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3. Health

Introduction

Health should be viewed as not merely the absence of disease but as a state of complete physical, mental and social well-being. The determinants of good health are: access to various types of health services, and an individual’s lifestyle choices, personal, family and social relationships. The latter are outside the scope of this sector. The focus of the 12th Plan for Health is on the strategy to deliver preventive, curative and public health services. Other sectors that impact good health of the citizens such as clean drinking water, sanitation, etc. are dealt with elsewhere in the 12th Plan.

Focus areas

1. Universal Immunization

The Universal Immunization program including the Pulse Polio Immunization (PPI) Programme of the GoI aims to provide vaccines to prevent vaccine preventable diseases for children between the age group of 0-15 years. The Universal Immunization Programme (UIP) is an important instrument for protecting children from disease not only during childhood but throughout their lives. The UIP in India is among the largest immunization programmes in the world in terms of number of beneficiaries, quantity of vaccine used, number of immunization sessions organized and the geographical spread and diversity of areas covered.  Full immunization has improved from 43.5% in 2005 to 61% in 2009. More recent data are not available, but it is certain to show further improvement.  However, the fact that routine immunization coverage is not universal is a major shortcoming. 12th Plan strategy for Universal Immunization can be seen under Para 20.123.

2. Maternal Mortality

The Janani Suraksha Yojana (JSY) is a safe motherhood intervention under the National Rural Health Mission (NRHM) being implemented with the objective of reducing maternal and neo-natal mortality by promoting institutional delivery among pregnant women. JSY is a 100% centrally sponsored scheme and integrates cash assistance with delivery and post-delivery care. The scheme focuses on poor pregnant woman with special dispensation for states having low institutional delivery rates, named as Low Performing States (LPS) and the remaining states named as High performing States (HPS). 12th Plan strategy for Maternal and Child Health can be seen under Para 20.119-20.122.

3. Improving affordability of healthcare by reducing Out of pocket expenditure

Affordability of health care is a serious problem for the vast majority of the population, especially in the case of tertiary care. The lack of extensive and adequately funded public health services pushes large number of people to incur heavy out of pocket expenditures on health services from the private sector. Out of pocket expenditures arise even in public sector hospitals, since lack of medicines means that patients have to purchase these. Since the percentage of the population covered by health insurance is very small, this results in a high financial burden on families in case of severe illness. The Janani-Shishu Suraksha Karyakram (JSSK) of the GoI aims to provide completely free and cashless services to pregnant women including normal deliveries, caesarean operations and sick new born (up to 30 days after birth) in Government health institutions in both rural and urban areas. The Free Entitlements under JSSK would include: Free and Cashless Delivery, Free C-Section, Free treatment of sick-new-born up to 30 days, Exemption from User Charges, Free Drugs and Consumables, Free Diagnostics, Free Diet during stay in the health institutions - 3 days in case of normal delivery and 7 days in case of caesarean section, Free Provision of Blood, Free Transport from Home to Health Institutions, Free Transport between facilities in case of referral as also Drop Back from Institutions to home after 48hrs stay. Free Entitlements for Sick new-born till 30 days after birth similarly include Free treatment, Free drugs and consumables, Free diagnostics, Free provision of blood, Exemption from user charges, Free Transport from Home to Health Institutions, Free Transport between facilities in case of referral and Free drop Back from Institutions to home. 12th Plan strategy for Maternal and Child Health can be seen under Para 20.119-20.122.