HEALTH

India has made substantial progress in health determinants over the past decades. The critical indicators of health, including Infant Mortality Rate, Maternal Mortality ratio, Disease prevalence, morbidity as well as mortality rates have shown consistent decline over the years. These achievements are the cumulative result of several interconnected changes. The improved coverage and efficiency of Public Health delivery system as well as expanding private health sector have contributed equal measures to ameliorating the suffering associated with adverse health events. The overall economic upturn as well as improvement in collateral determinants of health has assisted the country achieve critical milestones like elimination of leprosy and reducing the burden of Tuberculosis.

National Rural Health Mission

The National Rural Health Mission was launched on April 12, 2005, to provide accessible, affordable and accountable quality health services to the poorest households in the remotest rural regions. The thrust of the Mission was on establishing a fully functional, community owned, decentralized health delivery system with intersectoral convergence at all levels, to ensure simultaneous action on a wide range of determinants of health like water, sanitation, education, nutrition, social and gender equality.

NRHM has successfully provided a platform for community health action at all levels. Besides merger of Departments of Health and Family Welfare in all States, NRHM has successfully moved towards a single State and District level Health Society for effective integration and convergence. Through a concerted effort at decentralized planning through preparation of District Health Action Plans, NRHM has managed to bring about intra-health sector and inter-sectoral convergence for effectiveness and efficiency. In all the States, specific health needs of people have been articulated for local action. With the establishment of public institutions like the Village Health and Sanitation Committees (VH&SCs), Hospital Development Committees and PRI led Committees, it is the civil society to which the health system is being made increasingly accountable. Through untied and flexible financing, NRHM is trying to drive reforms that empower local communities to make their own decisions.

The NRHM has shown rapid progress in the North Eastern states. Over 40 thousand ASHAs have been selected, RKS constituted in 79 DH/SDH, 189 CHCs & 1166 PHCs. Five new DH & 8 new GNM Schools have been approved under NRHM. State Civil Hospitals at Itanagar and Pasighat have also been assisted to the tune of Rs. 1 crore each. IDHAP has been finalised for 84 districts. 6248 (out of 7758) SCs are functional with Joint Accounts and 2545 have positioned two ANMs. 678 (out of 1106) PHCs are reported operational on 24X7 basis and 244 PHCs have AYUSH MOs co-located in them. Facility surveys has been completed in 205 (out of 216) CHCs, upgradation works completed in 91 CHCs. 86 CHCs are reported operational as First Referral Units (FRUs).

Accredited Social Health Activists (ASHAs)

One of the key strategies under the NRHM is a community health worker, i.e., Accredited Social Health Activist (ASHA) for every village at a norm of 1,000 population. The role of ASHA visà- vis that of Anganwadi Worker (AWW) and Auxiliary Nurse Mid-wife (ANM) is also clearly laid down.

More than 5.4 lakh Accredited Social Health Activists (ASHAs) and link workers are connecting households to health facilities. The presence of community volunteers on this unprecedented scale has resulted in people’s growing pressure on utilization of services from the public sector health system. States across the country are reporting significantly higher utilization of outpatient services, diagnostic facilities, institutional deliveries and inpatient care. Large scale demand side financing under the Janani Suraksha Yojana (JSY) has brought poor households to public sector health facilities on a scale never witnessed before. Over 1 crore women have been covered under JSY so far since its introduction in 2005.

Major achievements under this Mission

• 5,43,315 ASHAs/Link Workers have been selected so far in the States.
  
  
• 1,86,606 ASHAs/Link Workers have drug kits.
  
  
• In all the States, ASHAs/Link Workers have facilitated the households’ links with the health facilities.
  
  
• 1,77,578 VH&SCs are already functional. Many other States have also issued Government Orders in this regard and are in the process of activating the Committees.
  
  
• Of the 1,41,492 functional Sub-Health Centres, 1,11,979 have operationalized a joint bank account of ANM and Sarpanch for united funds.
  
  
• ANMs are playing an important role in the organization of Village Health and Sanitation Days and nearly 4.8 lakh such days have been organized in the last two years.
  
  
• 25,987 ANMs have been appointed on contract so far. 14,440 Sub-Centres are reporting 2 ANMs.
  
