CM 17.

4 Describe National
Policies related to health,
health planning and
Millennium Development
goals (IPHS/Committees)
NATIONAL HEALTH POLICY, 2017
INTRODUCTION

• The National Health Policy, 1983.

• The National Health Policy, 2002.

• The National Health Policy, 2017.

 NHP 2017. NEED OF THE HOUR
Since the last health policy, 2022 there has been lot of changes in health
scenario of India:

➢ Increasing burden of NCDs.

➢ Emergence of a robust health care industry.

➢ Growing incidences of catastrophic expenditure due to health care costs
leading to poverty.

➢ Rising economic growth leading to enhanced fiscal capacity.

Therefore, a new health policy responsive to these contextual changes is

 GOAL of NHP,2017

•The attainment of the highest possible level of health and

well-being for all at all ages, through a preventive and
promotive health care orientation in all developmental
policies,

•Universal access to good quality health care services

without anyone having to face financial hardship as a
consequence.
KEY POLICY PRINCIPLES

• Professionalism, Integrity and Ethics

• Equity
• Affordability
• Universality
• Patient centred and quality of care
• Accountability
• Inclusive partnership
• Pluralism
• Decentralization
• Dynamism and adaptiveness.
OBJECTIVES

• Progressively achieve Universal Health Coverage.

• Reinforcing trust in Public Health Care System.

• Align the growth of private health care sector with public health
goals.
SPECIFIC OBJECTIVES
➢ Increase Life Expectancy at birth from 67.5 to 70 by
2025.

➢ Establish DALY Index as a measure of burden of

disease by 2022.

➢ TFR- 2.1 by 2025

➢ U5MR- 23 by 2025
➢ MMR 100- by 2020
➢ IMR 28- by 2019
➢ NNMR 16- by 2025
CONTD..
• Achieve 90:90:90 for HIV/AIDS by 2020.

• Eliminate Leprosy- 2018, Kala Azar- 2017, Lymphatic

Filariasis- 2017.

• TB cure rate > 85%, Elimination by 2025.

• Prevalence of blindness 0.25 per 1000 by 2025 (reduce

burden by 1/3rd).

• Reduce premature mortality from CVDs, cancer,

diabetes or chronic respiratory diseases by 25% by
CONTD..
• Increase utilization of public health facilities by 50%
by 2025.

• Antenatal care coverage > 90%, Skilled attendance at

birth > 90% by 2025…

• Full immunization of 90% of newborns by 1 year of

age by 2025.

• Meet need of family planning by 90% by 2025.

CONTD..
➢ Prevalence of current tobacco use by 15% by 2020 and 30%
by 2025.

➢ Access to safe water and sanitation to all by 2020.

➢ Reduction of occupational injury by half from current levels of

334 per lakh agricultural workers by 2020.

➢ Health expenditure by Government from 1.15% to 2.5 % by

2025.

➢ Increase State sector health spending to > 8% of their budget

by 2020.
CONTD..

➢ Establish primary and secondary care facility as per norms in

high priority districts by 2025.

➢ Ensure district-level electronic database of information on

health system, strengthen the health surveillance system and
establish registries for diseases of public health importance by
2020.

➢ Establish integrated health information architecture, Health

Information Exchanges and National Health Information
Network by 2025.
COMPARISON BETWEEN THE GOALS OF
NHP, 2002 AND 2017
GOALS SET IN NHP, ACHIEVEMENTS GOALS SET IN NHP,
2002 2017
Eradicate polio and yaws Polio and yaws have been ----------------
by 2005 eliminated.
Eliminate Leprosy by2005 Leprosy though Eliminate Leprosy by 2018
significantly reduced is
stagnant at current levels of
new infective cases and
disabilities

Eliminate Kala azar by Decline below the Eliminate Kala azar by

2010 threshold, except in a few 2017
blocks where the
prevalence is relatively
higher

Eliminate Lymphatic -do- Eliminate by 2017

filariasis by 2015
CONTD..
GOALS SET IN NHP, ACHIEVEMENTS GOALS SET IN NHP,
2002 2017
Achieve zero level growth Decline from a 0.41 % Achieve 90:90:90 for
in HIV/AIDS by 2007 prevalence rate in 2001 to HIV/AIDS by 2020.
0.27% in 2011.

