What are the main objectives of National Health Policy 2017?

The NHP 2017 has several core objectives. Primarily, it aims to achieve the highest possible level of health and well-being for all citizens, ensuring universal access to quality healthcare services without financial hardship. It emphasizes a shift towards preventive and promotive healthcare, adopting a 'health in all policies' approach. Key goals include increasing public health expenditure to 2.5% of GDP by 2025, strengthening primary healthcare, addressing human resource shortages, leveraging digital health, and mainstreaming AYUSH systems. It seeks to reduce out-of-pocket expenditure and align India's health targets with the Sustainable Development Goals.

How does the policy differ from the 1983 version?

The NHP 2017 significantly differs from the NHP 1983 in scope, focus, and ambition. While NHP 1983 aimed for 'Health for All by 2000' with a focus on primary care and communicable disease control, NHP 2017 adopts a broader 'health in all policies' approach, addressing the rising burden of non-communicable diseases and the need for comprehensive primary care. NHP 2017 explicitly commits to increasing public health spending to 2.5% of GDP, emphasizes digital health, AYUSH integration, and strategic purchasing from the private sector, aspects largely absent or nascent in the 1983 policy. It moves towards an assurance-based approach, focusing on financial protection and quality of care.

What is the role of the private sector in the policy?

The NHP 2017 acknowledges the significant role of the private sector in healthcare delivery in India, accounting for a large share of outpatient and inpatient care. The policy advocates for strategic engagement with the private sector through Public-Private Partnerships (PPPs) for service delivery, infrastructure development, and specialized care. It emphasizes regulating the private sector to ensure ethical practices, quality standards, and reasonable costs. The policy promotes strategic purchasing of secondary and tertiary care services from both public and private providers, as exemplified by schemes like Ayushman Bharat PMJAY, where private hospitals are empanelled to provide services.

How does the policy address healthcare workforce shortage?

The NHP 2017 recognizes the critical shortage and uneven distribution of human resources for health (HRH) as a major impediment. It proposes several measures: increasing the availability of doctors, nurses, and allied health professionals through expansion of medical education (e.g., new AIIMS, medical colleges); improving their skills and competencies; and establishing a robust regulatory framework. It also advocates for creating a dedicated public health management cadre, promoting task-shifting, and leveraging AYUSH practitioners to bridge gaps, particularly in rural and underserved areas. The policy aims to ensure equitable distribution and retention of health workers.

What are the key performance indicators for policy success?

Key performance indicators (KPIs) for NHP 2017 success include reducing the Infant Mortality Rate (IMR), Maternal Mortality Ratio (MMR), and Under-5 Mortality Rate (U5MR) to specific targets. Other crucial indicators are increasing life expectancy at birth, reducing premature mortality from non-communicable diseases, and decreasing the incidence of catastrophic health expenditure. The policy also tracks the Universal Health Coverage (UHC) service coverage index, the percentage of public health spending as a share of GDP, and improvements in health workforce density and bed-to-population ratios. These metrics help assess progress towards universal access, equity, and quality of care.

How does NHP 2017 align with the Sustainable Development Goals (SDGs)?

The NHP 2017 is strongly aligned with SDG 3: 'Ensure healthy lives and promote well-being for all at all ages.' Its targets for reducing MMR, IMR, and U5MR directly contribute to SDG 3.1 and 3.2. The policy's focus on eliminating communicable diseases (like TB) and reducing premature mortality from NCDs aligns with SDG 3.3 and 3.4. Furthermore, its overarching goal of achieving Universal Health Coverage (UHC) directly addresses SDG 3.8, which calls for financial risk protection, access to quality essential healthcare services, and access to safe, effective, quality, and affordable essential medicines and vaccines for all. The 'health in all policies' approach supports the broader SDG agenda.

What is the 'health in all policies' approach advocated by NHP 2017?

The 'health in all policies' approach is a core tenet of NHP 2017, recognizing that health outcomes are not solely determined by the healthcare system but are profoundly influenced by social, economic, environmental, and commercial determinants. This approach advocates for systematic consideration of the health implications of decisions made in other sectors, such as agriculture, education, urban planning, environment, and sanitation. It promotes inter-sectoral coordination and collaboration to address the root causes of ill-health and create a supportive environment for health. For example, policies related to clean water (Swachh Bharat Abhiyan) or nutrition (Poshan Abhiyan) are seen as integral to achieving health goals, rather than isolated initiatives.

How does NHP 2017 address the issue of out-of-pocket expenditure (OOP)?

High out-of-pocket (OOP) expenditure is a major cause of financial hardship for Indian households. NHP 2017 aims to significantly reduce OOP expenditure by increasing public health spending to 2.5% of GDP, thereby expanding the scope and quality of services available in the public sector. It also promotes financial risk protection through health insurance schemes like Ayushman Bharat PMJAY, which covers secondary and tertiary care hospitalization costs for vulnerable families. By strengthening comprehensive primary healthcare through Health and Wellness Centres, the policy seeks to reduce the need for expensive hospitalizations and provide essential services closer to home, further mitigating OOP expenses.

What is the role of AYUSH systems in NHP 2017?

