Five year plans

1. FIVE YEAR PLANS
Mrs. NAMITA BATRA GUIN
Professor
Dept. of Community Health Nursing

2. PLAN
• A deliberate attempt to spell out
how the resources of a country
should be put to use.
• Has general and specific goals
which are to be achieved in
specific period of time.

3. HEALTH SECTOR
PLANNING
The health sectors has been
divided into the following
subsectors:
– Water supply and sanitation.
– Control of communicable diseases.
– Medical education, training and
research.

4. Contd…
– Medical care including hospitals,
dispensaries and PHCs
– Public health services.
– Family planning.
– Indigenous system of medicine.

5. FIVE YEAR PLANS
• Conceived to rebuild rural India, for
industrial progress, balance between
development of all parts of the
country.
• Health programs were given
consideration during FYP with the
broad objectives :-
– Control and eradication of major
communicable diseases.

6. Contd…
– Strengthening of the basic health
services
– Population control and
– Development of manpower resources.

7. FIRST FIVE YEAR PLAN(1951-56)
Presented on 8th December, 1951.
AIM
• To fight against diseases, malnutrition and
unhealthy environment.
• To build up health services for rural population.
• To improve general health status.

8. Contd…
PRIORITIES
1.Safe water supply and sanitation
2.Control of malaria
3.Health care of rural population
4.Health services for mothers and children
5.Education and training of health personnel.
6.Self-sufficiency in drugs and equipments
7.Family planning and population control

9. Contd…
HEALTH OUTLAY
Health programs were alloted 5.9% of
the total public sector outlay which
was Rs.2,356 crores.

10. MAJOR DEVELOPMENTS
– BCG vaccination program (51)
– Central Council of health was constituted (52)
– ANM training was started (52)
– National Malaria Control Program (53)
– National Family Planning Program (53)
– National Water Supply and Sanitation Program (54)
– The National Filaria Control Program (55)

11. Second FIVE YEAR PLAN(1956-61)
Continuation of the development efforts
commenced in the first plan.
AIM
• To expand existing health services to bring them
in reach of all people.

12. Contd…
PRIORITIES
1.Establishment of institutional facilities for
rural as well as urban population.
2.Control of communicable diseases
3.Development of technical manpower
4.Water supply and sanitation
5.Family planning and other supporting
programs

13. Contd…
HEALTH OUTLAY
An outlay of Rs. 225 crores was
allocated for health programs

14. MAJOR DEVELOPMENTS
– Central Health Education Bureau was setup (56)
– National Malaria Control Program converted into
National Eradication Program (58)
– Mudaliar Committee was setup (59)
– National Nutrition Advisory Committee was formed
(60)

15. THIRd FIVE YEAR PLAN(1961- 66)
AIM
• To remove shortages and deficiencies especially
in rural areas – shortages of trained personnel
and supplies, lack of safe drinking water and
inadequate drainage system.

16. Contd…
PRIORITIES
1.Safe water supply in villages and sanitation
2.Expansion of institutional facilities.
3.Eradication of malaria and small pox and
various other communicable diseases.
4.Development of technical manpower
5.Family planning and other supporting
services

17. Contd…
HEALTH OUTLAY
An outlay of Rs. 342 crores was
allocated for health programs which
was 4.3% of overall layout.

18. MAJOR DEVELOPMENTS
– Central Bureau of Health Intelligence was established
(61)
– National Smallpox Eradication Program(62)
– School health program (62)
– National Trachoma Control Program (63)
– Lippes Loop was recommended as a safe and effective
family planning device (65)
– Madhok Committee was appointed for reviewing
the Malaria eradication program (67)

19. FOURTH FIVE YEAR PLAN(1969- 74
)
Due to political reasons it was presented in 1969
instead of 1966 as scheduled
AIM
• To strenghthen primary health centre network in
rural areas
• To take over the maintenance phase of
communicable diseases

20. Contd…
PRIORITIES
1.Family planning program
2.Strengthening of primary health centres
3.Strengthening of subdivisional and district
hospitals.
4.Intensification of control program
5. Expansion of medical and nursing
education and training of para-medics

21. Contd…
HEALTH OUTLAY
Rs.840 crores were allocated to the
health and Rs. 315 crores for family
planning.

22. MAJOR DEVELOPMENTS
– Central Births and Deaths Registration Acts was
promulgated(1969)
– Population Council of India was setup (70)
– MTP Act was implemented (72)
– Kartar Singh Committee submitted its report (73)
– National Programme of Minimum Need Programme
(73)

23. Achievements of first four five year
plans
• Mortality rate was declined from 27.4 in year 1949-50
to 15.1 in year 1971
• IMR dropped to 140/1000 live births from 183/1000
live births
• Life expectancy gone up from 32years to 50 years.
• Bed: population ratio increased upto 0.49/1000 from
0.32/1000

24. FIFTH FIVE YEAR PLAN(1974- 79 )
AIM
• To provide the minimum level of well integrated health,
MCH &FP, nutrition and immunization services to all
people with special reference to vulnerable groups.
• To remove the imbalance in medical facilities and
strengthen health infrastructure in rural and tribal
areas.