Reduce TB mortality by Prevalence is close to 211 TB cure rate > 85%,

50% by 2010 cases and mortality is 19 Elimination by 2025.
per Lakh population,
increase in MDR TB.
Reduce prevalence of Rapid survey conducted in Prevalence of blindness
blindness to 0.5% by 2010 India shows reduction of 0.25 per 1000 by 2025
prevalence of blindness (reduce burden by 1/3rd).
from 1.1% in 2001 to 1%
in 2010
Reduce IMR to 30/1000 IMR 41 and MMR 167 as Reduce MMR from current
and MMR to 100/Lakh by per NFHS4 data. levels to 100 by 2020 and
2010 IMR to 28 by 2019
CONTD..
GOALS SET IN NHP, ACHIEVEMENTS GOALS SET IN NHP,
2002 2017
Increase utilization of Govt. health expenditure as Increase utilization of
public health facilities from % of total health public health facilities by
<20% to >75% by 2010 expenditure is only 30.5% 50% by 2025.
as on 2011.
Increase health expenditure The Government spending Health expenditure by
by Govt. as a % of GDP on healthcare in India is Government to 2.5 % by
from existing 0.9% to 2% only 1.15% of GDP 2025.
by 2010

Increase state sector health ------------- Increase State sector health

spending from 5.5% to 7% spending to > 8% of their
of the budget by 2005 2nd budget by 2020.
further increase to 8% by
2010
 POLICY THRUST
1. Ensuring adequate investment-

➢ Proposal of raising public health expenditure from 1.15 to 2.5% of

GDP in a time bound manner.

➢ Increase state sector health spending to more than 8% of their budget

by 2020.

➢ Decrease in proportion of households facing catastrophic health

expenditure from the current levels by 25% by 2025.
2.Preventive and promotive health-
➢ Promotion of healthy living, prevention strategies from AYUSH,
Yoga at work place, in school and in community.
➢ Support from ASHA, local self Govt. and VHNSC.
• 3.Organization of Public Health Care Delivery:
Seven key policies

➢ In primary care – from selective care to assured

comprehensive care with linkages to referral hospitals

➢ In secondary and tertiary care – from an input

oriented to an output based strategic purchasing

➢ In public hospitals – from user fees & cost recovery

to assured free drugs, diagnostic and emergency
services to all
➢ In urban health – from token interventions to on-scale assured
interventions, to organize Primary Health Care delivery and
referral support for urban poor. Collaboration with other sectors
to address wider determinants of urban health is advocated.

➢ In National Health Programmes – integration with health

systems for programme effectiveness and in turn contributing to
strengthening of health systems for efficiency.

➢ In AYUSH services – from stand-alone to a three dimensional

mainstreaming
• National health programmes

➢ RMNCH+A services
➢ Child and adolescent health
➢ Interventions to address malnutrition and
micronutrient deficiencies
➢ Universal immunization
➢ Communicable diseases- TB, HIV, Leprosy, vector
borne diseases
➢ Non communicable diseases.
➢ Mental health
• Gender based violence-
➢ Making public hospitals more women friendly
➢ Ensuring that the staff have orientation to gender –sensitivity
issues.

• Supportive Supervision- Innovative measures such as use of

digital tools and HR.

• Mainstreaming the potential of AYUSH-

➢ Promotion of YOGA
➢ Linking AYUSH systems with ASHAs and VHSNCs
➢ Strengthen steps for farming of herbal plants.
• Emergency care and disaster preparedness-

➢ Army of community members trained as first responder.

➢ Development of earthquake and cyclone resistant health

infrastructure in vulnerable geographies.

➢ Development of mass casualty management protocols for

CHC and higher facilities and emergency response protocols at
all levels.
• Tertiary care services-
➢ Set up of new Medical Colleges, Nursing Institutions and
AIIMS.
➢ Periodic review and standardization of fee structure and
quality of clinical training in the private sector medical
colleges.
➢ Ensuring that deserving patients can be admitted on
designated free / subsidized beds.
➢ Establishment of National Healthcare Standards Organization.
➢ Tertiary care services from empanelled non-government sector
hospitals to assist the poor.
• Financing of health care-

➢ Major reforms in financing for public facilities – where

operational costs would be in the form of reimbursements for
care provision.

