3. HEALTH CARE POLICY
NATIONAL AND STATE

5. CONCEPT OF HEALTH AND
COMPREHENSIVE HEALTH CARE
HEALTH CARE: “Services provided to
individuals or communities by the agents of
health services or professionals for the purpose of
promoting , maintaining, monitoring or restoring
health.”

6. COMPREHENSIVE
HEALTHCARE
“The provision of integrated
,preventive ,curative and promotional
health services from womb to tomb, to
every individual residing in a defined
geographical area”

7. HEALTH STRATEGIES
 Restructuring the health infrastructure.

8. HEALTH STRATEGIES
 Developing health Manpower , research and
development.

9. NATIONAL HEALTH POLICY
1983
HISTORY
Bhore committee: 1943
First evolution: 1983
Revised: 2002

10. ELEMENTS OF NATIONAL HEALTH
POLCY IN INDIA
 Awareness Of Health Problems.
 Supply Of Safe Drinking Water And Basic
Sanitation.
 Reduction Of Imbalance In Health Services
 Dynamic Health Management Information
System.

11. ELEMENTS OF NATIONAL HEALTH
POLCY IN INDIA [contd]…….
 Legislative Support.
 Combat widespread Malnutrition.
 Alternative methods of health care delivery
system
Use of low cost technologies.
 Coordination of different systems of medicine.

12. COMPONENTS OF HEALTH POLICY
 Socioeconomic policies
 Employment
 Elementary Education
 Integrated rural development.
 Population Control.
 Welfare of women and children.

13. GOALS OF HEALTH POLICY
 Acceptable standard of good health
Increased access to decentralized public health
system.
Establishing new infrastructure
Equitable access to health services
Preventive and curative services.
Emphasis rational use of drugs and target burden
disease

14. NATIONAL POLICIES RELATED TO
HEALTH

15. NATIONAL HEALTH POLICY- 2002

16. NATIONAL POPULATION POLICY2000

17. NATIONAL AIDS PREVENTION AND
CONTROL POLICY-2002

18. NATIONAL BLOOD POLICY- 2002

19. NATIONAL POLICY FOR THE
EMPOWERMENT OF WOMEN-2001

20. NATIONAL POLICY AND CHARTER
FOR CHILDREN -2003

21. NATIONAL YOUTH POLICY -2003

22. NATIONAL POLICY FOR OLD
PERSON-1999

23. NATIONAL HEALTH RESEARCH
POLICY (DRAFT)

24. NATIONAL POLICY ON EDUCATION

25. NATIONAL PHARMACEUTICAL
POLICY

26. NATIONAL WATER POLICY

27. NATIONAL ENVIRONMENTAL
POLICY-2006

28. NATIONAL HOUSING AND HABITAT
POLICY -1998

29. PARTS OF NATIONAL HEALTH
POLCY

30. PARTS OF NATIONAL HEALTH
PARTS OF NATIONAL
POLICY
Introductory

31. PARTS OF NATIONAL HEALTH
POLICY
Our Heritage

32. PARTS OF NATIONAL HEALTH
POLICY
Progress achieved

33. PARTS OF NATIONAL HEALTH
POLICY
The Existing Picture:
1. High rate of population growth

34. 2. High mortality rate for women
children and Infants

35. 3.Malnutrition

36. 4. High prevalence of Communicable
and Non communicable diseases.

37. 5. Poor access to potable water supply
and the basic sanitation

38. 6. Poverty

39. 7.Ignorance

40. 8. Adoption of Health manpower
models

41. 9. Establishment of Curative centers.

42. 10.Emphasis on hospital based, cure
oriented approach

43. 11.Failure to involve the community in
the identification of health needs and
priorities.

44. PARTS OF NATIONAL HEALTH
POLICY
Revised 20-point programme

45. PARTS OF NATIONAL HEALTH POLICY
Population stabilization

46. PARTS OF NATIONAL HEALTH POLICY
Medical and Health Education

47. PARTS OF NATIONAL HEALTH POLICY
Need for providing primary health care
•
•
•
•
•
Comprehensive primary healthcare
Transfer of knowledge , skills and
technologies
Organized building
Referral system
Sanitary cum epidemiological stations

48. PARTS OF NATIONAL HEALTH POLICY
Need for providing primary health care
• Location of curative centers
•
•
•
•
•
Planned programmes
Speciality and Super speciality care
Well coordinated programmes.
Priority wise services
Adequate mobility of personnel

49. PARTS OF NATIONAL HEALTH POLICY
Reorientation of Existing Health Personnel

50. PARTS OF NATIONAL HEALTH POLICY
Private practice by Government Functionaries

51. PARTS OF NATIONAL HEALTH POLICY
Practitioners of indigenous and other systems of
medicine and their role in health care.

