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Healthcare Reforms in India and Its
SUBMITTED TO PRESENTED BY
Dr Ranu Sharma Oshin Raj
HOD (MBA Department) MBA (HM) 1st year
Poornima University Poornima University
Health system means “The combination of resources, organization finances and
management culminates in the delivery of the heath service to the population.”
The key institutional component of the health system are:-
• State government
• Healthcare provider
• Resource institutes
• Insurance companies
• Consumers or population
Health Sector Reforms
According to WHO, HSR is a sustain process of fundamental change in policy and
institutional arrangement guide by government and designed to improve the functioning
and performance of health system and ultimately the health status of the population.
HSR component are:-
• Defining priority
• Refining policies
Types of Reform
1. Changes of financing matter
2. Changes in health system organization and management
3. Public sector reform
Challenges to Reform
1. Unclear power of reform responsibility
2. Health insurers want more control and less spending
3. Doctor wants more freedom
4. Minister wants quick changes
5. Health specialist focus on health promotion
Health Reform Cycle
Health Sector Reforms in India
Health sector reforms have come centre stage since 1980s essentially from
the public system. By 1990s the process had taken concrete shape.
In India HSR, broadly covers the following area:
1. Reorganization and restructuring existing healthcare system
2. Involving Community in Health System Delivery
3. Health Management Information System
4. Quality of Care
Eighth Five Year Plan (1992-1997)
Concept of free medical care was revoked.
Ensured commitment for free subsidised care for needy BPL category
Promote social welfare measure like improved healthcare sanitation.
Check the population growth by creating mass awareness program.
Private sector promotion.
Ninth Five Year Plan (1997-2002)
Convergence and involvement of public private health care provider.
Establishment of Panchayat Raj Institution in planning and monitoring
Emphasis on basic infrastructural facilities like safe drinking water, PHC.
Inter sectoral coordination and utilisation of local and community
Tenth Five Year Plan (2002-2007)
Focused on primary, secondary and tertiary health care level.
Emphasis on equity and financial healthcare.
Social health insurance for BPL population under universal insurance
Human resources development.
Focuses on public private partnership.
Policy Shift in Five Year Plans
• Free medical care revoked
• Encouraged initiatives with private sector
• Profit/ non- profit NGOs in healthcare sector
• Inter-sectoral coordination of health programmes
• Panchayat Raj Institution in planning and controlling.
• Address issues of equity
National Rural Health Mission
Health care is now one of the thrust area for the Government of India.
Government of India focus on increasing the expenditure in health sector,
with main focus on primary healthcare for current level of 0.9% of GDP to
2-3% of GDP.
NRHM is the main vehicle for giving the effect from April 2005.
National Urban Health Mission
NUHM (2005-2007) launched by the Government of India in 2005 has a
sub-mission on basic services for the urban poor covering 60 cities in
Focuses on need of the urban poor people population has constituted a task
force on urban health to recommend strategies for improving health.
Integration of AYUSH
Eleventh Five Year Plan (2007-2012)
To achieve good health for the poor and under privilege group.
Reducing MMR to 100/ lakh life birth.
Reducing IMR to 28/1000 live birth.
Reducing malnutrition among children aged group 0-3 years to half.
• Human resources
• Health Management Informatics System
• Public Private Partnership
• Quality Assurance
Twelfth Five Year Plan (2012-2017)
Universal Health Coverage (UHC)
Expansion and Strenthing Public Private Sector
Mandatory practices of clinical treatment system
Grievance Rederessal System
Health Regulation extended and clinical establishment act 2012
Effective Health Sector Reform