India Adopts National Health Policy 2017 (16 March 2017). Part 1: Goal, Principles and Objectives

On 16th March 2017, the Government of India adopted the National Health Policy 2017 (NHP 2017).

This series of articles will describe the NHP 2017 in detail, offering comments where applicable.

This first article will describe the goal, principles and objectives of the NHP 2017.

Background information:

The NHP 2017 is preceded by two National Health Policies (NHPs): NHP 1983, and NHP 2002.

NHP 2017 is the result of consultations and discussions with stakeholders- a process that started in 2015. It aims to build on the progress made since NHP 2002, and realign policy with changing needs and contexts.

Key Messages:

 Goal:

The attainment of the highest possible level of health and wellbeing for all at all ages, through a preventive and promotive health care orientation in all developmental policies, and universal access to good quality health care services without anyone having to face financial hardship as a consequence.

Key Policy Principles:

  1. Professionalism, Integrity and Ethics
  2. Equity
  3. Affordability
  4. Universality
  5. Patient-centered & Quality of Care
  6. Accountability
  7. Inclusive Partnerships
  8. Pluralism
  9. Decentralization
  10. Dynamism and Adaptiveness

Objectives:

  1. Progressively achieve Universal Health Coverage
  2. Reinforcing  Trust in Public Health Care System
  3. Align the growth of private health care sector with public health goals
  4. Specific Quantitative Goals and Objectives
  • The major quantitative objectives are listed in the table below; other objectives are described thereafter.
Measure NHP 2002 NHP 2017 Current Status
Life Expectancy at birth 70 years by 2025 67.5 years
DALY as measure of burden of disease Establish tracking by 2022
Total Fertility Rate (No. of children born/ woman) 2.1 by 2025 2.2
Maternal Mortality Ratio Reduce to 100 by 2010 Reduce to 100 by 2020 167/ 100,000 live births
Under-5 Mortality Reduce to 23 by 2025 50/ 1000 live births
Infant Mortality Rate Reduce to 30 by 2010 Reduce to 28 by 2019 41/ 1000 live births
Neonatal Mortality Rate Reduce to 16 by 2025 28/ 1000 live births
Stillbirth Rate Reduce to “single digit” by 2025 23/ 1000 live + still births
Eradicate Polio by 2005 Certified Polio free 27.3.2014
Eradicate Yaws by 2005 Certified Yaws free 14.7.2016
Eliminate Leprosy by 2005 by 2018 Eliminated at National level in December 2005
Eliminate Kala Azar by 2010 by 2017 >70% of endemic blocks have achieved elimination
Eliminate Lymphatic Filariasis by 2015 by 2017 Eliminated in 203/255 districts
HIV/AIDS Achieve zero level growth by 2007 Achieve 90:90:90 target by 2020
Tuberculosis Reduce mortality by 50% by 2010 Reduce incidence to achieve Elimination by 2025 Prevalence: 211/ 100 000 population
Incidence: 171/ 100 000 population
Blindness Reduce prevalence to 0.5/ 1000 by 2010 Reduce prevalence to 0.25/ 1000 by 2025 Prevalence: 1/ 1000 in 2005-06
Utilization of Public Health Facilities Increase to >75% by 2010 Increase by 50% of current levels by 2025 OP: 25% (2014);
IP: 32% (Urban); 42% (Rural)
Govt. health expenditure (as a % of GDP) Increase to 2% by 2010 Increase to 2.5% by 2025 1.15% of GDP
State Sector health spending Increase to 8% by 2010 Increase to >8% by 2020

Other objectives include (italics added by me):

  • To reduce premature mortality from cardiovascular diseases, cancer, diabetes or chronic respiratory diseases by 25% by 2025.
  • Antenatal care coverage to be sustained above 90% and skilled attendance at birth above 90% by 2025.
  • More than 90% of the newborn are fully immunized by one year of age by 2025.
  • Meet need of family planning above 90% at national and sub national level by 2025.
  • 80% of known hypertensive and diabetic individuals at household level maintain “controlled disease status” by 2025.
  • Relative reduction in prevalence of current tobacco use by 15% by 2020 and 30% by 2025.
  • Reduction of 40% in prevalence of stunting of under-five children by 2025.
  • Access to safe water and sanitation to all by 2020 (Swachh Bharat Mission).
  • Reduction of occupational injury by half from current levels of 334 per lakh agricultural workers by 2020.
  • National/ State level tracking of selected health behaviours.
  • Decrease in proportion of households facing catastrophic health expenditure from the current levels by 25%, by 2025.
  • Ensure availability of paramedics and doctors as per Indian Public Health Standard (IPHS) norm in high priority districts by 2020.
  • Increase community health volunteers to population ratio as per IPHS norm, in high priority districts by 2025.
  • Establish primary and secondary care facility as per norms in high priority districts (population as well as time to reach norms) by 2025.
  • Ensure district-level electronic database of information on health system components by 2020.
  • Strengthen the health surveillance system and establish registries for diseases of public health importance by 2020.
  • Establish federated integrated health information architecture, Health Information Exchanges and National Health Information Network by 2025.

Useful Links:

Link to the National Health Policy 2017 policy document:

http://www.mohfw.nic.in/showfile.php?lid=4275

Link to the Situation Analysis (backdrop to NHP 2017) document:

http://www.mohfw.nic.in/showfile.php?lid=4276

Link to NHP 2002 policy document:

http://www.mohfw.nic.in/showfile.php?lid=2325

Links to selected sources for data in the table:

http://tlmindia.org/about-leprosy-in-india/facts-about-leprosy-in-india/#facts

http://apps.who.int/iris/bitstream/10665/185042/1/9789241509497_eng.pdf

http://timesofindia.indiatimes.com/india/Filariasis-may-be-history-by-year-end/articleshow/47579456.cms

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4263400/

http://www.searo.who.int/tb/annual-tb-report-2015.pdf

http://www.tbfacts.org/tb-statistics-india/

http://www.who.int/healthsystems/topics/financing/healthreport/20public-private.pdf

https://www.omicsonline.org/open-access/increasing-outofpocket-health-care-expenditure-in-indiadue-to-supply-or-demand-pe-1000105.php?aid=68476

http://www.firstpost.com/india/indias-new-national-health-policy-is-just-a-repackaged-version-of-the-2002-plan-3339382.html

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