➢ Creating an independent mechanism to ensure adherence to

standard treatment protocols by public and non-government
hospitals.

➢ Private not for profit and for profit hospitals would be

empanelled with preference for the former, for comparable
quality and standards of care.
• Availability of drugs and medical devices- Advocacy on the need to incentivize
local manufacturing to provide customized indigenous products for Indian
population in the long run

• Improving Public Sector Capacity for Manufacturing Essential Drugs and

Vaccines.
•Engagement with private sector-

➢Collaboration for primary care services

with not- for –profit organizations and
voluntary service in rural and under-served
areas on pro-bono basis by recognised
healthcare professionals

➢Corporate social responsibility

➢Voluntary acceptance of charitable hospitals

and “not for profit” hospitals for referrals
• Regulatory framework-

➢ Strengthening of six professional councils.

➢ Strengthening and rationalizing the drug regulatory

system, promotion of research and development in the
pharmaceutical sector.

➢ Harmonization of domestic regulatory standards with

international standards in case of medical device
regulation.
• Anti microbial resistance-
➢ Rapid standardization of guidelines regarding antibiotic use.

➢ Limiting the use of antibiotics as Over-the-Counter

medication.

➢ Banning or restricting the use of antibiotics as growth

promoters in animal livestock.

➢ Pharmacovigilance.
• Digital health technology eco system-

➢ Set up of a National Digital Health Authority (NDHA).

➢ Tele-education, Tele-CME, Tele-consultations and access to

digital library.

➢ Creation of registries or enhanced public health/big data

analytics.

➢ Use of National Optical Fibre Network, use of smart

phones/tablets for capturing real time data.
• Governance

➢ Distribution of responsibility and accountability between the

Centre and the States.

➢ Equity sensitive resource allocation.

➢ Strengthening of Panchayati Raj Institutions.

➢ Participation of local bodies and encouraging community

monitoring and programme evaluations.
• The policy also puts stress on-

➢ Women health and gender mainstreaming.

➢ Improve human resources for health and public

health management cadres.

➢ Effective regulation, research and development for

manufacturing new vaccines in accordance with
National vaccine policy, 2011.

➢ Rapid programme appraisal and public disease

National Nutrition Policy

• It was formulated in 1993 to improve the nutritional status of the

Indian Population through various direct and indirect interventions.
 Direct (short term) interventions
a) Nutrition interventions for vulnerable groups-

• Inclusion of adolescent girls within the ambit of ICDS.

• All girls should be provided with iron supplementation and skill

upgradation in health and nutrition, so as to prepare them for safe
motherhood.

• Supplementary nutrition to expectant mothers right from 1st

trimester in order to reduce the incidence of LBW babies to 10% by
2000AD. This should continue for the 1st year after pregnancy.
• Improving growth monitoring in 0-3 years. Mothers should be
involved in this process so that appropriate behavioural changes
can be triggered among them.

• Adequate health & nutrition education should be given to the

mothers so as to empower them to manage the nutition needs of
their child effectively.
b) Fortification of essential food with appropriate nutrients.

c) Efforts to produce and popularize low-cost nutrient foods from

indigenous and locally available raw materials to be intensified and to
involve women in the activity.
d) Control of micronutrient deficiencies amongst vulnerable groups by
intensification of existing programs so as to completely eliminate
nutritional blindness and reduce anaemia in expectant women.
Indirect (long-term) interventions
• To ensure adequate food security i.e a per capita availability of 215 kg
per person/year of food grains needs to be attained.

• Ensuring equitable food distribution at reasonable prices particularly to

those living BPL through the expansion of public distribution system.
• Improving the dietary pattern by promoting the production and
availability of nutritionally rich foods.

• Implementing measures to increase income of those below poverty line

by employment generation programs, land reforms, ensuring minimum
wages, women’s employment and education, equal remuneration to
women at work.
• Improving status of women by promoting education.

• Adopting small family norm and adequate birth spacing.

• Inclusion of nutrition education in school curricula.

