National Health Policy
National Health Policy
The primary goal of the National Health Policy is to inform, clarify, strengthen and prioritise the Government’s role in moulding the Health System in various dimensions such as investments in health, prevention of diseases and promotion of good health through cross-sectoral actions, organisation of healthcare services, developing human resources, access to technologies and more. This article talks about the National Health Policy 2017 and its various important aspects.
The National Health Policy 2017 continues to build on the progress made by the previous Policy back in 2002. The context of the National Health Policy 2017 has been different from the context in four significant ways. They are as follows:
- Ever Changing Health Priorities: Even with the rapid decline of maternal and child mortality rates, there has been a constant growth in the number of non-communicable and infectious diseases.
- Growth Rate of the Health Care Industry: One significant change is the emergence of a robust health care industry that is estimated to grow in leaps and bounds.
- Catastrophic Expenditure: The growing rate of catastrophic expenditure due to costs for healthcare is another reason. Poverty is said to be a result of these costs.
- Economic Growth: The rise in economic growth enables enhanced fiscal capacity.
The Policy aims to attain the highest level of health and well-being possible for every individual at any given age group. This is achieved through promotive and preventive health care orientation in every developmental Policy. Additionally, it also focuses on universal access to excellent quality health care services where no individual has to face the consequences of financial hardship.
This will be achieved through the offering more access, improving quality and lowering the overall expenses of the health care services. The Policy recognises the importance of Sustainable Development Goals along with an indicative list of time-bound quantitative goals aligned to ongoing national efforts and global strategic directions.
To improve the overall health status through concerted policy actions in every sector and expand preventive, promotive, curative, palliative and rehabilitative services offered throughout the Public Health Sector with an ultimate focus on quality.
The following are the fundamental principles of the National Health Policy 2017.
- Professionalism, Integrity and Ethics: The National Health Policy commits to offer the highest professional standards, integrity and ethics that can be provided. It aims to maintain the same through the entire system of the health care delivery services everywhere with the support of a credible, transparent and responsible regulatory environment.
- Equity: It is essential to reduce inequity to reach the poorest. This means that disparity based on account of gender, caste, poverty, disability and any other forms of social exclusions and geographical barriers must be removed entirely. This means that higher investments and financial protection for people who are poor and suffer from heavy medical conditions or diseases.
- Affordability: As costs of health care increases, affordability requires the utmost focus, as distinct from equity. Catastrophic household healthcare expenditures defined as health expenditures that exceed 10% of its total monthly consumption expenditures or 40% of its monthly non-food consumption expenditures are unacceptable.
- Universality: Prevention of any exclusions concerning social, economic or on current health status. Here, systems and services are designed to cater to every individual, including special groups.
- Patient-centred and Quality of Care: Gender-sensitive, safe, effective and convenient healthcare services are to be offered with confidentiality and dignity. There is a need to evolve and disseminate health standards and medical guidelines for every level of the facility along with a system to ensure that the quality of the same is not compromised.
- Accountability: This includes financial and performance responsibility along with transparency in decision making and elimination of corruption in healthcare systems in both; public and private.
- Inclusive Partnerships: A multistakeholder approach is required where the partnership and participation of all non-health ministries and communities are achieved. This approach would include collaborations with various academic institutions, non-profit agencies, and the healthcare industry as well.
- Pluralism: Individuals would have access to AYUSH care providers based on the documented and validated local, home and community-based practices. These systems, among others, would also have Government support with respect to research and the supervision to develop. This would enrich their contribution to achieving national health goals and objectives through various integrative practices.
- Decentralisation: Decision-making has to be decentralised to a level that is consistent with practical considerations and institutional capacities. Community participation is to be promoted simultaneously along with health planning processes.
- Adaptiveness and Dynamism: Constantly improvements on the dynamic organisation of healthcare, based on new knowledge and evidence with learning from communities, national and international knowledge partners is designed.
Health System Strengthening
- Increase the health expenditures by the Government as a percentage of GDP from the existing 1.15% to 2.5% by 2025.
- Increase the State sector health spending to above 8% of the Budget by 2020.
- Decrease the proportion of households facing catastrophic health expenditures from the current levels by a rate of 25% by 2025.
