT OF INDIA HAS EVOLVED A
NATIONAL HEALTH POLICY IN 1983.
ELEMENTS
 CREATION OF AWARENESS IN THE COMMUNITY
ABOUT THE HEALTH PROBLEMS.
 SUPPLY OF SAFE DRINKING WATER AND
SANITATION WITH AFFORDABLE TECHNOLOGY.
 REDUCTION IN THE RURAL/URBAN IMBALANCE OF
HEALTH SERVICES.
 PROMOTION OF RESEARCH FOR THE
ALTERNATE/LOW COST HEALTH INTERVENTIONS.
 IMPROVEMENT IN CO-ORDINATION OF THE
DIFFERENT SYSTEMS OF MEDICINE.
STRATEGIES FOR IMPLEMENTATION OF HEALTH
POLICY
 RECONSTRUCTING OF HEALTH
INFRASTRUCTURE ; THIS HOPEFULLY WILL
REMOVE THE EXISTING IMBALANCE.

 DEVELOPMENT OF HEALTH MANPOWER; SUCH

AS HEALTH WORKERS, TRAINED
DAIS,ANGANWADI WORKERS,VILLAGE HEALTH
GUIDES ETC.
 IT ALSO INCLUDES PERIODIC TRAINING OF THE
EXISTING MANPOWER.

 RESEARCH AND DEVELOPMENT ; STRESS TO BE

GIVEN ON EVOLVING THE LOW COST HEALTH
INTERVENTIONS AND RESEARCH ON
ALTERNATIVE APPROACH FOR HEALTH
PROBLEMS.
OPERATIONAL TARGETS
 ESTABLISHMENT OF ONE SUBCENTRE FOR EVERY
5000 POPULATION IN RURAL AND 3000
POPULATION IN HILLY/TRIBAL AREAS.

 ESTABLISHMENT OF ONE PHC FOR EVERY 30,000

POPULATION IN RURAL AREA AND FOR 20,000
POPULATION IN HILLY/TRIBAL AREA.

 ONE COMMUNITY HEALTH CENTRE PER LAKH

POPULATION.
 ONE VILLAGE HEALTH GUIDE FOR 1000
POPULATION AND ONE TRAINED BIRTH
ATTENDANT IN EACH VILLAGE.

 TRAINING OF VARIOUS CATEGORIES OF

PARAMEDICAL PERSONNEL.
POLICY PRESCRIPTION OF NHP 1983
• MEDICAL AND HEALTH EDUCATION :
 SETS OUT THE CHANGES REQUIRED TO BE
BROUGHT ABOUT IN THE CURRICULAR
CONTENTS AND TRAINING PROGRAMME OF
MEDICAL AND HEALTH PERSONNEL,AT VARIOUS
LEVELS OF FUCTIONING.

 TAKES INTO ACCOUNT THE NEED FOR

ESTABLISHING THE EXTREMELY ESSENTIAL
INTERRELATIONS BETWEEN FUCTIONARIES OF
VARIOUS GRADES.
 SEEKS TO RESOLVE THE EXISTING SHARP
REGIONAL IMBALANCES IN THEIR AVAILABILITY.

 ENSURES THAT PERSONNEL AT ALL LEVELS ARE

SOCIALLY MOTIVATED TOWARDS THE
RENDERING OF COMMUNITY HEALTH SERVICES.
 PRIMARY HEALTH CARE WITH SPECIAL
EMPHASIS ON THE PREVENTIVE, PROMOTIVE
AND REHABILITATIVE ASPECTS :
 A WELL DISPERSED NETWORK OF COMPREHENSIVE
PRIMARY HEALTH CARE SERVICES WITH ORGANIZED
SUPPORT OF VOLUNTEERS,AUXILIARIES,PARA-MEDICS
AND ADEQUATELY TRAINED MULTIPURPOSE
WORKERS.

 THE QUALITY OF TRAINING OF HEALTH GUIDES/

WORKERS.
 ESTABLISHMENT OF A WELL WORKED OUT REFERRAL
SYSTEM TO PROVIDE ADEQUATE EXPERTISE NEAREST
TO THE COMMUNITY.

