Slide 1: Presented by: Nitin Agrawal
3rd year CODS Slide 3: A state of complete physical, mental and social
well-being and not merely the absence of disease
(Can include components like nutritional, spiritual and intellectual also) What is Health ? Slide 4: Large number of world’s people, perhaps more than half have no access to health care at all, & for many of the rest the care they receive does not answer the problems they have. Against the above background, the 30th World Health assembly resolved in May 1977, that “The main social target of Government & WHO in the coming decades should be the attainment by all citizens of the year 2000 AD of a level of health that will permit them to lead a socially & economically productive life.” What does Health for All Means… Slide 5: BUT……
by the end of 20th century, it was clear that the Goals of Health for all by the year 2000 AD Would NOT be achieved… Biased and poor socioeconomic development in the regions where it was needed most
Discriminatory policies due to age, gender & ethnicity thus preventing access to health care surveillance. Factors responsible for this failure were: Slide 6: Health For All In The 21st Century… Goals :
Increase in life expectancy and quality of life.
Improved equality in Health between and within countries.
Access for all to sustainable health system and services. To realize the goals of HFA in the 21st century, WHO has come forward with an outline of visions, Goals & Targets to be achieved in the very near future. Slide 7: Improve Health Equality.
Reverse Global Trends for Five Major Pandemics.
Eradicate and Eliminate Certain Diseases.
Improve Access to Water, Sanitation, Food, and Shelter
Promote Health Enhancing Life Styles.
Develop, Implement & Monitor National HFA Policies.
Improve Access to Comprehensive Essential Quality Health Care.
Enhance Health Information and Surveillance System.
Support Research for Health. Targets National strategy for HFA… : National strategy for HFA… In this connection two important reports appeared :
Report of the Study Group on “Health for All- on alternative strategy” sponsored by Indian council of social science research (ICSSR) & Indian council of medical research (ICMR)
Report of the Working Group on “Health for All by 2000 AD” sponsored by the Ministry of Health & Family Welfare, Govt. of India
This reports forms the basis of the National Health Policy Formulated by
Ministry of Health & Family Welfare, Govt. of India
in 1983 As a signatory to the Alma-Ata Declaration in 1978, the Government of India was committed to taking steps to provide HFA to its citizens. Slide 9: Goals to be achieved...
Reduction of infant mortality from the level of 125 (1978) to below 60.
To raise the expectation of life at birth from the level of 52 years to 64.
To reduce the crude death rate from the level of 14 per 1000 population to 9 per 1000.
To reduce the crude birth rate from the level of 33 per 1000 population to 21 per 1000.
To achieve a net reproduction rate of one.
To provide potable water to the entire rural population. Millennium Development Goals(MDGs) : Millennium Development Goals(MDGs) Why the MDGs ? What are the MDGs ? Why the MDGs ? : Why the MDGs ? The 1990s: a decade of faltering progress
… but too slowly to reach agreed targets
… and slowing down Under-5 mortality rate
Maternal mortality rate
Water and sanitation
Primary education MDGs are meant to accelerate progress Slide 12: MDGs were set by all Government leaders at the UN Millennium Summit, September 2000
All UN organisations decided to be guided by MDGs in their future action: unity of purpose, coherent action, synergies and strategic approaches by the UN system as a whole.
Leaders pledged to strive, individually and collectively, towards these goals through international, regional and national action, concerted by the UN. What are the MDGs ? Slide 13: MDGs: Key actors United Nations Development Group (UNDG) – with UNESCO as a member
Chief Executives Board (CEB; formerly ACC) – with UNESCO as a member
UN Country Teams Slide 14: MDGs are a combination of … Millennium Goals …
Emanate from UN Summits and Conferences of the 1990s…
… proposed in the UN Secretary-General’s Millennium Report: « We, the peoples: the role of the United Nations in the 21st century »
… and endorsed in the United Nations Millennium Declaration (8 September 2000)
7 areas explicitly addressed in the Millennium Declaration:
Peace, security and disarmament
Development and poverty eradication
Protecting our common environment
Human rights, democracy and good governance
Protecting the vulnerable
Meeting the special needs of Africa
Strengthening the United Nations Development goals
& targets Slide 15: MDGs: 8 goals, 18 targets, 48 indicators (as of 22 May 2002) For each goal: one or several targets; one or several indicators. However, several key areas identified have not been captured adequately or at all Goal 1: Eradicate extreme poverty & hunger : Goal 1: Eradicate extreme poverty & hunger Reduce by half the proportion of people living on less than a dollar a day
