1. STATE AND NATIONAL HEALTH
POLICIES
PRESENTED BY
HEENA MEHTA
S.Y.M.SC NURSING
OBSERVED BY
MRS A.YONATANMADAM
ASSOCIATE PROFESSER
J G NURSING COLLEGE

2. NATIONAL HEALTH POLICY-
1983
• Introduction
• "A health policy generally describes
funda-mental principles regarding which health
providers are expected to make value
decisions." 'Health Policy' provides a broad
framework of decisions for guiding health
actions that are useful to its community in
improving their health, reducing the gap
between the health status of haves and have-
nots and ultimately contributes to the quality of
life.

3. • NHP 1983 stressed the need for providing
primary health care with special emphasis on
prevention, promotion and rehabilitation
• •Suggested planned time bound attention to
the following
• i) Nutrition, prevention of Food
• Adulteration
• ii) Maintenance of quality of drugs

4. The Priorities of this policy
• a. Nutrition
• b. Prevention of food adulteration and
quality of drugs
• c. Water supply and sanitation
• d. Environmental protection
• e. Immunization programs
• f. Maternal and child health services

5. • Other Aspects
• 1. Health Education.
• 2. Development of Managerial Information
System (MIS).
• 3. Production of Drugs and Equipments.
• 4. Health Insurance and Legislation.
• 5. Medical Research.
• 6. Policy Formulation
• i. Identifying Policy Needs
• ii. Formulating Policy
• iii. Designing Policy Strategies
• iv. Reviewing the Policy

6. Health Policy Formulation in
India
• a. Ministry of Health identified the need for
policy arising out of handling of the day-to-
day problems related to various health
programmes and commitment to achieving the
goals of HFA by 2000 AD.
• b. Ministry appointed a committee to review
environment in the health sector and
recommended a policy frame after needful
consultation.

7. • The draft policy document based on the
recommendation of 5th Joint Conference of
Central Council of Health and Family Welfare in
October 1978 was thrown open to various
individuals, groups, institutions and health
related sectors for wider discussions and
comments with a view to build inter-linkages
between various Ministries and provide
rationality, consis-tency in the content and
suggest alternates within the possible
resources, to improve the acceptability of
the policy.

8. • The revised draft was presented to subsequent
Joint Council of Health and Family Welfare to
get the views of Health Ministers of the States
and later to National Development Council
to get the views of the State Chief Ministers
and their concurrence.
• e. The final draft was presented to the Cabinet
for approval and adoption.

9. • f. After the Cabinet's approval the
document was presented in the National
Parliament for ratification in December
1982.

10. Policy Review

11. Elements
• 1. Solving of Health Problems.
• 2. Supply of drinking water and basic
sanitation, using technologies that the
people
• can afford.
• 3. Reduction of existing imbalance in
health services by increasing Rural
Infrastructure.

12. • 4. Establishment of HIS (Health
Information System).
• 5. Provision of legislature support to
health projection and health promotion.
• 6. Concerted actions to combat
widespread malnutrition.
• 7. Research into alternative methods of
health care delivery and low cost health
• technologies.
• 8. Greater coordination of different
systems of medicine.

13. Components
• 1. Reduction of regional disparities.
• 2. Fuller employment.
• 3. Elementary education.
• 4. Integrated rural development.
• 5. Population control.
• 6. Welfare of women and children.

14. Health Strategies
• 1. Restructuring of the health infrastructure.
• 2. Development of Health Manpower.
• 3. Research and development.

