What will the rebranded National Health Assurance Mission look like, as it emerges in 2015? The National Rural Health Mission’s younger sibling, the National Urban Health Mission, was born a year ago but is yet to walk.
Together these two missions acquired the family name of National Health Mission. The change of government in May led to its renaming as the
National Health Assurance Mission (NHAM), to conveying commitment to delivery of promised services.
The features of NHAM are likely to be unveiled early in the New Year, after a review by the Prime Minister. There are expectations of greater emphasis on health promotion and disease prevention, provision of essential drugs and basic diagnostic tests free of cost in public health care facilities, guaranteed provision of a defined package of primary, secondary and emergency services along with prioritized tertiary care services.
How these will be financed is yet to be announced but the Rashtriya Swasthya Bima Yojana is likely to be expanded, to provide a platform for public-private partnerships that can extend the public sector’s capacity for service delivery.
While these are important initiatives intended to improve health services, they are not novel. Where will the element of innovation come in, to fulfil the promise of raised expectations? More importantly, can we raise the steady state performance levels of our health system to assured levels of efficiency and safety? Will we avoid the pendulum swings of 2014, which began with the conferment of a Polio-free status by an applauding World Health Organisation but ended with the tragic sterilisation deaths in Chhattisgarh and mass blindness inflicted by ill performed cataract surgeries in Punjab, both of which left the nation outraged and the world aghast?
The Prime Minister’s twin calls, to improve basic health services and adopt innovative technologies, may provide the best blended prescription for our debilitated health system.
Handheld Android devices, with capability for performing several point of care diagnostics and in-built decision support systems, can greatly empower Auxiliary Nurse Midwives and community health workers. One such device developed in India, the Swasthya Slate, is now being used for improving maternal and child health services in Jammu and Kashmir.
Mobile phones, with their ubiquitous presence, can become important channels for transmission of health information, advice and treatment monitoring by enabling people, patients and primary care providers.
Information technology, with validated diagnostic algorithms, can improve the timeliness, completeness and accuracy of data collection and transmission by frontline health workers as well as rapid analysis and ready response by health system managers.
Indian pharmaceutical industry has to respond to the increased demand for quality assured generics, created by government programmes for free distribution of essential drugs in public health care facilities.
Without a substantial rise in funding for the health sector, mere injection of technology cannot energise an ailing health system. However, an
infusion of augmented financial resources, combined with innovations in health service design and delivery, can make the health system an ally for accelerated economic growth. Will 2015 fulfill this wish?
By K Srinath Reddy
President, Public Health Foundation of India (PHFI)