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J.K.

OKE

GOOD HEALTHCARE, AND THE RESULTANT GOOD HEALTH, CONTRIBUTES TO DEVELOPMENT IN THE FOLLOWING WAYS: HIGHER LABOUR PRODUCTIVITY HIGHER RATES OF DOMESTIC & FOREIGN INVESTMENTS IMPROVED HUMAN CAPITAL HIGHER RATES OF NATIONAL SAVINGS DEMOGRAPHIC CHANGES

MORTALITY INDICATORS MORBIDITY INDICATORS DISABILITY RATES NUTRITIONAL INDICATORS HEALTHCARE DELIVERY INDICATORS UTILISATION RATES SOCIO-ECONOMIC & DEMOGRAPHIC STATUS OF THE POPULATION HEALTH SYSTEM RESEARCH TO DETERMINE BETTER & COST-EFFECTIVE METHODS OF HEALTH DELIVERY

STATE GOVERNMENT
PUBLIC HEALTH DEPT (PRIMARY HEALTH CENTRES/HOSPITALS) MEDICAL COLLEGE HOSPITALS LOCAL GOVERNMENTS HEALTHCARE FACILITIES NON-ALLOPATHIC SYSTEMS OF MEDICINE

CENTRAL GOVERNMENT
CENTRAL HEALTH SERVICES MEDICAL COLLEGES

NON-GOVERNMENT
PRIVATE HOSPITALS

CENTRAL PRIVATE GOVERNMENT HEALTH PRACTITIONERS SERVICES EMPLOYEES STATE INSURANCE CORPORATION ARMED FORCES HOSPITALS NGO HEALTH FACILITIES

CORPORATE HOSPITALS

HOSPITALS UNDER NON-ALLOPATHIC MINISTRIES OF POWER/ PRACTITIONERS/ RAILWAYS/COAL/SHIP TRADITIONAL HEALERS PING/PETROLEUM

THE EVOLUTION OF INDIAS HEALTHCARE SYSTEM CAN BE CATEGORISED INTO THREE DISTINCT PHASES: PHASE-I (1947-1983) PHASE-II (1983-2000) PHASE-III (POST-2000)

THE HEALTHCARE POLICY WAS BASED ON TWO PRINCIPLES: 1. NONE SHOULD BE DENIED CARE FOR WANT OF ABILITY TO PAY 2. IT WAS THE STATES RESPONSIBILITY TO PROVIDE HEALTHCARE TO PEOPLE

THE FIRST NATIONAL HEALTH POLICY WAS ANNOUNCED IN 1983 THE 1983 NATIONAL HEALTH POLICY ARTICULATED THE NEED TO ENCOURAGE PRIVATE INITIATIVE IN HEALTHCARE SERVICE DELIVERY. AT THE SAME TIME, IT ALSO ENDEAVOURED TO EXPAND ACCESS TO PUBLICLY FUNDED COMPREHENSIVE PRIMARY HEALTH CARE

THE SALIENT FEATURES OF THE POST-2000 HEALTHCARE SYSTEM ARE AS FOLLOWS: 1. RE-DEFINING THE ROLE OF THE STATE FROM BEING ONLY A PROVIDER TO A FINANCIER OF HEALTH-SERVICES AS WELL 2. DESIRE TO UTILISE PRIVATE SECTOR RESOURCES FOR ADDRESSING PUBLIC HEALTH GOALS 3. LIBERALISATION OF THE INSURANCE SECTOR TO PROVIDE NEW AVENUES FOR HEALTH FINANCING

POOR GOAL SETTING & LACK OF FORMULATION OF STRATEGIC INTERVENTIONS MANAGEMENT FAILURES LIMITED ROLE OF STATE LACK OF FOCUS & MORE VERTICAL PROGRAMMES THAN HORIZONTAL PROGRAMMES WEAK EVIDENCE-BASED PLANNING FOR INTERVENTION