• Strengthening of prevention of food adulteration.

• Strengthening of nutrition surveillance by strengthening of National

nutrition Monitoring Bureau (NNMB) and National Institute of
Nutrition (NIN).
• Promoting community participation through involvement of
panchayats and women.

• Enhancing communication and research in the field of nutrition.

Health planning
• Health is a fundamental human right as per Article 21.

• The responsibility for health rests also upon the community, society and
state.

• As per the Constitution of India, health is a state responsibility.

• The state government is responsible for providing health services and

• Provision of quality health services to the whole nation is a difficult
task.

• Expensive illness and high healthcare cost can drive nonpoor into
poverty.

• Increasing demand of healthcare services with limited resources has

led to health planning.
WHO has defined health planning as :

“The orderly process of defining health problems, identifying unmet

needs and surveying the resources to meet them, establishing priority
goals that are realistic and feasible, and projecting administrative action,
concerned not only with the adequacy, efficacy and efficiency of health
services but also with those factors of ecology and of social and
individual behaviour that effect the health of the individual and the
community”.
Who does health planning in India?
 Earlier, National Health
Committees were formed to
do Health Planning.

1. Bhore Committee, 1946

2. Mudaliar Committee, 1962
3. Chadha Committee, 1963 Then, Planning
4. Mukherjee Committee, 1966
Now, NITI Aayog does
Commission drafted Five
5. Jungalwalla Committee, 1967 the Health Planning in
year plans for Health
6. Kartar Singh Committee, 1973 India
7. Shrivastava Committee, 1975 planning.
8. Bajaj Committee, 1986
Bhore Committee, 1946
• This committee is also known as The Health survey and Development
Committee.

• The committee was appointed by GoI under chairmanship o Sir Joseph

Bhore to make survey of current situation in regards to health
conditions and healthcare organization and to give suggestions for
future developments.

• The committee submitted its final report on 1946.

Important recommendations of Bhore Committee:

• Integration of preventive, promotive and curative services at all

administrative levels.

• Concept of Primary health centre was given

• 3 months training in preventive and social medicine to prepare “social

physicians”.

• Committee also proposed development development of national

health programmes.
Mudaliar Committee, 1962

• Strengthening of established PHCs before new ones are opened.

• Strengthening of district and sub-divisional hospitals with specialist

services.
Chadha Committee, 1963
• For every 10,000 population one basic health worker (Multi-Purpose
Worker) was recommended.

• Strict vigilance and monitoring of implementation of NMEP is to be

carried out by basic health workers.

• Basic health workers should visit house to house to implement malaria

activities once in a month.

• Basic health worker to take additional duties of family planning,

collection of vital statistics under supervision of the family Planning
Health Assistants.
Mukherjee Committee, 1965
• After implementation of Chadha Committee’s recommendations, it was
observed that basic health workers could not function effectively due to
multiple functions and could not do justice to malaria work or to family
planning work. So, Mukherjee Committee recommended separate staff
for family planning programme.

• Delink the family planning from malaria activities so that the former
would receive undivided attention of its staff.
 Jungalwalla Committee, 1967
• This committee was set up to look into various problems related to abolition
of private practice by Govt. doctors, integration of health services and the
service conditions of doctors.

• The committee defined “integrated health services” as:

1. A service with a unified approach for all problems instead of a

segmented approach for different problems.

2. Medical care and public health programmes should be put under charge
 Important recommendations of the committee:
1. Unified cadre
2. Common seniority
3. Improvement in their service conditions
4. Equal pay for equal work
5. Special pay for special work
6. Recognition of extra qualifications
7. Abolition of private practice by Govt. doctors.
 Kartar Singh Committee, 1973
• Also known as “Committee on multipurpose workers under Health and
Family Planning”.

• It recommended that all peripheral workers of various categories should be

amalgamated into a single cadre of multi-purpose workers.

• The auxiliary nurse midwives were to be converted into Female Health

• The work of 3-4 FHWs and MHWs was to be supervised by one health
supervisor (male or female respectively).

• The existing lady health visitor (LHV) were to be converted into

female health supervisors.