25. Contd…
PRIORITIES
Priorities of this plan was based on the
minimum needs program.
1. Increasing accessibility of health services in rural
areas.
2. Correcting the regional imbalance.
3. Further development of referral services
4. Integration of health, family planning and
nutrition.
5. Intensification of control and eradication
programs
6. Qualitative improvement in education and
training of health personnel.

26. Contd…
HEALTH OUTLAY
Total outlay for overall development
plan was Rs37,382 crores, out of
which a sum of Rs. 682 crores were
allocated for health programs and
497 crores for family planning.

27. MAJOR DEVELOPMENTS
– The water (prevention and control of pollution) Act
1974 was enacted by the Parliament.
– India became small pox free (1975)
– ICDS was launched on 3rd october 1975.
– Central council of health proposed 3 tier plan for
medical care in villages. (76)
– Rural health scheme was launched (77)
– Extended program of immunization started (78)

28. SIXTH FIVE YEAR PLAN(1980- 85 )
AIM
• To workout alternative strategy and plan of action for
primary healh care as part of national system.

29. Contd…
PRIORITIES
1. Rural health services
2. Control of communicable and other diseases
3. Development of rural and urban hospitals/
dispensaries.
4. Improvement in medical education and training.
5. Medical research
6. Drug control and prevention of food adulteration.
7. Population control and family welfare including
MCH
8. Water supply and sanitation
9. Nutrition

30. Contd…
HEALTH OUTLAY
Total outlay for overall development
plan was Rs97,500 crores, out of
which a sum of Rs. 1,821.05 crores
were allocated for health programs
and 1,010 crores for family welfare
programs.

31. MAJOR DEVELOPMENTS
– WHO declared eradication of small pox from the
world (80)
– India committed itself to the goal of providing the
drinking water and adequate sanitation for all by
1990. (81)
– Air prevention and control of pollution Act of 1981
was enacted.
– National Health policy was approved and placed in
the parliament. (82)
– NHP was approved (83)
– National Guinea worm eradication program was
started. (83)

32. SEVENTH FIVE YEAR PLAN(1985-
1990)
AIM
• To plan and provide primary health and medical
services to all with special consideration of vulnerable
groups.
• To emphasize on community participation, intersectoral
coordination and cooperation.

33. Contd…
PRIORITIES
1. Health services in rural, tribal and hilly areas
2. Medical education and training
3. Control of emerging health problems especially
non-communicable diseases.
4. MCH and family welfare
5. Medical research
6. Safe water supply and sanitation.
7. Standardization, integration and application of
Indian system of medicine.

34. Contd…
HEALTH OUTLAY
Total outlay for overall development
plan was Rs18,000 crores, out of
which a sum of Rs. 8,900 crores were
allocated for health programs and
3,256.25 crores for family welfare
programs.

35. MAJOR DEVELOPMENTS
– Univeral immunization program was launched on 19th
Nov. 1985.
– Separate deptt. Of women and child development
was established (85)
– Parliament passed Mental Health bill. (86)
– Juvenile Justice Act started working (86)
– National AIDS control program (86)
– World wide safe motherhood campaign was
started(87)
– National Diabetes control program was launched. (87)
– High power committee on Nursing and nursing
profession published its report in 1989.

36. EIGHTH FIVE YEAR PLAN(1992-
1997)
AIM
• To continue reorganization and strengthening of health
infrastructure and medical services accessible to all
with special consideration of vulnerable groups.

37. Contd…
PRIORITIES
1. Developing rural health infrastructure
2. Medical education and training
3. Control of communicable diseases
4. Strengthening of health services
5. Medical research
6. Universal immunization
7. MCH and family welfare
8. Safe water supply and sanitation.

38. Contd…
HEALTH OUTLAY
Total outlay for overall development
plan was Rs79,800 crores, out of
which a sum of Rs. 7,575.92 crores
were allocated for health programs
and 6,500 crores for family welfare
programs.

39. MAJOR DEVELOPMENTS
– CSSM was started (92)
– Revised strategy for National T.B. program with DOTS
(93)
– Panchayati Raj Act came into operation (94)
– First pulse polio immunization program for children
under 3years was organized. (94)
– Transplantation of Human organs Act was enacted.
(95).
– Family planning program was made target free. (96)
– Pre-natal diagnostic technique Act 1994 came into
force.

