India at 75: Major Healthcare policies and schemes since attaining independence

Over the years, the government has launched many Health Missions, Five Year Plans and National Health Policies to provide various healthcare benefits and facilities to the citizen of the country.

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The country has achieved some significant goals through increased penetration of healthcare services, improved immunisation, growing literacy and innumerable initiatives by the government and private sector.

India is currently the second-largest populated nation comprising of over 15 percent of the world’s population. The country is growing at a rapid pace and has achieved many strides healthcare sector which includes increased life expectancy to over 70 years and a significant decline in Infant Mortality Rate, Maternal Mortality Rate, and Death Rate. Since, freeing itself from the shackles of British rulers, diseases like polio, smallpox, guinea worm and leprosy have been nearly eliminated in the country. Moreover, the country has achieved some significant goals through increased penetration of healthcare services, improved immunisation, growing literacy and innumerable initiatives by the government and private sector. Over the years, the government has launched many Health Missions, Five Year Plans and National Health Policies to provide various healthcare benefits and facilities to the citizen of the country. Here are some of the crucial healthcare policies and schemes launched in India in the last 75 years:

National Leprosy Eradication Programme (NLEP)

The National Leprosy Eradication Programme (NLEP) is a Central-government sponsored Health Scheme and it has been implemented with the major objective of reducing the disease burden, preventing disability and improving awareness among the mass about Leprosy and its curability. It was launched in 1954- 55. In 1983, National Leprosy Eradication Program was launched as a continuation of the National Leprosy Control Programme. According to health experts, it is one of the largest leprosy eradication programme in the world. Under the NLEP, active case detection and regular surveillance under the Leprosy Case Detection Campaign (LCDC), ASHA-based Surveillance for Leprosy Suspects (ABSULS), Active Case Detection and Regular Surveillance (ACDRS) are being conducted to interrupt transmission of the causative organism Mycobacterium leprae. As per NLEP, the number of leprosy cases in India has witnessed a significant decline.

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Pulse Polio Immunisation programme

In 1995, following the Global Polio Eradication Initiative of the World Health Organization (1988), India launched the Pulse Polio immunisation program with Universal Immunization Program which aimed at 100 percent coverage. As a part of the programme, children in the age group of 0-5 years were administered polio drops during National and Sub-national immunization rounds (in high-risk areas) every year. About 172 million children are immunized during each National Immunization Day (NID). According to Health Ministry data, the last polio case in the country was reported from Howrah district of West Bengal with the date of onset 13th January 2011. Thereafter no polio case has been reported in the country. The World Health Organization (WHO) on 24th February 2012 removed India from the list of countries with active endemic wild polio virus transmission and received ‘Polio-free certification’ from the UN health body on 27 March 2014. India’s success story in eradicating the disease from its regions has been applauded by health experts across the globe.

National Rural Health Mission (NRHM)

According to health experts, National Rural Health Mission (NRHM) and National Urban Health Mission (NUHM) have had significant achievements. Launched in 2005, the mission provides accessible, affordable and quality health care to the rural population, especially the vulnerable groups. According to the guidelines, the basic objectives of implementing NRHM are: Reduction in infant mortality rate and maternal mortality rate; Ensuring population stabilisation; Prevention and control of communicable and non-communicable diseases; and Upgrading AYUSH(Ayurvedic Yoga Unani Siddh and Homoeopath) for promotion of a healthy lifestyle. This is one of the schemes that has placed a strong emphasis on enhancing maternal and child health through direct access. According to public health experts, this mission played a pivotal role in creating new institutions, decentralising services, and providing new ideas and resources for the health system.

Introduction of Accredited Social Health Activist (ASHA)

As a part of India’s National Rural Health Mission (NRHM), community health workers known as accredited social health activist (ASHA) are being employed by the country’s Ministry of Health and Family Welfare. According to the government, the idea behind ASHA was to connect marginalised communities to the health care system. Earlier this year, The one million ASHA (Accredited Social Health Activist) workers, who are at the forefront of healthcare delivery in India, received the Global Health Leaders Award-2022 at the 75th World Health Assembly. The global health agency applauded the workers’ efforts in connecting the community to the government’s health programmes. These workers are primarily married, widowed, or divorced women between the ages of 25 and 45 years from within the community. Other than mother and child care, these workers also provide medicines daily to patients with Tuberculosis under the treatment scheme of the national programme. Moreover, they are also tasked with screening for infections like malaria during the season. These workers also provide basic medicines and therapies to people under their jurisdiction such as oral rehydration solution, chloroquine for malaria, iron folic acid tablets to prevent anaemia, and contraceptive pills. It is noteworthy that these ASHA workers played a crucial role in the government’s pandemic response.

National Health Protection Mission (Ayushman Bharat Yojana/Pradhan Mantri Jan Arogya Yojana—PMJAY)

Launched in 2018, Ayushman Bharat is National Health Protection Scheme, which will cover over 10 crore poor and vulnerable families (approximately 50 crore beneficiaries) providing coverage upto 5 lakh rupees per family per year for secondary and tertiary care hospitalization. Ayushman Bharat – National Health Protection Mission will subsume the ongoing centrally sponsored schemes – Rashtriya Swasthya Bima Yojana (RSBY) and the Senior Citizen Health Insurance Scheme (SCHIS). Reportedly, it is the world’s largest government-funded health care programme. Meanwhile, the PM-JAY aims to provide a yearly cashless health insurance cover worth Rs 5 lakh per family, to cover 1,300 illnesses. The cover includes all the costs related to treatment across empanelled public and private hospitals including hospitalisation charges, up to 3 days pre-hospitalisation and 15 days of post-hospitalisation expenses. Earlier this month, Union Health Minister Mansukh Mandaviya said that a total of 1.5 lakh Ayushman Bharat Health and Wellness Centres will be available to serve the people by the end of December.

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