NATIONAL HEALTH POLICY

INTRODUCTION- The Ministry of health & Family Welfare, Govt. of India, evolved a
national policy in 1983 keeping in view of the national commitment to attain the goal of
Health for All by the year 2000. Since there have been significant changes in the determinant
factors relating to the health sector, necessitating revision of the policy, & a new national
health policy was evolved.
 National health policy in India was not framed and announced until 1983.
 The Ministry of health & family welfare evolved a National Health Policy in 1983
keeping in view a national commitment to attain the goal Health for All by 2000 A D.
 The policy was stressed on the preventive promotive, public health & rehabilitation
aspects of health care.
DEFINITION-National is used to describe something that belongs to or is typical of a
particular country or nation.
Health is a state of complete physical, mental and social wellbeing and not merely an
absence of disease or infirmity.
Policy is a course or principle of action adopted or proposed by an organization or individual.
STEPS FOR IMPLEMENTATION OF A POLICY-
 Identification and issue recognition
 Policy formulation
 Policy implementation
 Policy evaluation

NATIONAL HEALTH POLICY 1983-

To attain the objectives, “Health for All by 2000 A D” the Ministry of Health & Welfare
formulated National Health Policy 1983.
Key Elements of NHP-1983:
 Creation of greater awareness of health problems in the community & means to solve
problems by the community.
 Supply safe drinking water & basic sanitation using technologies that people can
afford.
 Reduction of existing imbalanced in health services by concentrating more on the
rural health infrastructure.
 Establishing dynamic health management information system to support health
planning & health programme implementation.
 Provision of legislative support to health protection & promotion.
 Concerned actions to combat widespread malnutrition.
 Research in alternative method of health care delivery & low cost health technologies.
 Greater co-ordination of different system of medicine.
FACTORS INTERFERING WITH THE PROGRESS TOWARDS HEALTH FOR
ALL-
 Insufficient political commitments to the implementation of Health for All.
 Failure to achieve equity in access to all primary health care elements.
 The continuing low status of women.
 Slow socio-economic developments.
 Difficulty in achieving intra-sectoral action for health
 Unbalanced distributionof and weak support for human resources.
 Widespread inadequacy of health promotion activity.
 Weak health information system & no baseline data.
 Pollution, poor food, safety & lack of water supply & sanitations.
 Rapid demography & epidemiological changes.
 Inappropriate use of & allocation of resources, high cost technologies.
 Natural & manmade disasters.

NATIONAL HEALTH POLICY 2001-

Considering the kind & level of progress, the barriers & the change in health problems & the
circumstances, the department of health, Ministry of health & family welfare felt it necessary
to formulate a new health policy framework as National Health Policy 2001 (NHP 2001).
Objectives-
 To achieve acceptable standard of good health amongst general population of the
country.

NATIONAL HEALTH POLICY 2002- Goals to be achieved by 2015:

Eradicate Polio & Yaws 2005
Eliminate Leprosy 2005
Eliminate Kala-azar 2010
Eliminate Lymphatic Filariasis 2015
Achieve zero level growth of HIV/AIDS 2007
Reduce mortality of 50% on account of TB,
Malaria &other vector born disease 2010
Reduce prevalence of blindness to 0.5% 2010
Reduce IMR to 30/1000 & MMR 100/1 lakh 2010
Increase utilization of public health facility from
Current level of <20% to >75% 2010
Establish an integrated system of surveillance
National Health Accounts & Statistics 2005
Increase Health Expenditure by [Link] a % of
GDP from the existing of 0.9% to 2.0% 2010
Increase share of central grants to constitute at
least 25% of total spending 2010
Increase state sector health spending from
5.5% to 7% of the budget 2005
Further increase of 8% of the budget 2010

CURRENT STATISTICS-
Problems Statistics
Polio Eradicated
Leprosy 72/10000
HIV/AIDS 0.36%
TB 1.8/100,000
Malaria 28.8/100,000
IMR 42/1000

NATIONAL HEALTH POLICY 2015-

The primary aim of NHP 2015 is to inform, clarify, strengthen & prioritize the role of [Link]
shaping health system in all dimension-
 Investment in health
 Organization & financing of health care services
 Prevention of disease & promotion of good health through cross sectoral actions
 Access to technologies
 Developing to human resources
 Encouraging medical pluralism
 Building the knowledge base required better health
 Financial protection strategies
 Regulation & legislation for health
Goal of NHP 2015-
 To attain the highest possible level of good health & well- being through a
preventive &promotive health care orientations in all development policies.
  Universal access of good quality of health care services without anyone having to
face financial hardship as a consequence.

Objectives of NHP 2015-

1. Improve population health status through concerted policy actions in all sectors &
expand preventive, promotive, curative& rehabilitative services provided by the public
health sectors.
2. Achieve a significant reduction in out of pocket expenditure due to health care cost &
reduction in proportion of households experiencing catastrophic health expenditures.
3. Assure universal availability of free comprehensive primary health care services as an
entitlement for all aspect of reproductive, maternal, child & adolescent health and for the
most prevalent communicable non communicable disease in the population.
4. Enable universal access to free essential drug, diagnostics, emergency ambulance
services & emergency medical surgical services in public health facilities so as to
enhance the financial protection role of public facility for all section of the population.
5. Ensure improved access & affordability of secondary & tertiary care services through a
combination of public hospitals& strategic purchasing of services from private health
sectors.
6. Influence the growth of private health care industry & medical technology to ensure
alignment with public health goals, and enables contributions to making health care
system more effectives, efficient, rational, safe, affordable & ethical.

NATIONAL HEALTH POLICY 2017-

The primary aim of the National Health Policy, 2017, is to inform, clarify, strengthen and
prioritize the role of the Government in shaping health systems in all its dimensions
-investments in health, organization of healthcare services, prevention of diseases and
promotion of good health through cross sectoral actions, access to technologies, developing
human resources, encouraging medical pluralism, building knowledge base, developing better
financial protection strategies, strengthening regulation and health assurance. NHP 2017
builds on the progress made since the last NHP 2002. The developments have
been captured in the document “Backdrop to National Health Policy 2017-“Situation
Analyses”,
Ministry of Health & Family Welfare, Government of India.
.
Key Policy Principles
I. Professionalism, Integrity and Ethics: The health policy commits itself to the highest
professional standards, integrity and ethics to be maintained in the entire system of health
care
delivery in the country, supported by a credible, transparent and responsible regulatory
environment.
II. Equity:

Reducing inequity would mean affirmative action to reach the poorest. It would mean
minimizing disparity on account of gender, poverty, caste, disability, other forms of social
exclusion and geographical barriers. It would imply greater investments and financial
protection for the poor who suffer the largest burden of disease.
III. Affordability:
As costs of care increases, affordability, as distinct from equity, requires emphasis.
Catastrophic household health care expenditures defined as health expenditure exceeding
10% of its total monthly consumption expenditure or 40% of its monthly non-food
consumption expenditure, are unacceptable.

IV. Universality:
Prevention of exclusions on social, economic or on grounds of current health status. In this
backdrop, systems and services are envisaged to be designed to cater to the entire population
-including special groups.

V. Patient Centered & Quality of Care:

Gender sensitive, effective, safe, and convenient healthcare services to be provided with
dignity and confidentiality. There is need to evolve and disseminate standards and guidelines
for all levels of facilities and a system to ensure that the quality of healthcare is not
compromised.

VI. Accountability:
Financial and performance accountability, transparency in decision making, and elimination
of corruption in health care systems, both in public and private.

VII Inclusive Partnerships:

A multi stakeholder approach with partnership & participation of all non-health ministries
and communities. This approach would include partnerships with academic institutions, not
for profit agencies, and health care industry as well.

VIII. Pluralism:
Patients who so choose and when appropriate, would have access to AYUSH care providers
based on documented and validated local, home and community based practices. These
systems, would also have Government support in research and supervision to develop
and enrich their contribution to meeting the national health goals and objectives through
integrative practices.

IX. Decentralization:
Decentralization of decision making to a level as is consistent with practical considerations
and institutional capacity. Community participation in health planning processes, to be
promoted side by side.

X. Dynamism and Adaptiveness:

The objectives of NHP 2017::

1. To achieve universal health coverage by ensuring the availability of free and

comprehensive primary health services to people of all ages. It also aims to improve access
and affordability to quality secondary and tertiary health-care services.

2. To make health services comprehensive, predictable, efficient, effective, safe, rational,

patient centric, and affordable.

3. To enable the public health sector to achieve public health goals.

Specific Goals

The 12 goals of NHP 2017 are listed below:

1. To increase the life expectancy at birth to 70 years by 2025.

2. To estimate the burden of disease and its trend through an index called Disability
Adjusted Life Year Index by 2022.

3. To reduce the total fertility rate (TFR) to 2.1 children per woman and the mortality rate
of the mother, neonatal, infant, and children under 5 years of age.

4. To achieve the target of HIV/AIDS as [Link] by 2020.

5. To eliminate leprosy, kala-azar, and lymphatic filariasis by 2018.

6 To improve the cure rate of sputum-positive TB cases and reduce the incidence of
new cases by 2025
7. To reduce the prevalence of blindness and the mortality rate of noncommunicable
diseases to 25% by 2025.

8. To improve the utilization of health services and immunization coverage by 90%

among infants up to 1 year of age by 2025.

9. To provide basic services such as safe and clean drinking water and sanitation to all.

10. To increase the funds allocated to the public health sector and ensure excellent health
infrastructure including workforce per Indian Public Health Standards.

11. To establish a health institution for primary and secondary health services.

12. To improve the health surveillance system, health management information system,
and information network
Areas of Policy

The policy is applicable in the following areas:

1. Ensuring adequate investment in public health.

2. Coordinated action on preventive and promotive health through "Health in All"

approach as a complement to "Health for All" on priority areas such as the following

 The Swachh Bharat Abhiyan

 Balanced healthy diets and regular exercises
 Addressing tobacco, alcohol, and substance abuse
 Preventing accidental traffic mortality
 Action against gender violence
 Safety at the workplace
 Reducing indoor and outdoor air pollution.

