1. The Role of Public Health Policy, Programmes and Health Financing.
Realizing the Right to Health: Societal Efforts, Responses and Responsibilities.
The Role of Public Health Policy, Programmes and Health Financing.
Dr. Thelma Narayan
Community Health Cell, Bangalore.

2. Public Health Policy Explicit & Implicit Policies- National Level
Shrivastava Report 1975, 6th Plan, ICSSR & ICMR report on Health for ALL.
National Health Policy – based on Primary Health Care principles, reflected in 5 year plans.
National Population Policy 2000
National Health Policy 2002-promotes medical tourism, privatisation, commercialisation.
National Pharmaceutical Policy 2002

3. State Health Policies Karnataka and Orissa
Adopted by Karnataka State
Cabinet in 2004
Constitutionally Health is a State subject
Karnataka Task Force on Health & FW
Orissa Health strategy

4. Important Policy Influences power & strategic positioning
Political Party
Manifestos &
willingness to be
influenced
Corporate
Interests
Pharmaceutical
and
Industrial
Lobbies
PHM/JSA
JAAK/MNI,
Networks,
Movements,
Civil Society,
Media
Professional bodies
& lobbies
Ministries and
Directorates
of Health
Patient
Groups &
Consumer Groups

5. Placebo Policies Those with no intention of being implemented.
Keeps people happy and hopeful.
Masks the situation
Allows for capture of policy space by elite
Occurs with a passive population, disempowered.

6. Policy Gaps
Lack of a strong enough countervailing power to articulate, demand and ensure policy & practice with a social justice, equity and rights based approach.
Thus was born the Peoples Health Movement globally and the Jan Swasthya Abhiyan, India in Dec 2000.

7. Policy Process giving direction, sustaining, building
Revitalizing the social goal of Health for All at all levels- Global, National, Local
Reviving the Spirit of Alma Ata
Policy Briefs for political parties
Critical Engagement with government
Creating Inclusive Networks & State units
community awareness and involvement, working with social movements -women’s movement, dalit movements, Right to Food Campaign etc.

8. National Rural Health Mission 2005-2012
Strengthening Health Systems Integration
Communitisation (Community action for Health) village health and sanitation committees, ASHAs, village health plans, village health days, PRI role; community monitoring.
Financing: budgets;untied funds; demand side financing
Better Management- Programme management units, Indian Public Health Standards

9. Implementation: The Black Box
Framework of Implementation approved by Cabinet;
Budget earmarked, state and district health societies, District Health Plan, State PIP, Reviews-concurrent, CRM,JRM.
National Health System Resource Centre, SHRC, RRC
Health and health related service staff
Motivation, morale
Capacity, Quality of Care
Integrity, Accountability, Transparency
Governance
Using a public health/community health approach
Strengthening comprehensive primary health care.

10. Eleventh Five Year Plan- 2008
Health Sector Allocation : Rs. 1,36,147 crores of which Rs. 89,478 crores for flagship NRHM.
Approved by National Development Council , Dec 9th 2007.
Three times increase for NRHM component.
State Budgets to increase by 10% annually

11. Peoples Rural Health Watch
State Health Assembly - 3 March 21st 2007, Bangalore
JSA working from the ground up -8 states.
State reports
Annual reports
Community monitoring in NRHM

12. Impacts
The measure of our efforts on health indicators –(NFHS, DLHS,SRS, NGOs) on Mortality, Morbidity, Disability, (Quality of Life)
Improvement in Health Services at district and taluk level with better governance
Ongoing policy change reg. emerging PH issues – tobacco, alcohol, environment
Strengthened civil society involvement

13. Thank You!