 THE LOCATION OF CURATIVE CENTRES SHOULD BE

RELATED TO DENSITIES OF POPULATION , DISTANCES,
TOPOGRAPHY AND TRANSPORT CONNECTIONS.

 INCREASED INVESTMENT BY NON-GOVERNMENTAL

AGENCIES IN ESTABLISHING CURATIVE CENTRES AND
BY OFFERING LOGISTICAL,FINANCIAL AND
TECHNICAL SUPPORT TO VOLUNTARY AGENCIES IN
THE HEALTH FIELD.
 REORIENTATION OF THE EXISTING HEALTH
PERSONNEL:

 A DYNAMIC PROCESS OF CHANGE AND

INNOVATION IS REQUIRED TO BE BROUGHT
ABOUT IN THE ENTIRE APPROACH TO HEALTH
MANPOWER DEVELOPMENT, ENSURING THE
EMERGENCE OF FULLY INTEGRATED BANDS OF
WORKERS FUCTIONING WITHIN THE “HEALTH
TEAM” APPROACH.
 PRIVATE PRACTICE BY GOVRNMENTAL
FUCTIONARIES:
 IT IS DESIRABLE FOR THE STATES TO TAKE STEPS TO
PHASE OUT THE SYSTEM OF THE PRIVATE PRACTICE
BY MEDICAL PERSONNEL IN GOVERNMENT SERVICE,
PROVIDING AT THE SAME TIME FOR PAYMENT OF
APPROPRIATE COMPENSATORY NON PRACTICING
ALLOWANCES.
 PRACTITIONERS OF INDIGENOUS AND OTHER
SYSTEMS OF MEDICINE AND THEIR ROLE IN
HEALTH CARE:
 IT IS NECESSARY TO INITIATE ORGANIZED MEASURES
TO ENABLE EACH OF THE VARIOUS SYSTEMS OF
MEDICINE AND HEALTH CARE TO DEVELOP IN
ACCORDANCE WITH ITS GENIUS.
 PROBLEMS REQUIRING URGENT ATTENTION:
 NUTRITION
 PREVENTION OF FOOD ADULTRATION AND
MAINTENANCE OF QUALITY OF DRUGS
 WATER SUPPLY AND SANITATION
 ENVIRONMENTAL PROTECTION
 IMMUNIZATION PROGRAMME
 MATERNAL AND CHILD HEALTH SERVICES
 SCHOOL HEALTH PROGRAMMES
 OCCUPATIONAL HEALTH SERVICES
 HEALTH EDUCATION:
 THE PUBLIC HEALTH EDUCATION PROGRAMMES
SHOULD BE SUPPLEMENTED BY HEALTH, NUTRITION
AND POPULATION EDUCATION PROGRAMMES IN ALL
EDUCATIONAL INSTITUTIONS AT VARIOUS LEVELS.

 MANAGEMENT INFORMATION SYSTEM:

 APPROPRIATE DECISION MAKING AND PROGRAMME
PLANNING IN THE HEALTH AND RELATED FIELDS IS
NOT POSSIBLE WITHOUT ESTABLISHING AN
EFFECTIVE HEALTH INFORMATION SYSTEM.
 MEDICAL INDUSTRY:
 EFFORTS SHOULD BE MADE TO ICREASE THE
PRODUCTION OF ESSENTIAL AND LIFE SAVING DRUGS
AND VACCINES.

 THE PRODUCTION OF THE ESSENTIAL, LIFE SAVING

DRUGS UNDER THEIR GENERIC NAMES AND THE
ADOPTION OF ECONOMICAL PACKAGING PRACTICES.
 HEALTH INSURANCE:
 IT WOULD BE NECESSARY TO DEVICSE WELL-
CONSIDERED HEALTH INSURANCE SCHEMES, ON A
STATEWISE BASIS FOR MOBILISING ADDITIONAL
RESOURCES FOR HEALTH PROMOTION AND ENSURING
THAT THE COMMUNITY SHARES THE COST OF THE
SERVICES , IN KEEPING WITH ITS PAYING CAPACITY.