  
• Strengthening of the PHCs for 24x7 services is a priority of NRHM. Of the 22,669 PHCs in the country, only 1,634 of them were working 24x7 on March 31, 2005 (before the NRHM). The number of 24x7 PHCs today, as reported by the States is 8,755 signifying the great leap forward in getting patients to the government system.
  
  
• 2,852 PHCs having three nurses
  
  
• More than 50 lakh women have been brought under the Janani Suraksha Yojana (JSY) for institutional deliveries in the last two-and-a-half years
  
  
• So far, 4,380 other para medical staff have been appointed on contract.
  
  
• 6,232 doctors, 2,282 specialists, 11,537 staff nurses have been appointed on contract in the States so far, reducing the human resource gaps in many institutions.
  
  
• 2,335 CHCs have completed their Facility Surveys and 441 their physical upgradation so far.
  
  
• IPH standards have been finalized and a first grant of Rs. 20 lakh was made available to all the District Hospitals of the country to improve their basic services, given the increased patient load due to JSY and other programmes.
  
  
• State level Societies have merged in 32 States/UTs and 527 districts so far.
  
  
• Project Management Units have been set up in 506 district and 2,432 blocks of 30 States.
  
  
• The Indian Public Health Standards developed for eight different level of public institutions in health,provide a basis for all programmes in the health sector.
  
  
• Most States have completed the Facility Surveys up to CHCs.
  
  
• 319 districts have received funds for Mobile Medical Units.
  
  
• So far, 188 Mobile Medical Units are operational in the States.
  
  

Major Public Health Programmes

Universal Immunization Programme

The coverage of the programme, first launched in the urban areas in 1985, was progressively extended to cover the entire country by 1990. Between 1988 and 2006, there has been a decline of 83 per cent in diphtheria, 83 per cent in pertussis, 59 per cent in measles, 94 per cent in neonatal tetanus and 97 per cent in poliomyelitis. Hepatitis-B vaccination programme which was started in 2002 in 33 districts and 15 cities as a pilot has been expanded to all districts of good performing States. Vaccination against Japanese encephalitis was started in 2006.

Polio Eradication Programme

India has made impressive progress towards polio eradication by implementing polio eradication strategies on a scale and intensity that is unprecedented in the history of eradication.The initiatives include use of Monovalent Oral Polio Vaccine (mOPV1 & mOPV3) in the high risk districts and States to enhance immunity against P1 and P3 virus,vaccinating the children in transit and covering children of migratory population Special rounds have been conducted in Haryana, Punjab, Gujarat and West Bengal during the year 2007.

National Vector Borne Disease Control Programme

The National Vector Borne Disease Control Programme (NVBDCP) is being implemented for prevention andcontrol of vector borne diseases like malaria, filariasis, kala-azar, Japanese encephalitis (JE), dengue and chikungunya. Most of these diseases are epidemic prone and have seasonal fluctuations. During 2007 (till October), 0.99 million positive cases, 0.44 million plasmodium falciparum cases and 940 deaths have been reported. Currently about 100 districts are identified as highly malaria endemic where focused interventions are being undertaken. To achieve NHP-2002 goal for Elimination of Lymphatic Filariasis by 2015, the Government. of India initiated Annual Mass Drug Administration (MDA) with single dose of Diethylcarbamazine citrate tablets to all individuals living at risk of filariasis excluding pregnant women, children below 2 years of age and seriously ill persons. During 2007, MDA has been observed in 19 States. The reported coverage of 19 States is 87.28 per cent.

Kala-azar is endemic in 4 States of the country, namely Bihar, West Bengal, Jharkhand and Uttar Pradesh. However, about 80 per cent of the total cases are reported from Bihar. During 2007 (up to October), 37,525 cases and 169 deaths have been reported. The National Health Policy (2002) envisages kala-azar elimination by 2010. Under the elimination programme the Central Government provides 100 per cent operational cost to the State Governments, besides anti kala-azar medicines, drugs and insecticides.