• 1 PHC should cover a population of 50,000. It should be divided into

16 SCs (one for 3000 – 5000 population) each to be staffed by a male
• The medical officer of PHC will be over-all incharge of all peripheral
staff.

• Training of all workers engaged in the field of family planning, health

and nutrition should be integrated.
 Shrivastava Committee, 1975
• Creation of bands of semi-professional and paraprofessional health
workers from within the community itself to provide comprehensive
preventive, promotive and curative health services.

• Establishment of 3 cadres of health workers namely- MPWs and health

assistants between community level workers & doctors at PHC.
• Medical colleges should be involved in healthcare of selected PHCs
with the objective of reorienting medical education according to rural
population called Reorientation of Medical Education (ROME). It led
to training of UGs & interns at PHCs.
Bajaj Committee, 1986
• National Medical and Health Education Policy formulation for
training of teachers in health education science technology.

• Formulation of National Health Manpower Policy based on

realistic survey.

• Educational Commission for Health Sciences (ECHS) is to be

established on the lines of UGC.
• Establishment of health manpower cells in the states and at centre.

• Establishment of Health Science Universities in various states and

union territories for uniform standard of medical and health science
education.

• Vocational course in paramedical sciences.

Planning Commission
• After independence, planning commission was established in 1950 by
the Govt to make assessment of capital, material and human resources
of the country and for the purpose of appropriate planning so that
available resources could be utilized most effectively.

• The Planning Commission had been formulating successive five year

plans.
• The planning commission consisted of Chairman, Deputy chairman
and five members.

• It was chaired by PM of the country.

• There were total 29 divisions in the planning commission such as

agriculture, housing, education, water supply, nutrition, health, family
welfare etc.
Health sector was divided into following subsectors:

• Communicable diseases

• Medical Education

• Family Planning

• Water Supply and Sanitation

• Public Health Services

• Indigenous system of medicine

• Curative Services
National Institution for Transforming India
(NITI) Aayog
• It acts like a Think Tank to provide directional & policy inputs.
• It consist of 2 parts : Team India Hub and Knowledge & Innovation
Hub.
• NITI Aayog is developing itself as a state of the art Resource Centre,
with the necessary resources, knowledge and skills, that will enable it
to act with speed, promote research and innovation, provide strategic
policy vision for the Govt and deal with contingent issues.
LEARNING OBJECTIVES
• To know about the background of SDGs.
• To know the about the MDGs in brief and what were its
achievements & failures that led to the formation of SDGs.
• To know what are the sustainable development goals.
• To know how SDGs are different from MDGs.
• To know about the challenges in achieving the SDGs.
BACKGROUND OF SUSTAINABLE
DEVELOPMENT GOALS (SDG)

1945 : Establishment of United Nations Organisation (UNO) post

Second World War to maintain world peace & security.

Same year at the conference held at San Francisco member

countries proposed the establishment of an International Health
Organisation.

1948 : On 7th April World Health Organisation officially came into

existence in order to fight against ill health and diseases. Since
health of all people is fundamental to the attainment of peace &
security.
1978 : The International Health Conference was held at
Alma-Ata, capital of Kazakhistan where the Global
social target “Health for All” by 2000 A.D was
launched.

HFA by 2000 AD “is attainment of the highest possible

level of health by all peoples that will permit every
individual to lead a socially and economically
productive life”.
Recommended strategies to attain HFA by 2000 AD
• Developing infrastructure starting from the level of
primary healthcare.

• Incorporate preventive, promotive, diagnostic,

therapeutic & rehabilitative dimensions in healthcare
services & programs.

• Use of technology that is appropriate (scientifically

sound, affordable and acceptable for providers and
users.)
• Involve individuals, families, communities and other stakeholders.

• Use and mobilize resources the country can afford and maintain.

• Create international support mechanism.

2000: MDGs were launched during the Millennium
Summit of the General Assembly of United Nations,
at New York.

It was recognized that there is a collective responsibility

of all societies and community to uphold the principles
of human equality, human equity and human
dignity at the global level.
• Thus a set of 8 goals known as Millennium
Development Goals were launched to be achieved by
2015.
MILLENNIUM DEVELOPMENT
GOALS
It consisted of : 8 Goals

+
18 Targets
+
53 Indicators.

