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Government of India
Ministry of Health and Family Welfare

Cabinet approves National Health Policy 2017

A huge milestone in the history of public health in India: J P Nadda

It provides policy framework for achieving universal health coverage, and is patient-centric and quality-driven: J P Nadda

Terming the Cabinet approval of the National Health Policy 2017 as a huge milestone in the history of public health in the country, Union Minister for Health & Family Welfare Shri J P Nadda said that it seeks to reach everyone in a comprehensive integrated way to move towards wellness. Shri Nadda added that NHP 2017, which is patient-centric and quality-driven, provides the much needed policy framework for achieving universal health coverage and delivering quality health care services to all at an affordable cost. The Union Health Minister stated under the guidance of the Hon. Prime Minister Shri Narendra Modiji, the Health Ministry has formulated the National Health Policy 2017, after a gap of 14 years, to address the current and emerging challenges necessitated by the changing socio-economic and epidemiological landscapes since the last National Health Policy was framed in 2002.

Shri Nadda said that “The Policy recommends prioritizing the role of the Government in shaping health systems in all its dimensions. The roadmap of this new Policy is predicated on public spending and provisioning of a public healthcare system that is comprehensive, integrated and accessible to all. Further, it advocates a positive and proactive engagement with the private sector for critical gap filling towards achieving national goals. It envisages private sector collaboration for strategic purchasing, capacity building, skill development programmes, awareness generation, developing sustainable networks for community to strengthen mental health services, and disaster management”. The Minister added that the Policy advocates financial and non-financial incentives for encouraging the private sector participation.

NHP 2017 seeks to promote quality of care, focus on emerging diseases and invest in promotive and preventive healthcare. It addresses health security and make in India for drugs and devices. The Policy has also assigned specific quantitative targets aimed at reduction of disease prevalence/incidence, for health status and programme impact, health system performance and system strengthening. It seeks to strengthen the health surveillance system and establish registries for diseases of public health importance, by 2020. It also seeks to align other policies for medical devices and equipment with public health goals.

Elaborating on the salient features of the NHP 2017, Shri Nadda said that the Policy advocates a progressively incremental assurance-based approach. The broad principles of the Policy are centered on professionalism, integrity and ethics, equity, affordability, universality, patient centered and quality of care, accountability and pluralism. It aims to achieve the highest possible level of good health and well-being through a preventive and promotive health care orientation in all developmental policies, and to achieve universal access to good quality health care services without anyone having to face financial hardship as a consequence, Shri Nadda added.

There is a sharpened focus to inform, clarify, strengthen and prioritize the role of the Government in shaping health systems in all its dimensions- investment in health, organization and financing of healthcare services, prevention of diseases and promotion of good health through cross sectoral action, access to technologies, developing human resources, encouraging medical pluralism, building the knowledge base required for better health, financial protection strategies and regulation and progressive assurance for health. The Minister also said that the Policy emphasizes reorienting and strengthening the public health institutions across the country, so as to provide universal access to free drugs, diagnostics and other essential healthcare.

The Policy positions primary healthcare to be comprehensive and universal. It also seeks to ensure improved access and affordability of quality secondary and tertiary care services through a combination of public hospitals and strategic purchasing in healthcare deficit areas from accredited non-governmental healthcare providers, achieve significant reduction in out of pocket expenditure due to healthcare costs, reinforce trust in public healthcare system and influence operation and growth of private healthcare industry as well as medical technologies in alignment with public health goals.

As a crucial component, the Policy proposes raising public health expenditure to 2.5% of the GDP in a time bound manner. It envisages providing larger package of assured comprehensive primary health care through the ‘Health and Wellness Centers’ and denotes important change from very selective to comprehensive primary health care package which includes geriatric health care, palliative care and rehabilitative care services. It advocates allocating major proportion (up to two-thirds or more) of resources to primary care followed by secondary and tertiary care. It also aspires to provide at the district level most of the secondary care which is currently provided at a medical college hospital. In order to provide access and financial protection at secondary and tertiary care levels, NHP 2017 proposes free drugs, free diagnostics and free emergency care services in all public hospitals. The Policy envisages strategic purchase of secondary and tertiary care services as a short term measure to supplement and fill critical gaps in the public health system.