3. Changes in health-care services in the following areas:

o Primary, secondary, and tertiary care

o Public hospitals
o Infrastructure
o Human resource development
o Urban health
o National Health
o Ayurveda, Yoga and Naturopathy, Unani, Siddha, and Homeopathy services

4. Strengthening national health programmes to achieve specific goals and objectives of

the policies:

o Reproductive-Maternal-Neonatal-Child-Adolescent Health (RMNCH+A) services

o Child and adolescent health programme
o -Planned strategies to address malnutrition and micronutrient deficiencies
o Universal immunization program
o Communicable diseases: control of tuberculosis, control of HIV/AIDS, leprosy
elimination, and vector-borne disease control
o Noncommunicable diseases
o Mental health
o Population stabilization.

5. Women's health and gender mainstreaming.

6. Gender-based violence (GBV).
7. Innovative measures (e.g. digital tools) with supportive supervision.
8 In urban areas comprising a population of 30 lakhs, only one trauma management center
is . However, in rural areas, it is one trauma center for a population of 10 lakhs to manage
emergency and disaster.
9 . Mainstreaming the potential of AYUSH: Linking AYUSH systems with accredited social
health activists (ASHAs) and Village Health Sanitation and Nutrition Committees
(VHSNCs).

10 . Establishing new medical colleges, nursing institutions, and All India Institute of
Medical Sciences (AIIMS) by the government.
11. Development of evidence-based standard guidelines of care.
12. Strengthening medical education by:

 Improving the infrastructure of medical colleges and converting district hospitals into
medical colleges
 Establishing new AIIMS

 A common medical entrance test and common exams for licensure for both medical
and nursing students
 Periodic licensure, and objectives tests in post-graduate entrance exams, revision of
curriculum, and quality education

 Attracting and retaining doctors in remote areas

 Specialist attraction and retention
Midlevel service providers: Creation of a cadre of midlevel care providers through
bridge courses, short courses, etc.

13. Nursing education:

■ Regulation and quality management of nursing education

■ Creation of cadres such as nurse practitioners and public health

■ Specialized courses such as critical care, cardio-thoracic, vascular care, neurological care,
trauma care, palliative care, and care of terminally ill

■ Establishment of nursing schools and centers of excellence for nursing at the state level

■ Exploring and appointing General Nurse Midwives

14 . Public health management cadre
15. Allocating funds for healthcare from National Health Accounts System.
16. Collaboration with nongovernment sector/engagement with private sectors for capacity
building, skill development programs, corporate social responsibility (CSR), mental health-
care programs, disaster management, strategic purchasing as stewardship, in immunization
programs and disease surveillance, tissue and organ transplantations, Make in India, health
information system, etc.
17. Strengthening regulatory framework for medical, clinical, food, drug, medical devices,
clinical trials, and pricing for equipment, drugs, and devices.
18. Vaccine safety: Effective regulation, research, and development for manufacturing new
vaccines by National Vaccine Policy 2011.
19. Medical technologies.
20. Public procurement involves ensuring access to free drugs and diagnostics through public
facilities.
21. Availability of drugs and medical devices: Domestic production of active pharmaceutical
ingredient and medical devices under Make in India goal.
22. Antimicrobial resistance.
23. Health technology assessment.
24. Digital health technology ecosystem: A National Digital Health Authority (NDHA) will
be set up to regulate, develop, and deploy digital health.
25. Health surveys.
26. Health research.
27. Governance and legal [Link] improving dynamic organization of health
care based on new knowledge and evidence with learning from the communities and from
national and international knowledge partners is designed.

National Policy on AYUSH 2002

Department of Indian Systems of Medicine and Homoeopathy (ISM &11) was given an
independent identity in March 1995 in the Ministry of Health and Family Welfare (MoHFW)
by creating a separate department, which was renamed as the Department of Ayurveda, Yoga
and Naturopathy. Unani, Siddha and Homeopathy (AYUSH) in November 2003. Sowa
Rigpa, a Tibetan system of medicine similar to Ayurveda, was also introduced under AYUSH

A separate Ministry of AYUSH was formed on November 9, 2014, to develop and propagate
the ISM. The objective of setting a separate ministry is to upgrade education standards of
ISM; to strengthen research institutions; to develop various schemes for promotion,
cultivation, and regeneration of medicinal plants; and to develop drugs standards. The first
International Yoga day was celebrated on June 21, 2015, and the Union Ministry of AYUSH
launched Mission Madhumeha on the occasion of the first National Ayurveda Day on
October 28, 2016.

The November 2003 policy on AYUSH is in place since 2002. Keeping in mind many
developments, its importance, and amendment in Acts, the Ministry of AYUSH is drafting a
new policy on AYUSH.

Main Objectives of AYUSH Policy 2002

The main objectives of AYUSH 2002 are listed below:

• To promote good health by expanding the outreach of AYUSH healthcare through

preventive, promotive, mitigating, and curative interventions

To improve the teaching and clinical standards of teachers and clinicians

• To ensure affordable and efficacious AYUSH services and drugs

To integrate AYUSH in health-care delivery system and national health programmes

To improve the quality of drugs for domestic consumption and export

• To sensitize people at national and international levels, other stakeholders, and providers of
health regarding AYUSH

• To develop and utilize these systems.

Strategies/Thrust Areas of Policy

The detailed list provides the various strategies of the policy:

1. Education and research

■Developing regulation to establish new colleges and to start new courses

 Establishment of model colleges and center of excellence or national institutes

Curriculum revision

Setting up separate regulatory council for Yoga and naturopathy

■ Compulsory reorientation programs for physicians and teachers

■Development of vocational training programs for homemakers, dais, nurses, dietitians, etc.
.■Separate entrance examination for undergraduate courses at the state level and unified
admission test for postgraduate (PG) courses in Ayurveda and Unani medicine
.■Setting up an accreditation system at the central level
■Strengthening studies based on clinical trials and other priority areas.

2. Medicinal plants

■Statutory status for Medicinal Plants Board to regulate the registration of farmers and
cooperative societies, transportation, marketing, procurement, and supply to the
pharmaceutical industry.

■ Establishment of an export authority

■ Focus on research studies of particular areas such as reproductive system of plants,

distribution, and storage

■ Research and development on rare and endangered plants.

3. Intellectual property rights and patents

■Creation of a digital library for each system to protect traditional medical knowledge
■ Addressing relevant international fora regarding the need for sharing benefits to the
custodian of knowledge and compensation to originators

■Setting up of a sui generis system to provide an incentive to grassroots' innovators to

disclose knowledge.

4. Integration of ISM & Hand national health programmes

■ Integration and the mainstream of ISM & H in health-care delivery system and vertical
national health programmes

■ Modification of laws o modi

programmes

■ Modification of laws about the practice of moder medicine by ISM practitioners

■ Upgradation of referral ISM hospitals

■ Setting up of specialty centers at primary healt center (PHC) and district hospitals, and als
Panchkarma and Ksharsutra facilities for treatin various disorders in allopathic specialty
hospita with the assistance of the central government

■ Consolidation of infrastructure and raising sala and status of ISM practitioners at the state
levels.

5. Drug standardization and quality control

■ Time target of 2005 to complete all pharmacope work related to all systems of medicine
through a activation mechanism
■ Introduction of quality certification scheme fo batch-by-batch testing by industry, and
financi support for obtaining ISO 9000 certification by ISL
■Creating new legislation for neutraceuticals and Fred supplements not covered under drug
and food licensing, respectively
■ Setting up quality control centers or recognition on regional basis
■ Amendment of Drugs and Cosmetics Act.

6. ISM industry
■Priority industry status to ISM industry as a green industry
■ Framing guidelines for patents, proprietary medicines, etc.

7. Revitalization to local/folk health traditions and home remedy kits

■ Identification, reinforcement, validation, and propagation of folk health traditions related to

birth attendants, herbal healers, etc.

■ Implementation of a scheme to identify medicines to be included in the home remedy kits.

8. Veterinary medicine

■ The inclusion of homeopathic medicines for treatment of animals under Drugs and
Cosmetics Act.

9. Operational use of ISM in Reproductive and Child Health (RCH) services

■ Use of Unani and homeopathic drugs in addition to Ayurveda drugs.

10. Finance, administration, and development of ISM sector

  To Raising the ISM share in the overall health plan
 Establishing separate directorates of ISM and autonomy to ISM sector the sector
 Developing utilization of medicinal plants, the setting of dispensaries, need-based
teaching institution in North East and other states, which are rich in medicinal flora
and fauna.

■Promotion of Panchkarma and Yoga in hotels and through road shows

■ Development of ISM parks and scheme for accreditation of Panchkarma and Yoga
facilities.

12. Intersectoral cooperation

■ Linking with other departments such as cultural tourism and railways for promotion and
propaga-tion
■ Schemes for the production and sale of medicinal plant products
■ Exploring the introduction of ISM in the school curriculum, and encouraging naturopathy
diets and yogic exercises in schools, colleges, and offices.

13. Exposing both foreign and Indian modern graduates to ISM

■Development of modules and courses on Ayurveda and Yoga in medical colleges and
institutions
■Provision of scholarships for PG and doctorate scholars for researching ISM.

14. Building awareness

Launching of electronic and print media programs on the utility and effectiveness of ISM &
H
■ Special incentive schemes for colleges and students, especially of management and science
courses to work and for innovative ideas to provide awareness
 Utilizing services from NGOS
 Allocation of budget for Information Education and Communication (IEC) on healthy
lifestyles and preventive health.