Acute Encephalitis Syndrome (AES)/Japanese encephalitis (JE) has been reported frequently from 12 States/ UTs. During 2007 (till 28.12.07), 3,887 cases and 910 deaths have been reported. Dengue is prevalent in different parts of the country but the outbreak of the disease is reported mainly in urban areas. However, in the recent past, dengue is reported from rural areas as well. In 2007 (up to December), 5,025 cases and 64 deaths have been reported. During 2006, chikungunya fever had re-emerged in the country in epidemic proportions after a quiescence of about three decades.. During 2007 (up to 28.12.2007), 56,355 suspected chikungunya fever cases have been reported. The Government has taken various steps to tackle the vector borne diseases (VBDs) including dengue and chikungunya which, include implementation of strategic action plan for prevention and control of chikungunya by the State Governments.

Revised National Tuberculosis Control Programme (RNTCP)

The Revised National Tuberculosis Control Programme (RNTCP) using Directly Observed Treatment Shortcourse (DOTS) is being implemented with the objective of curing at least 85 per cent of the new sputum positive patients initiated on treatment, and detecting at least 70 per cent of such cases. Since its inception, RNTCP has initiated more than 8.4 million TB patients on treatment, thereby saving over 1.4 million additional lives. Deaths have been reduced from over 5 lakh per year at the beginning of programme to less than 3.7 lakh per year currently. Good quality assured anti-TB drugs are provided in the patient-wise drug boxes, free of cost. Padiatric Patient Wise Drug Boxes have been introduced in the programme from January 2007. The treatment success of new infectious TB cases under RNTCP has consistently exceeded the global benchmark of 85 per cent. RNTCP detected 66 per cent of the estimated new infectious cases in 2006, which is close to the global target of 70 per cent. In the third quarter of 2007, the detection rate was 70 per cent. The national programme has initiated the DOTS plus services for management of Multi drug resistant TB (MDR-TB), The community based Drug resistance surveillance (DRS) conducted in Gujarat and Maharashtra recently estimated the prevalence of MDR-TB to be around 3 per cent among new cases, in terms of absolute numbers the burden is quite significant.

National AIDS Control Progamme (NACO)

HIV/AIDS being an important health problem, the Ministry of Health & Family Welfare has been implementing the National AIDS Control Programme (NACP).The programme components includes setting up of integrated counselling and testing centres, prevention of parent to child transmission, and sexually transmitted infections; care and support through Anti Retroviral Treatment (ART), national paediatric initiatives meant for children affected by HIV.

In order to reiterate the Government’s multisectoral response to prevent the spread of HIV and to facilitate a strong multi-sectoral response to combat it effectively, a National Council on AIDS (NCA) has been constituted, under chairmanship of Hon’ble Prime Minister with representation of 33 ministries and departments. Private sector, civil society organizations, PLHA networks and government departments would all play crucial role in prevention, care, support, treatment and service delivery.

Nearly 20,408 AIDS cases were reported in 2007 (December 2007), out of which, 87.4 per cent of the infections were transmitted through the sexual route and pre-natal transmission accounted for 4.7 per cent of infections. About 1.8 per cent and 1.7 per cent of infections were acquired through injecting drug use and contaminated blood and blood products respectively. Government of India has launched National AIDS Control Programme Phase III, with the goal to halt and reverse the epidemic in the country over the next 5 years by integrating programmes for prevention, care, support and treatment.

Ayurveda, Yoga & Naturopathy, Unani, Siddha and Homoeopathy (AYUSH)

Under AYUSH, there is a network of 3,203 hospitals and 21,351 dispensaries across the country. The health services provided by this network is largely focused on primary health care. The sector has a marginal presence in secondary and tertiary health care. In the private and nonprofit sector, there are several thousand AYUSH clinics and around 250 hospitals and nursing homes for in-patient care and specialized therapies like Panchkarma. The key interventions and strategies in the Eleventh Five Year Plan include training for AYUSH personnel, mainstreaming the system of AYUSH in National Health Care Delivery System, strengthening the regulatory mechanism for ensuring quality control, R&D and processing technology involving accredited laboratories in the Government and non-Government sector, and establishing centres of excellence.

National Leprosy Eradication Programme (NLEP)

Leprosy has affected humanity since 600 BC and existed in the civilizations of ancient China, Egypt & India. The Government of India has undertaken the National Leprosy Eradication Programme by training not only to improve the care available to the affected through Multi Drug Treatment but also to remove the stigma attached with the disease. In 2005 Leprosy has been eliminated as a public health problem at national level.