National Health Policy 2017 affirms commitment to pre-emptive care (aimed at pre-empting the occurrence of diseases) to achieve optimum levels of child and adolescent health. It envisages school health programmes as a major focus area as also health and hygiene being made a part of the school curriculum.

In order to leverage the pluralistic health care legacy, NHP 2017 recommends mainstreaming the different health systems: better access to AYUSH remedies through co-location in public facilities; Yoga would be introduced much more widely in school and work places as part of promotion of good health.

Under a ‘giving back to society’ initiative, the new Health Policy supports voluntary service in rural and under-served areas on pro-bono basis by recognized healthcare professionals. It also advocates extensive deployment of digital tools for improving the efficiency and outcome of the healthcare system and proposes establishment of National Digital Health Authority (NDHA) to regulate, develop and deploy digital health across the continuum of care.

There is also a strong focus on improving regulatory mechanisms recognizing the need to regulate the use of medical devices so as to ensure safety and quality compliance as per the standard norms.

Government of India formulated the Draft National Health Policy and placed it in public domain on 30th December, 2014. Thereafter following detailed consultations with the stakeholders and State Governments, based on the suggestions received, the Draft National Health Policy was further fine-tuned. It received the endorsement of the Central Council for Health & Family Welfare, the apex policy making body, in its Twelfth Conference held on 27th February, 2016.

National Health Policy, 2017 approved by Cabinet Focus on Preventive and Promotive Health Care and Universal access to good quality health care services.

The Union Cabinet chaired by the Prime Minister Shri Narendra Modi in its meeting on 15.3.2017, has approved the National Health Policy, 2017 (NHP, 2017).  The Policy seeks to reach everyone in a comprehensive integrated way to move towards wellness.  It aims at achieving universal health coverage and delivering quality health care services to all at affordable cost.

This Policy looks at problems and solutions holistically with private sector as strategic partners. It seeks to promote quality of care, focus is on emerging diseases and investment in promotive and preventive healthcare. The policy is patient centric and quality driven. It addresses health security and make in India for drugs and devices.

The main objective of the National Health Policy 2017 is to achieve the highest possible level of good health and well-being, through a preventive and promotive health care orientation in all developmental policies, and to achieve universal access to good quality health care services without anyone having to face financial hardship as a consequence.

In order to provide access and financial protection at secondary and tertiary care levels, the policy proposes free drugs, free diagnostics and free emergency care services in all public hospitals.

The policy envisages strategic purchase of secondary and tertiary care services as a short term measure to supplement and fill critical gaps in the health system.

The Policy recommends prioritizing the role of the Government in shaping health systems in all its dimensions. The roadmap of this new policy is predicated on public spending and provisioning of a public healthcare system that is comprehensive, integrated and accessible to all.

The NHP, 2017 advocates a positive and proactive engagement with the private sector for critical gap filling towards achieving national goals.  It envisages private sector collaboration for strategic purchasing, capacity building, skill development programmes, awareness generation, developing sustainable networks for community to strengthen mental health services, and disaster management. The policy also advocates financial and non-incentives for encouraging the private sector participation.

The policy proposes raising public health expenditure to 2.5% of the GDP in a time bound manner. Policy envisages providing larger package of assured comprehensive primary health care through the Health and Wellness Centers’. This policy denotes important change from very selective to comprehensive primary health care package which includes geriatric health care, palliative care and rehabilitative care services. The policy advocates allocating major proportion (upto two-thirds or more) of resources to primary care followed by secondary and tertiary care. The policy aspires to provide at the district level most of the secondary care which is currently provided at a medical college hospital.

The policy assigns specific quantitative targets aimed at reduction of disease prevalence/incidence, for health status and programme impact, health system performance and system strengthening. It seeks to strengthen the health, surveillance system and establish registries for diseases of public health importance, by 2020. It also seeks to align other policies for medical devices and equipment with public health goals.