INADEQUATE CAPACITY TO PLAN & IMPLEMENT AT THE CENTRE, STATE & DISTRICT LEVELS ABSENTEEISM FROM PLACE OF WORK QUESTIONABLE QUALITY OF SERVICE DELIVERY DUE TO POOR WORK FACILITIES LACK OF POLICIES FOR HRD LIMITED PROMOTIONAL & DUAL PRACTICES CORRUPTION & LACK OF DISCIPLINE

PRIVATE SECTOR HAS BEEN PLAYING A DOMINANT ROLE IN INDIAS HEALTHCARE DELIVERY SYSTEM 80% OF TOTAL PRACTITIONERS NUMBERING APPROX. 20 LAKHS, ARE IN PRIVATE SECTOR PRIVATE SECTOR HAS 75% OF SPECIALISTS AND 85% OF THE TECHNOLOGY IN THEIR FACILITIES PRIVATE SECTOR ACCOUNTS FOR 49% BEDS AND AN OCCUPANCY RATIO OF 44%

75% OF SERVICE DELIVERY FOR DENTAL HEALTH, MENTAL HEALTH, ORTHOPEDICS, VASCULAR AND CANCER DISEASES AND ABOUT 40% OF COMMUNICABLE DISEASES AND DELIVERY ARE PROVIDED BY THE PRIVATE SECTOR

ACCORDING TO A REPORT OF THE TASK FORCE ON MEDICAL EDUCATION,MINISTRY OF HEALTH & FAMILY WELFARE, THE QUANTUM OF HEALTH SERVICES THE PRIVATE SECTOR PROVIDES IS LARGE BUT IS OF POOR & UNEVEN QUALITY. SERVICES, PARTICULARLY IN THE PRIVATE SECTOR HAVE SHOWN A TREND TOWARDS HIGH COST, HIGH TECH PROCEDURES AND REGIMENS.

NATURE OF HEALTH FINANCING & PAYMENT SYSTEM TYPES OF TECHNOLOGY COST OF INITIAL EDUCATION/TRAINING PUBLIC EXPECTATIONS / PERCEPTIONS REGULATORY FRAMEWORK SOCIETAL VALUES FOCUS ON PROFIT MAXIMISATION NOT REALLY CONCERNED WITH PUBLIC HEALTH GOALS

IN THE HEALTH CARE SECTOR, FOLLOWING AREAS NEED TO BE ADDRESSED: 1. HEALTH CARE FINANCING 2. REFORMS IN HEALTHCARE PROVISION 3. RESOURCE GENERATION 4. GOVERNANCE 5. STRATEGIC 6. PPP

FINANCING SHOULD BE ACCORDING TO HEALTH NEEDS RISK SHARING SCHEMES FOR INFORMAL SECTOR (HEALTH INSURANCE) COMPETITIVE APPROACH PRIVATISATION (MUST ENSURE EQUAL DISTRIBUTION & CARE OF THE UNDERPRIVILEGED)

VERTICAL APPROACH: GOOD FOR DISEASE-SPECIFIC INTERVENTIONS,HOWEVER, IT MAY FAIL FOR WIDE RANGE OF SERVICES INTEGRATED APPROACH: THE WHO ADOPTED PRIMARYHEALTH CARE APPROACH FOR HEALTH DELIVERY SKEWED DISTRIBUTION OF RESOURCES (88% OF TOWNS HAVING HEALTHCARE FACILITIES COMPARED TO 24%IN RURAL AREAS) NEEDS TO BE CORRECTED

HUMAN RESOURCE DEVELOPMENT PRIVATE & INTERNATIONAL FUNDING

RE-ORIENTATION & RE-STRUCTURING DECENTRALISATION REFORMS RELATED WITH OTHER SECTOR:ONE SHOULD NOT LOOK FOR THAT WHAT OTHER SECTORS CAN DO FOR HEALTH RATHER ONE MUST ENSURE WHAT HEALTH SECTOR CAN DO FOR OTHER SECTORS

CAPACITY BUILDING PROMOTION OF RESEARCH FOR HEALTH SECTOR REFORMS EXCHANGE OF INFORMATION & LEARNING BY DOING