National Programme for Control of Blindness (NPCB)

The Plan of Action to implement National Programme for Control of Blindness during the 10th Plan has been prepared in line with Global Initiative “Vision 2020: The Right to Sigh” . Revised Scheme focuses on development of comprehensive eye care services targeting common blinding disorders including cataract, refractive error, glaucoma, diabetic retinopathy and Corneal Blindness. School health programme is also being taken up under the Programme.

National Iodine Deficiency Disorder Control Programme (NIDDCP)

In India there are more than 500 million people suffering from Iodine deficiency, 54 million from goiter, and two million from cretinism. It is Iodine Deficiency that causes goiter as well as cretinism, which retards physical and mental development and causes other health problems. The Government has put a complete ban on non-iodised salt for direct human consumption in the entire country under the Prevention of Food Adulteration Act from May 2006, in order to prevent and control IDD.

To spread awareness among people to consume iodized salt only, a film of 10 minutes duration on consequences of nutritional iodine deficiency disorders and benefits of consumption of iodized salt has been distributed to all States/UTs.

Integrated Disease Surveillance Project (IDSP)

The Ministry of Health & Family Welfare has launched the IDSP in 2004 to provide dedicated positions at State and District level for disease surveillance activities. It is a decentralized, State based Surveillance Programme in the country. It is intended to detect early warning signals of impending outbreaks and help initiate an effective response in a timely manner. Total Budget for the project from 2004-09 is Rs. 408.36 Crores. This programme is carried out in collaboration with NRHM, NVBDCP and the National Informatic Centre (NIC). Under the scheme contractual position of one Epidemiologist, one Microbiologist and one Entomologist at each State/District headquarters are proposed to be provided in addition to six Field Investigators in each District. Baseline survey has been completed for District Laboratories of Phase I & II and Procurement Plan for Laboratory equipments has been prepared.

The Pradhan Mantri Swasthya Suraksha Yojana (PMSSY)

The PMSSY has been initiated with the objective of correcting regional imbalance in the availability of affordable/reliable tertiary healthcare services and also to augment facilities for quality medical education in the country. Under the PMSSY, it has been decided to set up 6 AIIMS-like institutions, one each in the States of Bihar (Patna), Chattisgarh (Raipur), Madhya Pradesh (Bhopal), Orissa (Bhubaneshwar), Rajasthan (Jodhpur) and Uttarakhand (Rishikesh). Under the scheme, 13 existing medical institutions spread over 10 states are being upgraded. Follow up action is being taken on all the projects under the scheme.

National Cancer Control Programme (NCCP)

It is estimated that at any given point of time there are 20-25 lakh cancer patients in the country and every year about 7 lakh new cases come up. It is estimated that 50% of the cancer cases can be cured if detected early. The National Cancer Control Programme being implemented by the Govt. of India focuses both on providing treatment facilities and early detection. Under the programme more and more Regional Cancer Centres (RCC) are being recognized and geographical gaps in the availability of cancer treatment facilities are being filled up in the country. Side by side early detection and IEC activities are also taken up.

Tobacco Control Measures

Tobacco has been major cause for deadly diseases like cancer. The Govt. of India has been focussing its attention on tobacco control measures over these years. Spearheaded by the Ministry of Health & FW, India is in the forefront in enacting the tobacco control measures through tobacco control legislation. There is a ban on smoking in public places, ban on tobacco advertising in India, ban on sale of tobacco products to minor and a ban on the sale of tobacco products within a radius of 100 yards from educational institutions. The most recent and prominent contribution to tobacco control is the notification of the specified pictorial health warnings to be displayed on all tobacco product packs.

PNDT Act

In order to check female infanticide, the Pre-Natal Diagnostic Techniques (Regulation and Prevention of Misuse) Act 1994 has been amended to make it more comprehensive. It has been renamed as ‘Pre-Conception and Natal Diagnostic Techniques (Prohibition of Sex Selection) Act’. Punishment under the Act has been made stricter to discourage people from violating the Act.

