Focus on Public Health

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There is an urgent need for a dedicated Public Health cadre with support teams comprising of epidemiologists, entomologists, public health nurses, inspectors and male Multi-Purpose Workers backed by appropriate regulation at the state level. This can be ensured either through an All India Public Health Service or separate state public health cadre. Public health officials should be made responsible for the health of all people residing in their assigned areas or jurisdictions, including migrants. National Centre for Disease Control shall function as the apex public health institute for providing surveillance, prevention and control of all diseases of public health importance.

States shall be encouraged to enact their own Public Health Legislation based on draft Model Public Health legislation. Setting up of systems and community involvement for implementation of this legislation is essential.

There is need for screening for occupational diseases. Health promotion and periodic check- ups to be organised at workplaces, schools and prisons. Large and medium size industry offers good opportunity for surveillance of risk factors of NCDS.

Behaviour Change Communication

The existing campaigns urging the avoidance of harmful behaviours such as use of tobacco, alcohol and drugs, advocating the use of helmets and seat belts, valuing the girl child, shunning of sex-selective abortions, adoption of the small family norm, home-based newborn care, exclusive and continued breastfeeding would be further strengthened. Attention would also be given to prevention and control of NCDS.

Mass media campaigns on mental illness should be launched, to reduce the stigma, promote care seeking and encourage family members to be suppcrtive and sensitive.

Innovative state specific Behaviour Change Communication strategies would also be required apart from electronic and print media.

National Level Tertiary Care Institutions

A single Central Sector Scheme on ‘National Level Tertiary Care Institutions’ will fund up-gradation of existing medical colleges and converting tertiary care facilities of the Central Government across different departments into teaching institutions.

In addition to the eight already approved AllMS like institutions under the central government, more such institutions shall be established during the 12th Plan.

Centres of Excellence need to be created for training public health professionals in epidemiology, entomology and microbiology for effective disease surveillance and disease outbreak investigations and for effectively responding to outbreaks, epidemics and disasters, and also for AYUSH.

Health Manpower

National Commission for Human Resources and Health (NCHRH) would be created as an overarching regulatory body for medical education and allied health sciences with the dual
purpose of reforming the current regulatory framework and enhancing the supply of skilled human resource in the health sector. The proposed Commission would subsume many functions of the existing councils, namely Medical Council of India, Dental Council of India, Nursing Council of India and Pharmacy Council of India. The proposed NCHRH would also constitute a National Board for Health Education (NBHE) and a National Evaluation and Assessment Committee (NEAC) with a mandate to prescribe minimum standards for health education, and developing and maintaining a system of accreditation of health educational institutes respectively Apart from this, a National Council has also been proposed to be set up under NCHRH to inter alia ensure ethical standards among medical professionals. The NCHRH is expected to assess the demand and availability to plan for the creation of the right mix of human resource in health.

A new category of mid-level health-workers named Community Health Officers, could be developed for primary health care. These workers would be trained after Class XIl for a three vear period to become competent to provide essential preventive and primary care and implement public health activities at sub-centre level.

Simultaneously, programmes for Continuing Medical Education would be strengthened and expanded.

Information Technology in Health

It has been proposed to set up a composite Health Information System to provide for:

1.Nutritional surveillance

2.Disease surveillance

3.Out-patient and in-patient information through Electronic Medical Records to reduce response time in emergencies and improve general hospital administration.

4.Financial management in the public health system to streamline resource allocation and transfers, and accounting and payments to facilities, providers and beneficiaries Ultimately, it would enable timely compilation of the National Health Accounts on an annual basis.

5.Tele-medicine and consultation support to doctors at primary and secondary facilities from specialists at tertiary centres.

6.Nation-wide registries of clinical establishments, manufacturing units, drug-testing laboratories, licensed drugs and approved clinical trials to support regulatory functions of government.

7.Programme Monitoring support for National Health Programmes.

To achieve these goals, computer with internet connectivity would be ensured in every PHC and all higher level health facilities in this Plan period. Connectivity can be extended to sub- centres either through computers or through cell phones, depending on their state of readiness and the skill-set of their functionaries. All district hospitals would be linked by tele-medicine channels to leading tertiary care centres, and all intra-district hospitals would be linked to the district hospital and optionally to higher centres.

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