Seminar on

National health planning in india five

years

By Shivanand Ankalge
 Introduction

 In 1950 planning commission was Constituted to

help government to Plan out Integrated
development plan for the entire country with a
available resources for the period of five years
for its socioeconomic progress. The planning
commission was responsible for Five year plans.
 Five years plan is mechanism to bring about
uniformity in policy formulation in programmes
of national importance  
   Objectives

• Control and eradication of various communicable

disease, deficiency disease and chronic diseases.
• Strengthening of medical and basic health services
by establishing
 
District Health Units, Primary Health
 
Centres and   Sub-Centres.
 
• Population control
• Development of health manpower and research
• Development of indigenous system of medicine
• Improvement of environmental sanitation
• Drug control
 For the purpose of planning the health
sectors has been divided in two following
sub sectors.
 1. Water supply & sanitation.
 2. Control of communicable diseases.
 3. Medical education, training &
research.
 4. Medical care including hospitals,
dispensaries & PHCs.
 5. Public health services.
 6. Family planning.
 7. Indigenous system of medicine
 - The Aim- The aim of the First Five year plan was fight against,
malnutrition and unhealthy environment and to build up
health services for rural population and for mothers and children in
order to improve health status of people.
 
- The priorities
Safe water and sanitation
Control of Malaria
. Health care of rural population
Education training and health education
Self-sufficiency in drugs and equipments
Family planning and population control
 - The major developments are
-1951 the BCG vaccination programme to prevent and control
tuberculosis was launched
-1952 to the central council of health was constituted primary
Health centres where set up to render health services in rural
areas auxiliary nurse midwife training was started
-1953 the national malaria control programme was launched the
national family planning programme was launched
-1954 the central social welfare board was set up the national
leprosy control programme was launched the national water
supply and sanitation programme was launched the prevention
of food adulteration act was enacted
-1955 the national filaria control programme was launched
National TB sample survey was started the minimum age for
marriage 18 years for boys and 15 years for girls was prescribed
by Hindu marriage act.
 The aim - the aim of the second five year plan was to expand
existing health services to bring them within the reach of all people
so as to promote progressive improvement of nations health.
-The priorities
-Establishment of institutional facilities for rural as well as for urban
population
-Development of technical manpower
-Control of communicable diseases
-Water supply and sanitation
-Family planning and other supporting program
 -The major developments
-1957 demographic research centres were established
-1958 the national malaria control programme was converted to
national eradication program the three tier structure of local self
governing bodies from the village to the district level was
recommended
-1959 mudaliar committee was set by the government of India
Panchayat Raj was introduced the National institute of tuberculosis
was established at Mangalore
-1960 the national nutritional advisory committee was formed the
school health committee was appointed by the union ministry of
Health.
 The Aim- the main aim of the third five year plan was to remove the shortage and
divisions his which were observed at the end of the second Five year Plan in the
field of health
This where pertaining to institutional facilities especially in rural area shortage of
trained personnel and supplies lack of safe drinking water in rural areas and
inadequate drainage system
•Priorities
•Safe water supply in villages and sanitation specially the training facility in the
urban area
•Expansion of institutional facilities to promote accessibility especially in the rural
area
•Eradication of malaria and smallpox and control of various other communicable
diseases
•Family planning and other supporting services for improving health status of
people
•Development of manpower
Major developments
1961 The Central bureau of health intelligence was established strengthening and
upgrading of existing health centres in stages provision of ambulance services for
emergency medical care
1962 the national smallpox eradication programme and national water control
program were launched the district tuberculosis programme was conceptualized
1963 applied nutritional programme was started with the support of UNICEF w h o
f a o National Trachoma program was initiated.
1964 the National institute of Health administration and education was established
1965 look for recommended as safe and effective family planning device BCG
vaccination without tuberculin test was introduced on house to house basis a
committee under the chairmanship of Shri mukharji was appointed
1967 the central council of health recommended compulsory payment by patients
attending to hospital
1968 medical education committee was appointed to study the various aspects of
 