National Programme for Prevention and Control of Diabetes, Cardiovascular Diseases and Stroke (NPDCS)

The pilot programme for prevention and control of cardiovascular diseases, diabetes and stroke, has been planned with the objectives of providing effective promotion, prevention and control strategies to provide an integrated action plan for these chronic diseases. The pilot programme was recently launched on 4th January 2008 in 7 States with one district each namely Assam (district – Kamrup), Punjab ( district – Jalandhar), Rajasthan (district – Bhilwara), Karnataka ( district – Shimoga), Tamil Nadu (district – Kancheepuram), Kerala ( Thiruvananthapuram) and Andhra Pradesh ( Nellore – tentatively). Financial outlay for the pilot phase is Rs 5. 00Crore.

Trauma Care Programme

With a view to provide immediate treatment to the victims of road accident, the Ministry of Health & Family Welfare has decided to provide emergency trauma care facilities in State Government Hospitals located on National Highways under the Scheme-“Assistance for Capacity Building”, under which financial assistance was provided upto a maximum of Rs. 150 lakhs per hospitals or actual requirement of the hospital, whichever was less, during the Xth Plan. However, during the XIth Five Year Plan, a revised new scheme at a total outlay of Rs. 732.75 crores has been approved for developing a network of Taruma Centres along the Golden Quadrilateral, North-South and East-West corridors of the National Highways, keeping in view the fact that instead of random selection of hospitals as had been done in the past, the scheme should focus on development of a network of trauma care facilities along the selected corridors of National Highways and also to bring down the morbidity and mortality on account of accidental trauma in India.

Major Achievements in Health Sector in 2008-09

• Addition of Human Resources: 2231 Specialists, 10,489 MBBS Doctors, 17,979 Staff Nurses, 32,321 Auxiliary Nurse Midwives [ANMs], 7,590 Para Medics employed on contract under National Rural Health Mission.
  
  
• Conversion of Health Facilities into 24 X 7: A total of 11,135 Additional Primary Health Centres [APHCs], Primary Health Centres [PHCs], Community Health Centres [CHCs] and other Sub District facilities are functional 24 X 7.
  
  
• Janani Suraksha Yojana Beneficiaries: Over 1 crore women covered under Janani Suraksha Yojana [JSY] so far.
  
  
• ASHAs/Link Workers: 6.25 Lakhs Accredited Social Health Activists [ASHAs]/ Link Workers selected, 5.40 lakh trained at least in 1st module and 2.43 lakh with Drug kits in their respective villages.
  
  
• Rogi Kalyan Samitis: 547 District Hospitals(DHs), 4038 Community Health Centres (CHCs), 662 other than CHC Hospitals, 16735 Primary Health Centres (PHCs) have their own Rogi Kalyan Samitis(RKSs) with untied funds for improving quality of health services.
  
  
• Village Health & Sanitation Committees: 2.98 lakh villages (nearly 50%) have their own Village Health & Sanitation Committees out of which 2.10 lakh have received Rs.10,000/- untied grant for local action.
  
  
• Village Health & Nutrition Days: 30.48 lakh in 2006-07, 44.76 lakh in 2007-08 and 13.35 lakh so far in 2008-09, Village Health & Nutrition Days organized at ICDS Centres to reach basic health services.
  
  
• Mobile Medical Units [MMUs]: 212 MMUs functional so far.
  
  
• AYUSH: 4853 health facilities have co-located AYUSH services. 3933 AYUSH Doctors and 831 AYUSH paramedics added to the system.
  
  
• Programme Management Units: 398 District Programme Managers, 434 District Accounts Managers, 433 District Data Managers, 523 District Programme Management Units (DPMU), 34 State Programme Management Units(SPMUs), 1261 Block Managers, 1413 Accountants, 2550 Block PMUs added under NRHM.

Medical Tourism

• Medical Tourism in India is a budding concept whereby people from all over the world can visit the country for their medicinal and relaxation requirements. The reason for India being a favorable destination is because of its excellent health infrastructure and technology. Most common treatments are heart surgery, organ transplants, eye surgery, knee transplant, cosmetic surgery and dental care.
  
