NATIONAL HEALTH POLICY 2017

PRESENTED BY: DR. RIA GANGULY

GUIDED BY: DR. SRIKANTA KANUNGO
LEARNING OBJECTIVES:
• Introduction of NHP (1983 and 2002)
• Need of NHP 2017
• Goals, working principles and objectives of NHP2017
• Targets of NHP 2017
• NHP 2017 policy ideas
• Conclusion
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INTRODUCTION:

• Health policy refers to decisions, plans, and actions that are

undertaken to achieve specific health care goals within a
society.

• It defines a vision for the future which in turn helps to

establish targets.

• It outlines priorities and the expected roles of different groups,

builds consensus and informs people.
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INTRODUCTION contd…
• The joint WHO – UNICEF international conference in1978 at Alma
Ata (USSR) declared that: “The existing gross inequalities in the
status of health of people particularly between developed and
developing countries as well as within the country is politically,
socially and economically unacceptable.”

• So, the Alma Ata Declaration called on all the governments to

formulate National Health Policies according to their own
circumstance, to launch and sustain primary health care as a part of
national health system.
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INTRODUCTION contd…

HISTORY

• First national health policy

1983

• Revised in 2002 (by Ministry of Health and Family

2002 Welfare, Govt. of India)

• National Health Policy 2017 launched

• Aim: To inform, clarify, strengthen and prioritize the role
2017 of the Government in shaping health system in all its
dimensions.
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NEED OF A NEW HEALTH POLICY:

• Health priorities are changing, there is growing burden on account of

non-communicable diseases and some infectious diseases.
• Growing incidences of out of pocket expenditure due to health care
costs, which contributes to poverty.
• The emergence of a robust health care industry estimated to be
growing rapidly.
Therefore, a new health policy responsive to these contextual changes
is required.
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GOAL:

• Improve health status through policy action in all sectors

and expand preventive, promotive, curative, palliative
and rehabilitative services provided through the public
health sector with focus on quality.

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 Professionalism
& Ethics
Dynamism Equity

Decentralis
ation Affordability

PRINCIPLES: PRINCIPLES

Pluralism
Universality

Inclusive Patient
Partnership
Accountability Centered
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OBJECTIVES:

Specific Quantitative
Align the Goals and
Progressively Reinforcing growth of Objectives
achieve trust in Public private • Health system
performance
Universal Health Care health care • Health system
Health System sector with strengthening
• Health status and
Coverage public health programme impact
goals

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HEALTH STATUS AND PROGRAMME IMPACT:

Increase life expectancy at birth from 67.5 to 70 by 2025

Reduction of TFR to 2.1 at national and sub national level by 2025

Reduce infant mortality rate to 28 by 2019

Reduce Neonatal mortality rate to 16 and still birth rate to single digit by 2025

Reduce maternal mortality rate from current levels to 100 by 2020

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Contd…

Achieve Global Target of 90:90:90 for HIV/AIDS by 2020

Achieve and maintain cure rate of >85% for TB and to reach

Elimination by 2025
Reduce premature mortality from cardiovascular disease, cancer, diabetes or
respiratory diseases by 25% by 2025
Reduce the prevalence of blindness to 0.25/1000 by 2025 and disease burden by
1/3rd from current level
80% of known hypertensive and diabetics should be maintained at a controlled
disease status by 2025
Achieve and maintain elimination status of leprosy by 2018, Kala azar by 2017 and
lymphatic filariasis in endemic pockets by 2017

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HEALTH SYSTEM PERFORMANCE:

Increase utilisation of public health facility by 50% from the current level by 2025

Reduction in prevalence of current tobacco use by 30% by 2025

>90% of the newborns should be fully immunized by 1 year of age by 2025

ANC coverage to be sustained above 90% and skilled attendance at birth above 90% by
2025

Reduction in prevalence of stunting of under 5 by 40% by 2025

Access to safe water and sanitation to all by 2020

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HEALTH SYSTEM STRENGTHENING:

Ensure availability of paramedics and doctors as per IPHS

norms by 2020

Establish primary and secondary care facility as per norms in

high priority districts by 2025

Ensure district level electronic of information on health

system component by 2020

Increase health expenditure by Government as a percentage of

GDP from the existing 1.15% to 2.5 % by 2025

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PRIMARY CARE SERVICES

• The policy advocates enhanced outreach of public healthcare through Mobile

Medical Units (MMUs), etc
• The facilities which start providing the larger package of comprehensive
primary health care will be called “Health and Wellness Centers”.
• To make this a reality, every family would have a health card that links them
to primary care facility and be eligible for a defined package of services
anywhere in the country.

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• SECONDARY CARE aims to provide services at district health care centers
which were first being provided in medical college hospital such as caesarian
section, neonatal care etc.
• It aims to have at least two beds per thousand population to be accessible
within golden hour rule (efficient emergency transport system).
• This policy affirms in expanding the network of blood banks across the
country to ensure improved access to safe blood.

• TERTIARY HEALTH CARE services focus on co-ordination between

urban-district and zonal regions. It also envisages on opening of new AIIMS
hospitals and new medical colleges in the country.
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POLICY IDEAS:
PREVENTIVE AND PROMOTIVE HEALTH: seven priority areas for improving the
environment for health:

The Swachh Bharat Abhiyan

Balanced, healthy diets and regular exercises.