Health Infrastructure and Human Resource
- Ensure the availability of paramedics and doctors as per the Indian Public Health Standard (IPHS) norms in high priority districts by 2020.
- Increase the number of community health volunteers with respect to the population ratio as per the IPHS norms in high priority districts by 2025.
- Establish primary and secondary care facilities as per the norms in high priority districts by 2025.
Health Management Information
- Ensure district-level digital information database on health system components by 2020.
- Strengthen the health surveillance systems and establish registries for diseases that are of public health importance by 2020.
- Establish the federated integrated health information architecture called the Health Information Exchanges and National Health Information Network by 2025.
Health Status and Programme Impact
Life Expectancy and Healthy Life
- Increase Life Expectancy of an individual from 67.5 to 70 by 2025.
- Establish regular tracking of the Disability Adjusted Life Years (DALY) Index as a measure for diseases and its trends in significant categories by 2022.
- Reduction of TFR to 2.1 at the national and sub-national level by 2025.
Mortality by Age and Cause
- Reduce the Mortality Rate of children under the age of 5, to 23 by 2025 and the current levels of MMR to 100 by 2020.
- Reduce the Infant Mortality Rate to 28 by 2019.
- Reduce the Neo-Natal Mortality Rate to 16 and the Still Birth Rate to as minimum as possible or to a single digit by 2025.
Reduction of disease prevalence/ incidence
- Achieve a global target of 2020; which is also termed as the target of 90:90:90 for HIV/ AIDS. This means that 90% of all individuals living with HIV are aware of their status, 90% of all individuals diagnosed with HIV receive sustained Anti-Retroviral Therapy, and 90% of all individuals receiving the Anti-Retroviral Therapy have viral suppression.
- Achieve and maintain an elimination status for Leprosy by 2018, Kala-Azar by 2017 and Lymphatic Filariasis by 2017.
- To achieve and maintain the cure rate of 85% and more in the new sputum-positive patients for Tuberculosis and reduce the incidence of new cases as well as reach an elimination status by 2025.
- To reduce the existence of blindness to 0.25 out of 1000 by 2025 and disease burden by one-third from its current levels.
- To decrease pre-mature mortality from Cardiovascular Diseases, Diabetes, Cancer or Chronic Respiratory Diseases by 25% by 2025.
Health System Performance
Coverage of Health Services
- Increase the utilisation of multiple public health facilities by a minimum of 50% from the current levels by 2025.
- Antenatal Care coverage is to be sustained above 90% and Skilled Attendance at childbirth above 90% by 2025.
- More than 90% of infants born by 2025 up until the age of 1 completely immunised.
- Meet the needs of family planning above 90% at the national and sub-national level by 2025.
- 80% of known conditions like Hypertensive and Diabetic individuals at households levels to maintain the status of controlled disease by 2025.
Cross Sectoral goals related to health
- The relative reduction in the prevalence of tobacco use at present by 15% by 2020 and 30% by 2025.
- Reduction of almost 40% in the prevalence of stunting of children under the age of 5 by 2025.
- Access to safe water and sanitation under Swachh Bharat Mission to all by 2020.
- Reduction in occupational injuries by half from the current levels of 334 per Lakh of Agricultural Workers by 2020.
- National or State level tracking of selected health behaviour.
- Ensuring Adequate Investment: The National Health Policy proposes a potentially achievable target of raising the overall public health expenditures to 2.5% of the country’s GDP in a time-bound manner.
- Preventive and Promotive Health: The National Health Policy identifies co-ordinated action in 7 areas of utmost priority for improving the overall environment for a healthy lifestyle:
- The Swachh Bharat Abhiyan
- Balanced, healthy diets and regular exercises.
- Addressing tobacco, alcohol and substance abuse.
- Yatri Suraksha which aims to prevent deaths due to rail and road accidents.
- Nirbhaya Nari that takes action against gender violence.
- Reduced stress and improved safety in every workplace.
- Reducing the overall air pollution both indoor, as well as outdoor.
- Organisation of Public Health Care Delivery: The National Health Policy proposes 7 fundamental policy shifts in organising healthcare services.