Health policy break through in India: by dr joy banerjee; drjoy1@gmail.

com 2009

Title of the paper : SARV JAN SWASTH JAN ; going back to past to reengineer the future.

Executive summary :

Birth, death, old age and disease are the four most inevitable things to any organism starting from the
smallest unicellular to the most complex and highly evolved Homo sapiens. But in the race for
advanced technological expertise we have enormously lost to understand it lost on the basic front of
living. i.e. living a healthy long life. Is all this advancement of any use when the majority of the
world’s population has to struggle for the basic bare minimum.? Even an animal manages to carry out
4 basic activities of life and i.e. eating, mating, sleeping and defending with ease but we humans have
failed to do so. And in an attempt to gain it we have compromised the health and welfare of masses.
Health which is supposedly to be a common wealth to all is increasingly becoming a priced and rare
possession and by far everyone is only apparently healthy. Thus there is an urgent need felt of going
back to basics and of a policy to make health for all a reality, “SARV JAN SWASTH JAN”. the
simple policy we need is to bring health and fitness to the forefront and promote all that directly and
indirectly promotes health. Health by definition is spiritual, mental, physical and socio economic well
being of an individual and not merely absence of disease. !

Background and Context and importance of the problem :

One of the best ways to judge the well being of the people of any nation is by examining the standards
of health that ordinary people have attained. Healthy living conditions and access to good quality
health care for all citizens are not only basic human rights, but also essential prerequisites for social
and economic development. Hence it is high time that people’s health is given priority as a national
political issue. But surprisingly the present statistics show some grave signals. :

1) Infant and Child mortality snuffs out the life of 22 lakh children every year, more serious is
the fact that the rate of decline in Infant Mortality, which was significant in the 1970s and
80s, has slowed down in the 1990s.Three completely avoidable child deaths occur every
minute. If the entire country were to achieve a better level of child health, for example the
child mortality levels of Kerala, then 18 lakh deaths of under-five children could be avoided
every year.
2) The four major killers (lower respiratory tract infection, diarrheal diseases, perinatal causes
and vaccine preventable diseases) accounting for over 60% of deaths under five years of age
are entirely preventable through better child health care and supplemental feeding programs.
The most recent estimate of complete immunization coverage indicates that only 54% of all
children under age three were fully protected.
 Health policy break through in India: by dr joy banerjee; drjoy1@gmail.com 2009

3) About 5 lakh people die from tuberculosis every year, and 20 lakh new cases are added each
year, to the burgeoning number of TB patients presently estimated at around 1.40 crore
Indians !
4) India is experiencing a resurgence of various communicable diseases including Malaria,
Encephalitis, Kala azar, Dengue and Leptospirosis. The number of cases of Malaria has
remained at a high level of around 2 million cases annually since the mid eighties.
Environmental and social dislocations combined with weakening public health systems have
contributed to this resurgence.
5) Diarrhoea, dysentery, acute respiratory infections and asthma continue to take their toll
because we are unable to improve environmental health conditions..
6) Cancer claims over 3 lakh lives per year and tobacco related cancers contribute to 50% of the
overall cancer burden, which means that such deaths might be prevented by tobacco control
measures.
7) Estimates of mental health show about 10 million people suffering from serious mental
illness, 20-30 million having neuroses and 0.5 to 1 percent of all children having mental
retardation2 . One Indian commits suicide every 5 minutes.
8) The growing inequalities in health and health care are unjust!
The WHO. standard for expenditure on public health is 5% of the GDP. The average
spending today by Less Developed Countries is 2.8 % of GDP, but India presently spends
only 0.9% of its GDP on public health, which is merely one-third of the less developed
countries’ average.

Aims and objective of the policy.

 To look at health of an individual in a holistic way and wellbeing as all around growth of the
society.
 To promote all such activities which will involve intensified and regulated physical activity
and community brotherhood and partnership.
 To bridge the gap between reviving health care and beyond reach expensive medical care.
 To gather common consensus and representation from all age group of society and sexes for
health related decisions.
 To promote community multi religious institutions and encourage liberal discussions to
enlighten all sections of society to improve their spiritual quotient and help individuals to
realize their important purpose of life.
 To promote that spirituality without scientific stand is fanatic and scientific understanding
without spiritual understanding is madness.
 Health policy break through in India: by dr joy banerjee; drjoy1@gmail.com 2009

 To effectively remove health related myths and inculcate health as a dynamic and continuous
response of the body and mind from the intense and ongoing continuous interaction between
the internal and external environment of the body.
 To institutionalise other systems of medicines which have been holistic cost effective n stood
the test of time and different types of disease.
 To bring about increasing awareness on primary health services and involve community in
Continuous Community Health Care Education at neighbourhood level.
 To bring under law all medical and paramedical practioners by auditing and introducing
renewable Medical Practioner’s licenced every 5 years.

Recommendations including strategies and mechanism of implementation. :

 The policy has to be laid in 3 steps. Education, Motivation, Application.

