Comments on draft National Health
Policy 2015 – NG
Cursory
reading of the draft NHP 2015 document which is on the MOHFW website looks fine.
Many of the issues which JSA has been raising are incorporated in the new
policy. But reading it carefully, inconsistencies emerge which are open to
different interpretations. The draft does
not provide any clear road map and it is full of intents only. Instead of
drafting policy guided by the principles of socio-epidemiology, it has taken an
off the cuff and ad hoc method of formulation.
· The situational analysis is broad and
vague. It does not have any analysis of human resources for health in terms of
their distribution between rural and urban, between primary, secondary and
tertiary care and in public, private and not for profits.
· There is no analysis of distribution
of public spending between primary, secondary and tertiary health care
currently and what is the vision in this regard.
· Though it is mentioned at many a
places that there will be “Strategic purchase of secondary care hospitalization
and tertiary care services” but there is no assessment of any kind about
distribution and nature of secondary and tertiary care services available in
private sector or for that matter in not for profit entities. The fact of the
matter is that some documentation which is available shows that private sector
health institutions to cater to secondary and tertiary care are not available
in difficult and economically poor regions. Even outsourced mobile medical
units under the NRHM for remote and inaccessible areas did not function as
envisaged.
· Besides mentioning that India may
attain MDGs related to health, there is no attempt to define what is the highest
attainable standard of health in the context of India and also in terms of
indicators.
· There is mention of output based
measurement of health care. It was also mentioned in the NRHM but after 10
years nothing concrete has been in that direction. One of the most important
indicator of output based measurement is out of pocket spending and how much of
this will be reduced through invoking the new policy is neither analysed nor
anything mentioned about it. In order to gauge outputs, there ought to be
district epidemiological stations which regularly assess trends in disease
burden and its distribution society. This was envisaged in earlier policies but
there is no mention of it.
· There is regular mention the term “Purchase
of services”. This is very problematic
to ensure universal access.
JSA SHOULD CONSTITUTE A GROUP WITHIN
TO DRAFT AN ALTERNATIVE POLICY which is guided by the comprehensive analysis.
More later.
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