15. Specific Goals
• 1. To establish one HSC for every 5,000 (3,000
for hilly areas).
• 2. To establish one PHC for every 30,000
population.
• 3. To establish one CHC for every 100,000
population.
• 4. To train Village Health guides selected by
the community for 1000population in each
village.
• 5. To train TBAs in each village.
• 6. Training of various categories of field

16. Sr. no NATIONAL HEALTH POLICY - 2002 GOALS TO BE
ACHIEVED BY 2015 Year
1 Eradicate Polio and Yaws 2005
2 Eliminate Leprosy 2005
3 Eliminate Kala-azar 2010
Eliminate Lymphatic Filariasis 2015
4 Achieve zero level growth of HIV / AIDS 2007
5 Reduce mortality by 50% on account of TB 2010
6 Malaria and other vector and water borne diseases 2010

17. 7 Reduce prevalence of blindness to 0.5% 2010
8 Reduce IMR to 30/100 And MMR to 100/Lakh 2010
9 Increase utilization of public health facilities from 2005
current level of < 20% to > 75%
Establish an integrated system of surveillance, 2010
10 National Health Accounts and Health Statistics.
Increase health expenditure by Government as a 2010
11 % of GDP from the existing 0.9% to 2.0%
12 Increase share of central grants to constitute at 2005
least 25% of total health spending
13 Increase state sector health spending from 5.5% 2010
to 7% of the budget Further increase to 8% of
the budget

18. NATIONAL HEALTH POLICY-
2001
• National health policy 2001 for the accelerated
achievement of public health goals in the
contex of previling socio-economic
circumstance.
• The main objective of NHP-2001 is to achieve
acceptable standard o good health amongst the
general population of the country.

19. GOALS TARGET TIME
ERADICATION POLIO & YAWS 2005
ELIMINATE LEPROSY 2005
ELIMINATE KALA-AZAR 2010
ACHIEVE ZERO LEVEL GROWTH OF HIV/AIDS 2007
ELIMINATE LYMPHATIC FILARIASIS 2015

20. REDUCE MORTALITY BY 50% ON ACCOUNT OF TB 2010
,MALARIA
OTHER VECTOR BORN & WATER BORN 2010
PREVENLENCE
OF BLINDNESS TO 0.5%
REDUCE IMR TO 30/1000& MMR TO 1 LAKH 2010
IM PROVE NUTRITION & REDUCE LBW BABIES 2010
FROM30%
TO 10%
INCREASE UTILIZATION OF PUBLIC HEALTH
FACILITIES 2010
FROM CURRENTLEVEL OF <20 TO >75%

21. ESTABLISH AN INTEGRATED 2005
SYSTEM OF SURVELLANCE,
NATIONAL HEALTH ACCOUNT
AND HEALTH STATISTICS
INCREASE HEALTH 2010
EXPENDITURE BY GOVERNMENT
AS A
% GDP FROM 0.9 TO 2%
B INCREASE SHARE OF CENTRAL 2005
GRANTS TO CONSTITUTE
AT LEAST 25% OF TOTAL HEALTH
SPENDING
C INCREASE STATE SECTOR
HEALTH SPENDING FROM 5.5% TO
7% OF THE BUDGET

22. MAJOR ISSUE BEING
ADDRESSED BY NHP 2001
ARE AS UNDER-
• HAND OUT

23. NATIONAL HEALTH POLICY –
2002
• GOALS TO BE ACHIEVED
BY 2015
•

24. Sr. no NATIONAL HEALTH POLICY - 2002 GOALS
TO BE ACHIEVED BY 2015 Year
1 Eradicate Polio and Yaws 2005
2 Eliminate Leprosy 2005
3 Eliminate Kala-azar 2010
Eliminate Lymphatic Filariasis 2015
4 Achieve zero level growth of HIV / AIDS 2007
5 Reduce mortality by 50% on account of TB 2010
6 Malaria and other vector and water borne 2010
diseases
7 Reduce prevalence of blindness to 0.5% 2010

25. 8 Reduce IMR to 30/100 And MMR to 2010
100/Lakh
9 Increase utilization of public health 2005
facilities from current level of < 20%
to > 75%
Establish an integrated system of 2010
10 surveillance, National Health
Accounts and Health Statistics.
Increase health expenditure by 2010
11 Government as a % of GDP from the
existing 0.9% to 2.0%
12 Increase share of central grants to 2005
constitute at least 25% of total health
spending
13 Increase state sector health spending 2010