National Population Policy (NPP) 2002

Background
The inception of National Population Policy (NPP) started in 1940 by a "population
committee" constituted by the National Planning Committee under the chairmanship of RK
Mukherjee. The committee recommended various measures such as increasing the age of
marriage and creating awareness among people about safe methods of birth control, which is
achieved through communication methods and setting clinics. In 1946, the Bhore committee
also made a recommendation to focus on self-control to arrest population growth.
In 1951, the government started a "family planning programme," which was a state-
sponsored program in 1951. Later, in 1952, another committee was set up to frame a
population policy. A separate committee on "family planning research and programme
committee" was recommended, which also focused on self-control as a measure to arrest
population growth. However, steps o failure In 1956, the government set up a central family
planning board to deal with these issues, whose main focus was on sterilization.
In the Five-Year Plans, the government recommended various measures. In the first Five-
Year Plan, advising peo-ple on family planning became an integrated part of health services.
Many studies were conducted to gather informa-tion regarding factors affecting population
growth to find the appropriate method of controlling population growth. Many family
planning clinics were started in urban areas during the second Five-Year Plan. In the third
and fourth Five-Year Plans, the main focus was on family planning and birth control.
However, in the fifth Five-Year Plan (1974-1979), maternal and child health and nutrition
services were added under the Population Control Programme.

National Population Policy (NPP) 1976-1977

The government launched the first NPP in 1976-1977, and the family planning programme
came up as the family welfare programme and recommended the following measures:
 Legally enforce the minimum age for marriage as 18 years for girls and 21 years for
boys
 Freezing the population count of 1971 till 2001
 Financial incentives to those opting for birth control
 Improvement in the educational level of girls
 Performance-based assistance from the center to the
 Integrating family planning courses in education curriculum
 Use of communication media to motivate rural community
 Associating with voluntary associations to impart family planning programme
 Group awards for associations/organizations initiating family planning programs
 Involving all government institutions/ministries in family planning program
 Focus on research studies to generate evidence-based data.

National Health Policy 1983 focused on small family to attain the expected level of
population stability. The National Development Council constituted a committee in 1991 to
work out population control issues. The committee under the chairmanship of Karunakaran
submitted its report in 1993 and recommended to prepare the NPP and suggest guidelines for
programs, goals, and monitoring strategies. An expert committee under the chairmanship of
MS Swaminathan drafted the NPP, which came up as the NPP 2000.

Objectives of NPP 2000

The government adopted its second National Population Policy on February 15, 2000. It aims
at RCH services with an integrated approach consisting of the following objectives:
 The immediate objective was to provide services related to maternal and child and
women empowerment after considering the needs for contraception, health-care
facilities, and workforce requirement.
 The midterm objective is to reduce the TFR up to 2.1 children per woman by 2010.
  The long-term objective is to stabilize the expected population growth by 2045.
On May 11, 2000, the National Population Commission was formed under the chairmanship
of the prime minister to monitor and evaluate the implementation of NPP 2000.

Goals
The NPP possesses sociodemographic-based goals that are required to be achieved by 2010.
 To find the needs for RCH services, facilities, and workforce requirement
 To make school education free and compulsory up to age 14
 To reduce dropouts of both girls and boys at primary and secondary school levels
 To reduce infant mortality rate (IMR) by less than 30/1,000 live births
 To reduce maternal mortality ratio to below 100/1 lakh live births
 To encourage delayed marriage for girls
 To achieve universal immunization of children
 To achieve a target of 80% deliveries in the health institutions and 100% by skilled
health professionals• To provide universal access for counseling, fertility regulation,
 and contraception services on choice basis
• To achieve 100% registration of births, deaths, marriages, and pregnancies
 To control the spread of AIDS, integrate reproductive tract infection (RTI) and
sexually transmitted infection (STI) services with the National AIDS Control
Organization
 • To prevent and control communicable diseases
 integrate AYUSH medicine in RCH services
 To promote the norms of small family
 To make family welfare programmes as central to all national health programmes.

Strategic Themes and Action Plans

The subsequent list is about the themes and action plans of NPP 2000:
1. Delegation of planning and program implementation to Panchayati Raj institutions at
village level and further delegating administrative, financial, and resource mobilization power
to them. The panchayat representative committees are formed to promote the gender-sensitive
and multisectoral agenda for population stabilization.
2. Integrating essential services, family planning, and Maternal and Child Health (MCH)
services at the village level can be achieved through self-help group, mobile clinics, and
counseling services. It also needs to collaborate with voluntary and nongovernment sectors to
provide services.
3 Empowering women for improved health and nutrition by creating enabling environment,
opening childcare centres,providing access to drinking water through reward scheme
improving health management,adequate transport etc
4. Child health and survival can be achieved through various programs and by setting a
national technical committee, baby-friendly hospitals, perinatal audits, breastfeeding,
complementary feeding, immunization, control of childhood diseases, etc.
5. Meeting the needs of family welfare services and improving facilities at every level by
making the public accountable at all levels, i.e. improving infrastructure and facilities for
referral transport and providing special loan schemes, site allocation, etc.
6. Focusing on providing basic healthcare to vulnerable especially the urban slum population,
tribes, migrants, and people living in hilly areas. Coordinating with municipal bodies for the
provision of water supply, sanitation, and waste disposal, disseminating information through
IEC campaigns, and involving men in parenthood.
[Link] with governmental and other organization for advertisement and campaigns,
promoting transport, providing preventive RCH services for its employees,and creating a
national network to provide free services to clients.
8. Sensitizing people for ISM. It requires training orientation to ISM & H medical
practitioners wi regard to RCH services, utilizing their services, ant providing advocacy and
counseling.
9. Focusing on contraceptive techniques and resear on RCH. The government needs to
encourage, train and provide funds to conduct studies on RCH and restructure population
research centres.
10. Building geriatric health concerns, which include training urban and rural health centers
to provide geriatric care

Legislation
The government extended the freezing of 1971 census from 2001 to 2026 as motivational
measures for states to work fearlessly to attain population stabilization through various
population policy initiatives.

Institutional Setup
The new institutional structure is proposed to bring comprehensive and multisectoral is
proposed to welfare services and other schemes and programs to stabilize population,
which are as follows:

1. At national level: A national commission on population at the national level headed by

the prime minister oversees and reviews the implementation of policy. It comprised chief
ministers of all states and union territories (UTs), central ministers of the Department of
Health and Family Welfare (H&FW), and other ministries.

2. At state and UT level: A state/UT levels commission at the state/UT level headed by
the chief minister to oversees and reviews the implementation of policy.

3. Coordination cell: The planning commission consisted of a coordination cell at that

time. Now it is under the National Rural Health Mission (NRHM).
4. Technology mission: A technology mission in the Department of H&FW provides
technical support to design and monitor the project.

National AYUSH Mission

National AYUSH Mission (NAM) was launched in the 12th plan to implement the
participation of states and UTs, with the aim to improve planning, supervision, and
monitoring of various schemes under it.

Objectives
 promote the AYUSH system by upgrading its hospitals and dispensaries and
improving facilities at various levels of health-care delivery systems
 Strengthen AYUSH educational system by upgrading and setting these institutions
including drug testing labs at state levels
 Facilitate quality control of Allopathic, Siddha, Unani, and Homeopathic (ASU&H)
drugs by its enforcement mechanisms
 Maintain the availability of raw materials for preparing ASU&H drugs by adopting
better agricultural practices and setting up clusters through various methods
 Develop infrastructure for entrepreneurs.

Components/Activities
1. Mandatory component: Mandatory component includes activities related to AYUSH
services, its institutions, the medicinal plants of ASU&H, and quality control of the related
drugs.
2. Flexible component: The flexible component includes various activities such as wellness
centers, telemedicine, sports medicine, IEC, research and development, innovations such as
public-private partnership, interest subsidy for private institutions, reimbursement, voluntary
certification, and market promotion.

Structure/Mechanism
1. At national level: At the national level, NAM has a governing body and an appraisal
committee. A National Mission Directorate is a governing body that is headed by the
secretary of AYUSH, a chairperson with eight members including the member secretary of
different departments, and may include experts as co-opted members with the approval of
theIts main role is to approve the State Annual Action Plan (SAAP) recommended by the
appraisal committee. The appraisal committee constitutes the joint secretary in charge of
NAM as a chairperson with eight other members including the secretary member and may
also include experts as co-opted members. The main role of this committee is to appraise and
submit SAAP to the governing body for approval.
2. At state level: At the state level, NAM possesses a governing body and an executive
body. The State AYUSH Mission Society is the governing body that is headed by the chief
secretary, a chairperson with nine members including member secretary, and also experts as
co-opted members with the approval of the chairperson. Its main role is to overview the
system, review its policies and program implementation, work on requirements, and approve
SAAP. The executive body headed by the principal secretary/secretary in charge of
AYUSH/H&FW as a chairperson and also comprise the vice-chairperson and eight members
including the member secretary of different departments and may include experts as co-
opted members with the approval of the chairperson. Its main role is to prepare and execute
SAAP and administration of society, follow the decision made by the governing body,
implement, review, monitor, account, etc. .

Program Management Units

Program Management Units (PMUs) are setup at both national and state levels. It comprises
management and technical staff. The function of PMUs is to give technical assistance to
NAM for its implementation.
Monitoring and Evaluating Cells
Health Management Information System (HMIS) is setup at the center/state for concurrent
monitoring and evaluation. It is proposed to have three HMIS managers at the national level
and one HMIS at the state level.

National Health Mission (NHM) 2012-2017

National Health Mission is a flagship health sector program to revitalize both rural and urban
health sectors to achieve universal access to equitable, affordable, and quality health-care
services according to the health needs of people. The framework of the NHM implementation
has two major sub-missions, i.e. the NRHM, which was started in 2005 and approved for
continuation up to 2017 by the ministry, and the National Urban Health Mission (NUHM),
which was approved by the cabinet on May 1, 2013.