 HEALTH LEGISLATION:
 IT IS NECESSARY TO URGENTLY REVIEW ALL EXISTING
LEGISLATION AND WORK TOWARDS A UNIFIED,
COMPREHENSIVE LEGISLATION IN THE HEALTH FIELD,
ENFORCEABLE ALL OVER THE COUNTRY.
 MEDICAL RESEARCH:
 CONTAINMENT AND ERADICATION OF THE
EXISTING , WIDELY PREVELANT DISEASES.
 TRANSLATION OF AVAILABLE KNOWN HOW INTO
SIMPLE,LOW COST, APPROPRIATE TECHNOLOGIES.
 CONTRACEPTIVE RESEARCH
 NUTRITION RESEARCH
 INTERSECTORAL COOPERATION:
 IT IS NECESSARY TO SECURE INTERSECTORAL
COORDINATION OF THE VARIOUS EFFORTS IN THE
FIELDS OF
 HEALTH AND FAMILY PLANNING
 MEDICAL EDUCATION AND RESEARCH
 DRUGS AND PHARMACEUTICALS
 AGRICULTURE,FOOD
 WATER SUPPLY, DRAINAGE, HOUSING
 EDUCATION, SOCIAL WELFARE
 RURAL DEVELOPMENT
 MONITORING AND REVIEW OF PROGRESS:
 IT WOULD BE OF CRUCIAL IMPORTANCE TO
MONITOR AND PERIODICALLY REVIEW THE
SUCCESS OF THE EFFORTS MADE AND RESULTS
ACHIEVED.
 LIMITATIONS OF NATIONAL HEALTH
POLICY 1983
 NO DEFINITE PROGRAMME HAS BEEN SUGGESTED FOR
PROMOTING COMMUNITY PARTICIPATION IN HEALTH.

 THE POLICY IS TOTALLY SILENT ABOUT HEALTH BUDGET.

 IT DOES NOT GIVE ADEQUATE EMPHASIS TO CERTAIN

AREAS SUCH AS ACCIDENT PREVENTION, GERIATRIC CARE
AND PREVENTION OF NON-COMMUNICABLE DISEASES ;
EXAMPLE: OBESITY, CORONARY HEART DISEASE AND
DISEASES RELATED TO USE OF TOBACCO, ALCOHOL, ETC.
 OBJECTIVES
 TO ACHIEVE AN ACCEPTABLE STANDARD OF GOOD
HEALTH AMONGEST THE GENERAL POPULATION OF
THE COUNTRY.

 PRIORITY TO PREVENTIVE AND FIRST LINE

CURATIVE INITIATIVE AT PRIMARY LEVEL.

 FOCUS ON DISEASES THAT ARE CAUSING BURDEN

SUCH AS TB, MALARIA, BLINDNESS, HIV/AIDS.

 EMPHASIS ON RATIONAL USE OF DRUGS.

 TARGETS
 YEAR 2005:
1. ERADICATION OF POLIO
2. ERADICATION OF YAWS
3. INCREASE HEALTH SECTOR HEALTH SPENDING
TO FROM 5% TO 7%

 YEAR 2007:
1. ACHIEVE ZERO LEVEL GROWTH OF HIV/AIDS
 YEAR 2010:
1. ELIMINATE KALA-AZAR
2. REDUCTION IN MORTALITY DUE TO MALARIA,
OTHER VECTOR BORNE DISEASES AND TB BY 50%.
3. REDUCE PREVALENCE OF BLINDNESS TO 0.5%
4. INCREASE UTILIZATION OF HEALTH FACILITIES
TO 75%
5. INCREASE CENTRAL GRANT TO CONSTITUTE
ATLEAST 25% OF TOTAL HEALTH SPENDING

• YEAR 2015:
ELIMINATE LYMPHATIC FILARIASIS
 POLICY PRESCRIPTION NHP 2002
 FINANCIAL RESOURCES:
 INCREASE THE HEALTH SECTOR EXPENDITURE
TO 6% OF GDP, WITH 2% OF GDP BEING
CONTRIBUTED AS PUBLIC HEALTH INVESTMENT,
BY THE YEAR 2010.

