National Health Policy to ensure universal access to quality healthcare

The union cabinet has approved the National Health Policy, 2017 (NHP, 2017) which seeks to reach everyone in a comprehensive integrated way and achieve universal wellness through universal health coverage and provision of quality health care services to all at affordable cost.

The policy, cleared at a meeting of the union cabinet chaired by Prime Minister Narendra Modi on Thursday, looks at problems and solutions holistically with private sector as strategic partners. It seeks to promote quality of care, with special focus on emerging diseases and investment in promotive and preventive healthcare.

The policy is patient-centric and quality-driven and addresses health security and "Make in India" for drugs and devices, an official release stated.

The main objective of the National Health Policy 2017 is to achieve the highest possible level of good health and well-being through universal access to good quality health care services without imposing financial burden on anyone.

In order to provide access and financial protection at secondary and tertiary care levels, the policy proposes free drugs, free diagnostics and free emergency care services in all public hospitals.

The policy envisages strategic purchase of secondary and tertiary care services as a short-term measure to supplement and fill critical gaps in the health system.

The policy recommends prioritising the role of the government in shaping health systems in all its dimensions. The roadmap of this new policy is predicated on public spending and provisioning of a public healthcare system that is comprehensive, integrated and accessible to all.

The NHP, 2017 advocates a positive and proactive engagement with the private sector for critical gap filling towards achieving national goals. It envisages private sector collaboration for strategic purchasing, capacity building, skill development programmes, awareness generation, developing sustainable networks for community to strengthen mental health services, and disaster management. The policy also advocates financial and non-incentives for encouraging the private sector participation.

The policy proposes raising public health expenditure to 2.5 per cent of GDP in a time bound manner. Policy envisages providing larger package of assured comprehensive primary health care through the 'Health and Wellness Centers'.

This policy denotes important change from very selective to comprehensive primary health care package, which includes geriatric health care, palliative care and rehabilitative care services. The policy advocates allocating major proportion (up to two-thirds or more) of resources to primary care followed by secondary and tertiary care. The policy aspires to provide at the district level most of the secondary care, which is currently provided at a medical college hospital.

The policy assigns specific quantitative targets aimed at reduction of disease prevalence / incidence, for health status and programme impact, health system performance and system strengthening. It seeks to strengthen the health, surveillance system and establish registries for diseases of public health importance, by 2020. It also seeks to align other policies for medical devices and equipment with public health goals.

The broad principles of the policy are centered on professionalism, integrity and ethics, equity, affordability, universality, patient centered and quality of care, accountability and pluralism.

It seeks to ensure improved access and affordability of quality secondary and tertiary care services through a combination of public hospitals and strategic purchasing in healthcare deficit areas from accredited non-­governmental healthcare providers, achieve significant reduction in out of pocket expenditure due to healthcare costs, reinforce trust in public healthcare system and influence operation and growth of private healthcare industry as well as medical technologies in alignment with public health goals.

The policy affirms commitment to pre-emptive care (aimed at pre-empting the occurrence of diseases) to achieve optimum levels of child and adolescent health. The policy envisages school health programmes as a major focus area as also health and hygiene being made a part of the school curriculum.

In order to leverage the pluralistic health care legacy, the policy recommends mainstreaming the different health systems. Towards mainstreaming the potential of AYUSH the policy envisages better access to AYUSH remedies through co-location in public facilities. Yoga would also be introduced much more widely in school and work places as part of promotion of good health.

The policy supports voluntary service in rural and under-served areas on pro-bono basis by recognized healthcare professionals under a 'giving back to society' initiative.

The policy advocates extensive deployment of digital tools for improving the efficiency and outcome of the healthcare system and proposes establishment of National Digital Health Authority (NDHA) to regulate, develop and deploy digital health across the continuum of care.