Objectives
 To reduce IMR to 25/1,000 live births

 To reduce maternal mortality rate to 1/1,000 live births

 To achieve TFR to 2.1

 To prevent and reduce anemia among women of age-group 15-49 years

 To reduce both morbidity and mortality rates caused by communicable and

noncommunicable diseases, injuries, and emerging diseases
 To reduce the annual incidence and mortality dueto TB by half
 -To prevent leprosy to less than 1/10,000 population and its incidence to zero in all
districts
 - To reduce the annual incidence of malaria to be less than 1/1,000

 To reduce the prevalence of microfilaria to less than 1% in all districts

 To eliminate kala-azar by 2015, i.e. to less than 1 case/10,000 population in all
blocks.
 To reduce household's out-of-pocket expenditure on total health-care expenditure.
Components of NHM
The four components of NHM consist of financial manage-ment group, strengthening health
system, RMNCH+A, and national disease control programmes.
1. Financial management group: It deals with financial matters and managing funds to
resources. It is under the finance division of the NHM. It manages the funds for state health
societies and helps it to setup the financial management group. This division helps districts to
build their financial capacity.
2.. Strengthening health system: The government under the health mission planned to
strengthen the health services in both rural and urban sectors in the following areas:
 Mobile medical units to provide outreach health-care services
 Patient Transport Services, to implement National Ambulance services that can be
availed on dialing 108/102
 Infrastructure at all levels of the health system
 Human resources including doctors, nurses, and specialists under NRHM
 Provision of free essential drugs and logistics under ΝΗΜ.

The government took various initiatives to strengthen these areas by:

■ Adopting Indian public health standards for planning and evaluating health
infrastructure and human resources.
■ Improving quality standards by defining and implementing clinical protocols and
guidelines on RCH
■Preparing treatment protocols and packages such as Skilled Birth Attendant (SBA) and
ANM training protocols, Integrated management of neonatal and childhood illness
(IMNCI) package
■ Creating hospital management societies to improve the quality of care
■ Building quality management systems including audits and certification of hospitals
and institution.

[Link]-Maternal-Neonatal-Child Adolescent Health: Reproductive-

Maternal-Neonatal-Child-Adolescent Health is an important component under NHM
concerning maternal and child health. The government launched this program under
MoHFW in January 2013 to achieve the goals of the 12th Five-Year Plan and NRHM, so
that the millennium developmental goals 4 and 5 are met for healthy mother and child,
thus reducing IMR and maternal mortality rate. It is a strategic approach to safeguard the
health of women, children, and adolescents. It is based on the "continuum of care"
focusing on various stages of life and emphasizes maternal health, child health and
immunization, and adolescent health [Rashtriya Kishor Swasthya Karyakram (RKSK)],
family planning, the involvement of AYUSH doctors in carrying out the related
activities, and aspirational district program.

4. Communicable and noncommunicable diseases:

  National Iodine Deficiency Disorders Control Programme
 National Vector Borne Disease Control Programme (NVBDCP) to control malaria,
dengue, lymphatic filariasis, kala-azar, Japanese encephalitis, and chikungunya in
India.
 Revised National TB Control Programme
 National Programme for Control of Blindness
 National Leprosy Eradication Programme
 Integrated Diseases Surveillance Programme
 National Mental Health Programme
 Noncommunicable Disease Programmes
 Prevention and Management of Burn Injuries Programme.

Framework for Implementation

1. At national level: The Mission Steering Group under the chairmanship of the Union
Health Minister, Empowered Programme Committee under union secretary (H&FW),
and the mission headed by the mission director is responsible for planning,
implementing, and monitoring the NHM activities, and a "National Programme
Management Unit" is setup, and the National Health Systems Resource Centre is to serve
as an apex body for technical assistance to the center and the states.

2. At state level: At the state level, the State Health Mission (SHM) would be under the
state chief minister, with minister of H&FW as the co-chairperson, principal
secretary/secretary as the convener, and other members. The State Health Society will be
headed by the chief secretary or development commissioner, with the convener officer
designated as the mission director of the SHM. State Program Management Unit
(SPMU) will act as the main secretariat for the SHM. The State Health Systems
Resource Centre would serve as an apex body for providing technical assistance to the
state. The State Institute of Health and Family Welfare is the apex body to train
professionals.

3. At district level: At the district level, the head of the local self-government would
head the District Health Mission (DHM)/City Health Mission (CHM), and the District
Health Society (DHS) by the district collector. It recommends the District Program
Management Unit (DPMU) would link with a District Health Knowledge Centre
(DHKC) for technical assistance and a Distric Training Center (DTC)for training.

National Rural Health Mission

National Rural Health Mission is a strategy of the government to provide an integrated,
comprehensive primary healthcare to the rural people, especially the poor and vulnerable
population. The Honorable Prime Minister launched NRHM on April 12, 2005, for 7 years.
However, it continued till 2017 as a sub-mission under NHM. It is a framework to implement
and attain the goals of NHP 2002. The key national programs are RCH-2, National Disease
Control Programmes, and the Integrated Disease Surveillance Project under NRHM. It
integrates all vertical health programs run by the Department of H&FW.

Objectives of NRHM
To restructure the delivery mechanism for health toward providing universal access to
equitable, affordable, and quality healthcare to attain the targets laid down in NHP 2002
 Reducing infant mortality rate (IMR) from the current 41 per thousand to 30 per
thousand by 2010
 Reducing maternal mortality rate (MMR) from the current 300 per lakh to 100 per
lakh by 2010
 Reducing TFR from the current 2.6 to 2.1 by 2010
 Increasing awareness of RTI/STI and HIV/AIDS from the current 36% to 100% by
2010
 Completing immunization
o Improving access to maternal and child health-care services, nutrition, and sanitation
o Doing prevention and control of communicable and noncommunicable diseases
o Strengthening comprehensive primary health-care services
o Achieving population stabilization and balance in the sex ratio
o Mainstreaming of AYUSH
o HIV/AIDS prevention and control efforts.

Aim and Purpose

NRHM aims to correct and enable the health system to effectively handle allocation and to
promote policies to strengthen public health management and service delivery in the country.
The main objectives are as follows:
• To make public health system accountable, affordable, and accessible by improved
management and community action
• To develop pro-people partnerships with the private sector, so that quality health-care
services are provided to the poor
• To make health professionals and paramedics deliver quality health services in rural areas.

Strategies of NRHM
The formulating strategies are based on the principles of "Health for All," i.e. equitable
distribution, community participation, intersectoral coordination, and appropriate technology
at the village, district, state, and national [Link] main focus areas are Family Welfare,
AYUSH, nutrition, and sanitation to achieve the NRHM goal.

Action Plan
1. At community level: ASHA: The government recommended over 400,000 female
ASHAs; one for 1,000 population (flexible for tribal hilly and deserted areas) in 18 high-
focus areas with poor health indicators/weak health infrastructure to increase the accessibility
to health services.
2. Strengthening subcenters: The government recommended an additional ANM at each
subcenter and establishing about 21,983 new subcenters per the 2001 population norms. The
estimated total requirement for the country is 200,000 ANMs.
3. Strengthening primary health centers: The government proposed the availability of
three staff nurses against one staff nurse, appointing/posting AYUSH doctors over and above
the medical officers posted in PHCs, an additional 24,000 MBBS/AYUSH doctors, and
46,000 staff nurses to provide 24x7 hours of service. It is also proposed to have an additional
4,436 PHCs per the 2001 population norms
4. Strengthening community health centers: The government proposed a functional 30-
bedded rural hospital at the Community Health Center (CHC) level to provide round-the-
clock hospital services with specialist facilities, seven specialists, and nine staff nurses. The
plan is to have a separate AYUSH setup and an additional 3,332 CHCs and its upgradation in
a phase manner. All CHCs are to be first made the referral units to provide emergency
obstetric and newborn care, ensuring the availability of doctors in rural areas.
5. Strengthening district health plan: The focus areas of this plan are water supply,
sanitation, and hygiene and nutrition under DHM. It integrates all vertical and centrally
sponsored schemes. There is one project management unit for all districts of a state.
6. Strengthening sanitation and hygiene: It covers the total sanitation campaign,
information education, and communication activities, school, household, and public
sanitation programs.
7. Strengthening disease control programmes: All communicable and noncommunicable
disease control and disease surveillance programs are part of DHM. At every level, it is also
responsible for supplying generic drugs for common ailments and has the provision of mobile
medical unit.
8. Strengthening public-private partnership: The government recommended involving the
private sector in providing health services and their representation in regulatory bodies and
district institutional mechanisms. At every level, the need is to develop clear-cut guidelines
and plans for Public-Private Partnershin (PPP)).
9. Strengthening health financing mechanism: The government planned to strengthen the
financial mechanisms through an accounting system, standardizing hospital care and
serviceperiodically. The need is to have community-based health insurance schemes with the
help of Insurance Regulatory and Development Authority (IRDA).
10. Strengthening reorienting health/medical education: Strengthening health/medical
education is one of the important action plans of the government under NRHM. It emphasizes
to have a referral care chain and guidelines and to setup a commission for excellence in
healthcare.

11. Capacity building: It includes training of ANMs as skilled birth attendants, training, and
monitoring of ASHAs, the involvement of medical colleges, improved career progression for
medical/paramedical staff, strengthening of nursing colleges/ANM training schools, and
partnership with NGOs and professional bodies.
12. Ensuring quality and accountability: Quality and accountability of service delivery are
ensured by setting standards by the constituting committees at health centers/hospital levels.

National Urban Health Mission

National Urban Health Mission was approved by the cabinet on May 1, 2013 and was
launched on January 20, 2014 by the union health minister as a sub-mission under NHM to
improve the health status of urban poor both listed and unlisted living in slums, vulnerable
population such as homeless, ragpickers, limekiln workers, and sex workers by addressing
their particular health issues.
Urban local self-governments such as municipal corporation, municipality, notified area
committee, and town panchayat are the unit of planning. All these urban local governments
except municipal corporations are the part of the District Health Action Plan, which has a
separate plan of action per the norms for urban areas.