Reduce by half the proportion of people who suffer from hunger Target: Halve between 1990 and 2015, the proportion of people whose income is less then one dollar a day Goal 2: Achieve universal primary education : Goal 2: Achieve universal primary education Ensure that all boys and girls complete a full course of primary schooling. Targets: Ensure that by 2015, children everywhere boys & girls alike, will be able to complete a full course of primary schooling. Goal 3: Promote gender equality and empower women : Goal 3: Promote gender equality and empower women Eliminate gender disparity in primary and secondary education preferably by 2005, and at all levels by 2015 Target: To get gender equality in primary & secondary education no later than 2015. Goal 4: Reduce child mortality : Goal 4: Reduce child mortality Reduce by two thirds (2/3) the mortality rate among children under five Target: Proportion of 1 year-old children immune against measles. Goal 5: Improvement of maternal health : Goal 5: Improvement of maternal health Reduce by three quarters the maternal mortality ratio. Target: Reduce by three-quarters. Between 1990 and 2015 the maternal mortality rate. Goal 6: Combating HIV/AIDs, malaria & other diseaes : Goal 6: Combating HIV/AIDs, malaria & other diseaes Halt and begin to reverse the spread of HIV/AIDS
Halt and begin to reverse the incidence of malaria and other major diseases Target: Have Halted by 2015 & begun to reverse the spread of HIV/AIDS, malaria and other disease. Goal 7: Ensuring Environmental Sustainability : Goal 7: Ensuring Environmental Sustainability Integrate the principles of sustainable development into country policies and programmes; to reverse loss of environmental resources
Reduce by half the proportion of people without sustainable access to safe drinking water
Achieve significant improvement in lives of at least 100 million slum dwellers, by 2020 Target: To provide safe drinking water, and improvement for the slum dwellers by 2020. Goal 8: Developing a Global Partnership For Development : Goal 8: Developing a Global Partnership For Development Address the least developed countries' special needs.
Develop further an open trading and financial system that is rule-based, predictable and non-discriminatory, includes a commitment to good governance, development and poverty reduction - nationally and internationally. Target: To deal with the debt problem of the developing countries through international measures. Slide 24: HEALTH PLANNING IN INDIA What Is Planning ? : What Is Planning ? Planning is defined as formulation and execution of a series of systematic & interrelated measures of clearly specified goals to be achieved within a specified period of time. Purpose of Planning :
Its to achieve rapid, balanced, economic, & social development of the country as a whole. What Is Health Planning ? It’s a part of National Development Plan, which is a combination of sectoral plans, viz food & agriculture, health & family welfare, communication, transport, education, social welfare, power & irrigation. Slide 26: Concepts in Health Planning......
Health needs & Demands
Programs Slide 27: Types of Planning…
Directional Planning : It’s a framework of intent & Philosophy within which the programs proceed.
Administrative (Managerial) Planning : It’s the overall implementation of policies, mobilization, & co-ordination of resources in terms of men, materials, money in a scheduled time frame.
Operational Planning : It’s the actual delivery of services or programs to the people, based on local conditions, needs & attitudes. Slide 28: Evolution Of Health Planning In Independent India…
Phase one (1947-1972) : A rapid expansion of Primary health care infrastructure was the highlight of this period.
It consists of :
First Five Year plane (1951-1956)
Second Five Year plane (1956-1961)
Third Five Year plane (1961-1966)
Fourth Five Year plane (1969-1974)
Phase Two (1972-1977) : Launch of MTP act (April 1, 1972), Minimum need program, India declared Small pox free (April, 1977), where some of the major achievement in this phase.
It consists of :
Fifth five year plane (1974-1979) Slide 29: Phase Three (1977-1991) : Rural health Scheme Program was launched.
It consists of :
Sixth Five year plan (1980-1985)
Seventh Five year Plane (1985-1990)
Eighth Five year plane (1992-1997)
Phase Four (1991 onwards) :
It consists of :
Ninth Five year plane (1997-2002)
Tenth Five year plane (2002-2007)
Eleventh Five year plane (2007-2012)
The eleventh plan has the following objectives:
Income & Poverty ,
environment Slide 30: India has been pioneer in planning its requirements both in pre-independent and post-independent era.
The planning started in India in 1938, when National
Planning Committee of Indian National Congress was set up.
In 1943 the Bhore Committee was set up
After that a number of committees were set up by the Gov. Of India time by time Like
Mudaliar Committee 1962
Chadah committee 1963
Kartar singh Committee 1973
Shrivastav committee 1975 Slide 31: BHORE COMMITTEE (1946) The Health Survey and Planning Committee in 1943.
Sir Joseph Bhore the chairman.
To survey the then existing position regarding the health conditions and health organization in the country
To make recommendations for the future development.
The committee submitted its report in 1946 its famous report which had for volumes. Slide 32: OBSERVATIONS MADE BY THE COMMITTEE The health status of the country as indicated by various indicators was poor.
The mortality rates were very high (CDR 22.4/1000; IMR 162/1000 live births; MMR 20/1000 live births).
Life expectancy at birth was
about 27 years. Slide 33: IMPORTANT RECOMMENDATIONS Integration of preventive and curative services at all administrative levels.
The committee visualized the development of primary health centres in two stages:
Short term plan
A long term plan (3 million plan)
Major changes in medical education which includes 3 months training in preventive and social medicine to prepare ‘social physicians’.