 Education : will come when inter personal myths will go. This can be removed by
organizing functional clusters of different people for a single cause.
Launching a 3 stage plan at the level of school, neighbour hood community and work place.
 At school : compulsory health and hygiene education from nursery to class 10 th and
encouragement to community work. All the schools should dedicate fixed hours to
the neighbour hood work and encourage parent guardian partnership to mobilize
people n bring awareness.
 At neighbourhood : HAMARA SAATH DO, an elected body comprising
compulsory of 10% senior citizen, 10% teenagers, 20% women and a flexible but
compulsory percentage of SC/ ST. This body will look into mainly proper sanitation
and organize neighbourhood health camps and educations camps by inviting
lecturers / professionals from field of health. The idea is to convey the long lost
valuable possession of health knowledge to the common people. The elected body
will be re-elected on six monthly basis. And will be receiving community health
funds partly from local government and part from generous voluntary contribution
from the neighbourhood. At the end of three months a tri monthly letter should be
published consisting of the present statistics and audit of the team.
 At work-place : positive incentive be given to those who are physically fit and
maintain a regular check up. Organization should encourage vertical and horizontal
association among employees. The government should recognise such work stations
with maximum number of healthy people.
In regards to hazardous work the employer should mandatorily increase the health
insurance and give benefits on yearly basis with rotation of job if possible.
 Motivation :
 Health policy break through in India: by dr joy banerjee; drjoy1@gmail.com 2009

 Launching of health insurance at neighbourhood level will take care of the person’s
in need and such people be given naming it as JEEVAN RAKSHA.
 Pan health insurance for geriadritic and paediatric group. The neighbour hood to take
the responsibility for the welfare of senior citizen and toddlers by pooling of
resources with proportionate contribution from the beholders and the able ones.
 Sports a missing event from our present life should be actively be introduced and all
sorts of games should be encouraged among people. This would require immense
investments from the government but can be maintained on PPP basis naming it as
KHEL KHEL MEIN.
 The local government should create service enthusiasm amongst medical staff by
appreciating all those who can create a rapport outside the hospital with the probable
patients. The staff should perform such exercise during duty hours and be encouraged
by authorities. Best performing hospitals to receive higher recognition.
 APkE SAATH APkE HATH an initiative to train on short term basis the young
adults to learn certain important health and supportive care methods and they be
maintained by the community. To bring homogeneousness they should go to nearest
big public hospital n be trained under special teaching staff assigned for the purpose.
 Application :
This will take care of the main issues in hand. The idea is to converge and decentralize the
health care from being a doctor centric institutionalized industry to community based free for
all effort. PRAN .i.e. Primary Resurrection and Application Network. The major parts of
aims and objectives will see the light of the day through this PRAN.
Not only this will hold the medical staff responsible for re mewing their licence but make sure
the doctor’s in private practice give regular community service. PAY or PLAY will extract a
% contribution from the doctor adding to the community health fund in case he misses out his
service. The community in return should provide the doctor with area and assistance to carry
out his work. Also community should visit the nearest doctor and register. The quacks are not
always harmful and should be considered as a strategic pawn in this initiative. The hospitals
should have all three systems department and in case of absence the private prctioners should
be allowed to help in. A governing body under the CMO should not only be the source of
providing technical and administrative assistance but should also be a regulator to avoid mal
practices. The statistics of different communities should be collected and authentic zed by
him.

Critique of the policy :

 Health policy break through in India: by dr joy banerjee; drjoy1@gmail.com 2009

 This policy is a long term and has to be implemented in stages. The education and
motivations should begin first and has to be constantly maintained .
 The clear demarcation of funds in community and different temperaments of community(s) is
subject to thought.
 There is great requirement of changes to be made at higher levels in health policy to
incorporate PRAN and Community Insurance Scheme JEEVAN RAKSHA.
 Changing the mind set, getting common consensus, preventing ulterior motives and trying to
bring religious and socio cultural equilibrium will be a daunting task and shall always be a
burning issue in Indian context.

Sources:

1. SRS Bulletin. Government of India.1998.

2. Planning Commission, Government of India. Tenth Five Year Plan 2002-2007. Volume II.

3. International Institute for Population Sciences and ORC Macro. National Family Health Survey
(NFHS-II) 1998-99. India.

4. International Institute for Population Sciences. RCH-RHS India 1998-1999.

5. National Crime Records Bureau. Ministry of Home Affairs. Accidental Deaths and suicides In
India 2000.

6. World Health Organization. The World Health Report 2003.

7. International Institute for Population Sciences. Facility Survey.1999.

8. Misra, Chatterjee, Rao. India Health Report.Oxford University Press, New Delhi.2003 9.
Morbidity and Treatment of Ailments. NSS Fifty second round. Government of India. 1998.

10. Changing the Indian Health System – Draft Report, ICRIER, 2001

11. Shariff Abusaleh. India Human Development Report.Oxford University Press New Delhi.

12. Duggal,Ravi. Operationalizing Right to Healthcare in India. Right to Healthcare, Moving from
Idea to Reality. CEHAT Mumbai.2003.

13. National Coordination Committee for the Jana Swasthya Sabha. Health for All NOW. 2004.
 Health policy break through in India: by dr joy banerjee; drjoy1@gmail.com 2009

14. Central Bureau of Health Intelligence.Directorate General of Health Services, Ministry of Health
and Family Welfare. Health Information of India 2000 &2001.

15. National Sample Survey Organization. Department of Statistics.GOI.42nd and 52nd Round.

16. Census of India 2001: Provisional Population Totals.Registrar General and Census Commissioner
GOI.
Health policy break through in India: by dr joy banerjee; drjoy1@gmail.com 2009