Objectives
• To reduce IMR by 40% (in urban areas); national IMR to 20 per 1,000 live births by 2017
• Forty percent reduction in Under 5 mortality rate (U5MR) and IMR
• To achieve universal immunization in all urban areas
• To reduce the maternal mortality rate and 100% Antenatal care (ANC) coverage (in urban
areas) and TFR
• To provide universal access to reproductive health including 100% institutional deliveries
• To achieve all targets of disease control programmes such as National Iodine Deficiency
Disorders Control Programme and Revised National Tuberculosis Control Programme.

Strategies

• Strengthening the existing public-sector primary health structure and referral system
• Establishing community-based groups such as Mahila Arogya Samiti (MAS) at the
household level
• Having coverage with other schemes and programs such as the Jawaharlal Nehru National
Urban Renewal Mission (JNNURM), Rajiv Awas Yojana, Swarn Jayanti Shahri Rozgar
Yojana (SJSRY), North Eastern Region Urban Development Programme, School Health
Programmes, and Adolescent Reproductive and Sexual Health (ARSH)
• Utilizing other areas of synergy such as Member of Parliament Local Area Development
Scheme (MPLADS) and CSR for mobilization of funds to provide health facilities
• Coordinating and integrating various programs implemented by health and family welfare.
ICDS by Human Resource Development for School Health Programmes and Adolescent
Reproductive, and Social Health, and by the Ministry of Minority Affairs for multisectoral
developmental programs.

 Public-private partnership to carry out innovative promotive and preventive actions at the
community level, such as water and environmental sanitation, nutrition, and other aspects
of health
 Creating revolving fund to provide increased access to healthcare
 Effective tracking, monitoring, and timely intervention system through information
technology-enabled services and e-governance at the state level
 Capacity building of health-care providers
• Identifying and prioritizing the most vulnerable urban poor
• Ensuring quality health-care services through quality management and assurance
mechanism.

Framework for Implementation

The National Urban Health Mission planned to operationalize at national/center, state,

district-city, and community levels.

1. At national level:
The Mission Steering Group under the chairmanship of Union Health Minister, Empow-ered
Programme Committee under secretary (H&FW), and National Programme Coordinator
Committee un-der mission director is responsible for planning, coordi-nating, monitoring,
and financing programs. A National Program Management Unit is setup to provide technical
assistance for implementing and monitoring NUHM.

2. At state level:
There is an SPMU, the extension of NRHM SPMU, with a separate urban health cell under
the state mission director NRHM. There is SHM under the chief minister of state, the State
Health Society under the chief secretary, Health Mission Directorate serviced by urban health
division will be responsible for planning, monitoring, and financing at the state level.
3. At city/community level
The states may either have a separate City Urban Health Mission/City Urban Health Societies
or use the existing structure of District Health Society (DHS) (headed by municipal
commissioner/District Magistrate (DM)/District Health Mission (DHM) (headed by
mayor/chairman) under NRHM, with additional staff. A City Programme Management Unit
(CPMU) may also be set up.

Urban Health-Care Delivery System

The services included under Urban Health-Care Delivery System are given below:
1. At the community level for outreach services: At the community level, the frontline
workers designated as ASHAS, MAS members, and ANMs.
[Link] Social Health Activist: The activist is similar to NRHM ASHA and covers
1,000-2,500 beneficiaries between 200 and 250 households located at Anganwadi center,
providing doorstep services at the slum level. She should be a resident of slum and in the age-
group of 25-45 years and acts as a link between Urban Primary Health Centre (UPHC) and
urban slum population. She is expected to promote desired health-seeking behavior among
the urban poor of the assigned area and to extend help to ANM for providing outreach
services. They are responsible to MAS.
b. Mahila Arogya Samiti: It is a community group comprising 10-12 women with an elected
chairperson and a treasurer supported by ASHA under SJSRY. One MAS is for every 50-100
slums and urban poor households. It forms linkages between UPHC and urban slum
population, and its main function is to facilitate health awareness on essential services and
monitoring.
c. ANM: One ANM is expected to cover 10,000-12,000 population and four to five ANMs
per UPHC. At the community level, she is responsible for providing preventive and
promotive health-care services through regular visits and by organizing outreach sessions in
coordination with ASHA and MAS members (one routine session monthly and special
outreach session weekly along with other health professionals).
[Link] the first level of service delivery
a. Urban Primary Health Centre: One UPHC is to cover approximately 50,000-60,000
population located near the slum area to cater to the health needs of approximately 25,000-
30,000 slum population. Each UPHC should be manned by two doctors, i.e. one regular and
another part-time, three staff nurses, one pharmacist, one lab technician, one Lady health
visitor (LHV), and four to five ANMs (depending upon the population size) with co-opted
AYUSH centre.
[Link] the referral level
a. Urban Community Health Centre: For referral services, one UCHC-satellite hospital
(30-50 beds) for every four to five UPHCs to provide inpatient services including medical
care, minor surgical facilities, and facilities for institutional deliveries to a population size of
250,000, and 100 beds for a population size of more than 5 lakhs for metro cities.
4 Referral linkages: Existing hospitals, apart from the private hospitals, are also considered
the referral linkages for availing different types of health services.
5. School health services: School health services for the urban poor population under
UPHC are integrated with the existing School Health Program and Scheme

Programs Under NHM

Programs Under Maternal Health
The five main programs under maternal health are as follows:
1. Janani Suraksha Yojana: Janani Suraksha Yojana (JSY) under the overall umbrella of
NRHM was launched in April 2005 and proposed by modifying the existing
National Maternity Benefit Scheme (NMBS). Although NMBS provides a better diet for
pregnant women from below poverty line (BPL) families, ISY integrates cash assistance with
antenatal care during the pregnancy period, institutional care during delivery, and immediate
postpartum period in a health center by establishing a system of coordinated care by field-
level health worker. The JSY is a 100% centrally sponsored scheme. The objectives of this
yojana are to reduce the overall maternal mortality ratio and neonatal mortality rate/IMR and
to promote institutional deliveries and provide incentives to BPL SC/ST pregnant women
delivering in government institutions/accredited private institutions.
2. Janani Shishu Suraksha Karyakram: Janani Shishu Suraksha Karyakram (JSSK)
scheme was launched on June 1, 2011, with the objective of providing free and no expense
delivery to all pregnant women delivering, including cesarean section, in government
hospitals. They will provide free medicine, diagnostics, blood, diet, and transport facility
from home to back home in case of referral after delivery.
3. The Pradhan Mantri Surakshit Matritva Abhiyan: The Pradhan Mantri Surakshit
Matritva Abhiyan (PMSA) was launched on June 9, 2016, by the MoHFW, Government of
India, to boost health-care facilities to those poor pregnant women (3-6 months' pregnant)
who approach the public health institutions. They will provide free health checkup and the
required treatment on ninth of every month. Its objective is to reduce maternal mortality rate
and IMR, ensuring safe delivery and healthy child, and to make pregnant women aware of
their health issues.
4. Labour Room Quality Improvement Initiative Programme: The government launched
Labour Room Quality Improvement Initiative (LaQshya) Programme to improve the quality
of services provided in labor rooms and its operational theaters, so that quality care is
provided to both mother and newborn programs:
The government has initiated other programs such as:
 Comprehensive abortion care services
 Provision of RTI and STI services
 Establishing blood storage centers
 Village and Nutrition Day
 Screening for gestational diabetes and hypo-thyroidism and deworming, etc.

Child and Adolescent Health-Related Schemes/Programs

The five programs of child and adolescent health-related schemes are the following:
[Link] Bal Swasthya Karyakram: Rashtriya Bal Swasthya Karyakram (RBSK)
scheme under NHM was launched in 2013 by the MoHFW, Government of India. The aim of
this initiative was early deficiencies, and development delays including disability for children
from birth to 18 years of age, all provided free of cost. Early detection is planne at the
delivery point by the attending staff, after 48 hours by ASHA at home, outreach screening by
mobile health team (comprises two doctors, ANM/staff nurse, and pharmacy/paramedical)
both from 6 weeks to 6 years at Anganwadi center and from 6 years to 18 years at school.
2. India Newborn Action Plan: Under Global Strategy for Women's and Children's health,
the Government of India launched "Newborn Action Plan" in June 2014, with an aim to
eliminate newborn deaths and stillbirths.
3. Intensified Diarrhea Control Fortnight: Intensified Diarrhea Control Fortnight (IDCF) is
a special campaign/drive started national wide since 2014 for a period of 2 weeks from July
to August to prevent and control the risk of childhood diarrhea and will be observed every
year during this period to achieve "zero child deaths due to childhood diarrhea," so that IMR
and child mortality rate are reduced. It includes a various set of activities related to advocacy,
awareness generation, management service, establishing oral rehydration solution (ORS)-zinc
corners, distributing ORS by ASHA, screening of undernourished children and treating them,
infant and young child feeding activities, handwashing, etc. through capacity building,
multisectoral involvement.
4. Rashtriya Kishor Swasthya Karyakram: Rashtriya
Kishor Swasthya Karyakram, a national health programme for adolescent of age-group of 10-
14 years, was launched by the MOHFW on January 7, 2014, to improve nutrition, to improve
sexual and reproductive health including menstrual hygiene practices, to prevent injuries and
violence, and to improve mental health. It is a community-based interventional program
through peer educators and was started in collaboration with other ministries and state
governments. It involves the provision of providing guidance and counseling through
adolescent-friendly health clinics, supervisory weekly iron and folic acid (IFA) supplements,
and twice a year antihelminthic medication to control helminthic.
5. Mothers' Absolute Affection Programme: Mothers' Absolute Affection (MAA)
Programme, a flagship national program, was launched by the Union Minister of Health and
Family Welfare on August 5 promote breastfeeding and provide councelling services through
the health system.
technologies for sanitation and management of solid and | liquid wastes planned at national,
state, district, block, and e gram panchayat/village, and water sanitation committee SBM-G
replaced Nirmal Bharat Abhiyan 2012.