52. PARTS OF NATIONAL HEALTH POLICY
Problems requiring urgent attention
1. Nutrition
2. Prevention of food adulteration and
maintenance of quality of drugs.
3. Water supply and Sanitation
4. Environmental protection.
5. Immunization program.
6. Maternal and child health services.
7. School health program
8. Occupational health services.

53. PARTS OF NATIONAL HEALTH POLICY
Health Education

54. PARTS OF NATIONAL HEALTH POLICY
Management information System

55. PARTS OF NATIONAL HEALTH POLICY
Medical Industry

56. PARTS OF NATIONAL HEALTH POLICY
Health Insurance

57. PARTS OF NATIONAL HEALTH POLICY
Health legislation

58. PARTS OF NATIONAL HEALTH POLICY
Medical research:

59. PARTS OF NATIONAL HEALTH POLICY
Inter sectoral cooperation

60. PARTS OF NATIONAL HEALTH POLICY
Monitoring and review of progress

61. COMMENTS OF NATIONAL HEALTH
POLICY
 Mentions about poverty alleviation and not
about social justice.
 No program for Community Participation
 Totally silent about health budget

Not integrated

No emphasis to certain areas.

62. REVISED NATIONAL HEALTH
POLICY (2002)
OBJECTIVES:
1. Achieve acceptable standard of Good Health
2. Increase access to the decentralized public health system
3. Ensure more equitable access to health services .
4. Increase aggregate public health investment.
5. Strengthen the capacity of public health administration.

63. REVISED NATIONAL HEALTH
POLICY (2002)
OBJECTIVES
6. Enhance the contribution of Private sector
7. Rationalize use of drugs within allopathic system.
8. Increase access to tried and tested systems of
traditional medicine

64. INITIATIVES OF REVISED
NATIONAL HEALTH POLICY
1. A widespread network of comprehensive
health care services.
2. Intermediation through Health Volunteers.
3. Referral System
4. Speciality and Superspeciality services.

65. CURRENT SCENARIO OF OUR
COUNTRY
1. Financial Resources:
 Low public health investment
 Declined GDP

66. CURRENT SCENARIO OF OUR COUNTRY
2. Equity

Lack of equitable distribution of resources

67. CURRENT SCENARIO OF OUR COUNTRY
3. Delivery of National Public Health Programme
 Lack of flexibility of Public health infrastructure
 No permit for state to craft their own
programmes
 Not need based.

68. CURRENT SCENARIO OF OUR COUNTRY
4. State of Public health infrastructure:
 Existing Public health infrastructure is not satisfactory.
 Based on an Objective assessment of the quality and
efficiency of existing public health infrastructure.

69. CURRENT SCENARIO OF OUR COUNTRY
5. Extending public health Services
 Shortage of Medical power
 No incentive system is attempted so far, has induced private
medical manpower