26. Objectives
* The main objective of this policy is to
achieve an acceptable standard of good
health amongst the general population of
the country.
• Decentralized public health system by
establishing new infrastructure in deficient
areas, and by upgrading the infrastructure
in the existing institutions.
• Ensuring a more equitable access to
health services across the social and

27. • Emphasis will be given to increasing
the aggregate public health investment
through a substantially increased
contribution by the Central
Government.
• Strengthen the capacity of the public
health administration at the State level
to render effective service delivery.

28. NHP-2002 - Policy
prescriptions
• Financial resources
• Equity
• Delivery of national public health
programmes
• The state of public health infrastructure
• Extending public health services
• Role of local self-government
institutions

29. Need for national health
policy
• Population stabilization
• Medical and Health Education
• Providing primary health care with special
emphasis on the preventive, promotive and
• rehabilitative aspects
• Re-orientation of the existing health personnel
• Practitioners of indigenous and other systems
of medicine and their role in health care

30. •NATIONAL
HEALTH
POLICY-2010

31. IMPROVED HEALTH
INDICATORS
• In 2010, India has the lowest ever polio
transmission levels, especially during the high
transmission season, amidst high quality
surveillance. There has been a sharp decline in
the number of polio cases reported this year –
only 41 polio cases in the country as on
30.11.2010 compared to 633 polio cases in the
corresponding period of 2009.

32. • As per latest data made available by National
AIDS Control Organization, the India HIV
estimates 2008-09 highlight an overall reduction
in adult HIV prevalence and HIV incidence (new
infections) in India. Adult HIV prevalence at
national level has declined from 0.41% in 2000
to 0.31% in 2009. The estimated number of
new annual HIV infections has declined by
more than 50% over the past decade.
• Leprosy Prevalence Rate has been further
reduced to 0.71/10,000 in March, 2010. 32
State/UTs have achieved elimination by March
2010, leaving onlyBihar, Chhattisgarh and

33. • TB mortality in the country has reduced from
over 42/lakh population in 1990 to 23/lakh
population in 2009 as per the WHO global
report 2010. The prevalence of TB in the
country has reduced from 338/lakh population
in 1990 to 249/lakh population by the year 2009
as per the WHO global TB report, 2010.

34. NEW INITIATIVES
•HAND OUT

35. HEALTH
INFRASTUCTURE
SERVICE
DELIVERY
COMMUNITY
MONITORING ACHIEVEMENT HUMAN
RESOURCE
SYSTEM
STRENGTHENING

36. •OTHER NATIONAL
HEALTH POLICIES
•

37. NATIONAL NUTRITIONAL
POLICY
• Formultion and acceptance of
national Nutitional Policy in
1993 by Government

38. SHORT TERM MEASURE
• The NNP suggested and recommended to
expand the nutritio intervention net through
ICDS to cover 0 to 6 age children, which is 18%
of the population. Out of this 51 million children
come from below poverty line,since only 15.3
million children are covered atpresent, the
remaining were to be covered by extending
ICDS to another 2388 blocks by the year 2000.
• Behaviour change By involving mothers in
nutrition intervention like growth monitoring,
supplementary nutrition, etc one can reduce
severe and moderate malnutrition

39. • Reaching adolescent girls the policy
suggested to include all adolescent girls
from poor families under ICDS by 2000 in
all community development blocks in rural
ares and in 50% of urban slums.
• Better coverage of lactating mothers The
policy intended to acheve a target of 10%
LBW by covering pregnant women from
first trimester to one year after pregnancy
under supplementary nutrition.

40. • Other short term inventions
fortification of essential foods with
appropriate nutrients popularization of
low cost nutritionous foods involving
local women,intensified programme of
supplementation of Vit A ,iron folic
acid and iodine among
pregnant,lactating and 0-6 children to
eradicate nutritional blindness by
2000 and to reduce anaemia among
lactating mother to 25% by 2000.