The primary aim of the National Health Policy, 2017, is to inform, clarify, strengthen and prioritize the role of the Government in shaping health systems in all its dimensions- investment in health, organization and financing of healthcare services, prevention of diseases and promotion of good health through cross sectoral action, access to technologies, developing human resources, encouraging medical pluralism, building the knowledge base required for better health, financial protection strategies and regulation and progressive assurance for health. The policy emphasizes reorienting and strengthening the Public Health Institutions across the country, so as to provide universal access to free drugs, diagnostics and other essential healthcare.

The broad principles of the policy is centered on Professionalism, Integrity and Ethics, Equity, Affordability, Universality, Patient Centered & Quality of Care, Accountability and pluralism.

It seeks to ensure improved access and affordability of quality secondary and tertiary care services through a combination of public hospitals and strategic purchasing in healthcare deficit areas from accredited non-­governmental healthcare providers, achieve significant reduction in out of pocket expenditure due to healthcare costs, reinforce trust in public healthcare system and influence operation and growth of private healthcare industry as well as medical technologies in alignment with public health goals.

The policy affirms commitment to pre-emptive care (aimed at pre-empting the occurrence of diseases) to achieve optimum levels of child and adolescent health. The policy envisages school health programmes as a major focus area as also health and hygiene being made a part of the school curriculum.

In order to leverage the pluralistic health care legacy, the policy recommends mainstreaming the different health systems. Towards mainstreaming the potential of AYUSH the policy envisages better access to AYUSH remedies through co-location in public facilities. Yoga would also be introduced much more widely in school and work places as part of promotion of good health.

The policy supports voluntary service in rural and under-served areas on pro-bono basis by recognized healthcare professionals under a ‘giving back to society’ initiative.

The policy advocates extensive deployment of digital tools for improving the efficiency and outcome of the healthcare system and proposes establishment of National Digital Health Authority (NDHA) to regulate, develop and deploy digital health across the continuum of care.

The policy advocates a progressively incremental assurance based approach.

Background:

The National Health Policy, 2017 adopted an elaborate procedure for its formulation involving stakeholder consultations. Accordingly, the Government of India formulated the Draft National Health Policy and placed it in public domain on 30th December, 2014. Thereafter following detailed consultations with the stakeholders and State Governments, based on the suggestions received, the Draft National Health Policy was further fine-tuned. It received the endorsement of the Central Council for Health & Family Welfare, the apex policy making body, in its Twelfth Conference held on 27th February, 2016.

The last health policy was formulated in 2002. The socio economic and epidemiological changes since then necessitated the formulation of a New National Health Policy to address the current and emerging challenges.

Statement by Shri Jagat Prakash Nadda, Minister of Health and Family Welfare on 16th March, 2017 In both the Houses of Parliament on  The National Health Policy, 2017

The Cabinet has approved the National Health Policy 2017. Itis a huge milestone in the history of health sector in the country. The Health Ministry has formulated the National Health Policy 2017, under the guidance of the Hon. Prime Minister Shri Narendra Modiji. The last National Health Policy was framed in 2002. So, this policy has come after a gap of 15 years to address the current and emerging challenges necessitated by the changing socio-economic, technological and epidemiological landscape.

The Government of India adopted a highly participative and consultative approach in policy formulation process. The Draft National Health Policy was placed it public domain on 30th December, 2014. Over 5000 suggestions were received. This was followed by consultations with the State Governments and other stakeholders for further fine tuning of the policy. The policy was placed before the Central Council for Health & Family Welfare, the apex policy making body and was unanimously endorsed by it.

The policy informs and prioritizes the role of the Government in shaping health systems in all its dimensions- investment in health, organization and financing of healthcare services, prevention of diseases and promotion of good health through cross-sectoral action, access to technologies, developing human resources, encouraging medical pluralism, building the knowledge base required for better health, financial protection strategies and regulation and progressive assurance for health. The policy is aimed at reaching healthcare in an assured manner to all, particularly the underserved and underprivileged.

The policy aims for attainment of the highest possible level of health and well-being for all at all ages, through a preventive and promotive health care orientation in all developmental policies, and universal access to good quality health care services without anyone having to face financial hardship as a consequence. This would be achieved through increasing access, improving quality and lowering the cost of healthcare delivery.The broad principles of the Policy are centered on professionalism, integrity and ethics, equity, affordability, universality, patient centered and quality of care, accountability and pluralism.