■M-Health Initiation
☐ Union Health Minister of India launched m-Health Initiative Programme, as a part of the
Digital India Programme on January 17, 2016, to strengthen public health infrastructure It
consists of four mobile services, namely kilkari, mobile academy, m-cessation, and TB
missed call initiative.
1. Kilkari: The Hindi word kilkari means "baby's gurgle. It is a program developed by BBC
Media Action to deliver free, weekly, and time-appropriate 72 audio messages via mobile and
the messages are related to pregnancy, childbirth, and childcare delivery by health-care
workers (ASHA) to pregnant mothers in their second trimester till the child becomes 1 year.
In the first phase, this program was launched in six states
2. Mobile academy: The mobile academy is another audio-training program developed by
BBC Media Action to train ASHA frontline health workers in maternal and child healthcare
to use interactive voice response messages on a mobile hone and improve their
communication skills.
3. M-cessation: It is a campaign to reach out and support those who are willing to quit
tobacco use, which is achieved through text messages sent through mobile phones.
4. TB missed call initiative: The TB missed call initiative is a helpline/support services to
give information, counseling, and treatment to a caller who gives a missed call and the
support service return the call to the caller. The service is available in the states of Punjab,
andigarh, Haryana, and Delhi.

Programs Under National Institute for Transforming India (NITI) Aayog

The various schemes of NITI Aayog are listed below:
1. Sustainable action for transforming human capital programme: Under the agenda of
cooperative federalism, the NITI Aayog, a "Sustainable Action for Transforming Human
Capital (SATH)" program, was launched on July 2, 2016, to identify and build three future
role models of health system in collaboration with the respective state governments and
implemented with selected McKinsey & Co. & IPE Global Consortium in order to transform
the health sector.
2. Performance index: NITI Aayog launched performance on health index with MOHFW on
December 23, 2016, with the aim to improve health outcome and data collection systems at
the state level to get its annual incremental index of health improvements.
3. Aspirational district programme: The government launched this program in January
2018 to raise people's standard of living and to improve the India's ranking in human
development index by 2022. At present, under NITI Aayog, 117 were identified as
aspirational districts by health and nutrition (30% weight), education (30%), agriculture and
water (20%), financial consideration (10%), and skill development and basic infrastructure
(10%). Overall it has 49 indicators and 13 core indicators related to the health sector. Apart
from this index, the government developed health atlas, a diagnostic tool launched on April
14, 2018, guidelines and checklist on health and nutrition, and e-Mitra, a mobile integrated
tool kit for providing statistical information regarding RMNCH+A launched on October 22,
2018.
WHO CONTRIBUTION FOR HEALTH FOR ALL IN 21 st CENTURY-
 Serve as the World’s health advocate, by providing leadership for Health for All to all
it’s member countries.
 Develop global, ethical, scientific norms and standards.
 Develop international instruents that promote global health.
 Engage in technical co-operative with all countries.
 Strengthen countries capabilities of building sustainable health system & improve the
performance of essentials public health functions.
 Protect the health of vulnerable & poor communities & countries
 Faster the use of the innovation in science & technology for health.
 Provide leadership for eradication, elimination or control of selected disease.
 Provide technical support to prevention of public health emergencies & post
emergency rehabilitation.
 Build partnership of health.
 NATIONAL POPULATION POLICY

INTRODUCTION-Population policy in general refer to the policies intended to decrease the

birth rate or growth rate.
Population Policies formulated to address the unmet needs for contraception, health care
infrastructure, and health personnel, and to provide integrated service delivery for basic
reproductive and child health care. The main objective is to achieve a stable population at a
level consistent with the requirements of sustainable economic growth, social development,
and environmental protection.
In April 1976 India formed it’s first – “National Population Policy”. It is called for an
increase the legal minimum age of marriage from 15 to 18 for females & from 18 to 21 for
males. However, the most part the 196 statements became irrelevant & the policy was
modified in [Link] policy statement reiterated the important of the small family norm
without compulsion & changed the programme title to “family welfare programme.”
The NHP was approved by the parliament in 1983 has set the long term demographic goals of
achieving a Net Reproduction Rate (NRR) of one by the year 2000(which was not achieved)

HISTORY OF INDIA'S POPULATION

1. When India gained independence from the United Kingdom sixty years ago, the
country's population was a mere 350 million. Since 1947, the population of India has
more than tripled.
2. In 1950, India's total fertility rate was approximately 6 (children per woman).
Nonetheless, since 1952 India has worked to control its population growth. In 1983,
the goal of the country’s National Health Policy was to have a replacement value total
fertility rate of 2.1 by the year 2000. That did not occur.
3. In 2000, the country established a new National Population Policy to stem the growth
of the country’s population. One of the primary goals of the policy was to reduce the
total fertility rate to 2.1 by 2010. One of the steps along the path toward the goal in
2010 was a total fertility rate of 2.6 by 2002.

As the total fertility rate in India remains at the high number of 2.8, that goal was not
achieved so it is highly unlikely that the total fertility rate will be 2.1 by 2010. Thus, India’s
population will continue to grow at a rapid rate.
DEFINITION-
A population is the summations of all the organism of the same group of species, which live
in the same geographical area and have the capability of interbreeding.
Policy-
 Set of ideas or plans that is used as a basis of decision making.
 Attitude & actions of an organization regarding a particular issue.
 General statement of understanding which guide of decision making.
National population Policy-The need for NPP was felt since 70’s. It was drafted in
[Link] statement on family welfare programme was also prepared in 1977. Both these
statements were tabled in the parliament but were never discussed or adopted.
The NHP of 1983 emphasized the need for securing the small family norm through voluntary
efforts & moving towards the goal of population stabilization.

FIVE-YEAR PLANS BY THE GOVERNMENT OF INDIA FOR POPULATION

CONTROL

First Five Year Plan: India is the first country in the world to begin a population control
programme in 1952. It emphasized the use of natural devices for family planning.

Second Five Year Plan: Work was done in the direction of education and research and the
clinical approach was encouraged.

Third Five Year Plan: In 1965, the sterilization technique for both men and women was
adopted under this plan. The technique of copper- T was also adopted. An independent
department called the Family Planning Department was set up.

Fourth Five-Year Plan: All kinds of birth control methods (conventional and modern) were
encouraged.

Fifth Five Year Plan: Under this plan the National Population Policy was announced on 16
April, 1976. In this policy, the minimum age for marriage determined by the Sharda Act,
1929 was increased. It increased the age for boys from 18 to 21 years and for girls from 14 to
18 years. The number of MPs and MLAs was fixed till the year 2001 on the basis of the
census 1971. Under this Plan, forced sterilization was permitted which was later on given up.
In 1977, the Janata Party government changed the name of Family Planning Department to
Family Welfare Department.

In the Sixth, Seventh and Eighth Plans, efforts were done to control population by
determining long-term demographic aims.

Ninth Five-Year Plan: In 1993, the government had established an expert group under the
chairmanship of M.S. Swami Nathan for formulating national population policy. Though this
group had prepared the draft of the new population policy in 1994, it was reviewed in 1999
by the Family Welfare Department and was passed by the Parliament in 2000. The Central
Government formulated the 'new national population policy' in February 2000. This policy
has three main objectives:

Objectivesof Ninth Five Year Plan

1. Temporary objective: The easy supply of birth control devices was included in it.
Besides, the development of health protection framework and recruitment of health workers
were also made a part of it.

2. Middle-term objective: Under it, the total fertility rate (TFR) had to bring down to the
replacement level of 2.1 by 2010.

3. Long-term objective: Under it, the Objective of population stabilization by 2045 is to be

achieved.

The population has to be stabilized at that level which must be harmonious from the points of
view of economic and social development and environmental protection.

It has been announced in the new population policy to keep the composition of the Lok Sabha
unchanged by 2026 so that the states could co-operate without any fear. Under current
provisions, the number of MPs in different states by 2001 has been determined on the basis of
the census 1971. It was to be changed in 2001 on the basis of the new census report (2001).
But it might be harmful to those states which had taken part in the population control
programme with great fervor. Those states which had not laid proper attention on population
control could get more shares in the Lok Sabha resulting in wrong effect on the population
control programme. So, the Lok Sabha would not have more than 553 elected seats till 2026
and the number of Lok Sabha seats of each state would remain the same as it is at present.
While announcing this new policy, the Central Health Minister said that the people living
below poverty line would be rewarded properly if they would marry after 21 years, adopt the
standard of two children and undergo sterilization after two children.

The following major Objectives had been set in the National Population Policy till the
year 2010:

1. The 'total fertility rate' to be reduced to 2.1.

2. The high class birth control services had to be made available publically so that the
standard of two children could be adopted.

3. The infant mortality rate had to be reduced to 30 per thousand.

4. The mother mortality rate had also to be reduced to below 100 per one lakh.

5. The late marriage of girls had to be encouraged.

A high level 100-membered National Population Commission has been set up under the
chairmanship of the Prime Minister on 11 May 2000 to supervise and analyze the
implementation of this new population policy.

The population policy of the Government of India has passed through the following
phases from time to time:

1. Pre-Independence Period:
Before independence, the Britishers did not consider population growth as a problem. Their
attitude towards birth control was one of indifference because they never wanted to interfere
with the values, beliefs, customs and traditions of Indians. That is why this phase is called the
Period of Indifference.

However, the intelligentsia in India was aware of the problem of growing population and did
advocate birth control. Among them P.K. Wattal was the pioneer who wrote a book on
Population Problem in India in 1916, followed by R.D. Karve, Rabindranath Tagore, P.N.
Sapru, Jawaharlal Nehru and Bhore Committee among others who advocated birth control.

