Express Healthcare

There has been a paradigm shift in the approach, from sickness care to health and wellness care

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After a gap of 15 years, the new National Health Policy 2017 has been enacted. It envisages the increase in public health expenditure to 2.5 per cent of the GDP by 2025. There has been a paradigm shift in the approach, from sickness care to health and wellness care, with focus on prevention and health promotion.

India was declared polio-free by WHO in March 2014 and we continue to maintain the status till date with the introduction of inactivated polio vaccine. India successfully validated maternal and neonatal tetanus elimination since May 2015, and it has become free from Yaws since 2016. India has successfully achieved the goal of elimination of Active Trachoma as specified by WHO under GET2020 programme, in December 2017. The government expresses commitment to make India free from kala azar, filariasis, leprosy and measles by 2020.

To reduce mortality and morbidity in children due to vaccine preventable diseases, Mission Indradhanush was launched with an aim to increase immunisation coverage to 90 per cent by 2020 through focus on hard to reach, high risk areas and pockets of low immunisation coverage. But, encouraged by the four phases of the mission, the target to achieve 90 per cent coverage was preponed to 2018 with the new form of the programme called Intensified Mission Indradhanush, was launched
by the Prime Minister from Vadnagar in Gujarat on October 8, 2017. Over 1,70,000 lives are lost on account of rotavirus, diarrhoea and pneumococcal pneumonia, hence the government has introduced pneumococcal conjugate vaccine and rotavirus vaccine.

Overall under-five mortality has come down from 45 per 1000 live births in 2014 to 43 in 2017 with a dip in neonatal mortality rate from 26 to 25. This means 14.85 lakh under-five child deaths have been averted.

Pradhan Mantri Surakshit Matritva Abhiyan was launched in November 2016 to provide assured maternal and child health services on the ninth of every month through involvement of private sector. More than 90 lakh antenatal check-ups have been conducted and over five lakh high risk pregnancies identified.
WHO Global TB Report 2017 shows a decreasing trend towards incidence and mortality estimates of tuberculosis in India. The government has decided to eliminate tuberculosis in India by 2025 which is five years ahead of the target set under the SDGs of UN.

The government will roll out free universal population screening and management of common NCDs amongst all aged 30 years and above to cover all districts by year 2022. As of now, the programme is in effect in 100 select districts of the country.
Pradhan Mantri National Dialysis Programme in a PPP mode under NHM provides support to states for free dialysis services to poor currently functional in 384 government facilities.

National Free Drugs & Diagnostics initiative has been started by the government with an aim to move towards health for all. Essential drugs are being provided free of cost in public health facilities in consonance with the National Health Policy, 100 SHCs are being upgraded to wellness centres and gradually all the SHCs shall be
converted to wellness centres to make prevention a primary goal of health and family welfare.

The AMRIT initiative was started with outlets that provide drugs and
implants for cancer patients and cardiovascular diseases at 60 to 90 per cent discount than the prevailing market rates. More than 42.41 lakh patients have been served by 105 stores whichhas resulted in more than `222.06 crores savings to the patients.

As per GATS-2 Report, the absolute prevalence of tobacco use has decreased by six percentage points and it is a great step forward towards a healthier nation. India was conferred the WHO DG’s Special Recognition Award of contribution to global tobacco control.

Through various interventions, it is proposed to achieve doctor-population ratio to 1:1272 by 2022. Nearly 13,000 MBBS seats and 7,000 PG new medical seats have been created. 56 new medical colleges were attached with existing district hospitals have been sanctioned. A uniform entrance examination NEET has been introduced for admission to all medical seats in the country. For the first time in any field of higher education common counselling for entrance to all medical seats has also been made mandatory. Medical PG Diploma courses run by college of physicians and surgeons, Mumbai have been granted all India recognition. For-profit companies registered under Companies Act have been allowed to set up medical
colleges. Nurse practitioner courses have been launched to promote specialisation amongst nurses. The model curriculum for graduate courses in physiotherapy has been amended to include a full course on yoga. Out of 20 new AIIMS to be set up, 13 new AIIMS have been announced during last three years and cabinet approval for setting up of seven new AIIMS has already been accorded and work has started in five new AIIMS.

To promote Make in India, the government has streamlined the approval process for drug manufacturing licencing and clinical trials, etc. under SUGAM initiative that provides a single online window for multiple stakeholders like pharma industry, regulators, citizens etc. 1.5 lakh health sub-centres across the country will be transformed into health and wellness centres (HWCs) to provide comprehensive primary care services close to the community. The HWCs are envisaged to be managed by a team led by a mid-level care provider BSc (Community Health)/B.Sc Nursing or Ayurveda practitioner trained through an appropriate bridge course in public health and primary care.

Through enactment of Clinical Establishment Amendment Act 2016, the government has ensured proper check on the clinical establishments
and bills charged by them so that they cannot exploit the common people
approaching them for treatment of various diseases apart from compelling them to use expensive branded medicines. Taking cognisance of the grave medical negligence by Max Hospital, Union Health Minister has urged the states to adopt the Clinical Establishments Act so that regulatory authorities are operative and can oversee working and functioning of private institutions.

In order to provide for mental healthcare and services for persons with mental illness and to protect, promote and fulfill the rights of such persons during delivery of mental healthcare and services, the Mental Healthcare Act, 2017 has been enacted by the government. The HIV/AIDS Prevention and Control Act, 2017 has been enacted to legally protect HIV-infected and affected persons from any social,
medical, educational, employment and financial discrimination.

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