The NHP 2017 emphasizes the mainstreaming of AYUSH (Ayurveda, Yoga & Naturopathy, Unani, Siddha, and Homoeopathy) systems into the national health framework. It recognizes the potential of these traditional systems to provide holistic healthcare, promote wellness, and offer cost-effective solutions, especially for preventive and promotive health. The policy advocates for integrating AYUSH practitioners into the public health workforce, establishing AYUSH facilities alongside conventional ones, and promoting research and development in AYUSH. This integration aims to provide a wider range of healthcare choices to citizens and leverage India's rich traditional medical heritage.

What are the governance mechanisms for NHP 2017 implementation?

The implementation of NHP 2017 is primarily overseen by the Ministry of Health and Family Welfare (MoHFW) at the Union level, with significant roles played by state health departments. The National Health Mission (NHM), encompassing both rural and urban components, serves as the main vehicle for implementing many of the policy's provisions, especially at the primary and secondary care levels. NITI Aayog provides strategic guidance, policy monitoring, and fosters competitive federalism among states through its health index. Various health councils and committees facilitate coordination between the Centre and states, and with other ministries, to ensure a multi-sectoral approach. Community participation and local self-governments are also crucial for decentralized planning and implementation.

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Ayushman Bharat

National Health Policy

Social Justice & Welfare

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The National Health Policy 2017 envisions the attainment of the highest possible level of health and well-being for all at all ages, through a preventive and promotive healthcare orientation in all developmental policies, and universal access to good quality healthcare services without anyone facing financial hardship as a consequence. This would be achieved through increasing access, improving qu…

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The National Health Policy (NHP) 2017 is India's guiding framework for achieving universal health coverage and improving health outcomes. Its core vision is to ensure the highest possible level of health and well-being for all, through a strong emphasis on preventive and promotive healthcare, and equitable access to quality services without financial hardship.

The policy commits to increasing public health expenditure to 2.5% of GDP by 2025, a crucial step towards strengthening the public health system. It prioritizes Comprehensive Primary Health Care (CPHC) delivered through Health and Wellness Centres (HWCs), which form the backbone of the Ayushman Bharat initiative.

NHP 2017 also addresses critical areas such as human resource development, public health surveillance, and the integration of digital health technologies like the Ayushman Bharat Digital Mission (ABDM).

It recognizes the importance of mainstreaming AYUSH systems and adopting a 'health in all policies' approach, linking health outcomes to broader social determinants like sanitation and nutrition. Constitutionally, the policy draws its mandate from the expansive interpretation of Article 21 (Right to Life) and the directive principle under Article 47 (Duty to improve public health).

Implementation involves intricate Centre-State coordination, with states adapting national guidelines to local contexts. Challenges include persistent human resource shortages, infrastructure gaps, high out-of-pocket expenditure, and the need for robust governance.

The policy's success is measured by key performance indicators like IMR, MMR, U5MR, life expectancy, and the UHC service coverage index, all aligning with India's commitments to Sustainable Development Goal 3.

Post-COVID-19, the policy's emphasis on resilient health systems and pandemic preparedness has gained renewed urgency, driving initiatives like PM-ABHIM.

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NHP 2017: Vision for highest health & well-being for all.

Core Principle: Preventive & Promotive healthcare.

Key Target: Public health expenditure to 2.5% of GDP by 2025.

Primary Care: Comprehensive Primary Health Care (CPHC) via HWCs.

Flagship Scheme: Ayushman Bharat (PMJAY + HWCs).

Constitutional Basis: Article 21 (Right to Health), Article 47 (DPSP).

Disease Targets: MMR to 100 (2020), IMR to 28 (2019), U5MR to 23 (2025).

NCD Target: Reduce premature mortality from NCDs by 25% by 2025.

Digital Health: National Health Stack, ABHA (Unique Health ID).

AYUSH: Mainstreaming traditional medicine systems.

'Health in All Policies': Multi-sectoral approach (e.g., sanitation, nutrition).

OOP Expenditure: Aim to reduce catastrophic health expenditure by 25% by 2025.

Governance: MoHFW, NHM, NITI Aayog (monitoring, competitive federalism).

Federalism: Health is a State Subject, Centre provides policy & funding.

Post-COVID Initiative: PM-ABHIM (Health Infrastructure Mission).

SDG Alignment: Directly linked to SDG 3 (Good Health and Well-being).

HRH Focus: Address shortages, public health management cadre.

Private Sector: Strategic engagement, regulation.

NHP 1983 vs 2017: Shift from disease control to comprehensive care, digital focus.

Landmark Case: Paschim Banga Khet Mazdoor Samity (Right to Health under Art 21).

Vyyuha Quick Recall: NHP 2017 - 'HEALTHY INDIA 2025'

Health in All Policies (Multi-sectoral) Expenditure: 2.5% GDP by 2025 (Public) Ayushman Bharat (PMJAY + HWCs) Life Expectancy: 70 by 2025 Targets: MMR 100 (2020), IMR 28 (2019), U5MR 23 (2025) Human Resources (Cadre, Training) Youth & AYUSH (Integration, Wellness)

Infrastructure: PM-ABHIM (Post-COVID) NCDs: 25% reduction by 2025 Digital Health: ABHA, Telemedicine Inter-sectoral (Convergence) Article 21 & 47 (Constitutional Basis)

2025 - The key year for many targets!

National Health Policy

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