Health is defined as the physical, mental, emotional, spiritual and social wellbeing of

an individual. Based on this definition

HEALTH

PHYSICALMENTAL

SPIRITUAL

EMOTIONAL

SOCIAL

The art of Health Care in India can be traced back nearly 3500 yearsEarly days of Indian history the Ayurvedic tradition of medicine has been practicedHealthcare is one of India’s largest sectors, in terms of the revenue and employment

Contribution to health of a population also derives from social determinants of health living conditions, nutrition, safe drinking water, sanitation, education, early child development,social security measures.

MAJOR GOAL

Getting better/ more health care protection for as many people as possible at the lowest possible cost.

BEFORE INDEPENDENCE :

HEALTHCARE HAS BEEN BASED ON VOLUNTARY WORKTRADITIONAL METHODS USED FOR MADICATIONMEDICINAL PROPERTIES OF PLANT AND HERBS WAS PASSED FROM ONE GENERATION TO ANOTHERMedicine was dominated by magical and religious beliefs which were an integral part of ancient cultures and civilizations

AFTER INDEPENDENCE

Birth of preventive medicineRise of public healthSanitary awakeningCurative medicine Social medicineGOVT OF INDIA LAID DOWN A STRESS ON PRIMARY HEALTH CAREALTERNATE SOURCES OF FINANCE WERE CRITICAL FOR SUSTAINABILITY

CHANGING CONCEPTS IN PUBLIC HEALTH

Disease control phase(1880-1920)

Health promotional phase(1920-1960)

Social engineering phase.

Health for all phase

PUBLIC HEALTH PROBLEMSSince independence, major public health problems

like malaria, tuberculosis,leprosy, high maternal and child mortality lately, human immunodeficiency virus (HIV) have

been addressed through a concerted action of the government

1600s-Introduction of western medicine in India. First medical officers arrive along with the British East India Company's first fleet as ship's surgeons.

1664 Madras General Hospitalis the first hospital opened in India

1802 A Superintendent General of Vaccination in India is appointed after the discovery of the smallpox vaccine

Cholera outbreaks and pandemicsFirst, 1816–26Second, 1829–51 Third, 1852–1860Fourth, 1863–1875 Fifth, 1881–1896 Sixth, 1899–1923Seventh, 1961–1975Notable outbreaks (1991–2009Notable outbreaks (2010–present

1823 The Jawaharlal Institute of Postgraduate Medical Education & Research (JIPMER) is founded. It's the oldest to teach European medicine in Asia. Today considered an Institute of National Importance

1835 Calcutta Medical College is established- 1ST MEDICAL COLLEGE

1869 Public Health Commissioner and a Statistical Officer are appointed to the Government of India

1870 central sanitary department is formed1873 Birth and Death Registration Act is

passed1880 act is passed for the compulsory vaccination

of children in municipalities and cantonments. Smallpox is the main target during this period,

although vaccinations are also carried out for plague and other diseases

tuberculosis1939 Tuberculosis Foundation of India is establishedThe Tuberculosis Association of India is a voluntary

organization. It was set up in February, 1939. It is also affiliated to the Govt. of India & is working with TB Delhi center

1997 Revised National Tuberculosis Control Program (RNTCP) is launched by the government with aims at achieving universal access to tuberculosis control services

DOTS (directly observed treatment, short-course), also known as TB-DOTS, is the name given to the tuberculosis control strategy recommended by the World Health Organization.

TB-Mission 2020 is Government of India's mission to eliminate tuberculosis from India by 2020

1896 Plague Commission is constituted1896 Bombay plague epidemic breaks out. It

spreads across all of India and kills at least 2 million people

1897 Epidemic Diseases Act is passed. The Governor General of India confers special powers upon local authorities to implement the necessary measures for control of epidemics

sanitation1912 Government of India sanctions the

appointment of Deputy Sanitary Commissioners and Health Officers with the local bodies and releases funds for sanitation

1986- national rural sanitation policy 2008 OCT-NATIONAL URBAN SANITATION POLCYThis programme focussed mainly on providing

subsidies to people to construct sanitation facilities.

 In 1999, a restructured Total Sanitation Campaign (TSC) was initiated

2012. Nirmal Bharat Abhiyan. target for reaching total sanitation was changed from 2012 to 2022

2014 OCT 2 -Swachh Bharat Abhiyan

1925 National Institute of Mental Health and Neurosciences is established. Today listed as an Institute of National Importance

 All India Institute of Mental Health (AIIMH)

National mental health program• The national mental health program (NMHP,

1982) is run by the government of India for MEETING THE UNMET NEEDS of the mentally ill people

• In 1947- Fifteen mental hospitals with 10,000 beds for 400 millioN

• One of the first countries in the developing world to formulate a national mental health program

NATIONAL MENTAL HEALTH PROGRAM1.Prevention and treatment of mental and

neurological disorders and their associated disabilities.

