For an all-party manifesto on health (opinion)
- Indian political parties preparing for electoral battle in 2014 have no concrete agenda to address health issues faced by the Indian populace.
- There are threats of communicable diseases, never ending discussion on maternal and child health care, nutrition. India has emerged as epicenter of chronic diseases – diabetes, hypertension, heart ailments and mental disorders.
- Good news is that National Rural Health Mission sets the agenda. Over 8,00,000 Accredited Social Health Activists (ASHA) workers, 33,000 nurses, 14,000 paramedics, 8,000 doctors and 3,000 specialists have been inducted thus far.
- Over 20,000 facilities have been constructed; and over 20,000 ambulances deployed, medical graduate seats increased by 55% and postgraduate seats by 75%.
- Janani Suraksha Yojana ensures an additional 12 to 13 crore women deliver ed in government facilities.
- Over 6 lakh newborn babies are receiving neonatal care nurseries in district hospitals each year.
- Polio has been eliminated from India.
- Infant mortality rate (IMR) declines from 68 to 42 per 1000 live births between 2000 and 2012.. In Brazil, IMR is 13 and in China it is 12.
- Bad news is: Over 40 million people, mostly in rural areas, impoverished and have run into massive debts trying to access healthcare. Contribution of out-of-pocket medical expenses to poverty often not fully appreciated.
- Need of hour is a coordinated effort by Centre and states and a National Manifesto on Health, approved by all political parties
- 12th plan proposes Universal Health Coverage (UHC) as long-term goal. It ensures cashless access to a defined package of quality health services to citizens.
- UHC like system has been there for long in Germany, U.K., Canada, Japan, Australia, New Zealand & in Scandinavian countries. Thailand, Mexico and Brazil has adopted it now.
- In India private and public health sectors need to work together to provide appropriate, equitable and affordable care at all levels.
- High-Level Expert Group (HLEG) on UHC, formed by Planning Commission, envisions a National Health System.
- A strong public sector proposed to lead, design and delivery UHC, drawing on support from private sector in a well-regulated framework, is the need for the hour.
- Under the new system citizens are entitled to a comprehensive package of primary, secondary and tertiary care services
- Citizens to have access to government & accredited private facilities for diagnostics, vaccines, drugs or surgeries services as an entitlement. No need to pay at the point of care.
- UHC will likely increase public spending on healthcare upto 3.0% of the GDP or more.
- Need for political parties to adopt healthcare as a core priority for 10 years.
- Proposed 5 point national agenda on health:
- Commit to goal of achieving UHC by 2025, develop a roadmap for same by mid-2015
- Public spending on health be raised from 1.04% of GDP in 11th Plan to 3% by 2020, & 4% by 2025
- All essential drugs, including anti-cancer agents, be made available free
- Standards of care including clinical guidelines, be applicable to public and the private sectors, be developed and enforced in next 5 years
- Equity be ensured in provision of health services in districts, communities and gender.
- National Health Regulatory and Development Authority be formed to help implement the Five-point agenda.
Exams Perspective:
- Universal Healthcare
- National Rural Health Mission (NRHM)
- Janani Suraksha Yojana (JSY)
- 5 Point Agenda on Health