Gandhiji also favored birth control but emphasized natural methods like self-control or
abstinence and safe period instead of artificial methods of birth control. Prof. Gunnar Myrdal
wrote about this period thus: “During the last time of British colonialism, the intelligentsia
prepared background thoughts related to birth control. The logical and systematic policies of
birth control were put in force after independence.”

2. The Period of Neutrality, 1947-51:

The period following independence and before the beginning of the planning era was one of
neutrality. The Government of India was busy with the post-independence problems like
rehabilitation of the people following the Partition, reorganization of the States and
Pakistan’s invasion of Kashmir. However, at one of the meetings of the Planning
Commission in 1949, Jawaharlal Nehru laid emphasis on the need for family planning
programme in India.

3. The Period of Experimentation, 1951-61:

During the first decade (1951-61) of planned economic development, family planning as a
method of population control was started as a government programme in India. The National
Family Planning Programme was launched in 1952 with the objective of “reducing birth rate
to the extent necessary to stabilize the population at a level consistent with the requirement of
the national economy.”

This programme was started on an experimental basis with a Plan outlay of Rs. 65 lakhs in
the First Plan and Rs. 5 crores in the Second Plan. It was based on Clinical Approach to
provide service to those who were motivated to visit family planning centers set up by the
Government.

4. The Beginning of the Population Control Policy 1961 to 2000:

With the rapid growth of population in the 1961 Census by 21.5 per cent, the Extension
Approach to family planning was adopted in the Third Plan. This approach emphasized the
adoption of an educational approach to family planning through Panchayat Samitis, Village
Development Committees and other groups so as to change the attitudes, behaviour and
knowledge of the people towards family planning.

The family planning programme was also made target oriented and Rs. 27 crores were
allocated during the Plan for this purpose. The target was to reduce the birth rate to 25 per
1000 persons by 1973. To make this programme more popular, Cafeteria Approach was
adopted.
Under it, the couples were given advice on different types of family planning methods to be
adopted. The choice of a particular method was left to them. For the effective working of the
family planning programme, a separate Department of Family Welfare was created in the
Ministry of Health and Family Planning in 1966.

High priority was accorded to the family planning programme during the Fourth Plan by
allocating Rs. 330 crores.

The aim was to reduce the birth rate to 25 per 1000 persons by 1980-81. For this, efforts
were to be directed towards:

(a) Social acceptability for a small family;

(b) Increasing information and knowledge about family planning methods both in urban and
rural areas; and

(c) Making available the various devices and equipment to the couples.

Another important measure was the integration of family planning services with health,
maternity and child health care and nutrition. Thus the family planning programme was made
more broad-based. To make this programme more effective, Selective Approach was adopted
under which couples in the reproductive age group of 25 to 35 years were persuaded to
undergo sterilization.

The 1971 Census showed a rapid growth in population by 24.6 per cent. To control this, the
Fifth Plan laid down the ambitious target of reducing the birth rate to 30 per 1000 by the end
of the Plan (1978-79) and to 25 per 1000 by 1983-84.

For achieving this, it proposed to protect 33 per cent of couples against conception by 1978-
79 against 16-17 per cent at the end of the Fourth Plan. To implement it, monetary incentive
was given to couples undergoing sterilization. This was followed by compulsory sterilization
under The National Emergency in 1975.

IMPORTANT FEATURES OF NPP OF 1976-

 Increase the age of marriage from 15 to 18 years for girls & from 18 to 21 years for
boys
 Freeze the population figures at the 1971 level until 2001.
 Make some portions of the central assistance provided to the state dependent upon the
performance in family planning.
 Give greater attention to the education of girls.
 Ensure a proper place for population education in the total system of education.
 Involve all ministries & departments of the Govt. in the family planning programme.
 Increase the monetary compensation for sterilization.
 Institute group awards as incentives for various organizations & bodies representing
the people at local levels, including Zilaparishad& Panchayat Samity.
 Encourage intimate association of voluntary organizations. Particularly those
representing women with implementation of programme.
 Impart more importance to research activities in the field of population control
  Use mass media for motivation, particularly in rural area to increase the acceptance of
family planning method.

In the post-emergency period, the Janata Government announced a New Population

Policy in 1977. The main features of this policy were:

(a) Renaming the family planning programme into family welfare programme;

(b) Fixing the marriage age for girls at 18 years and for boys at 21 years. This has been
implemented by the Child Marriage Restraint (Amendment) Act, 1978;

(c) Making sterilization voluntary;

(d) Including population education as part of normal course of study;

(e) Monetary incentive to those who go in for sterilization and tubectomy;

(f) Private companies to be exempted in corporate taxes if they popularize birth control
measures among employees;

(g) Use of media for spreading family planning in rural areas, etc. this policy put an end to
compulsory sterilization and laid emphasis on voluntary sterilization. This slowed down the
family planning programme. As a result, the number of sterilizations fell from 82.6 lakh in
1976-77 to 9 lakh in 1977-78.

The Sixth Plan laid down the long-term demographic goal of reducing the net reproduction
rate (NRR) to 1 by 2000 by reducing crude birth rate to 21, crude death rate to 9, infant
mortality rate to less than 60 per 1000, and couple protection rate (CPR) to 60 per cent.

The goal of attaining NRR of 1 was revised to 2006-11 in the Seventh Plan by reducing crude
birth rate to 29, crude death rate to 10.4, infant mortality rate to 90 per 1000, and couple
protection rate to 42 per cent. Further, the Seventh Plan laid emphasis on the two-child family
norm. To make it successful, it intensified family planning and maternity and child health
programmes.

To achieve the goal of NRR of 1, the Eighth Plan extended it to the period 2011 -16. The
targets laid down during the Plan were crude birth rate at 26, infant mortality at 70 per 1000
and couple protection rate to 56 per cent.

To achieve these, the Government replaced the earlier Population Control Approach by the
Reproductive and Child Health Approach in October 1997 to stabilize population and
improve quality of life. The focus of this approach was on decentralized area specific macro-
planning.

It led to several new schemes for improving quality and coverage of welfare services for
women, children and adolescents such as child survival, safe motherhood programme, and
universal immunizationprogramme (UIP), reproductive tract infections (RTI), etc.
During the Ninth Plan, the earlier approach of using NRR (Net Reproduction Rate) of 1.0
was changed to a Total Fertility Rate (TFR) of 2.1. This level of TFR had been projected to
be achieved by 2026 in the Plan. Further, with increased RCH (Reproductive and Child
Health), the targets laid down by the end of the Ninth Plan (2002) had been infant mortality
rate of 50 per 1000, crude birth rate of 23, total fertility rate of 2.6 and CPR of 60 per cent.

In 2001, the National Policy for Empowerment of Women was adopted with the ultimate
objective of ensuring women their rightful place in society by empowering them as agents of
socio-economic change and development. Women empowerment is, therefore, an important
approach adopted in the Tenth Five Year Plan for the development of women.

To this effect, a National Plan of Action for Empowerment of Women, with a view to
translating the National Policy of Empowerment of Women into action in a time bound
manner has been adopted as a priority agenda for action by the Department of Women and
Child Development (DWCD) of the Ministry of HRD. So the Government’s population
policy has shifted from population control to family welfare and to women empowerment.

NATIONAL POPULATION POLICY 2000-

In 1998 the draft of NPP was finalized after consultation it was approved by the cabinet &
was examined by the groups of ministers. The draft was discussed in cabinet on 19 th
November 1999. The suggestion was incorporated & the final draft of NPP was placed before
the parliament. It was adopted by the Govt. of India on 15 th February 2000.
OBJECTIVES:

There are three types of objectives of National Population Policy (NPP) 2000:

1. The Immediate Objective:

The immediate objective is to address the unmet needs for contraception, health care
infrastructure and health personnel and to provide integrated service delivery for basic
reproductive and child health care.

2. The Medium Term Objective:

The medium term objective is to bring the Total Fertility Rate (TFR) to replacement level by
2010 through vigorous implementation in inter-sectorial operational strategies.

3. The Long Term Objective:

The long term objective is to achieve a stable population by 2045 at a level consistent with
the requirements of sustainable economic growth, social development, and environment
protection.

National socio-demographic goal for 2010-

Strategic Themes-
 Decentralized planning &programme implementations.
 Convergence of service delivery at village level.
  Empowering women for improved health & nutrition.
 Child survival & child health.
 Meeting the unmet need of family welfare service.
 Underserved populations group-
 Diverse health care’s providers
 Collaborations with commitments from non-govt. organizations & private sectors.
 Mainstreaming Indian system of medicine & homeopathy
 Providing for the older populations.
 Information, education & communication.
TARGETS:

The following are the targets of National Population Policy 2000:

1. Achieve zero growth rate of population by 2045.

2. Reduce infant mortality rate of below 30 per thousand live births.

3. Reduce maternal mortality ratio of below 100 per 1, 00,000 live births.

4. Reduce birth rate to 21 per 1000 by 2010.

5. Reduce total fertility rate (TFR) to 2.1 by 2010.

National Socio-Demographic Goals for 2010:

To fulfill these objectives and targets. National Socio-Demographic goals have been
formulated which in each case are to be achieved by the year 2010.

They are as follows:

1. Make school education free and compulsory up to the age of 14 and reduce dropouts at
primary and secondary school levels to below 20 per cent for both boys and girls.

2. Address the unmet needs for basic reproductive and child health services, supplies and
infrastructure.

3. Achieve universal immunization of children against all vaccine preventable diseases.

4. Promote delayed marriage for girls, not before 18 and preferably after the age of 20 years.

5. Prevent and control communicable diseases.

6. Achieve universal access to information/counselling and services for fertility regulation

and contraception with a wide basket of choices.

7. Achieve 80 per cent institutional deliveries and 100 per cent deliveries by trained persons.

8. Achieve 100 per cent registration of births, marriage and pregnancy.

9. Integrate Indian Systems of Medicine (ISM) in the provision of reproductive and child
health services and in reaching out to households.