Goals 4, 5 and 6 are direct health goals.

Achievements of MDGs worldwide

•MDG1 : Eradicate
extreme poverty
and hunger.
2) MDG6 : Combat HIV/AIDS, Malaria & other
diseases.

3) MDG7 : Ensure environmental sustainability.

Target 6 & 7 was partially achieved.
Failures of MDGs worldwide
MDG 4 :
target was not met.
The global under 5 mortality rate reduced by 53% but short of targeted two third
reduction.

MDG 5 :
Target was not met.
The global MMR declined by 44%, well short of targeted 75% reduction.
2015: By 2012, countries around the world realised that the
achievements in MDGs though good were not sufficient and it was
necessary to carry them forward in a more sustainable way. This led to
drafting of the SDGs which was approved on 25th September, 2015
during the United Nations Sustainable Development Summit held in
New York.
SUSTAINABLE DEVELOPMENT
GOALS
• December, 2015 : End of Millennium Development Goals
(MDGs).
• 1st January, 2016 : 2030 Agenda for Sustainable Development
Goals (SDGs) came into force.
2030 Agenda for Sustainable Development consist of :

17 Goals
+

169 Targets
What is new and different about the 17 SDGs?
• One of the limitations of MDG was lack of interlinkages between
different goals. So SDGs are integrated and indivisible.

• SDGs focuses on 5 Ps.

• People: SDGs aim to completely curb poverty and
hunger, to ensure that all human beings can live a life
with dignity and equality in a healthy environment.

• Planet: environment protection.

• Prosperity: SDGs are determined to ensure that all

human beings can enjoy socially and economically
fulfilling lives.
• Peace: SDGs are determined to foster peaceful, just and inclusive
societies which are free from fear and violence.

• Partnership
• Universality

• “Leaving no one behind” will be an overarching theme.

• SDGs covers 3 dimensions of sustainable development :

Economic, Social & Environmental factors.

• Integration
The SDGs can be broadly divided into 3 categories:
1st group is an extension of MDGs: SDG1 to SDG7
2nd group is based on inclusiveness: SDG 8,9 & 10
3rd group is based on sustainability & urbanization:
SDG 11 to 17
17 SDGs are as follows:
End poverty in all its forms everywhere

End hunger, achieve food security &

improved nutrition, & promote sustainable
agriculture.

Ensure healthy lives & promote wellbeing

for all at all ages.
 Ensure inclusive and equitable quality education
& promote lifelong learning opportunities for all.

Achieve gender equality & empower all women &

girls.

Ensure availability & sustainable management of

water & sanitation for all.
Ensure access to affordable, reliable, sustainable &
modern energy for all.

Promote sustained, inclusive & sustainable economic

growth, full & productive employment & decent
work for all.

Build resilient infrastructure, promote inclusive &

sustainable industrialization & foster innovation.
Reduce inequality within and among countries.

Make cities & human settlements inclusive,

safe, resilient & sustainable.

Ensure sustainable consumption & production

patterns.
Take urgent action to combat climate change & its
impact.

Conserve & sustainability use the oceans, seas &

resources for sustainable development.

Protect, restore & promote sustainable use of

terrestrial ecosystems, sustainably manage forests,
combat desertification & halt & reverse land
degradation & halt biodiversity loss.
Promote peaceful & inclusive societies for
sustainable development, provide access to justice
for all and build effective, accountable & inclusive
institutions at all levels.

Strengthen the means of implementation & revitalize

the global partnership for sustainable development.
SUSTAINABLE DEVELOPMENT
GOAL 3positioned within the 2030 Agenda, with one
Health is centrally
comprehensive goal – SDG3

SDG 3 consist of 13 targets

• 4 targets based on unfinished & expanded MDGs.
• 4 targets are new, addresses NCDs, Mental health, Injuries & Environmental
issues.
• 4 targets are means of implementation.
• Target 3.8 is Universal Health Coverage which provides an overall
framework for the implementation of a broad & ambitious agenda in all
countries.

Universal health Coverage is the key to achievement of all targets &

development of strong resilient health system.
Target 3.8 : Achieve universal health coverage, including financial risk protection,
access to quality essential health care services, medicines & vaccines to all.

