NATIONAL HEALTH POLICY IN

INDIA

DR. KANUPRIYA CHATURVEDI

DR. KANUPRIYA
 National Health Policy 2002
Objectives:
• Achieving an acceptable standard of
good health of Indian Population,
• Decentralizing public health system by
upgrading infrastructure in existing
institutions,
• Ensuring a more equitable access to
health service across the social and
geographical expanse of India.
DR. KANUPRIYA
NHP 2002, Objectives……..

• Enhancing the contribution of private

sector in providing health service for
people who can afford to pay.
• Giving primacy for prevention and first
line curative initiative.
• Emphasizing rational use of drugs.
• Increasing access to tried systems of
Traditional Medicine

DR. KANUPRIYA
Goals – NHP 2002

1. Eradication of Polio & Yaws 2005

2. Elimination of Leprosy 2005

3. Elimination of Kala-azar 2010
4. Elimination of lymphatic Filariasis 2015
5. Achieve of Zero level growth 2007
of HIV/AIDS
DR. KANUPRIYA
Goals – NHP 2002……
6.Reduction of mortality by 50% 2010
on account of Tuberculosis,
Malaria, Other vector and
water borne Diseases
7.Reduce prevalence of blindness 2010
to 0.5%

DR. KANUPRIYA
Goals – NHP 2002……
8. Reduction of IMR to 30/1000 & 2010
MMR to 100/lakh
9. Increase utilisation of public 2010
health facilities from current
level of <20% to > 75%
10. Establishment of an integrated 2007
system of surveillance,
National Health Accounts and
Health Statistics
DR. KANUPRIYA
Goals – NHP 2002……

11.Increase health expenditure 2010

by government as a % of
GDP from the existing
0.9% to 2.0%
12. Increase share of Central 2010
grants to constitute at least
25% of total health spending

DR. KANUPRIYA
Goals – NHP 2002……
13. Increase State Sector 2005
Health spending from
5.5% to 7% of the budget
14. Further increase of 2010
State sector
Health spending
from 7% to 8%

DR. KANUPRIYA
 NHP-2002
Policy prescriptions

DR. KANUPRIYA
Differentials in health status
among rural/urban India

103.7
120

94.9
100

75
70

63.1
80

49.6
47.0
60

38.4
44
27.09
23.62
26.1

40

20

0
BPL IMR UFMR Wt. for age
India Rural Urban

DR. KANUPRIYA
Equity…..
• To overcome the
social inequality, NHP
10%
2002 has set an
increased allocation
of 55% total public 35% 55%
health investment for
the primary health
sector, 35% for
secondary sector and Primary Secondary Tertiary

10% for tertiary

sector.
DR. KANUPRIYA
Delivery of national public
health programmes
• NHP 2002 envisages the gradual
convergence of all health programmes
under a single field administration.
• It suggests for a scientific designing of
public health projects suited to the local
situation.

DR. KANUPRIYA
Delivery of national public
health programmes…….

• Training and reorientation of rural

health staff and free hand to district
administration to allocate the time of
the rural health staff between the
various programmes, depending on
the local need is stressed.

DR. KANUPRIYA
Public health spending in
select countries
Population IMR Health Public
with income /1000 expenditure expenditur
of less than to GDP e on health
one dollar per to total
day health
expenditur
e
India 44.2 % 70 5.2% 17.3%

China 18.5 % 31 2.7% 24.9%

Sri Lanka 6.6 % 16 3.0% 45.4%

UK - 6 5.8% 96.9%

USA - 7 13.7% 44.1%

DR. KANUPRIYA
Delivery of national public
health programmes…….
• Therefore, the policy places reliance on
strengthening of public health outcomes
on equitable basis.
• It recognises the need of user charge for
secondary and tertiary public health care
for those who can afford to pay.

DR. KANUPRIYA
Extending public health services

• Expanding the pool of General

Practitioners to include a cadres of
licentiates including Indian systems of
Medicine and Homoeopathy is
recommended in the policy.
• In order to provide trained manpower in
under served areas it recommends
contract employment.

DR. KANUPRIYA
 Suggested norms for health personnel

Category of personnel Norms suggested

1 . Doctors 1 per 3,500 population
2. Nurses 1 per 5,000 population
3. Health worker female and 1 per 5,000 population in plain area and
male 3000 population in tribal and hilly
areas.
4. Trained dai 1per village
5. Health assistant (male and 1 per 30,000 population in plain area and
female 20000 population in tribal and hilly
areas.
6. Health assistant (male provides supportive super­vision to
and female) 6 health workers (male /female).

7. Pharmacists 1 per 10,000 population

8. Lab. technicians 1 per 10,000 population

DR. KANUPRIYA
Education of health care
professionals
• NHP 2002 recommends setting up of a
Medical Grant Commission for funding
new government medical/dental
colleges.
• It suggests for a need based, skill
oriented syllabus with a more significant
component of practical training.

