Health planning in India and National Rural Health Mission 2005-2012 DR.REKHA DUTT

HEALTH PLANNING IN INDIA Health planning in India is an integral part of national socioeconomic planning .the guidelines for national health planning were provided by various committees appointed by Government of India . 1. Bhore committee ,1946 Integration of preventive and curative services at all administrative level. Development of primary health centers in rural area. Major change in medical education- 3 months training in PSM to make social physicians

Mudaliar committee also called as Health Survey and Planning Committee, 1962 Strengthening of PHC (for 40,000 population) , sub divisional and district hospitals . To improve the quality of health services. Constitution of All India Health Service on the pattern of Indian administrative services. Chadah committee ,1963: to study the arrangements for maintenance phase of National Malaria Eradication Programme. Vigilance operations in National Malaria Eradication Programme should be the responsibility of PHC. Basic health workers OR Multipurpose health workers for 10000 population has to carry out monthly home visits. The family planning health assistants were to supervise 3 or 4 basic health workers .

MUKERJI COMMITTEE,1965 Separate staff for family planning programme To delink the malaria activities from family planning MUKERJI COMMITTEE,1966 Worked out details of Basic health services at the block level JUNGALWALLA COMMITTEE,1967 Integrated health services Unified cadre ,common seniority ,recognition of extra qualification ,equal pay for equal work, no private practice . KARTAR SINGH COMMITTEE,1973 Multipurpose health workers for all the programmes. One PHC to cover 50,000 population. Each sub centre for 3000-3500 population and staffed by one male and female health worker Health supervisors to supervise 3-4 health workers.

SHRIVASTAV COMMITTEE,1975 Creation of bands of paraprofessional and semiprofessional health workers (Community participation) referral services RURAL HEALTH SCHEME,1977 Involving medical colleges for ROME SCHEME The National Health Plan ,1983 One PHC for 30,000 population in rural plains and for 20,000 population in hilly ,tribal and backward areas

National Rural Health Mission 2005-2012 The vision : To provide effective health care to rural population throughout country with special focus on states with weak infrastructure. To raise public spending on health from 0.9% of GDP to 2-3% of GDP. Provision of Accredited Social Female Health Activist (ASHA) in each village. To undertake architectural correction of health system. Decentralization of programmes. To improve access to rural people . To revitalize local health traditions (AYUSH)

Goals Reduction of IMR to 30 per 1000 live births. Reduction of MMR to 100 per 100,000 live births by 2012. Reduction of total fertility to 2.1. Universal access to public health services. Prevention and control of communicable and non communicable diseases. Access to integrated comprehensive PHC. Population stabilization ,gender and demographic balance. Revitalize local health traditions. Promotion of healthy life style.

PLAN OF ACTION Component (A) : ASHA Every village will have ASHA chosen by and accountable to village panchayat to act as the interface between the community and the public health system. She will be trained honorary volunteer receiving performance based compensation. She will be given training for 23 days, on the job training would continue for 1 year. She will prepare and implement village health plan along with AWW,ANM and other functionaries under the leadership of village panchayat. She is given drug kit for common ailments.

Component (B) :strengthening of subcentre Each subcentre will have fund Rs. 10000 per annum. This is deposited in joint bank account of ANM and sarpanch. Supply of essential drugs. Posting additional health workers and upgrading existing subcentres. Component (C) :strengthening of PHCs Provision of 24 hour services Adequate supply of essential quality drugs and equipments like auto disable syringes. Provision of second doctor in case of additional outlays.

Component (D): strengthening of CHCs 30 -40 beds in It and making it 24 hours first referral unit with posting of anesthetist. To upgrade quality of services. Component (E) :District Health Plan Component (F) :Total Sanitation Campaign Component (G) :Strengthening disease control programmes Strengthening of disease surveillance system Provision of mobile medical unit at district level. Component (H) : Public –private partnership for public health goals

Component (I) : New health finance mechanism Component (J) : Reorienting medical education to support rural health issues