Hospital Administration
Editor: Dr Narinder Kumar, MD (AIIMS, New Delhi)
The National Health Policy (NHP) 2017 is a comprehensive and ambitious policy document formulated by the Government of India to address the diverse healthcare needs of the country's population. It aims to promote health and well-being, improve the quality and accessibility of healthcare services, and reduce health disparities among different sections of society. The NHP 2017 builds upon the successes and lessons learned from the previous National Health Policy (2002) and aligns with the Sustainable Development Goals (SDGs) adopted by the United Nations. This detailed overview will discuss the NHP 2017's key features, the challenges it faces, and the conclusions that can be drawn from its implementation.
Health and Well-being for All: The NHP 2017 envisions health and well-being for all citizens by focusing on preventive and promotive healthcare, addressing the social determinants of health, and ensuring equitable access to quality healthcare services.
Comprehensive Healthcare Services: The policy emphasizes the provision of comprehensive healthcare services, including primary, secondary, and tertiary care, as well as mental health, geriatric care, palliative care, and rehabilitative services.
Universal Health Coverage: The NHP 2017 aims to achieve universal health coverage, ensuring that all citizens have access to affordable and quality healthcare services without facing financial hardships.
Strengthening Primary Healthcare: The policy recognizes the importance of primary healthcare as the foundation of the healthcare system and seeks to strengthen primary healthcare infrastructure, services, and human resources.
Human Resources for Health: The NHP 2017 emphasizes the need to develop a robust and skilled healthcare workforce, including doctors, nurses, allied health professionals, and public health practitioners, to meet the healthcare needs of the country's population.
Quality of Care: The policy aims to improve the quality of healthcare services by establishing and implementing standards, guidelines, and protocols for healthcare delivery, enhancing the skills and competencies of healthcare providers, and promoting a patient-centered and responsive healthcare system.
Health Financing: The NHP 2017 calls for increased public health expenditure, risk pooling mechanisms, and strategic purchasing of healthcare services to ensure adequate financing for healthcare services and reduce out-of-pocket expenditures for households.
Inter-Sectoral Convergence: The policy emphasizes the need for inter-sectoral convergence and collaboration among various sectors, such as education, nutrition, sanitation, and housing, to address the social determinants of health and promote overall health and well-being.
Health Technology Assessment: The NHP 2017 recognizes the importance of health technology assessment in guiding the adoption, utilization, and management of health technologies to ensure cost-effective and evidence-based healthcare interventions.
Monitoring and Evaluation: The policy underscores the need for robust monitoring and evaluation mechanisms to track the progress and performance of health programs, inform evidence-based decision-making, and ensure accountability and transparency in healthcare service delivery.
Resource Constraints: The NHP 2017's ambitious goals and extensive scope require substantial investments in healthcare infrastructure, human resources, and service delivery. Mobilizing adequate resources in a resource-constrained environment remains a significant challenge.
Implementation and Coordination: Effective implementation and coordination of the NHP 2017 across various levels of governance and among diverse stakeholders remain a challenge. This includes ensuring adequate support and capacity at the central, state, and local levels to effectively plan, implement, and monitor health programs.
Quality of Care: Despite efforts to improve healthcare infrastructure and service delivery, the quality of care remains a significant concern. Issues such as inadequate staff training, insufficient equipment and supplies, and poor adherence to standard treatment protocols can undermine the effectiveness of health programs and the NHP 2017's overall goals.
Health-seeking Behavior and Awareness: Low levels of health awareness and health-seeking behavior among the population can hinder the NHP 2017's success. This challenge highlights the need for targeted health education and awareness campaigns to promote healthy lifestyles, encourage early detection and treatment of diseases, and improve overall health-seeking behavior.
Addressing Non-Communicable Diseases: The increasing burden of non-communicable diseases (NCDs) in India poses a significant challenge to the NHP 2017. Addressing NCDs requires not only strengthening healthcare infrastructure and service delivery but also adopting a multi-sectoral approach to promote healthy lifestyles, reduce risk factors, and improve the social determinants of health.
Urban Health: The rapid urbanization of India and the unique challenges posed by urban health require innovative solutions and strategies to address the healthcare needs of the urban population. While the NHP 2017 acknowledges these challenges, there is still a need for more targeted interventions and programs tailored to the urban context.
Monitoring and Evaluation: Ensuring robust monitoring and evaluation of health programs remains a challenge due to inadequate data availability, weak information systems, and limited capacity for data analysis and utilization. Strengthening monitoring and evaluation systems is crucial for evidence-based decision-making and continuous improvement of health programs.
The National Health Policy 2017 is an ambitious and comprehensive policy framework that seeks to address the complex and diverse healthcare needs of India's population. Its key features, such as health and well-being for all, comprehensive healthcare services, universal health coverage, strengthening primary healthcare, human resources for health, quality of care, health financing, inter-sectoral convergence, health technology assessment, and monitoring and evaluation, reflect a holistic and integrated approach to healthcare service delivery.
However, the NHP 2017 faces several challenges in achieving its objectives, including resource constraints, implementation and coordination issues, quality of care concerns, low health-seeking behavior and awareness, addressing non-communicable diseases, urban health challenges, and ensuring effective monitoring and evaluation. Overcoming these challenges requires concerted efforts from various stakeholders, including the government, healthcare providers, civil society organizations, and communities.
In conclusion, the National Health Policy 2017 has the potential to significantly impact the health and well-being of India's population by addressing the complex and diverse healthcare needs of the country. However, realizing this potential requires overcoming the challenges faced by the policy and ensuring its effective implementation and coordination. By doing so, the NHP 2017 can contribute to improving the overall health status of the Indian population, promoting equity and inclusiveness in healthcare access, and supporting the country's social and economic development.