Mainstreaming AYUSH: Practice and promotion of AYUSH in the states would be carried out under the broad umbrella of the National Health Mission. States would be encouraged to integrate AYUSH facilities, and provide AYUSH services in all facilities offering treatment in modern systems of medicine. AYUSH therapies known for restoration and rejuvenation, will be used for care of elderly.
In addition, the concept of AYUSH Gram will be promoted, wherein one will be selected for implementation of integrated primary system of medicine. In these villages, herbal medicinal gardens will be supported, regular Yoga camps will be organised, preferably through PRI institutions and youth clubs, and the community provided basic knowledge on hygiene, promotion of health and prevention of diseases.
Research: Research to validate AYUSH therapies and drugs that address chronic and life style-related emerging diseases shall be priority. The documentation of traditional knowledge associated with medicinal plants will be continued to preserve it and to contest bio-piracy and bio-prospecting.
Standards: The Department of AYUSH would develop standards for facilities at the primary, secondary and tertiary levels as a part of IPHS; Standard Treatment Guidelines and a Model Drugs List of AYUSH drugs for community health workers will be developed.
Regulation and Quality Control: Systems for quality certification of raw materials accreditation of educational programmes, health services and manufacturing units and products would be promoted in the 12th Plan. Modernisation of pharmaceutical technology, in order to standardise the use of natural resources and production processes that are used by AYUSH, will be taken up as a Th of priority.
Instruments for Service Delivery
Effective Governance Structures: The broad and flexible governance structure of the National Health Mission would be used to seek willing participation of all sectoral agencies, and civil SOciety in identifying risks and planning for their mitigation, and integrated delivery of quality services. States would be advised to converge the existing governance structures for social sector programmes, such as drinking water and sanitation, ICDS, AIDS control and NRHM at all levels pool financial and human resource under the leadership of local PRI bodies and make multi- sectoral social plans to collectively address the challenges.
The existing National Programme Coordination Committee (NPCC) of NRHM will be expanded to serve the National Health Mission.
Gaps in the management capacity at the state level need to be addressed. States will be encouraged to set up efficiently functioning agencies/cells for procurement and logistics, recruitment and placement of human resource, human resource management, design, construction and upkeep of health care buildings, use of Information Technology, financial management, transport systems, standards setting and quality control, monitoring and evaluation of process and outcomes.
The Rogi Kalyan Samiti model of facility autonomy launched under NRHM would be expanded to enable investment in facility upkeep and expansion, or even filling temporary HR gaps. Enhanced autonomy would have to be matched by greater accountability. This will also need stringent regulation to ensure that mismanagement of funds, drugs and equipments does not happen.
Health Personnel: The current availability of health personnel in the country (241) is below the minimum requirement of 250 (desirable: 474) per lakh of population. Given the existing production capacity, we can expect an availability of 354 health workers by 2017. Current doctor to nurse ratio in the country is 1:6. In order to correct this ratio to desired1:3 and if we adopt a goal of 500 health workers per lakh population by the end of 13th Plan, we would need an additional 240 medical colleges, 500 General Nursing and Midwifery (GNM)/nursing colleges and 970 ANMS training institutes. This is proposed to be achieved through government efforts as well as participation of private sector.
For refresher courses for doctors and paramedical workers district hospitals and CHCS will be upgraded into knowledge centres. The long term goal would be to build at least one training centre in each district, and one paramedical training centre in each sub-division/block. District can also be accredited for postgraduate hospital veIn the Pharmacy sector, strengthening and up-gradation of Pharmacy Colleges and setting up of colleges of pharmacy attached to government medical colleges would be initiated, wherever possible. Courses such as Family Medicine.
In the Pharmacy sector, strengthening and up-gradation of Pharmacy Colleges and setting up of colleges of pharmacy attached to government medical colleges would be initiated, wherever possible.
Production of skilled health workers, such as Physician Assistants,Dialysis Technician, Operation Theatre/Anaesthesia Technician, Paramedic, Lab Technician, Patient Care Coordinator cum Medical Transcriptionist shall be encouraged. The profession of midwifery will be revived, and provided training and legal authority to serve as autonomous medical practitioners for primary maternity care, so that primary maternity care is universalised.
The plan also proposes to provide training opportunities to a large number of unqualified practitioners in the country such as RMPS, compounders and dais.
Practitioners of AYUSH systems may be considered for bridge prescribing allopathic medicines and supported by amending the legislation in this regard. Suitably trained, AYUSH graduates can courses to train them for provide primary health care, and help fill in the human resource gaps in rural areas.
Community Participation and PRI Involvement: Government health facilities at the level of blocks and below can become more responsive to population needs if funds are devolved to the Panchayati Raj Institutions, and these institutions made responsible for improving public health outcomes in their area.
Greater efforts at community involvement in planning, delivery, monitoring and evaluation of health services would be made using established strategies from NRHM like community based monitoring, citizens’ charters, patients’ rights, social audits, public hearings and grievance redressal mechanisms.
Strengthening of Health Systems:
A major objective of enhanced funding, flexibility to and incentivisation of states is to build health systems.