  
• India is also catching up as a popular medical tourism destination for its low-cost but world-class medical treatment. For example, according to a news in Financial times (in April) Madras Medical Mission, a Chennai- based hospital, successfully conducted a complex heart operation on an 87-year-old American patient at a reported cost of $8,000 (€7,000, £4,850) including the cost of his airfare and a month's stay in hospital. The patient claimed that a less complex operation in America had earlier cost him $40,000.
  
  
• The Indian healthcare market according to industry sources is reporting to be growing at over 30% annually. A recent McKinsey study on healthcare says medical tourism alone can contribute Rs. 5,000 - Rs. 10,000 crore (Rs. 50-100 billion) additional revenue for up market tertiary hospitals by 2012, and will account for 3-5% of the total healthcare delivery market.
  
  
• The Ministry of Tourism has taken several initiatives, in partnership with the private sector, to promote India as a destination for medical tourism to foreign tourists and make it a global health destination. The Ministry is also considering setting up of a National Accreditation Board for Hospitals.
  
  
• Measures for rationalizing the flow of tourist traffic have already been taken. Government has decided that there should be a fast track clearance for the medical patients at the airport.

Schemes to improve the health status of Children and Women

• As per National Family Health Survey III (2005-06) Child Mortality Rate is 18 down from 29 in NFHS-II (1997-98). Maternal Mortality Rate as per Sample Registration Survey (SRS) has declined from 398 per hundred thousand in 1997-98 to 301 in (2001-03).
  
  
• The National Rural Health Mission (NRHM) (2005-2012), and under its umbrella, the Reproductive and Child Health Programme Phase II, launched by the Government of India in the year 2005, aims to improve access to equitable, affordable, accountable and effective primary health care, in the rural areas of the country, especially for poor women and children, with a special focus on 18 States which have weak public health indicators and weak infrastructure. Strengthening of District Hospitals, Community Health centres Primary Health Care centres and Sub-centres to provide basic essential maternal and child health care.
  
  
• Janani Suraksha Yojana (JSY), a cash benefit scheme to promote Institutional Delivery with a special focus on Below Poverty Line (BPL) and SC/ST pregnant women. JSY has rapidly increased the demand for Institutional deliveries & off take of funds has substantially expanded. More than a crore women have benefited from the scheme.
  
  
• Appointment of an Accredited Social Health Activist (ASHA) for every village to facilitate accessing of health care services by the community including pregnant women.
  
  
• Operationalising Community Health Centers as First Referral Units (FRUs) and 50% of all Primary Health Centers for providing 24X7 services.
  
  
• Augmenting the availability of skilled manpower by means of different skill- based trainings such as for providing Skilled Attendance at Birth.
  
  
• Training of MBBS Doctors in Life Saving Anesthetic Skills and Emergency Obstetric Care including Caesarian Section.
  
  
• Strengthening of District Hospitals, Community Health centres, Primary Health Care centres and Sub-centres to provide basic essential maternal and child health care.
  
  
• Provision of 24 hours service in Primary Health Care centres and Skilled Attendance at Birth.
  
  
• Strengthening of CHCs for first referral care -Provision of Emergency Obstetric and Neonatal Care at FRUs & Training of MBBS Doctors in Life Saving Anesthetics Skills for Emergency Obstetric Care.
  
  
• Supplementary nutrition to pregnant and lactating mothers.
  
  
• National nutrition anaemia prophylaxis programme.
  
  
• Essential newborn care (care at birth – protection from hypothermia - provision of warmth, cord care - protection from infection and early initiation of breastfeeding).
  
  
• Immunization.
  
  
• Infant and young Child Feeding (Exclusive breastfeeding for 6 months & timely introduction of complimentary feeding).
  
  
• Vitamin A+ supplementation.
  
  
• Iron and Folic Acid supplementation.
  
  
• Integrated Management of Neonatal and Childhood Illness (IMNCI), early detection and appropriate management of Acute Respiratory Infection (ARI), Diarrhoea and other infections among new born and under five children.
  
  
• National Programme for Prevention and control of diabetes, cardiovascular disease and stroke has been launched in 10 states (1 district in each state) on a pilot basis early this year. The Planning Commission has provided an outlay of Rs. 1660.50 crore for 11th Five Year Plan
  

Policy Initiatives

In the recent budget of 2009-10, Rs.12,070 crore were alloted for National Rural Health Mission. Although several initiatives have been taken for Health Sector during the budget of 2008-09:

• Rs.16,534 crore allocated, for the health sector marking an increase of 15% over 2007-08.
  