medical education a bill on registration of births and deaths was passed.
 The aim- the main aim of this plan was to strengthen primary Health centre
network in the rural areas for undertaking preventive curative and family planning
services and to take over the maintenance phase of communicable diseases.
.
The priorities-
-family planning programme
-strengthening of primary Health centre
-strengthening of sub divisional and district hospitals to provide effective referral
support to primary Health centre.
-intensification of control programs
-expansion of medical and nursing education training of paramedical personal to
meet the minimum technical manpower requirement.
Major developments-
-1969 the nutritional research laboratory was expanded to National
institute of Nutrition
Central birth and death registration act was promulgated.
-1970 the population council of India was set up all India hospital
family planning programme was launched mobile training come
service unit scheme was launched the drug order was promulgated.
-1971 the family pension scheme for industrial workers was introduced
the medical termination of pregnancy bill was passed by the
parliament.
-1972 the kartar Singh committee report submitted
-1973 minimum needs programme was formulated a scheme of sitting
30 bedded rural hospital serving for primary Health centres was
conceptualized.
 The Aim- the main aim of the fifth five year plan was to provide minimum level of
well integrated health MCH and FP nutrition and immunization services to all the
people with special reference to vulnerable groups especially children , pregnant
women and nursing
mothers through a network of infrastructure all the blocks and well structured
referral system.
It emphasis of the plan was on removing imbalance respect of medical facilities and
strengthening of health infrastructure in the rural and tribal areas.

The priorities-
- Increasing accessibility of health services in the rural areas.
-. Correcting regional imbalance.
-. Further development of reference services by moving deficiencies in district and
sub divisional hospitals.
-. Integration of Health family planning and nutrition.
-. Qualitative improvement in the education and training of health personnel.
Major developments-
-1975 integrated child development scheme was launched,
children welfare board was Set, the cigarette regulation act
was enacted in the parliament, Shrivastav committee
submitted its report.
-1976 Indian factory act 1948 was amended, the prevention
of food adulteration act came into force and new population
policy was announced.
-1977 rural Health scheme was launched, training of
community Health workers was initiated, revised modified
plan of malaria eradication was implemented, the goal of
health for all was adopted by WHO.
-1978 the child marriage restaurant Bill 1978 it filing the
minimum marriage age that is 21 years for boys and 18 years
for girls was passed.
SIXTH FIVE YEAR PLAN (1980-
1985)
The Aim- the main aim of the sixth five year plan was worked out
alternative strategy and plan for action for primary Health care as
part of National Health system, which is accessible to all sections of
society and specially those living in tribal,hilly, remote rural areas
and urban slums.
The priorities-
-rural Health services.
-control of communicable and other diseases.
-improvement in medical education and training.
-medical research.
-water supply and sanitation.
-nutrition.
Major developments

-1980 the working group on health was constituted.

-1991 the air prevention and control of pollution act of 1981 was
enacted.
-1982 the national health policy was announced. The 20 point
programme was announced.
-1983 the national leprosy control programme was changed to
National leprosy eradication programme.
-1984 the Bhopal Gas tragedy a devastating industrial accident
occurred. The workmen’s compensation act 1984 come into
force.
 The aim of the seventh five year plan was to plan and provide
primary healthcare and medical services which special consideration
to vulnerable groups and those who are living intribal hilly and
remote rural areas so as to achieve the goal of health for all by 2000 .

The priorities
-health services in rural tribal and hilly areas under minimum need
program.
-medical education and training.
-medical research.
-safe water supply and sanitation.
-MCH and family welfare.-
-control of emerging health problems especially in the area of non
communicable diseases.
 Major developments

-1985 universal immunization program was launched.

-1986 the environment protection was promulgated,
parliament passed mental health bill.
-national AIDS control programme was started.
-1987 worldwide safe mother hood campaign was started
by by World Bank. National diabetes control programme
was launched today.
-1988 to 1991 acute respiratory infection programme was
started, the 1991 census was conducted, the high power
committee on nursing and nursing profession published its
report in 1989.
 The main aim of this plan was to continue reorganization and
strengthening of health infrastructure and medical services accessible
to all especially to vulnerable groups and those living in tribal, hilly
remote rural areas.

