Why in news?
The Union cabinet recently approved the National Health Policy, 2017.
What are the features?
- The policy includes progressive steps towards universal and affordable access to healthcare services for the underprivileged.
- It does this by making provisions for comprehensive primary care via the conversion of 150,000 sub in Indian villages to “Health and Wellness Centres”.
- Every family is to be provided with a health card that will link it to the primary care facility and make it eligible to receive a defined package of services anywhere in the country.
- To increase “accountability and governance”, the government will aim at increasing both horizontal and vertical accountability by providing a greater role for local body participation and encouraging community monitoring.
What are the problems?
- Absenteeism - In a study conducted by the World Bank and Harvard University in 2003, it was found that in 1,500 primary healthcare centres across India, 40% of healthcare workers in government health clinics were absent from work.
- In another study conducted in the sub-centres of 135 villages of Udaipur from 2005-07, suggested that monitoring, coupled with punitive pay incentive, reduced the absence of nurses from 60% to 30% in healthcare centres.
- This proves that healthcare workers are responsive to properly administered incentives, and that comprehensive monitoring does make a difference.
- Distrust - For the underprivileged, a visit to a primary healthcare centre may mean the loss of a day’s wage, especially given a bad service delivery system.
- A lack of understanding of the benefits of vaccination, and, to some extent, distrust in government healthcare services, exacerbate the problem.
- A research study helped provide immunization services through mobile camps on fixed days in one intervention. In the other intervention, it incentivized parents with a gift of 1kg of lentils on immunization days and a thali on the completion of the whole schedule.
- It showed that providing poor families with non-financial incentives in addition to reliable services and education about immunization was more effective.
- Lack of evidence - While the healthcare policy relies heavily on technical research in pharmaceuticals and equipment, when it comes to service delivery, evidence-based policy has been absent in India.
- Policymakers need to know what works and what doesn’t. There is evidence to show that projects fail largely as they are not evidence-based.
- The government will also require a robust mechanism to implement and monitor the mammoth mission.
Source: Livemint