  
• Under National Rural Health Mission (NRHM), 462,000 Associated Social Health activitists have been trained, 177,924 villages have sanitation committees functional and 323 district Hospitals have been taken up for upgradation.
  
  
• The National Aids Control Programme have been provided Rs.993 crore.
  
  
• Drive to eradicate polio continues with revised strategy and focus on thehigh risk districts in Uttar Pradesh and Bihar. Rs. 1,042 crore have been allocated in 2008-09.
  
  
• Rashtriya Swasthya Bima Yojana to provide health cover of Rs.30,000 for every worker in the unorganised sector falling under the BPL category and his/her family. The Yojana will be launched in Delhi and in the States of Haryana and Rajasthan on April 1, 2008. Rs.205 crore provided as the Centre's share of the premia in 2008-09.
  
  
• National Programme for the Elderly: National Programme for the Elderly to be started in 2008-09 with a Plan outlay of Rs.400 crore. Two National Institutes of Ageing, eight regional centres, and a department for geriatric medical care in one medical college/tertiary level hospital in each State to be established during the Eleventh Plan period.
  
  
• Integrated Child Development Services (ICDS): Allocation for ICDS enhanced from Rs.5,293 crore in 2007-08 to Rs.6,300 crore in 2008-09; Remuneration of Anganwadi workers being increased from Rs.1,000 per month to Rs.1,500 per month; remuneration of Anganwadi Helpers increased from Rs.500 per month to Rs.750 per month; over 18 lakh Anganwadi workers and helpers to benefit; 5,959 ICDS projects and 932,000 Anganwadi and mini-Anganwadi centres functional under ICDS at the end of December 2007.

Research and Development

There are a number of autonomous institutions under the Ministry of Health and Family Welfare, which conduct research in various specific areas. Main institutions involved are:

• Indian Council Of Medical Research (ICMR)
  
• Indian Medical Association (IMA)
  
• Central Drug Research Institute (CDRI)

Awards & Recognitions

In recognition of India’s initiatives and achievements in various healthcare activities, international community has honoured the country . Some of these are –

• Luther L. Terry award was awarded during the world conference on Tobacco in Washington DC for exemplary leadership of Ministry of Health & FW, GOI, in recognition of consistent excellence in anti-tobacco advocacy.
  
  
• The award of “Polio Eradication Champion” in grateful appreciation of extraordinary effort, from the Rotary International and Rotary Foundation.
  
  
• WHO-Director General’s special Award for “Leadership in Global Tobacco Control”.
  
  
• WHO-Director General’s special Award for introducing “Smoke –Free inside Policy”

Goals: 2000-2015

Table for the long-term goals (to be reached by 2010) enunciated in the National Health policy is as follows

Investment Opportunities

• Health Insurance
  
• Medical Tourism
  
• Hospital Management
  
• Curative and Preventive Services
  
• Infrastructure Facilities like Hospitals and Diagnostic Centre
  
• Training Manpower (doctors, nurses, technicians)

Policy Initiatives

• National Health Policy (2002)

Key highlights

• Achieve an acceptable standard of good health amongst the general population of the country.
  
• Increase access to the decentralized public health system.
  
• The contribution of the private sector in providing health services would be much enhanced.
  
• Increased access to tried and tested systems of traditional medicine will be ensured.

FDI Policy

100 percent is permitted for all health related services under the automatic route

Key Players

Private players have made significant investments in setting up state-of-the-art private hospitals in cities like Mumbai, New Delhi, Chennai and Hyderabad. They have introduced latest medical technology and have created a competitive environment. The government's share in the healthcare delivery market is 20 percent while 80 percent is with the private sector. Emergence of corporate hospitals has led to increased professionalism in medical practices and use of hospital management tools.

• Apollo Group
  
• Fortis
  
• Max
  
• Wockhardt
  
• Piramal
  
• Duncan
  
• Ispat
  
• Escorts
  
• Ranbaxy Group Company

Useful Web links

• Ministry of Health and Family Welfare