National Health Policy 2017

  • The policy aims to attain the highest possible level of health and well-being for every citizen through a preventive and promotive healthcare orientation.
  • It seeks to provide and deliver healthcare services, particularly to underprivileged and socially vulnerable groups of people in the country.
  • Under the policy, every family will have a health card to access primary care facilities and a nationwide package of services.
  • Health and hygiene to become part of the school curriculum – Yoga would be introduced much more widely in schools and workplaces to promote good health.
  • The policy envisages a three-dimensional integration of AYUSH systems by promoting cross referrals, co-location and integrative practices across systems of medicines.
  • The policy also addresses health security and promotes Make in India for drugs and devices. It seeks to establish a Public Health Management Cadre (PHMC) in all states.
  • It also proposes raising public health expenditure to 2.5% of the GDP in a time-bound manner.

Specific Quantitative Goals and Objectives  

Health Status and Programme Impact Life

  • Expectancy and healthy life Increase Life Expectancy at birth from 67.5 to 70 by 2025.
  • Establish regular tracking of the Disability Adjusted Life Years (DALY) Index as a measure of the burden of disease and its trends by major categories by 2022.
  • Reduction of TFR to 2.1 at national and sub-national levels by 2025.

Mortality by Age and/ or Cause

  • Reduce Under Five Mortality to 23 by 2025 and MMR from current levels to 100 by 2020.
  • Reduce infant mortality rate to 28 by 2019.
  • Reduce neonatal mortality to 16 and stillbirth rate to “single digit” by 2025.

Reduction of disease prevalence/ incidence

  • Achieve the global target of 2020 which is also termed a target of 90:90:90, for HIV/AIDS i.e, – 90% of all people living with HIV know their HIV status, – 90% of all people diagnosed with HIV infection receive sustained antiretroviral therapy and 90% of all people receiving antiretroviral therapy will have viral suppression.
  • Achieve and maintain the elimination status of Leprosy by 2018, Kala-Azar by 2017 and Lymphatic Filariasis in endemic pockets by 2017. To achieve and maintain a cure rate of >85% in new sputum-positive patients for TB and reduce the incidence of new cases, to reach elimination status by 2025.
  • To reduce the prevalence of blindness to 0.25/ 1000 by 2025 and disease burden by one-third from current levels.
  • To reduce premature mortality from cardiovascular diseases, cancer, diabetes or chronic respiratory diseases by 25% by 2025.

Health Systems Performance

Coverage of Health Services

  • Increase utilization of public health facilities by 50% from current levels by 2025.
  • Antenatal care coverage to be sustained above 90% and skilled attendance at birth above 90% by 2025.
  • More than 90% of the newborn are fully immunized by one year of age by 2025.
  • Meet family planning needs above 90% at national and sub-national levels by 2025.
  • 80% of known hypertensive and diabetic individuals at the household level maintain “controlled disease status” by 2025.

Cross-Sectoral goals related to health

  • The relative reduction in the prevalence of current tobacco use by 15% by 2020 and 30% by 2025.
  • Reduction of 40% in the n prevalence of stunting of under-five children by 2025.
  • Access to safe water and sanitation to all by 2020 (Swachh Bharat Mission).
  • Reduction of occupational injury by half from current levels of 334 per lakh agricultural workers by 2020.
  • National/ State level tracking of selected health behaviour.

Health Systems strengthening

Health finance

  • Increase health expenditure by Government as a percentage of GDP from the existing 1.1 5 % to 2.5 % by 2025.
  • Increase State sector health spending to > 8% of their budget by 2020.
  • Decrease in the proportion of households facing catastrophic health expenditure from the current levels by 25%, by 2025.

Health Infrastructure and Human Resource

  • Ensure the availability of paramedics and doctors as per the Indian Public Health Standard (IPHS) norm in high-priority districts by 2020.
  • Increase community health volunteers to population ratio per IPHS norm, in high-priority districts by 2025.
  • Establish primary and secondary care facilities per norms in high-priority districts (population and time to reach norms) by 2025.

Health Management Information

  • Ensure district–level electronic database of information on health system components by 2020.
  • Strengthen the health surveillance system and establish registries for diseases of public health importance by 2020.
  • Establish federated integrated health information architecture, Health Information Exchanges and National Health Information Network by 2025.

Policy Thrust

Ensuring Adequate Investment -The policy proposes a potentially achievable target of raising public health expenditure to 2.5% of the GDP in a time-bound manner.

Preventive and Promotive Health – The policy identifies coordinated action on 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 workplace Reducing indoor and outdoor air pollution

Organization of Public Health Care Delivery – The policy proposes seven key policy shifts in organizing health care services.

Criticism of the Policy

  • The policy duplicates portions of the Health Section 2017 Budget speech.
  • It reiterates health spending targets set by the High-Level Expert Group (HLEG) set up by the erstwhile Planning Commission for the 12th Five-Year Plan (which ends on March 31, 2017)
  • It also fails to make health a justifiable right through National Health Rights Act like the Right to Education Act 2005 did for school education.
  • A health cess was a path-breaking idea in the Health Ministry’s draft policy; it has now been dropped from the final policy
  • Through the 2002 policy, the government promised to increase health spending to 2 per cent of GDP, which never happened under the National Democratic Alliance (NDA-1) or during the 10 years of the United Progressive Alliance (UPA) administration.
  • Old Targets and New Deadlines:
  • The IMR in 2015-16 was 41.
  • The MMR in 2015-16 is 167.
  • The 2002 NHP had set the target of eliminating leprosy by 2005, kala-azar by 2010 and lymphatic filariasis by 2015–none of which could be achieved yet.
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