Demographic Health Indicators

Sex Ratio

Post independence, the sex ratio (Number of females per 1000 males) in India had recorded decline till 1991. Sex ratio in India has since shown some improvement. It has gone up from 927 females per 1000 males in 1991 census to 933 females per 1000 males in 2001 census and to 940 females per 1000 males in 2011 Census of India. The sex ratio among children less than 6 years of age has worsened in the last decade to 914 per 1000 males. Haryana with 830 girls per 1000 boys, Punjab with 846 girls per 1000 boys and Jammu & Kashmir with 859 girls per 1000 boys are the States with most adverse child sex ratios in the country.

Health and Family Welfare

According to the Twelfth Five Year Plan, health is not merely the absence of disease but as a state of complete physical, mental and social well-being. The determinants of good health are: access to various types of health services and an individual�s lifestyle choices, personal, family and social relationships.

(Source: Annual Report to the People on Health, December 2012)

National Health Policy, 2017

The National Health Policy (NHP), 2017, approved by the Cabinet in March, 2017 seeks to reach everyone in a comprehensive integrated way to move towards wellness. It aims at achieving universal health coverage and delivering quality health care services to all at affordable cost. This Policy looks at problems and solutions holistically with private sector as strategic partners. It seeks to promote quality of care, focus is on emerging diseases and investment in promotive and preventive healthcare. The policy is patient centric and quality driven. It addresses health security and make in India for drugs and devices.

The main objective of the National Health Policy 201 7 is to achieve the highest possible level of good health and well-being, through a preventive and promotive health care orientation in all developmental policies, and to achieve universal access to good quality health care services without anyone having to face financial hardship as a consequence. In order to provide access and financial protection at secondary and tertiary care levels, the policy proposes free drugs, free diagnostics and free emergency care services in all public hospitals. The policy envisages strategic purchase of secondary and tertiary care services as a short term measure to supplement and critical gaps in the health system.

The Policy recommends prioritizing the role of the Government in shaping health systems in all its dimensions. The roadmap of this new policy is predicated on public spending and provisioning of a public healthcare system that is comprehensive, integrated and accessible to all. The NHP, 2017 advocates a positive and proactive engagement with the private sector for critical gap filling towards achieving national goals.� It envisages private sector collaboration for strategic purchasing, capacity building, skill development programmes, awareness generation, developing sustainable networks for community to strengthen mental health services, and disaster management. The policy also advocates financial and non-incentives for encouraging the private sector participation.

The policy proposes raising public health expenditure to 2.5% of the GDP in a time bound manner. Policy envisages providing larger package of assured comprehensive primary health care through the Health and Wellness Centres. This policy denotes important change from very selective to comprehensive primary health care package which includes geriatric health care, palliative care and rehabilitative care services. The policy advocates allocating major proportion (upto two-thirds or more) of resources to primary care followed by secondary and tertiary care. The policy aspires to provide at the district level most of the secondary care which is currently provided at a medical college hospital.

The policy assigns specific quantitative targets aimed at reduction of disease prevalence/incidence, for health status and programme impact, health system performance and system strengthening. It seeks to strengthen the health, surveillance system and establish registries for diseases of public health importance, by 2020. It also seeks to align other policies for medical devices and equipment with public health goals.

The primary aim of the National Health Policy, 2017, is to inform, clarify, strengthen and prioritize the role of the Government in shaping health systems in all its dimensions-investment in health, organization and financing of healthcare services, prevention of diseases and promotion of good health through cross sectoral action, access to technologies, developing human resources, encouraging medical pluralism, building the knowledge base required for better health, financial protection strategies and regulation and progressive assurance for health. The policy emphasizes reorienting and strengthening the Public Health Institutions across the country, so as to provide universal access to free drugs, diagnostics and other essential healthcare.

The broad principles of the policy is centered on Professionalism, Integrity and Ethics, Equity, Affordability, Universality, Patient Cantered & Quality of Care, Accountability and pluralism.

It seeks to ensure improved access and affordability of quality secondary and tertiary care services through a combine inflation of public hospitals and strategic purchasing in healthcare deficit areas from accredited non-�governmental healthcare providers, achieve significant reduction in out of pocket expenditure due to healthcare costs, reinforce trust in public healthcare system and influence operation and growth of private healthcare industry as well as medical technologies in alignment with public health goals.

The policy aims commitment to pre-emptive care (aimed at pre-empting the occurrence of diseases) to achieve optimum levels of child and adolescent health. The policy envisages school health programmes as a major focus area as also health and hygiene being made a part of the school curriculum. In order to leverage the pluralistic health care legacy, the policy recommends mainstreaming the different health systems. Towards mainstreaming the potential of AYUSH the policy envisages better access to AYUSH remedies through co-location in public facilities. Yoga would also be introduced much more widely in school and work places as part of promotion of good health. The policy supports voluntary service in rural and under-served areas on pro-bono basis by recognized healthcare professionals under a �giving back to society� initiative. The policy advocates extensive deployment of digital�� tools for improving the efficiency and outcome of the healthcare system and proposes establishment of National Digital Health Authority (NDHA) to regulate, develop and deploy digital health across the continuum of care.

The policy advocates a progressively incremental as insurance based approach. The last health policy was formulated in 2002. The socio economic and epidemiological changes since then necessitated the formulation of a New National Health Policy to address the current and emerging challenges.

Written by princy

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