DR. KANUPRIYA
Education of health care
professionals…..

• The need for inclusion of contemporary

medical research and geriatric concern
and creation of additional PG seats in
deficient specialities are specified.

DR. KANUPRIYA
Need for specialists in
'public health' and 'family
medicine'
• For discharging public health responsibilities in
the country NHP 2002 recommends
specialisation in the disciplines of Public Health
and Family Medicine
• where medical doctors, public health engineers,
microbiologists and other natural science
specialists can take up the course.

DR. KANUPRIYA
Nursing personnel
• NHP 2002 recognises acute shortage of
nurses trained in superspeciality disciplines.
• It recommends increase of nursing personnel
in public health delivery centres and
establishment of training courses for
superspecialities.

DR. KANUPRIYA
Urban health
• Migration has resulted in urban growth which is
likely to go up to 33%.
• It anticipates rising vehicle density which lead
to serious accidents.
• In this direction, 2002 NHP has recommended
an urban primary health care structure as
under;

DR. KANUPRIYA
Urban health……
First Tier:-
• Primary centre cover 1 Lakh
population
– It functions as OPD facilities.
– It provides essential drugs.
– It will carry out national health
programmes.

DR. KANUPRIYA
Urban health……
Second Tier:-
• General Hospital a referral to primary
centre provides the care.
• The policy recommends a fully
equipped hub-spoke trauma care
network to reduce accident mortality.

DR. KANUPRIYA
Mental health

• Decentralised mental health service for

diagnosis and treatment by general duty
medical staff is recommended.
• It also recommends securing the human
rights of mentally sick.

DR. KANUPRIYA
Information Education and
Communication

• NHP 2002 has suggested

interpersonal communication by
folk and traditional media to bring
about behavioural change.

DR. KANUPRIYA
Information Education and
Communication…….

• School children are covered for promotion

of health seeking behaviour, which is
expected to be the most cost effective
intervention where health awareness
extends to family and further to future
generation.

DR. KANUPRIYA
Health research

• 2002 NHP noted the aggregate annual health

expenditure of Rs. 80,000 crores and on
research Rs. 1150 crores is quite low.
• The policy envisages an increase in govt.
funded health resources to a level of 1% total
health spending by 2005 and upto 2% by 2010.
• New therapeutic drugs and vaccines for
tropical disease are given priority.

DR. KANUPRIYA
Role of private sector

• The policy welcomes the participation of the

private sector in all areas of health activities
primary, secondary and tertiary health care
services;
• but recommended regularitory and
accreditation of private sector for the conduct
of clinical practice.

DR. KANUPRIYA
Role of private sector…..

• It has suggested a social health insurance

scheme for health service to the needy.
• It urges standard protocols in day-to-day
practice by health professionals.
• It recommends tele-medicine in tertiary care
services.

DR. KANUPRIYA
Health statistics

• NHP 2002 has recommended full baseline

estimate of tuberculosis, malaria and
blindness by 2005, and
• In the long run for cardiovascular
diseases, cancer, diabetes, accidents,
hepatitis and G.E.

DR. KANUPRIYA
Women's health

• After recognising the catalytic role of

empowered women in improving the
overall health standard of the country,
NHP 2002 has recommended to meet
the specific requirement of women in a
more comprehensive manner.

DR. KANUPRIYA
Medical ethics

• In India we have guidelines on

professional medical ethics since 1960.
• This is revised in 2001.
• Government of India has emphasised
the importance of moral and religious
dilemma.

DR. KANUPRIYA
Medical ethics…….

• NHP 2002 has recommended notifying

a contemporary code of ethics, which is
to be rigorously implemented by
Medical Council of India.
• The Policy has specified the need for a
vigilant watch on gene manipulation and
stem cell research.

DR. KANUPRIYA
Enforcement of
quality standard for
food and drugs

• NHP 2002 envisaged that Food and

Drug administration be strengthened in
terms of laboratory facilities and
technical expertise.

DR. KANUPRIYA
Regulation of standards in
paramedical disciplines
• More and more training institutions
have come up recently under
paramedical board which do not have
regulation or monitoring.
• Hence, establishment of Statutory
Professional Council for paramedical
discipline is recommended.

DR. KANUPRIYA
Environmental and
occupational health

• Government has noted the ambient

environment condition like unsafe drinking
water, unhygienic sanitation and air
pollution.
• Child labour and substandard working
conditions are causing occupational linked
ailments.

DR. KANUPRIYA
Environmental and
occupational health…….

• NHP 2002 has suggested for an

independent state policy and programme
for environment apart from periodic health
screening for high risk associated
occupation.

DR. KANUPRIYA