The policy seeks to move away from Sick- Care to Wellness, with thrust on prevention and health promotion. While the policy seeks to reorient and strengthen the public health systems, it also looks afresh at strategic purchasing from the private sector and leveraging their strengths to achieve national health goals. The policy looks at stronger partnership with the private sector.

As a crucial component, the Policy proposes raising public health expenditure to 2.5% of the GDP in a time bound manner. The Policy advocates a progressively incremental assurance-based approach. It envisages providing larger package of assured comprehensive primary health care through the ‘Health and Wellness Centers’ and denotes important change from very selective to comprehensive primary health care package which includes care for major NCDs, mental health, geriatric health care, palliative care and rehabilitative care services. It advocates allocating major proportion (two-thirds or more) of resources to primary care. It aims to ensure availability of 2 beds per 1000 population distributed in a manner to enable access within golden hour. In order to provide access and financial protection, it proposes free drugs, free diagnostics and free emergency and essential healthcare services in all public hospitals.

The Policy has also assigned specific quantitative targets aimed at reduction of disease prevalence/incidence under 3 broad components viz.(a)health status and programme impact, (b) health system performance and (c) health systems strengthening, aligned to the policy objectives. Some key targets that the policy seeks to achieve are –

1. Life Expectancy and healthy life

a. Increase Life Expectancy at birth from 67.5 to 70 by 2025.

b. Establish regular tracking of Disability Adjusted Life Years (DALY) Index as a measure of burden of disease and its trends by major categories by 2022.

c. Reduction of TFR to 2.1 at national and sub-national level by 2025.

2. Mortality by Age and/ or cause

a. Reduce Under Five Mortality to 23 by 2025 and MMR from current levels to 100 by 2020.

b. Reduce infant mortality rate to 28 by 2019.

c. Reduce neo-natal mortality to 16 and still birth rate to “single digit” by 2025.

3. Reduction of disease prevalence/ incidence

a. Achieve global target of 2020 which is also termed as target of 90:90:90, for HIV/AIDS i. e,- 90% of all people living with HIV know their HIV status, – 90% of all people diagnosed with HIV infection receive sustained antiretroviral therapy and 90% of all people receiving antiretroviral therapy will have viral suppression.

b. Achieve and maintain elimination status of Leprosy by 2018, Kala-Azar by 2017 and Lymphatic Filariasis in endemic pockets by 2017.

c. To achieve and maintain a cure rate of >85% in new sputum positive patients for TB and reduce incidence of new cases, to reach elimination status by 2025.

d. To reduce the prevalence of blindness to 0.25/ 1000 by 2025 and disease burden by one third from current levels.

e. To reduce premature mortality from cardiovascular diseases, cancer, diabetes or chronic respiratory diseases by 25% by 2025.

This policy focuses on tackling the emerging challenge of non-communicable diseases. It supports an integrated approach where screening for the most prevalent NCDs with secondary prevention would make a significant impact on reduction of morbidity and preventable mortality.

The policy envisages a three dimensional integration of AYUSH systems encompassing cross referrals, co-location and integrative practices across systems of medicines. This has a huge potential for effective prevention and therapy,that is safe and cost-effective. Yoga would be introduced much more widely in school and work places as part of promotion of good health.

To improve and strengthen the regulatory environment, the policy seeks putting in place systems for setting standards and ensuring quality of health care. The policy is patient centric and empowers the patient for resolution of all their problems. The policy also looks at reforms in the existing regulatory systems both for easing manufacturing of drugs and device s, to promote Make in India, as also for reforming medical education. The policy, has at its centre, the person, who seeks and needs medical care.

The policy advocates development of cadre of mid-level service providers, nurse practitioners, public health cadre to improve availability of appropriate health human resource.

The policy also seeks to address health security and make in India for drugs and devices. It also seeks to align other policies for medical devices and equipment with public health goals.

The policy envisages a time-bound Implementation Framework with clear deliverables and milestones to achieve the policy goals.

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