The priorities
developing rural Health infrastructure.
Medical education and training.
Control of communicable diseases.
Universal immunization.
Safe water supply and sanitation.
MCH and family welfare.
 Major developments

1992 child survival and safe motherhood programme was

started.
1993 dots programme was implemented.
1994 the panchayat raj act come into operation.
1995 ICDS for change day to integrated mother and child
development services.the first pulse polio programme for
children under 3 years was organised.
1996 family planning programme for made Target free
approach.
 The night plan continued with the same m as that of the eighth
plan.

The priorities-
Control of communicable and noncommunicable diseases
Strengthening of existing infrastructure.
efficient primary Health care system as part of basic healthcare
services to optimise accessibility and quality care.
Improvement of referral linkage.
Disaster and emergency management.
Involvement of practitioners from indigenous system of medicine.
Strengthening of health research.
 Significant events where

-reproductive and child Health programme was launched.

-Government of India announced a National population policy
2000.
-National malaria eradication programme was renamed as national
anti malaria programme in 1999.
. -phase 2 of national AIDS control programme started.
-census 2001 was completed.
-Government of India announced the national health policy 2002.
-Government of India announced to national AIDS prevention and
control policy 2002.
 The focus of planning has shifted from expansion of services to the
enhancement of human well being.

The priorities
-reconstruction of existing health infrastructure.
-upgrade the skills of health personnel.
-improve the quality of reproductive and child health.
- Improve logistic supplies.
- carry out research on nutritional deficiencies and on optimum daily requirements
of nutrition for Indian men and women.
-promote rational drug use.
Status as on 30 April 2008

-State Health missions have been constituted in all states.

-asha training module as developed and revised.
-Against the target of 5 lakh fully trained asha workers by 2008 the initial
phase of training has been imparted to 5.36 lakh. Asha in position with
drug kits are 224151 in number.
-out of the 142272 subcenters expected to be functional with two auxiliary
nurse midwives by 2008 only 22470 one had the same.
-22370 primary Health centres are functional and out of which 3450 phcs
are functional with three staff nurses by 2008.
-IMNCI started in 142 districts.
.
 Eleventh five year plan provides an opportunity to restructure policies to achieve a new
vision based on faster and inclusive growth.one objective of the five year plan is achieving
good health for people especially the poor and the underprivileged.

Goals
Reducing maternal mortality ratio to 1 per thousand live births.
Reducing infant mortality rate to 28 per thousand live births.
reducing Mall tradition among children of age group 0 to 3 to half its present level.
. Raising sex ratio for age group 0 to 6 to 935 by 2011-12 And 950 by 2016 -17.
. Improving access to and utilisation of essential and quality healthcare.
. Focusing on excluded or neglected areas.
. Increasing survival.
. Providing focus to health system and biomedical research.
. Enhancing efforts at disease reduction.
 TWELTH FIVE YEAR PLAN (2012-
2017)
The twelfth five year plan was formulated based on the recommendation of a
high-level expert group and other stakeholder consultation.
The long term objective of this strategy is to establish a system of universal health
coverage in the country.Long term objective of this strategy is to establish a system
of universal health coverage in the country.
Priority areas in 12th Five year Plan
-Full immunization among children under 3 years of age.
-full antenatal natal and postnatal care.
-iron and folic acid supplementation for children adolescent girls and pregnant
women.
-regular treatment of intestinal worms especially in children and reproductive age
women.
-universal use of iodine and iron fortified salt.
-HIV testing and counselling during antenatal care.
-school check up of Health and wellness followed by advice and treatment.
-diagnosis and treatment of tuberculosis leprosy including drug
and multidrug-resistant cases.
-management of diarrhoea, vaccine for hepatitis b and c for high
risk groups.
-patient transport systems including emergency response
ambulance services of the dial 108 model.
-free drug to pregnant HIV positive mothers to prevent mother
to child transmission of HIV, malaria prophylaxis, using long
lasting in sector side treated nets, diagnosis using rapid
diagnostic kits and appropriate treatment.
.