NATIONAL HEALTH POLICY

1983
Dr Rukman Mecca
Residency
SETH GSMC
Mumbai
REVISION- EVOLUTION OF HEALTH SYSTEM IN INDIA

Phase I (1947-83)- Based on

1. none should be denied care for want of ability to pay.
2. It is states responsibility to provide health care services.
Phase II(1983-2000)
1. Private initiative in health care services.
2. Expanding public access
Phase III(Post 2000)
1. To utilize private sector for addressing public health goals
2. Liberalization of insurance to provide new avenues for health financing
3. Redefining state as from provider to financier of health services.
Introduction
"A health policy generally describes fundamental principles regarding
which health providers are expected to make value decisions."
'Health Policy' provides a broad framework of decisions for guiding
health actions that are useful to its community in improving their
health, reducing the gap between the health status of haves and have-
nots and ultimately contributes to the quality of life.
The working group on HEALTH FOR ALL by 2000 A.D
formulated by declaration of Alma Ata declaration forms a basis of
The National Health Policy devised by Ministry Of Health And
Family Welfare, Govt . Of India in 1983.
NATIONAL HEALTH POLICY 1983 suggested the necessity of
complete integration of all plans for human development with socio
economic development.
Essence
The need for meeting National requirements of life saving drugs and
vaccines by quality control, economic packages practice, reduction in
unit cost of medicine and well considered health insurance schemes to
allow community to share the cost of the services, in keeping with the
paying capacity.
The NHP, 1983, was an attempt to synthesize recommendations of
three important earlier committees
1. The Bhore Committee of 1946
2. The Mudaliar Committee of 1962
3. The Shrivastav Committee of 1975
Why there was no NHP before?
Since the inception of planning process, successive five year plan
provide frame work for the state for developing health policy of their
own.
Similar guidance has sought to be provided through the discussions
and conclusions arrived at in the Joint Conferences of the Central
Councils of Health and Family Welfare and the National Development
Council.
Central legislation was demanded for standards of medical education,
prevention of food adulteration, maintenance of standards in the
manufacture, sale of certified drugs etc.
During 50s and 60s health system was busy managing epidemics
 The draft policy document based on the recommendation of 5th Joint
Conference of Central Council of Health and Family Welfare in
October 1978
After the Cabinet's approval the document was presented in the
National Parliament for rectification in December 1982.
 India had its first national health policy in 1983 i.e. 36 years after
independence.
In the circumstances then prevailing, this policy provided the
initiatives like:
a. Comprehensive health care linking with extension and health
education.
b. Intermediation by health volunteers
c. Decentralisation to reduce burden of high level referral system
d. To make government facility limited to eligible poor, private
investment encouraged for establishing speciality centres.
(affluent can access paying clinics)
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 National health policy 1983 stressed the need for providing primary
health care with special emphasis on prevention , promotion and
rehabilitation aspects.
It was curative oriented western model of health care.
Its emphasis was on team approach, ban on private practice by govt
health professionals and use of our large stock of health manpower
from alternative system of medicine like Ayurveda, Unani, Sidda,
Homoeopathy, Yoga and Naturopathy.
It set up targets for achievements primarily demographic in nature.
Suggested planned time bound attention to the following

1.Nutrition, prevention of food adulteration.

2.Mainatince of quality of drug
3.Water supply and sanitation
4.Environmental protection
5.Immunisation Programme
6.Maternal and Child Health Services
7.School Health Programme
8.Occupational Health
Other Aspects

1. Health Education.
2. Development of Managerial Information System (MIS).
3. Production of Drugs and Equipments.
4. Health Insurance and Legislation.
5. Medical Research.
SPECIFIC GOALS
1. To establish one HSC for every 5,000 (3,000 for hilly areas).
2. To establish one PHC for every 30,000 population.
3. To establish one CHC for every 100,000 population.
4. To train Village Health guides selected by the community for
1000population in each village.
5. To train TBAs in each village.
6. Training of various categories of field functionaries.
 INDICATOR GOAL BY ACHIEV 2016
2000 ED BY
2000
1. INFANT MORTALITY 60 70 41
RATE (IMR)

2. PERI NATAL 33 46 28
MORTALITY RATE
(PNMR)
3. CRUDE DEALTH RATE 9 8.7 7.9
(CDR)
5. UNDER FIVE 10 9.4 74
MORTALITY RATE
(UFMR)
6. LIFE EXPENTANCY 64 62.4 66.9
BIRTH- MALE(yrs)
FEMALE(yrs) 64 63.4 69.9
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 8. CRUDE 21 26.1 20.4
BIRTH RATE

9. COUPLE 60% 46.2%

PROTECTION
RATE
10. NET 1 1.45 1.039
REPRODUCTI
ON RATE
11. GROWTH 1.2 1.93 1.19
RATE

12. FAMILY 2.3 3.1 4.9

SIZE

13. ANTE 100% 67.2% with ANC

NATAL CARE still less with full
(ANC) ANC

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14. TT PREGNANT 100 83

15. DPT 85 87

16. OPV 85 92

17. BCG 85 82

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18. TYPHOID NOT UPTO THE MARK

19. LEPROSY

20. TUBERCULOSIS

21. BLINDNESS

17
Achievements Through The Years 1951-2000
2016

66.9

7.9

41

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Achievements Through The Years 1951-2000
2016

<2

<1

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Achievements Through The Years - 1951-2000

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But by the end of 2000 century it was clear that
the goals of health for all by the year 2000 AD
would not be achieved ......

The observed progress suggested that we may need

some new and additional strategy or new sizable
intervention in achievement of an unacceptable
health of the country.

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Factors responsible for this failure were:

Biased and poor socio- economic development in the region where it

was needed most.

Discriminatory policies due to age, gender and ethnicity thus

preventing access to health care surveillance.

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 J Kishore 5 th edition
PSM park 25 th edition
NHP 1983 draft Dept of health and family welfare, GOI
THANK YOU