 THE STATE GOVT. WOULD ALSO NEED TO

INCREASE THE COMMITMENT TO THE HEALTH
SECTOR.
• DELIVERY OF NATIONAL PUBLIC HEALTH
PROGRAMMES:
1. NHP-2002 ENVISAGES THE GRADUAL CONVERGENCE
OF ALL HEALTH PROGRAMMES UNDER A SINGLE
FIELD ADMINISTRATION.

2. PROGRAMME IMPLEMENTATION BE EFFECTED

THROUGH AUTONOMOUS BODIES AT STATE AND
DISTRICT LEVELS.

3. THE POLICY ALSO HIGHLIGHTS THE NEED FOR

DEVELOPING THE CAPACITY WITHIN THE STATE
PUBLIC HEALTHY ADMINISTRATION FOR SCIENTIFIC
DESIGNING OF PUBLIC HEALTH PROJECTS, SUITED TO
THE LOCAL SITUATION.
 THE STATE OF PUBLIC HEALTH INFRASTRUCTURE:
THE POLICY ENVISAGES KICK STARTING THE REVIVAL OF
THE PRIMARY HEALTH SYSTEM BY PROVIDING SOME
ESSENTIAL DRUGS UNDER CENTRAL GOVT. FUNDING
THROUGH THE DECENTRALIZED HEALTH SYSTEM.

 EXTENDING PUBLIC HEALTH SERVICES:

1. IT RECOGNIZE THE NEED FOR STATES TO SIMPLIFY THE
RECRUITMENT PROCEDURES AND RULES FOR
CONTRACT EMPLOYMENT IN ORDER TO PROVIDE
TRAINED MEDICAL MANPOWER IN UNDER DERVED
AREAS.
2. STATE GOVT. COULD ALSO RIGOROUSLY ENFORCE A
MENDATORY 2 YEAR RURAL POSTING BEFORE THE
AWRDING OF THE GRADUATE DEGREE.
 ROLE FOR LOCAL SELF-GOVERNMENT INSTITUTION:
1. NHP 2002 LAYS GREAT EMPHASIS UPON THE
IMPLEMENTATION OF PUBLIC HEALTH
PROGRAMMES THROUGH LOCAL SELF GOVT.
INSTITUTIONS.

2. THE POLICY URGES ALL STATE GOVT. TO CONSIDER

DECENTRALIZING THE IMPLEMENTATION OF THE
PROGRAMMES TO SUCH INSTITUTION BY 2005
 EDUCATION OF HEALTH CARE PROFESSIONALS:
1. SETTING UP OF MEDICAL GRANTS COMMISSION
FOR FUNDING NEW GOVT. MEDICAL AND
DENTAL COLLEGES IN DIFFERENT PARTS OF THE
COUNTRY.

2. A NEED BASED SKILL ORIENTED SYLLABUS WITH

A MORE SIGNIFICANT COMPONENT OF
PRACTICAL TRAINING, WOULD MAKE FRESH
DOCTORS USEFUL IMMEDIATELY AFTER
GRADUATION.
 NURSING PERSONNEL:
1. THE POLICY EMPHASIS THE NEED FOR AN
IMPROVEMENT IN THE RATIO OF NURSES VIS-À-
VIS DOCTORS/BEDS.
2. THE PUBLIC HEALTH DELIVERY CENTRES NEED
TO INCREASE THE NUMBER OF NURSING
PERSONNEL.
3. ESTABLISH TRAINING COURSES FOR SUPER
SPECIALITY NURSES REQUIRED FOR TERTIARY
CARE INSTITUTIONS.
 USE OF GENERIC DRUGS AND VACCINES:
THE NATIONAL PROGRAMME FOR UNIVERSAL
IMMUNIZATION ASSURE OF AN UNINTERRUPTED SUPPLY OF
VACCINES AT AN AFFORDABLE PRICE.