Addressing tobacco, alcohol and substance abuse

Yatri Suraksha – preventing deaths due to rail and road traffic
accidents
Nirbhaya Nari –action against gender violence

Reduced stress and improved safety in the work place.

Reducing indoor and outdoor air pollution

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contd…
THE POLICY PROPOSES 7 KEY POLICY SHIFTS IN ORGANISING
HEALTH CARE SERVICES:
 Primary care:

Assured
Selective care comprehensive care
 Secondary and Tertiary care:

Input Oriented Output Driven

 Public Hospital:
Assured free drugs,
User fees & Cost diagnostics &
recovery emergency services

 Integration of National Health Programmes with health systems for

programme effectiveness.

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contd..
 Infrastructure and human resource development:

Normative Approach TargetedApproach

 AYUSH system:

3 Dimensional
Stand Alone Mainstreaming

 Urban Health: To organise Primary Health Care deliver and referral

support for urban poor.

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 SHIFTING FOCUS FROM:
SICK CARE TO WELLNESS

PALLIATIVE MENTAL GERIATRIC REHABILITA NON

CARE HEALTH HEALTH TIVE CARE COMMUNICABLE
SERVICES DISEASES

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NATIONAL HEALTH PROGRAMMES:
 RMNCH+A Services: Developmental action of all sectors to
support Maternal and Child survival.

 Child & Adolescent Health: Aiming at pre-emptive care to achieve

optimum level of child and adolescent health.

 Intervention to address Malnutrition: IFA, Calcium supplements,

iodized salt, zinc, Vitamin Aetc.

 Universal Immunisation: Ensure coverage, quality and safety of

vaccines also introduction of new vaccines.
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Contd…

• Communicable Diseases: Inter relationship between communicable

disease control program and public health system strengthening(enhanced
public health capacity to collect, analyse and respond to the disease outbreaks)

 Non Communicable Diseases: There is a need to halt and reverse

the growing incidence of chronic diseases.

 Mental Health: National Mental Health Policy 2014 is considered.

 Population Stabilisation: Increase the proportion of male

sterilisation from less than 5% currently to atleast 30% or more
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higher if possible.
TO ADDRESS GENDER BASED VIOLENCE:

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 EMERGENCY CARE AND DISASTER
PREPAREDNESS:
 Group of community members should be well trained as first responder
for accidents and disaster.

 Development of mass casualty management protocols for CHCs and

emergency management protocol at all levels.

 Creation of a unified emergency system,linked to a universal access

number and with a network of emergency care that has an assured
provision of life support ambulances, trauma management centres-
 1/30 lakh population in urban area
 1/10 lakh population in rural area 23
HUMAN RESOURCES FOR HEALTH

MEDICAL
Paramedical EDUCATION
Skill

Human Doctors in
ASHA Resources Remote
for Health areas

Nursing Mid level

Education Service
providers
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 The critical gaps in public health service can be filled by healthcare schemes
Insurance (RSBY)
Aim: To improve health outcome and reduce out of pocket expenditure.

 Enhancing accessibility in private sector: Charitable hospital and non profit

hospitals should volunteer for accepting referral from public facilities.
Private hospitals may provide for subsidized beds for poor patients.

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REGULATORY FRAMEWORK:

 There is a regulatory role of

 Ministry of Health and Family Welfare on:
 Regulation of clinical establishments
 Professional and Technical Education- Strengthening of 6 professional
councils – Medical, Ayurveda, Unani & Siddha Homeopathy, Nursing,
Dental Pharmacy
 Food Safety
 Drug regulation
 Medical devices regulation

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 DIGITAL HEALTH TECHNOLOGY:

 Recognising the integral role of technology in healthcare delivery, National

Digital Health Authority (NDHA) will be set up to regulate, develop, and
deploy digital health across the continuum of care.

 The policy will promote utilization of National Knowledge Network for Tele-
education, Tele-CME, Tele-consultation etc.

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HEALTH RESEARCH:

 It supports strengthening health research in India in the following fronts:

 Medical product innovation
 Fundamental research in all areas relevant to health

 Drug research on critical diseases like TB, HIV/AIDS, Malaria etc may be
incentivized to address priority.

 Research on social determinants of health along with neglected health issues

like disability and transgender health will be promoted.
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GOVERNANCE:
 Role of Centre & State: The policy recommends equity sensitive resource
allocation, strengthening institutional mechanisms for consultative decision-
making and coordinated implementation.

 Role of Panchayati Raj Institutions: This will be strengthened to play an

enhanced role at different levels for health governance, including the social
determinants of health.

 Improving Accountability: The policy would be to increase both horizontal

and vertical accountability of the health system
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CONCLUSION:
• One of the fundamental policy questions being raised is whether to pass a
health rights bill making health a fundamental right- in the way that was done
for education.

• The question is whether we have reached the level of economic and health
systems development so as to make this a justiciable right- implying that its
denial is an offense.

• Right to health cannot be perceived unless the basic health infrastructure like
doctor-patient ratio, patient-bed ratio, nurses-patient ratio, etc are near or above
threshold levels and uniformly spread-out across the country.
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• The policy therefore recommends assurance based approach, with assured
funding to create an enabling environment for realizing health care as a right
in the future.

• The National Health Policy envisages that an implementation framework be

put in place to deliver on these policy commitments which would provide a
roadmap with clear milestones to achieve the goals of the policy.

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