41. LONG –TERM MEASURES
BY NNP
• -Food production to rise to 250 million tonners
per year by 2000.
• - Per capita food availability 215 kg/person/year
• *Production for improvement of dietary
pattern
• -Increase in production of pulses,oilseed,other
food crops
• -Augmentation of production of protective
foods.

42. • High yield variety cultivation recommended.
• -Transit and storage wastage is minimized.
• *Policy for Entitlement package
• -Restructuring of poverty allevation programme
like IRDP,Jawahar rozgar Yojana, Nehru
• Rozgar Yojana and DWCRA.
• -Additional employment of 100 days to rural
landless family.
• -Opportunities to slum dwellers and urbanpoor.
• -PDS to distribute coarse
grain, pulses, juggery, bedsides
rice, wheat, and sugar and oil.

43. • Land reformation measures
• -Tenural reforms
• -Implementation of ceiling laws.
• *Health services and FW service
• -Health and nutrition are made inseparable
parts.
• -Provision of health care and FP care along
with nutritional care.
• *Health knowledge health education to
the community, Nutritional education to the
community

44. • *Strengthening of prevention of food
adultration act.
• *Nutrition monitoring food and nutrition
board is made accountable for the
monitoring of nutritional programme.
• *Research NNP recommends research in
various aspects of nutrition.
• *Equal remuberation
• -Stringent enforcement of equal
Remnuneration Act.
• -Expansion of employment opportunities to
women

45. NATIONAL POLICY FOR
EDUCATION
• The Government of india considered
the question of evolving a national
policy for the welfare of children and
accordingly in 1974 adopted National
Policy for children.
•

46. • Under National Educational
Policy, the new thrust is elementary
education. This emphasizes two
aspects
• 1-Universal enrolment and universal
retention of children up to 14 age.
• 2- It brings about improvement in
quality of education

47. CHILD CENTERED
APPROACH
• At primary stage a child centered and
activity based process of learning is
dopted. The kids are allowed to set
their own pace and given
supplementary remedial instruction.At
a later stage,component of cognitive
learning is increased and skills are
organized through practice.

48. • SCHOOL FACILITIES
• NON – FORMAL
EDUCATION

49. NATIONAL POLICY FOR
CHILDREN
• Government of india
adopted the National
policy for children in
August 1974.

50. • The basis of National policy for children is
the United Nations Declaration of Rights of
the child.
• Following principle s are drawn from the
UN declarations.
– Child should have its right irrespective
of nation, social origin and
withoutdiscriminition of race ,sex and
religion.
– Healthy and normal environment are
provided for child which can enjoy
physical, mental , moral and spiritual.

51. – Name and nationality should be its birth right.
– It should get access to social
security, nutrition, recreation and medical services.
– Special treatment, care and education should be
given to a physically handicapped child.
– Family, society and public are responsible for the
tender care, love and understanding of the child.
– It should receive free and compulsory elementary
education thereby it can be a useful member of the
society.
– Protection and relief should be given to a child as
first priority.
– It must be protected from cruetly, exploitation and
child labour.

52. • Following measures are recommended for
adoption to attain the set objectives under the
policy for children.
• They are.
• Children are covered by comprehensive health
care programme.
• Nutritional services to overcome nutritional
deficiencies are adopted.
• Care of pregnant and lactating takes care of
general improvement of children

53. • Free and compulsory education is providedto
children upton14 years of age.
• A programme of informal education for girls
and children of weaker section of society is
undertaken.
• Other form of education to children who do not
take up formal education is advocated.
• Games, sports and recreational activities are
made compulsory in educational system.
• Special assistance to SC,ST and economically
weaker section is provided both in urban and
rural areas.
•