40. NINTH FIVE YEAR PLAN(1997-
2002)
AIM
• To tackle both communicable and non-communicable
diseases
• To further intensify the efforts to improve the health
status of population by optimizing coverage and quality
care by identifying critical gaps.

41. Contd…
PRIORITIES
1. Control of communicable and non-communicable
diseases
2. Efficient primary health care system
3. Strengthening of existing infrastructure
4. Improvement of referral linkages
5. Strengthening existing national vertical programs.
6. Disaster and emergency management
7. Involvement of practitioners from ISM.
8. Intersectoral coordination

42. MAJOR DEVELOPMENTS
– RCH was launched (1997)
– National population policy was announced in 2000
– NFHS -2 was undertaken in 98-99
– Phase II of National AIDS control program was
started.
– NHP-2002 was announced.
– National AIDS prevention and control policy 2002 was
announced by GoI.

43. TENTH FIVE YEAR PLAN(2002-
2007)
AIM
• To provide essential primary health care, emergency life
saving services, services under national programs
totally free of cost for all individuals.
• To provide essential health care on basis of the needs
of the population and not according to their ability to
pay.

44. Contd…
PRIORITIES
1. Reorganization and restructuring of existing
health care system.
2. Horizontal integration of all vertical programs
3. Transparent norms for quality and cost of care.
4. Quality education to health professionals
5. Research and development.
6. Health management and information system
7. Effective system of disease surveillance
8. Mainstreaming ISM &H practitioners to improve
coverage
9. Public private partnership
10.Health care financing

45. MAJOR DEVELOPMENTS
– NRHM was launched in 2005 in 18 states of India
– RCH-II strategy was launched in 2005.
– Vision 2020 was initiated by planning commission
– Mainstreaming of ISM &H was done
– ISM&H was formed as a separate deptt. And was
given the name of AYUSH.
– JSY was launched under the RCH-II.
– Quality control systems were developed at district
level known as Rogi kalyan samitis.
– GoI announced pharmaceutical policy (2002)
– National environmental policy was formed in 2006
– Act against domestic violence (2005)

46. ELEVENTH FIVE YEAR PLAN(2007-
2012)
AIM
• To improve the primary health care system through
integrated district health plans
• To reduce the burden and levels of risk of existing,
growing and emerging diseases.
• To address special health care needs of elderly.

47. Contd…
PRIORITIES
1. Improving health equity
2. System centric approach
3. Health insurance
4. Decentralized governance.
5. Establishing e-health
6. Health tourism
7. Disease reduction
8. Health research
9. Disability and mental health
10.Clean water for all and sanitation

48. MAJOR DEVELOPMENTS
– Sale of non-iodized salt banned (2007)
– Draft of NUHM was produced in parliament
– NACP-III was launched
– IPHS on PHC and subcentres were formulated.
– Maintenance and welfare of parents and Senior
citizens Bill passed (2007)
– Non-communicable disease program as pilot project
launched (2008).

49. TWELFTH FIVE YEAR PLAN(2012-
2017)
Importance :
 First time in the history of India, widespread
public consultation to prepare the draft of 12th
Five year Plan
 High level Expert Group on Universal Health
Coverage

50. Contd…
Objectives
1. Reduction of MMR (75/1000 live Births)
2. Reduction of IMR (19/1000 Live Births)
3. Reduction of TFR 2.1
4. Prevention and reduction of underweight
children under 3 years of age.
5. Prevention and reduction of anemia among
women aged 15-49 years.
6. Raising child sex ratio in the 0-6 year age group
from 914 to 935
7. Prevention and reduction of burden of diseases.
8. Reduction of household out of pocket
expenditure from 71% to 50% of the total health
care expenditure.

51. Contd…
Strategies
• Strengthening of public health sector.
• Substantial increase in health care expenditure.
• Efficient financial and managerial systems.
• Coordinated delivery of services.
• Cooperation between public and private sector.
• Expansion of skilled human resource.
• Prescription drug reforms.
• Effective regulation through the public health cadre.
• Inclusive agenda.
• Pilots on universal health care.
• Promote research in national health outcomes.
• Integration of AYUSH in teaching, research and practice.

52. MAJOR DEVELOPMENTS
• India became Polio free – 2014.
• Rasthriya bal suraksha karayakaram launched. (2013).
• Four new vaccines- rotavirus, rubella and polio injectable.
And one adult vaccine against JE added. (2014)
• National Urban Health Mission launched (2013).
• Saksham scheme for adolescent boys (2014).