10. Contain the spread of Acquired Immuno-Deficiency Syndrome (AIDS) and promote
greater integration between the management of Reproductive Tract Infections (RTI) and
Sexually Transmitted Infections (STI) and the National AIDS Control Organization.

11. Bring about convergence in implementation of related social sector programmes so that
family welfare becomes a people centeredprogramme.

12. Promote vigorously the small family norm to achieve replacement levels of TFR.

The Technical Group on Population Projection has projected India’s population of 116 crores
in 2010, but it may reduce to 110.70 crore in 2010 if the National Population Policy, 2000 is
fully implemented. This can be seen from Table 32.2.

Moreover, the projections of crude birth rate, infant mortality rate and total fertility rate are
shown in Table 32.3. These projections are feasible if the National Population Policy 2000 is
fully implemented.

ORGANISATION:

To implement and achieve the various objectives, targets and socio-demographic goals,
the following organizational structure has been proposed by the National Population
Policy:
1. The appointment of a National Commission on Population to be presided over by the
Prime Minister. The chief ministers of all States and related ministers will be its members.

2. There will be a State Commission on Population in every State headed by its chief
minister.

3. The new policy will be implemented by the Panchayats and municipalities at the grassroots
levels.

Motivational and Promotional Measures for Adoption of the Norms of Small Family:

The motivational and promotional measures for adoption of small family norms are:

1. Strict enforcement of Child Marriage Act, 1976.

2. Facilities for safe abortion to be expanded and strengthened.

3. Strict enforcement of the Pre-Natal Diagnostic Techniques Act, 1994.

4. Increased vocational training schemes for girls leading to self- employment to be

encouraged.

5. Panchayats and ZilaParishads to be rewarded and honored for exemplary performance in

universalizing the small family norm, achieving reductions in infant mortality and birth rates
and promoting literacy with completion of primary schooling.

6. A revolving fund to be set up for income-generating activities by village level self-help

groups who provide community level health care services.

7. The BalikaSamridhiYojna run by the Department of Women and Child Development to

promote survival and care of the girl child to be continued. A cash incentive of Rs. 500 is
awarded at the birth of the girl child up to two children.

8. A Family Welfare-Linked Health Insurance Plan to be introduced. Couples below the

poverty line who undergo sterilization with not more than two living children would become
eligible (along with children) for health insurance (for hospitalization) not exceeding Rs.
5,000 and a personal accident insurance cover for the spouse undergoing sterilization.

9. Maternity Benefits Scheme run by the Department of Rural Development to continue. A

cash incentive of Rs. 500 is awarded to mothers who have their first child after 19 years of
age, for birth of the first or second child only. Disbursement of cash award will in future be
linked to compliance with antenatal checkup, institutional delivery by trained birth attendant,
registration of birth and BCG immunization.

10. Couples below the poverty line who marry after the legal age of marriage, register the
marriage, have their first child after the mother reaches the age of 21, accept the small family
norm and adopt a terminal method after the birth of the second child to be rewarded.
11.A wider affordable choice of contraceptives to be made accessible at diverse delivery
points with counselling services to enable acceptors to exercise voluntary and informed
consent.

12. Products and services to be made affordable through innovative social marketing
schemes.

13. Crèches and child care centers to be set up for income generating activities by village
level self-help groups who provide community level health care services.

14. Local entrepreneurs at village levels to be provided soft loans and to be encouraged to run
ambulance to supplement the existing arrangements for referred transportation.

15. The 42nd Constitutional Amendment has frozen the number of representatives in the Lok
Sabha (on the basis of population) at 1971 Census levels. The freeze is currently valid until
2001, and has served as an incentive for State Governments to fearlessly pursue the agenda
for population stabilization. This freeze needs to be extended until 2026.

IMPLEMENTATION OF NPP, 2000: NATIONAL COMMISSION ON

POPULATION:

In pursuance of NPP, 2000, the Central Government has set up a National Commission on
Population (NCP) on 11 May, 2000. It is presided over by the Prime Minister, with the Chief
Ministers of all States and UTs and the Central Minister-in-charge of concerned Central
Ministries and Departments, reputed demographers, public health professionals and non-
government organizations as members. State Level Commissions on Population presided
over by the Chief Minister have been set up with the objective of ensuring implementation of
the NPP.

The functions of the Commission are:

(i) To review, monitor and give direction for the implementation of the NPP with a view to
achieve the goals set by it;

(ii) To promote synergy between health, educational, environmental and developmental

programmes so as to hasten population stabilization;

(iii) To promote inter-sectoral co-ordination in planning and implementation of the

programmes through different agencies at the Centre and in the States; and

(iv) To develop a vigorous people’s programme to support this national effort.

The first meeting of NCP was held on 22 July, 2000, where the Prime Minister
announced two major steps:

1. The formation of an Empowered Action Group within the Ministry of Health and Family
Welfare to focus on those States which are deficient in national socio-demographic indices.
2. Establishment of National Population Stabilization Fund (NPSF) with a seed money of Rs.
100 crores to provide a window for channelizing funds from national voluntary sources. The
Prime Minister appealed to the corporate sector, industry, trade organizations and individuals
to generously contribute to this fund and thus help in the national effort to stabilize
population.

A Strategic Support Group consisting of secretaries of concerned sectoral ministries has been
constituted as a Standing Advisory Group to the Commission. Nine working groups have
been constituted to look into specific aspects of implementation of the programmes aimed at
achieving the targets set in NPP NCP has allocated funds for action plans drawn up by district
magistrates in poorly performing districts to implement programmes to accelerate the decline
in fertility.

Evaluation:

This is a broad-based policy which relies more on persuasive and positive measures rather
than on coercive methods. It demonstrates the Government’s concern for the rapid growth of
population and its stabilization from the long-term perspective. At the same time, it lays
emphasis on both the qualitative and quantitative aspects of population.

However, this policy has been criticized on the following grounds:

1. The Swaminathan Committee (1993) had recommended the year 2015 as the target for
population stabilization which the NPP has pushed to the year 2045.

2. The Swami Nathan Committee was against providing cash incentives to couples
undergoing sterilization because these are misused. But the NPP has proposed the same.

3. Critics point out that the NPP is soft towards the male participants. The various
motivational and promotional measures for adoption of small family norms appear to convey
that the women will bear the burden of population control rather than men. This is borne out
by the fact that there has been a steady decline in vasectomies over the last two decades and
presently over 97 per cent of sterilizations are tubectomies of women.

4. The NPP commits the same mistake which had been made by the earlier population
policies. It depends upon its implementation on the bureaucracy rather than on NGOs (non-
governmental organisations).

5. The proposal that the National Commission on Population (NCP) should be chaired by the
Prime Minister has been criticized because being a very busy person, the Prime Minister
would not be able to attend it. This would delay the taking of important decisions on
population control.

PROGRESS IN THE MILESTONES OF THE POPULATION POLICY OF INDIA:

1. Bhor Committee Report in 1946.

2. Implementation of Family Planning Programme in 1952.

3. National Population Policy Statement in 1976.

4. Policy Statement of Family Welfare Programme in 1977.

The National Population Policy Statement of 1976 and Policy Statement on Family Welfare
Programme of 1977 were laid on the Table of the House of Parliament. But they have never
been discussed or adopted by the Parliament.

5. National Health Policy was adopted in 1983, which emphasized the need for “securing the
small family norm through efforts and moving towards the goal of population stabilization.”
At the time of adoption of National Health Policy, the need for a separate National Population
Policy had been emphasized by the Parliament.

6. A Committee on Population under the Chairmanship of Shri Karunakaran was appointed

by the National Development Council in 1991. To take “a long term holistic view of
development, population growth and environmental protection” and to “suggest policies and
guidelines for formulation of programmes” and “a monitoring mechanism with short,
medium and long term perspectives and goals.” The Karunakaran Report had been endorsed
by National Development Council in 1993.

7. A group was asked to prepare a draft of a National Population Policy in 1993 which was
headed by Dr. M.S. Swami Nathan. This was supposed to be discussed by the Cabinet and
then by the Parliament. This report was circulated among the Members of Parliament in 1994
and the comments thereof had been invited from Central and State agencies.

It was expected that Parliament would help to produce a broad political consensus for
National Population Policy which was approved by the National Development Council. But
no action was taken to implement it.

8. The then Prime Minister I.K. Gujral promised to announce a National Population Policy in
1997 at the time of the 50th anniversary of India’s Independence. The Cabinet approved the
National Population Policy Draft during November 1997 with the recommendation to place
the same before the Parliament. But due to the dissolution of the Lok Sabha, this draft could
not be placed before the Parliament.

9. Another Draft of National Population Policy was finalized after one more round of
consultations during 1998 which was placed before the Cabinet in March 1999. To examine
the draft policy, the Cabinet appointed a group of Ministers headed by the Deputy Chairman
of Planning Commission. After several meetings, the group of Ministers invited a cross-
section of experts from public health, professionals, demographers, academia, social
scientists and women representatives.

The final draft of population policy prepared by the group of Ministers was placed before the
Cabinet which was discussed on 19th November, 1999. On the basis of the suggestions made
in the Cabinet meeting a fresh draft was prepared, placed before the Cabinet and approved as
National Population Policy, 2000.

CONCLUSION: Although India has created several impressive goals to reduce its
population growth rates, India and the rest of the world has a long way to go to achieve
meaningful population controls in this country with a growth rate of 1.6%, representing a
doubling time of under 44 years.

LESSON PLAN
ON
NATIONAL HEALTH POLICY
AND
FIVE YEAR PLAN
 Submitted to: Submitted by:
Madam N Saha Doli Ghosh
Professor MSc. Nursing PartII Student
C.O.N [Link] .MCH C.O.N [Link]

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[Link] Neelam , essentials of community health nursing,1st ed , 2011, PV books,
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[Link] K K : Community Health Nursing:2nd Edition, 2009, Kumar Publishing House:
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Five years plan