70. CURRENT SCENARIO OF OUR COUNTRY
6. Role of Local Self- government institutions

71. CURRENT SCENARIO OF OUR COUNTRY
7. Medical Education

72. CURRENT SCENARIO OF OUR COUNTRY
8. Need for specialists in „Public health‟ and „Family
Medicine‟

73. CURRENT SCENARIO OF OUR COUNTRY
9. Urban Health

74. CURRENT SCENARIO OF OUR
COUNTRY
10.Mental Health

75. CURRENT SCENARIO OF OUR COUNTRY
11. I E C
Information
Communication
Education

76. CURRENT SCENARIO OF OUR COUNTRY
12. Medical Research

Limited to ICMR

77. CURRENT SCENARIO OF OUR COUNTRY
13.Role of the Private Sector

78. CURRENT SCENARIO OF OUR COUNTRY
14. Role of Civil society

79. CURRENT SCENARIO OF OUR COUNTRY
15.National Disease surveillance
Network

80. CURRENT SCENARIO OF OUR COUNTRY
16. Health Statistics

81. CURRENT SCENARIO OF OUR COUNTRY
17. Women‟s Health

82. CURRENT SCENARIO OF OUR COUNTRY
18. Medical ethics

83. CURRENT SCENARIO OF OUR COUNTRY
19. Enforcement of Quality standards for food and
Drugs

84. CURRENT SCENARIO OF OUR COUNTRY
20. Regulation of Standards in Para medical
disciplines.

85. CURRENT SCENARIO OF OUR COUNTRY
21. Occupational Health

86. CURRENT SCENARIO OF OUR COUNTRY
22. Providing Medical facilities to users from
Overseas

87. CURRENT SCENARIO OF OUR COUNTRY
23. Impact of Globalization on the health
sector

88. CURRENT SCENARIO OF OUR COUNTRY
24. Non Health Determinants

89. CURRENT SCENARIO OF OUR COUNTRY
25. Population Growths and Health Standards

90. CURRENT SCENARIO OF OUR COUNTRY
26. Alternative Systems of
Medicine

91. DEMOGRAPHIC trends of
National health policy
 Population : 1.21 billion
Growth rate: 1.51%
Birth rate : 20.22 birth / 1000 population
 Death rate : 7.4 death /1000 population
 Life expectancy: 68.89 years

92. SWOT ANALYSIS OF NATIONAL
HEALTH POLICY
Strengths:
 Identified deficiencies of the policy.
 Advancement of technology and proven
public health strategies
 Commitment to enhance the budget on
health expenditure

93. SWOT ANALYSIS OF NATIONAL
HEALTH POLICY
Weakness
 Lack of Monitoring and Evaluation
 Lack of Government Expenditure on
Public Health
 Gap in Situation analysis and problem
prescription

94. SWOT ANALYSIS OF NATIONAL
HEALTH POLICY
Opportunities
 Move ahead in Health through Health Policy
Supportive environment and absence of obvious threat
of water and unrest etc.
 Policy initiative will provide a new impetus to the
development of Health Sector

95. SWOT ANALYSIS OF NATIONAL
HEALTH POLICY
Threats:

Health Tourism

97. OBJECTIVES OF STATE HEALTH
POLICY 2013
Information
Governance
Financing
PEOPLE
Human
Resources
Service
Delivery
Medicines and
Technologies

98. KERALA
CURRENT SCENARIO

99. 2. HEALTH FINANCING
• Budget allocation: From NRHM Fund.

100. 3.SOCIAL DETERMINANTS OF
HEALTH

101.  Water Supply
• Increased reclamation of wetlands and Water
bodies
• Increased Pollution

102.  Sanitation
• Problems of Toilet construction in water
logged areas.
• Absence of appropriate models in areas of water
scarcity.
• Sanitary toilets without Septic Tank

103.  Solid and Liquid waste Management
system
•
Accumulation of Plastic waste
• Issue of Thin Plastic Bags
• Ecological degradation
• Contamination of Water bodies
• Misuse of Pesticides

104.  Climate Change and Public
Health
• Challenges to control of infectious
Diseases.
• Seasonal changes in the availability of
Fresh water.
• Regional drop in Food Production
• Rising Sea level

105.  Other Social Determinants of Health

106. Other Social Determinants of Health
• Food and Nutrition

107. Other Social Determinants of Health
• Regular Employment

108. Other Social Determinants of Health
• Housing

109. Other Social Determinants of Health
• Women empowerment

110. 4.
Managing Emerging and
Re emerging Diseases

111. 5. Non- Communicable Diseases
•
50% of Total Deaths – between the age
group of 30-60
• 27% Adult males and 19% Adult
females are diabetic.
• Kerala – “ Diabetic Capital of
India.”

112. 5. Non- Communicable Diseases
Contd……….
 Introduction of NPCDCS
 Introduction of “Amrutham
Arogyam” [ NCD Control
Programme]

113. 6.CANCER CARE- EARLY
DETECTION AND PREVENTION
• Cancer treatment is limited.
• Kerala reports nearly 35,000
new registrations
• Nearly 1 lakh patients are under
treatment every year

114. 7. WOMEN‟S HEALTH

115. 8. MATERNAL HEALTH

116. 9. CHILD HEALTH
•
•
•
•
IMR of Kerala is 12/1000
Achieve universal immunisation
Nutritional Monitoring
Organisation of New born Screening
programmes

117. 10.ADOLESCENT HEALTH
[ARSH]
 WIFS- Weekly Iron and Folic acid
Supplementation programme
 AFHCs – Hospital based Adolescent Friendly
Clinics

118. 11. SCHOOL HEALTH
• Implementation of modified School Health
programme.
• Vision of a School: “ That constantly
strengthens its capacity as a healthy
setting for living and
Working………………’’

119. 12. HEALTH PROBLEMS OF
ELDERLY
• Present elderly population( above 60 years) is
12% and is expected to cross 25% by 2050
• Geriatric friendly Hospitals
• Palliative care policy in Kerala (2008)
• 700 palliative care units are
established with PHC.
• 250 Palliative Care Unit Attached
with Community Based Organizations

120. 13. MENTAL HEALTH
PROBLEMS:

121. 14. HEALTH OF
VULNERABLE SECTIONS
AND HEALTH
INFRASTRUCTURE IN
KERALA

122. OVERVIEW OF HEALTH
SERVICE SYSTEM OF THE
STATE
• Tertiary care
• Secondary care Institutions
• Primary health center
• Sub -center

123. Tertiary Care:

124. Secondary care Institutions

125. Primary Health centers

126. Sub -centers
 5500 ANMs
 3500 JHI
 5403 Sub centers

127. • Emergency medical services and
management of trauma.

