Health is easy to define in technical terms as being the level of functional and metabolic efficiency of a living organism. The World Health Organization (WHO) defined health in a broader sense in its 1948 constitution as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity”.
Yet when it comes to practicality the important fact about health is that it’s not a state but a dynamic process. Hence at an individual, social, institutional and society level, we need to be constantly mindful of our efforts, leverage technology to its best and be innovative all the time to achieve the same. In tandem with this, the US Department of Health and Human Services in December 2010 released a national objective plan “Healthy People 2020” which gives more prominence to health promotion and preventive approaches and adds a substantive focus on the importance of addressing societal determinants of health.
“Coming to my homeland India, I would say the healthcare ecosystem in India is at an inflection point. “
Coming to my homeland India, I would say the healthcare ecosystem in India is at an inflection point. Whilst the outlook for the healthcare industry is optimistic, there is a need to move towards an integrated healthcare delivery system with the patient at its centre. After 15 years since the last health policy was approved, the Union Cabinet has approved the National Health Policy 2017. Prime Minister Narendra Modi called it a “historic moment…to create a healthy India where everyone has access to quality healthcare”. According to the government document released, the policy aims to strengthen India’s healthcare system in the face of social, economic and technological changes.
Some of the highlights of the policy are:
- Raising public healthcare expenditure to 2.5% of GDP from the current 1.4%.
- Providing a larger package of assured comprehensive primary healthcare through the ‘Health and Wellness Centres’, which includes care for major non-communicable diseases (NCDs), mental health, geriatric healthcare, palliative care andrehabilitative care services.
- Ensuring the 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, the policy proposes free drugs, free diagnostics and free emergency and essential healthcare services in all public hospitals.
- The policy also looks at reforms in the existing regulatory systems both for easing manufacturing of drugs and devices to promote “Make in India”and also for reforming medical education.
The Policy is focussing on the following targets:
- Increase life expectancy at birth from 67.5 to 70 by 2025.
- Increase use of public health facilities by 50% from current levels by 2025.
- Reduce infant mortality rate to 28 by 2019.
- By 2020, reduce current use of tobacco by 15%, and 30% by 2025.
- A 40% reduction in the stunting of children under-five by 2025.
- Everyone has access to safe water and sanitation by 2020.
- To ensure that by 2025, more than 90% of new-borns are immunised by the time they turn one.
- Meet more than 90% of family planning needs by 2025.
The National Health Policy2017 advocates a positive and proactive engagement with the private sector for critical gap filling towards achieving national goals. However, the Policy could facepotential challenges. It calls for the existing 150,000 peripheral public health facilities to be upgraded into “health and wellness centres”- a new term that this policy introduces, with every family linked by a health card to a primary care facility providing a defined package of services. With thefirst examples of such centres are yet to be established, one is concerned at the ability of the government to deliver on this promise.
An additional policy shift is the clear commitment to re-orient public hospitals and shift away from a user fee and cost recovery approach which requires substantially increased outlays for public hospitals. As recently as January this year, the Finance Ministry released an order applicable to central hospitals to raise 30% of the revenues required to meet its Seventh Pay Commission obligations. This would mean that hospitals that are actually involved in charity will now have to meet revenue targets thus introducing user fees.
Though there are challengesahead, the National Health Policy of India has tried to address the need of the hour. Time will tellhow much was achieved,yet starting with right intentions gives us hope that the end result won’t be disappointing.
Dr. Swati Maheshwari
Internal Medicine Specialist, TV Health & Wellness Show (Dr Swati Show) Host and Producer