History of public health in India

Presented by: Deepali Sahu

Contents

• Introduction• Early history• Public health in British India• Public health in the post

independence era

Introduction

Focusing on clinical services while neglecting services that reduce exposure to disease is like mopping up the floor continuously while leaving the tap running .

(paraphrased from Laurie Garrett, Betrayal of Trust)

Early history• India had ancient civilization- Indus

valley 3000B.C

• 1400 BC Aryans invaded-ayurveda & siddha

• Manu Samhita

Early history-post vedic600BC TO 600 AD

• Religious teachings of Buddhism and Jainism

• Medical education introduced in universities of Taxila and Nalanda

• Hospital system developed by King Rahula sankirtyana for men women and animals

650 to 1850 AD

• Rise and fall of Moghul empire, Arabic system of medicine

• Changes in political system, medical education and services became static

• Ancient universities and hospitals disapeared

Public Health in British India• 1757 British established their rule in

India• 1859- royal commission appointed to

investigate causes of unsatisfactory health in British army in India

• 1864- sanitary commissioners appointed in Bombay ,Madras and Bengal

• 1869- public health commissioner and statistical officer appointed with GOI

Public Health in British India

1873 to 1880- birth and death registration actThe vaccination actIndian factories act1881- first all India census taken1896- epidemic of plague, plague

commission appointed

Public Health in British India

• 1911- ICMR established

• 1912- deputy sanitary commissioners and health officers• 1918-lady reading health school,

Delhi ,nutrition research lab, coonnor

Public Health in British India

• 1919- first step towards decentralization of health administration ,

• 1930- the all India Institute of Hygiene and Public Health, Calcutta.

Child Marriage restraint act Maternity and Child welfare Bureau

established

Public Health in British India• 1937- central advisory board • 1939- the Madras Public Health Act first rural health training centre,

Singur Tuberculosis Association of India1940 to 1946 Drugs act Health survey and Development

Committee (Bhore committee)

• Bhore committee submitted its report in 1946

• Health of nation reviewed under1. Public health2. Medical relief3. Professional education4. Medical research5. International health

Post independence era

• Bhore committee’s report became basis for planning and measures adopted by GOI.

• 1947- Ministry of Health established at centre and states, several high posts were introduced

Post independence era

• 1948- India joins WHO Employees state insurance act

and report on environmental hygiene committee was published

• 1949- constitution of India adopted 26 Nov.

• Rs.140 crores(5.9%) alloted for health prog, BCG Vaccination prog launched• National malaria control prog.• Nation wide family planning prog started• Committee to draft a Model Public Health Act• National water supply and sanitation prog• National leprosy control prog

Post independence era 1951- first five yr plan

First five yr plan

• VDRL antigen production in Calcutta

• Prevention of food adulteration act

• National filaria control prog.

• Hindu marriage act – 18 yrs for boys and 15 yrs for girls

Second five yr plan(1956-1961)

• Rs.225crores for health prog, (5%)

• Model public health act published

• Central health education bureau

• Influenza pandemic swept country(1957), • NMCP converted to national malaria

eradication prog.

Second five yr plan

• National TB survey completed• Mudliar committee to survey the progress

made in field of health since submission of bhore committee’s report

• Central expert committee under ICMR to study problems of Cholera and Smallpox

• Rajasthan first state to introduce Panchayati Raj

Second five yr plan

• School health committee

• National nutrition Advisory Committee

• Vital statistics transferred to Registrar general of India , ministry of home affairs, from the Directorate General Health Services

Third five yr plan (1961-66)

• Rs.342crores (4.3%)• Mudliar committee report was published• The central bureau of health intelligence• The central Family Planning Institute

established , Delhi• National smallpox eradication prog.• National goitre control prog.

Third five yr plan• Chaddha committee established a norm

of one basic health worker for every 10,000 population

• Emphasis on family planning

• Shantilal shah committee to study the question for legalizing abortions

Third five yr plan

• Director , ICMR recommended Lippes Loop as safe and effective for mass prog.

• MUKHERJEE committee constituted to look in to minimum additional staff required for PHC s to take over maintainence of malaria and small pox prog.

Fourth five yr plan 1969 to1974• Allocation of 840 crores to health and 315

crores to Family planning• Report of medical education committee

• Drug price control order

• Registrationof birth and death act

• Family pension scheme

Fourth five yr plan• MTP act • National program of minimum needs-

elementary education, rural health, nutrition, rural roads, water supply, housing, slum improvement, rural electrification

• Kartar singh committee – “multi purpose workers”

Fifth five yr plan 1974 to 79

• 796 crores to health and 516crores to family planning

• 5july 1975 India becomes free of smallpox• ICDS• The cigarettes regulation• Srivastav committee submitted report on

medical education and support manpower• National prog for prevention of blindness

Fifth five yr plan• Bill on air pollution introduced

• Child marriage act amendment: boys 21yrs and girls 18 yrs

• 1979-Declaration of Alma Ata –PHC approach

• Regional office for health and family welfare

Sixth five yr plan 1980 to 84

• WHO and member states adopted global strategy for HFA

• New 20 point prog announced• GOI announces its national health policy• “IMPACT India” prog. National plan against

avoidable disablement• 1984- BHOPAL GAS TRAGEDY, ESI bill

(amendment), the Workmen’s compensation act, Juvenile Justice Act 1986

Seventh five yr plan 85 to 90

• Universal immunization prog• Environment protection act• World wide “safe motherhood” campaign by

world bank• National diabetes control and national AIDS

control prog initiated• Blood safety prog launched

`

1991

India stages the last decadal census of thecentury

Eighth five yr plan 1992 to 1997• Child survival and safe motherhood prog.

(1992)

• The infant milk substitute , feeding bottles and infant foods act 1992 came into force

• DOTS pilot project

• Return of plague after 28 yrs of silence (1994)

Eighth five yr plan• Legislation on transplantation of

human organs enacted

• Pulse polio immunization , largest single day public health event on 9th Dec 1995 and 20th Jan 1996

• RCH prog launched

Ninth five yr plan 1998 to 2002

• National family health survey-2 undertaken

• Signatory to UN millennium declaration 2000• 2001- first census of century

• National policy for empowerment of women

• National health policy announced

Tenth five yr plan 2003 to 2007

• Emergence of SARS• Parliament approves

prohibition, regulation of trade and commerce of cigarettes and other tobacco products

• Vandematram scheme

• Mid day meal scheme

• National prog for prevention of vector borne diseases

Tenth five yr plan

• Integrated disease surveillance project launched

• National guidelines for infant and young child feeding formulated in aug,2004

• 2005-1. RCH II launched2. JSY launched3. NRHM launched4. Indian public

health standards for CHCs formulated

20061. WHO releases new pediatric growth chart

2. Ban on child labor as domestic servant

3. National family health survey-3 conducted

4. Ministry of women and child carved out

5. IMNCI launched in 16 states

Eleventh five yr plan

• 11th five yr plan launched in 2007• NACP III launched• Indian public health standards for PHC and

sub centres• Maintenece and welfare of parents and

senior citizen bill • Non communicable disease prog as pilot

project launched

11th Five Year Plan Health

• Reduce infant mortality rate (IMR) to 28 and maternal mortality ratio (MMR) to 1 per 1000 live births.

• Reduce Total Fertility Rate to 2.1.

11th Five Year Plan Health

• Provide clean drinking water for all by 2009 and ensure that there are no slip - backs by the end of the 11th Plan.

• Reduce malnutrition among children of age group 0 - 3 to half its present level.

• Reduce anemia among women and girls by 50% by the end of the 11th Plan.

THANK YOU