54. • They are protected against neglet, cruelty
and exploitation.
• No child labour is admitted on any
account.
• Physically handicapped ,emotionally
disturbed and mentally retarded are
provided facilities for treatment.
• They are given priority in natural calamity.
•

55. NATIONAL DRUG POLICY
• In the year 1975 Hathi Committee listed 116
drugs as essential drugs.
• Rational drug policy needs a National frug
Formulary, through we have , it needs updating
along the line of British Natioal Formulary.
Drugs listing under following category is
mandatory for an effective drug policy.
•

56. • 1-Graded essential drugs
• -for primary health care
• -for secondary and tertiary care
• -research and super speciality care
• 2-Priority drugs
• -drug for emergency
• -drug for epidemic
• -drug for national health programmes.
• 3-Essential drugs which are
national, scientifically proven, therapeutically
effective.,economical and socially acceptable.

57. • 4- Rational Drugs accepted worldwide and are
available for evidence based medicine.
• Fole projected following objectives canan
effective national grug policy,
• a-Community need assessment allow the
requirement of essential drugs for primary
health care. This also eliminate toxic drugs.
• b- Total quality control on production, price and
quality I possible by the policy.
• c-Drug information system can be developed.
• d-It ensures ethical marketing of drugs

58. • e-The nation can develop self-
sufficiency,reliance in drug technology and
reduction in import quantum.
• f-The policy can update exiting legislations to
make it consistant with requirement of
community health care and safety.
• -The poisons Act,1919
• -The Dangerous Drugs Act,1930
• -The Drug and Cosmetics Act,1940, amended
later in 1955,1962,1964,1972 and 1982.

59. NATIONAL ANTIBIOTIC
POLICY
• Objectives of the policy
• Monitoring through refence laboratory for susceptibility
and resistance.
• Bioavailability studies , research and development of new
antibiotics.
• Uniformity in antibiotic use at hospital, PHC and General
practitioners.
• Survellance of antibiotis usage.
• Development of national registry on sensitivity and
resistance.
• Proper and effective legislative enforcement.
•

60. NATIONAL ALCOHOL
POLICY
• In an effort towards finding solution, World
Health Organisation has begun to give
• Emphasis to the development of National
alcohol policy. They are also health problems
and hence it is legitimate to include in national
strategy.
• The health problem that are seen are;
• Liver cirrhosis

61. • Cancer of GI Tract
• Road traffic accidents
• Fires
• Child abuse
• Suicide
• The second problem is seen with alcohol
industry and its review, which cannot be tackled
without a national consensus.

62. • Since a democratic country like india need
background information, one can suggest the
of following for the development of policy.
• -Definition of alcoholism
• -Response of the society
• -Administrative responsibility
• -Major alcohol problems, its magnitude.
• -Influence of international alcohol market.
• The country has to look into the political level
for declaration, responsible office for
implementation and a suitable system for
implementation.

63. •HAVE ANY
QUIRY?

64. •Summary
•conclusion

65. BIBLIOGRAPHY
• 1. Basvanthappa : Community Health
Nursing, 1st Ed. New Delhi, Jaypee Brothers
Medical Publishers, Reprint 2003. Pp. :317-
318.
• 2. Dr. Mrs. Rao Kasturi Sunder : An Introduction
to Community Health Nursing, 4th
Ed., Chennai, B.I. Publications, Reprinted 2005.
Pp.: 574-579.

66. • 3. Gulani K. K. : Community Health Nursing-
Principles & Practices. 1st Ed., Delhi, Kumar
Publishing House, 2005. Pp.:322-325.
• 4. Mahajan B. K. & Gupta M. C. : Textbook of
Preventive & Social Medicine, 2nd Ed., New
Delhi, Jaypee Brothers, 1995.
• 5. Park J. E. : Textbook of Preventive & Social
Medicine, 20th Ed., Jabalpur, M/s Banarsidas
Bhanot, 2000. Pp.: 423- 424.

67. •THANK YOU
AND HAVE A
NICE DAY