MDG unfinished and New SDG 3 targets SDG 3 Means of

expanded agenda 3.4 : Reduce mortality from Implementation targets
3.1 : Reduce Maternal NCDs & promote mental 3.a : strengthen
mortality health implementation of FCTC.
3.2 : End preventable newborn 3.5 : strengthen prevention 3.b : Provide access to
& child deaths & treatment of subs abuse medicines & vaccines for all,
3.3 : End the epidemics of 3.6 : halve global deaths & 3.c : Increase health financing
AIDS, TB, Malaria & NTDs injuries from road traffic & health workforce in
& combat hepatitis, accidents. developing countries.
waterborne & other 3.9 : Reduce deaths & 3.d : strengthen capacity for
communicable diseases. illness from hazardous early warning, risk reduction
3.7 : Ensure universal access chemicals & air, water & & management of
to sexual & reproductive soil pollution & health risk.
health care services. contamination
Universal Health Coverage
 • The end of the 20th century saw landmark movements
like Health for All by 2000 AD.

• However, when situational analysis was done, it was

found that
1. in some countries <10% births were attended by
SBA,
2. poor children were dying earlier and rich children
were living longer,
3. millions of people faced financial hardships
because of catastrophic healthcare cost.
 • Therefore, in 2005, WHO recommended Universal
Health Coverage (UHC) strategy with an emphasis on
sustainable health financing.

• Objectives –
1. Reducing morbidity & mortality
2. Ensuring patient satisfaction
3. Prevention of financial impoverishment from
catastrophic costs of illness
Coverage box of UHC
 • Universal Health Coverage have 3 key elements:

1. Health service coverage

2. Financial protection coverage
3. Whole population
Key strategies recommended to achieve UHC

• Health insurance

• Adequate and equitable distribution of good quality

healthcare facilities, healthcare manpower and
essential services.

• Sustainable financing system.

• Planning keeping in mind international development

goals.

• Development should be contextual to sociocultural,

HOW SDGs ARE DIFFERENT FROM MDGs?
MILLENNIUM DEVELOPMENT SUSTAINABLE DEVELOPMENT
GOALS GOALS
1) MDGs were drawn up by a group of 1) SDGs have evolved after a long &
experts extensive consultative process.
2) Originated in September, 2000. 2) Originated in September, 2015.
3) It was for a period from 2000-15. 3) It is for a period from 2015-30.
4) Consisted of 8 goals + 18 targets + 53 4) SDGs are successor of MDGs. It consists
indicators. of 17 Goals + 169 Targets.
5) MDGs had 3 direct health goals, with 5) SDGs have one comprehensive goal
emphasis on child & maternal mortality emphasizing well being & healthy living
& communicable diseases. which also included NCDs & Mental health.
6) MDGs were intended for action in 6) SDGs are universal and apply to all
developing countries only. countries.
7) The MDG targets were set to get us “ 7) The SDGs are designed to get a statistical
half way “ to the goal of ending hunger zero on hunger, poverty, preventable child
& poverty & other targets. Getting half births & other targets. Getting to zero is not
way there encouraged member countries going to be easy. It will require real focus on
to do the easiest parts first. empowering the poorest & hardest to reach.
Millennium Development Goals Sustainable Development Goals
8) The inclusion of peace building is 8) Included in SDGs.
critical to the development. But it is
ignored in MDGs.
9) The MDGs focussed on quantity of 9) SDGs represent the first attempt by the
education (e.g high enrollment ratio) only world community to focus on the quality
to see decline of quality. of education.
10) Easy to understand, implement & 10) SDGs are too many & difficult to
monitor. implement & monitor.
Challenges in achieving SDGs
• Cost required meeting the targets will be high.

• Maintaining peace is essential for development. Recent conflicts (eg Syrian

Crisis), growing extremism & unprecedented levels of migration will pose a
hindrance in achieving the targets in time.

• Having 17 Goals & 169 targets is a huge task which will be difficult to achieve. In
this regard MDGs were better.

• Accountability : there was lack of accountability for inputs into MDGs at all
levels. This challenge needs to be addressed in SDGs.
THANK YOU