128. MEDICAL ESTABLISHMENT
BILL 2013

129. HUMAN RESOURCE POLICY IN
HEALTH

130. NURSING CARE AND NURSING
EDUCATION

131. TREATENT PROTOCOLS,
REFERRAL PROTOCOLS AND
MANAGEMENT GUIDELINES

132. DATA MANAGEMENT SYSTEM

133. DECENTRALIZATION AND
HEALTH

134. PRIVATE SECTOR

135. PLAN OF ACTION

136.  DETERMINANTS OF HEALTH
CARE
• Clean drinking water

137.  DETERMINANTS OF HEALTH CARE
• Sanitation facilities

138.  DETERMINANTS OF HEALTH CARE
• Solid waste management policy and plan of
action

139.  DETERMINANTS OF HEALTH CARE
• Poverty

140.  ENFORCEMENT OF
REGULATIONS FOR GOOD
HEALTH

141. • Food safety

142. • Public health act

143. • Reorganization of Government
Health systems:
•
•
•
•
•
Primary Health centers
Community Health centers
Taluk Head quarters Hospital
District/ General Hospitals.
Medical College Hospitals

144. •
OTHER SPECIALISED AREAS
o Public health cadre and Health protection
Agency

145. o Communicable Disease Surveillance
And Execution Of Control Measures”

146. o Non Communicable Disease
Control

147. o Community Mental Health Care
and Services.

148. o Measures for reducing the Road
traffic accidents other trauma and
developing systemic trauma care
services
• Construction of an “Act force System” ,
involving police.

149. o Strengthening Laboratory
Network in the State:

150. o AYURVEDA

151. o AYURVEDA
 Research and Documentation

152. o AYURVEDA

Quality Assurance

153. o AYURVEDA
Support to Manufacturing

154. o AYURVEDA

Awareness regarding the Benefits of
Ayurveda

155. HOMEOPATHY
• In 1928, The Maharaja of Travancore
acknowledged Homoeopathy as an
acceptable system of treatment.
• Homeopathic health care services:
1. 31 Homeopathic Hospitals.
2. 611 Homeopathic Dispensaries
3. 348 NRHM Homeo Dispensaries
4. 29 Dispensaries at SC/ST dominant areas.

156. HOMEOPATHY
o ESI: 13 Dispensaries and 1 Hospital
o Seethalayam
o Ayushman bhava
o Jyothir gamaya
o Chethana

157. ORAL HEALTH

158. FUTURE DEVELOPMENTS
 Quality up gradation in health sector
 Universal Health Coverage

161. SSSS
CONCLUSION

162. BIBLIOGRAPHY
Text books:
 Gupta M.C, Mahajan B.K . Textbook of preventive and Social medicine:(3rd
ed).New delhi : Jaypee Medical Brothers pvt.ltd; 2003
 Keshav Swarnkar. Community Health Nursing: Includes behavioural sciences
and personal hygiene: (2nd ed). Indore: N.R Brothers publishers Pvt.ltd:2006
 Mary Lucita. Nursing: Practice and public health administration, current
concepts and trends: Newdelhi: Elsevier India pvt.ltd; 2004
 Park.K. Textbook of preventive and social medicine;(16th ed):
Indore;Banarasi Bhanot Brothers; 2007

163. BIBLIOGRAPHY
Government Document:
 Kerala Health care policy 2013. Department of Health and family welfare;
2013.
Online Database
 Chaukar D.A, Walvekar RR, Das A.K, Deshpande MS,Pai. P.S, Chaturvedi . P,
Kakade A, D’cruz A.K; Quality of life in head and neck Cancer Survivors: A cross
sectional study. [Internet]. 2009 May-June [ cited 2009June];30(3): 176-80;
Available from pubmed , http;//:en://www.ncbi.nlm.nib.gov/pubmed]
Website:
 www.slideshare.chantal .net.com
 www.pubmed.com
 www.wikipedia.com