 URBAN HEALTH:
1. SETTING UP OF AN ORGANIZED URBAN PRIMARY
HEALTH CARE STRUCTURE.
2. ADOPTION OF APPROPRIATE POPULATION NORMS FOR
THE URBAN PUBLIC HEALTH INFRASTRUCTURE.
3. THE FUNDING FOR THE URBAN PRIMARY HEALTH
SYSTEM WILL BE JOINTLY BORNE BY THE LOCAL SELF
GOVT. INSTITUTIONS AND STATE AND CENTRAL GOVT.
 MENTAL HEALTH:
 A NETWORK OF DECENTRALIZED MENTAL HEALTH
SERVICES FOR AMELIORATING THE MORE COMMON
CATEGORIES OF DISORDERS.

 INFORMATION EDUCATION AND

COMMUNICATION :
 NHP 2002 GIVE PRIORITY TO SCHOOL HEALTH
PROGRAMMES WHICH AIM AT PREVENTIVE HEALTH
EDUCATION ,PROVIDING REGULAR HEALTH CHECK UPS
AND PROOTION OF HEALTH SEEKING BEHAVIOUR
AMONG CHILDREN.
 HEALTH RESEARCH:
 DOMESTIC MEDICAL RESEARCH WOULD BE FOCUSED
ON NEW THERAPEUTIC DRUGS AND VACCINES FOR
TROPICAL DISEASES, SUCH AS TB AND MALARIA, AS
ALSO ON THE SUB TYPES OF HIV/AIDS PREVALENT IN
THE COUNTRY.

 ROLE OF THE PRIVATE SECTOR:

 POLICY WELCOMES THE PARTICIPATION OF THE
PRIVATE SECTOR IN ALL AREAS OF HEALTH
ACTIVITIES –PRIMARY , SECONDARY OR TERTIARY.
 ROLE OF CIVIL SOCIETY:
 NHP-2002 RECOGNIZES THE SIGNIFICANT CONTRIBUTION
MADE BY NGO’SAND OTHER INSTITUTIONS OF THE CIVIL
SOCIETY IN MAKING AVAILABLE HEALTH SERVICES TO
THE COMMUNITY.

 HEALTH STATISTICS:
 THE POLICY ENVISAGES THE COMPLETION OF BASELINE
ESTIMATES FOR THE INCIDENCE OF THE COMMON
DISEASES-TB,MALARIA,BLINDNESS BY 2005.
 MEDICAL ETHICS:
 A CONTEMPORARY CODE OF ETHICS BE NOTIFIED AND
RIGOROUSLY IMPLEMENTED BY THE MEDICAL COUNCIL
OF INDIA.

 OTHERS:
 ENFORCEMENT OF QUALITY STANDARDS FOR FOOD
AND DRUGS
 REGULATION OF STANDARDS IN PARAMEDICAL
DISCIPLINES
 ENVIRONMENTAL AND OCCUPATIONAL HEALTH
 IMPACT OF GLOBALIZATION ON THE HEALTH SECTOR
 BIBLIOGRAPHY
 BASAVANTHAPPA B.T. “COMMUNITY HEALTH NURSING”
2ND EDITION 2008, PARAS OFFSET PVT. LTD. , NEW DELHI,
JAYPEE, Pp 889-94
 KISHORE J’S “NATIONAL HEALTH PROGRAMMES OF
INDIA- NATIONAL POLICIES AND LEGISLATIONS
RELATED TO HEALTH” 7TH EDITION , 2007, NEW DELHI,
CENTURY PUBLICATION , Pp 50-53
 PARK K. “TEXTBOOK OF PREVENTIV AND SOCIAL
MEDICINE” 19TH EDITION 2007 , PREMNAGAR, JABALPUR,
M/S BANARSIDAS BHANNOT, Pp728-29
 PIYUSH GUPT,GHAI O.P.’S “TEXTBOOK OF PREVENTIVE
AND SOCIAL MEDICINE” 2ND EDITION 2007, NEW DELHI,
CBS PUBLISHERS & DISTRIBUTERS, Pp 743_42