Home arrow Archives arrow Open Forum arrow Open Forum-2017 arrow Focus on Wellness: NATIONAL HEALTH POLICY 2017, By Dr S Saraswathi, 20 April, 2017
News and Features
INFA Digest
Parliament Spotlight
Journalism Awards
Focus on Wellness: NATIONAL HEALTH POLICY 2017, By Dr S Saraswathi, 20 April, 2017 Print E-mail

Open Forum

New Delhi, 20 April 2017

Focus on Wellness


By Dr S Saraswathi

(Former Director, ICSSR, New Delhi)


After a gap of 15 years, the new National Health Policy has been announced which seeks to transform healthcare in India. In the context of much publicised Obamacare in the US (popular label for the Patient Protection and Affordable Care Act), people of India may be tempted to  look forward to a new era of healthcare that can be named as “Modicare” that will lessen one of  their worst worries of daily life.


The policy shifts the focus from “sick care” to “wellness” – a concept well known in indigenous systems of medicine in India. It brings in inclusive partnership of medical, para-medical, and non-medical teams in a joint endeavour. Good health and well-being is listed as Goal 3 in the Sustainable Development Goals to be reached before 2030. It is supported by another included as Goal 6 to ensure clean water and sanitation.


The policy seeks to strengthen health systems through action in four directions – moving towards universal coverage, re-orienting conventional care towards people-oriented care, integrating health in all policies, and ensuring more inclusive health governance. The complexity of the problem cannot be denied.


The WHO Report of 2016 has depicted India as one of the worst performing regions in health after Africa. India’s rank in any health related matter – nutrition, birth disorders, infant and maternal mortality, air-borne disease, etc, is at the bottom.  The Global Nutrition Report for 2016 ranks India at 114 among 132 countries with the incidence of stunting at 38.7 per cent. It is even reported that India bears one-fifth of world’s disease burden and fast becoming the centre of non-communicable diseases like diabetes and high blood pressure.


Policy-makers, bound to address the situation, cannot remain satisfied with adopting a policy as a ritual. Policies must realistically approach the problem and show direction for action. The new Health Policy makes an ambitious proposal to provide “assured health services to all” in the country.  


Important targets fixed in this policy include increasing life expectancy from the current 67.5 years to 70 years by 2025; reducing total fertility rate to 2.1 at national and sub-national levels; reducing mortality rate of children under 5 years to 23 per 1,000 by 2025 from 40 in 2013, and maternal mortality rate to 100 by 2020 from 167 in 2013; and neo-natal mortality to 16 and “still birth rate’ to single digit by 2025.


The Universal Declaration of Human Rights of the UNO (1948) includes health as a human right. India was also keen on declaring health as a fundamental right in 2015, and also considered enacting a National Health Rights Act, but in the course of debating the issue dropped it as not feasible. With totally inadequate infrastructure, no government would be able to grant and guarantee such a fundamental right. However, the Supreme Court has held that the right to health is inherent in the right to life guaranteed under fundamental rights. A Directive Principle also enjoins the government to regard raising the standard of nutrition and the standard of living of its people and the improvement of public health as among its primary duties.


The report of the WHO on the “Health Workforce in India” released in 2016 reveals that the density of doctors of all schools is 80 per one lakh population compared to 130 in China. Using the data of 2001 census, it says that 31 per cent of those who claimed to be allopathic doctors had only secondary level education and 57 per cent had no medical qualification. Situation was found much worse in rural India where only 18.8 per cent of allopathic doctors had medical qualification. On the whole, 42.7 per cent of allopathic doctors, 60.1 per cent of ayurvedic doctors, 41.8 per cent of homeopathy doctors, 45.8 per cent of unani doctors, and 42.3 per cent dentists had medical qualifications.


In India, as in many developing countries, information on human resources in the health sectors is incomplete and unreliable. Records showing the presence of “unqualified doctors” practising the profession as well as huge shortage of medical personnel, the policy faces a huge dilemma.   We cannot bat for fakes and quacks, but cannot overlook the positive contributions made by a number of technically unqualified practitioners, who are available and approachable and within means doing tremendous healthcare service.


We have to think of matching our needs with our human power resources. There is need to utilise the knowledge and experience of “unqualified doctors” in the proposed “wellness” service. For, wellness is a much wider responsibility than cure of diseases in which wider participation of people from different walks of life is possible and desirable. In promotional and preventive aspects of healthcare, there is need for dedicated workforce with background in health related work. The policy has rightly adopted principles of professionalism, integrity, and ethics in health service.


The policy envisages three-dimensional integration of AYUSH systems, that is, Ayurveda, Yoga, Unani, Siddha, and Homeopathy -- encompassing cross referrals, co-location, and integrative practices across systems of medicines. This needs to be pursued in right earnest as already, there is a strong tendency among people to consult different schools of medicine and make the best use of them.


Unhygienic atmosphere and pollution, lack of proper and adequate tools, ill-paid and over-worked nurses are common problems everywhere. The policy has responded to the situation by going beyond the boundaries of health systems and addressing the social determinants of health and the interaction between health and other sectors.


Public health expenditure is set to increase from the present 1.4 per cent of the GDP to 2.5 per cent with two-thirds of the amount going to primary healthcare. This is much below the figure recommended earlier in the draft policy which calculated that public expenditure of 4 to 5 per cent of the GDP was required to meet the millennium development goals.


It is much lower than the expenditure of many countries and far below 6 per cent recommended by the WHO. Most of these resources are to be spent on primary healthcare. Per capita expenditure on health was estimated by the WHO as $267 in 2014 – a figure below even that of Indonesia and Sri Lanka not to mention European countries spending several thousands.


The new policy seeks to reach everyone in a comprehensive integrated way to move towards wellness. It aims at achieving universal health coverage and delivery of quality healthcare services to all at affordable cost. It promises a comprehensive package that will include care for non-communicable diseases (NCDs), geriatric healthcare, mental health, palliative care, and rehabilitative care services.


The policy proposes to introduce a system of health card for every family to provide access to primary care facility and to a set package of services throughout the country. Patient-centric approach is recommended. Further, it proposes free diagnostics, free drugs, free emergency and essential care services in all public hospitals.


The more we examine our requirements, and the actual situation obtaining in the country, we cannot but admit that conditions are going beyond control. Health is a recurring problem and also multiplies with time. Without firm commitment on the part of health providers, health managers, hospital staff, and pharmaceutical industry and trade, policies will not be sufficient. ---INFA


(Copyright, India News & Feature Alliance)

< Previous   Next >
  Mambo powered by Best-IT