Healing public healthcare

Union Minister of Health and Family Welfare JP Nadda’s recent statement that “devolution, decentralisation and timely responsiveness would be the focus of the National Health Mission (NHM)” is a continuation of the move to strengthen the existing framework

201604ehm02Union Minister of Health and Family Welfare JP Nadda’s recent statement that  “devolution, decentralisation and timely responsiveness would be the focus of the National Health Mission (NHM)” is a continuation of the move to strengthen the existing framework. Need-based approvals of state wise proposals were the underlying principles of the National Rural Health Mission (NRHM) when it was launched. They form the basis for the National Urban Health Mission (NUHM) as well. Both of these sub missions now come under the overarching NHM.

The statement was made at the third meeting of NHM’s Mission Steering Group.  Clearly, this move is “to enhance the reach and effectiveness of the health programmes under the NHM.”  Even though the Union Minister went on to list the not inconsiderable achievements of his Ministry, there is always room for improvement and modifications based on a review of past performance, as well as evolving disease and demographic profiles.

It is certainly good news that state health administrations will be further strengthened as they are the best judge of which schemes will offer greater benefits. More importantly, with this stated focus, state health authorities would be better equipped to respond more quickly and effectively to health related emergencies like epidemics as well as natural calamities like earthquakes, floods, droughts etc. These leave a lingering disease burden and take a long term toll on the health indices of resident and displaced populations.

The MSG was also attended by Venkaiah Naidu, Union Minister of Urban Development. He underlined the role of endeavours like the Smart Cities initiative being taken by his Ministry which will impact healthy living. Hence, better co-ordination among these ministers and ministries is crucial.  In fact, around the same time, the Union Health Minister also launched a GIS-enabled Health Management Information System (HMIS) application and self-printing of e-CGHS Card, which he hailed as “significant steps towards Digital India and for easy access of health services to the common man.” At present, 1.94 lakh health facilities (across all States/ UTs) upload facility wise data on monthly basis on the HMIS web portal. This data is presently available to various stakeholders as standard and customised reports, fact sheets, score-cards etc. Reportedly, HMIS data is widely being used by the Ministry and States for policy planning, monitoring and supervision.

HMIS currently covers the public health facilities but shall soon be expanded to cover private facilities as well, according to the Union Health Minister. Will this be acceptable to corporate healthcare chains? Secondly, the application is currently available in the login domain of HMIS portal but there are plans to put it in the public domain soon, according to a PIB release.

While all this data would be a wonderful tool for public health policy makers and researchers to ensure evidence-based policy making, would the private sector be game? The Health ministry is clearly moving towards an evidence-based policy formulation approach. For instance, the Longitudinal Ageing Study in India (LASI) launched on March 22, 2016, will “provide scientifically validated data on various issues of the elderly”. The data would help “provide guidance to move forward in designing schemes for the elderly”, according to BP Sharma, Secretary (HFW), who launched the study. Link this to the allocation of a special component of Rs 30,000 for the elderly in families in the recent Budget, and it is clear that the while the government will allocate funds, it will also demand data to see how these funds are being utilised.

Emphasising the importance of the LASI, Dr Soumya Swaminathan, DG, ICMR said, “It will also lay the foundation for other studies on social justice issues” and “will be a strong study which will help in designing key interventions.”

This is the right approach, especially if we need to stretch our existing public resources and make every rupee count. A MoH&FW offical also explained that there is a shift from a top-down, district level approach to a bottom-up, community-health approach, as evidenced by a focus on capacity building of health workers. Certain public health concerns like NCDs, TB and immunisation are likely to get more focus as well, going by the topics discussed at the MSG.

All in all, it was the best time for Express Healthcare to launch its first public health focused event, Healthcare Sabha, supported by the NHM. For detailed coverage and analysis, see pages (20-43). A big thank you from the editorial team to all our dealegates, speakers and partners. Watch out for more  photographs and videos which will be uploaded shortly at http://www.healthcaresabha.com.

Viveka Roychowdhury


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