2. Use of mental health technology to improve general health services.

3. Application of mental health principles in total national development to improve quality of life.

MALARIA PROGRAM one-fourth of India’s population suffered from

malaria, particularly in the states like Punjab and BengalNational Malaria Control Programme in April

1953.the programme was changed to a more

ambitious National Malaria Eradication Programme in 1958

implementation of urban malaria scheme (UMS) in 1971-72 

Regulatory bodies1933 Medical Council of India is formed, with

the purpose of establishing uniform and high standards of medical education in India

1938 Bombay Medical Practitioner's Act is passed. With it comes the first legal recognition and registration for the Indian systems of medicine

1940 Drugs Act is passed and drugs are made under the control of the government for the first time

Regulatory bodies1953 Delhi Nursing Home Registration Act is

passed1964 government body for setting norms for

the manufacture and the control of the quality of traditional medicinal preparations is formed

1970 Policy The government of India passes the Indian Medical Central Council Act to standardize Ayurvedic teaching institutions, their curriculum and their diplomas

Regulatory bodies Pharmacy Act, 1948 Indian Nursing Council Act, 1947 Dentists Act, 1948 Indian Medicine Central Council Act, 1970 Homeopathy Central Council Act, 1973

1939 first Rural Health Training Center is established near Calcutta

1948 Employees' State Insurance Scheme (ESIS) is launched with the objective of achieving universal health coverage. Targeted at employees with income less than Rs 15000/month and dependents

1953 Manipal Hospitals is founded as a part of the Manipal Education and Medical Group (MEMG)

1954 CENTRALl Government Health Scheme (CGHS) is launched with the objective of achieving universal health coverage in government employees and families

1956 All India Institutes of Medical Sciences (AIIMS) are founded with a first college in New Delhi. These institutes are declared institute of national importance by the Act of Parliament

2012 All India Institute of Medical Sciences expand to six locations

1962 Postgraduate Institute of Medical Education and Research is established. Today listed as an institute of national importance

FAMILY PLANINGThe national family planning programme was

launched in 195113% of married women used modern contraceptive

methods, which rose to 35% by 1997 and 48% by 2009

The Ministry of Health and Family Welfare is the government unit responsible for formulating and executing family planning related government plans in India. An inverted Red Triangle is the symbol forfamily planning health and contraception services in India

FOOD & NUTRITON POLICY1970 Government of India launches the Balwadi

Nutrition Programme to provide food supplements at Balwadis to children of the age group 3–6 years in rural areas.

The food supplement provides 300 calories of energy and 10 grams of protein per child per day.

TO improve the nutritional and health status of children in the age group 0-6 years;

- to lay the foundation for proper psychological, physical and social development of the child;

- to reduce the incidence of mortality, morbidity, malnutrition and school drop out;

NATIONAL NUTRITIONAL POLICY1975Program launch (nutrition, child health)The Integrated Child Development Services (ICDS) scheme is launched with the purpose of improving nutrition and health status in children.NNP HAS BEEN ADOPTED BY INDIAN GOVT 1993 GOALS: PROVIDEING

SURVEILLANCE

MONITERING

Kangaroo Mother Care(KMC) and optimal feeding in Low Birth Weight infants SUB DIVISION OF NATIONAL HEALTH MISSION

Private sector1983 Apollo Hospitals opens its first facility. It

is the first hospital to be registered as a publicly listed company in India

1976 Aravind Eye Hospitals chain is opened by Dr. Govindappa Venkataswamy as a network of eye hospitals. Having a major impact in eradicating cataract related blindness in India, today the model of Aravind Eye Care hospitals is highly recognized and has won multiple awards

1990 Pharmaceutical company Wockhardt opens its first medical center

1996 Fortis Healthcare is founded2000  Krishna Heart Institute is founded as a high-

end medical facility, specializing in heart disease2000–presentOrganization (hospital chain)

Narayana Health system is opened as a multi-specialty hospital chain by Dr. Devi Shetty under the guidance of the Asian Heart Foundation. Today it has 31 hospitals in 19 locations. It is one of India's largest and considered the world's most economical[34] healthcare providers with a reputation for high quality

Uniresal immunization programme1985 government of India launches the 

Universal Immunization Programme, consisting in massive vaccination for nine diseases : tuberculosis, 

diphtheria, pertussis (whooping cough), tetanus, poliomyelitis, measles, Hepatitis B,Diarrhoea, Japanese Encephalitis and Pneumonia

Mission indradhanush2014 Mission Indradhanush is launched by the 

Ministry of Health and Family Welfare with the purpose of immunizing all children against seven vaccine preventable diseases,namely

 diphtheria, pertussis, tetanus, polio,tuberculosis, measles and hepatitis B by 2020

plague1994 plague in India was an outbreak of 

bubonic and pneumonic plague in south-central and southwestern India from August 26 to October 18, 1994

In the first week of August 1994 health officials reported unusually large numbers of deaths of domestic rats in Surat city of Gujarat state. On 21 September 1994 the Deputy Municipal Commissioner of Health(DMCH) for Surat city received a report that a patient had died seemingly due to pneumonic plague.

1831 Bonallu celebration for eradication of plague in twin cities.

Polio free indiavaccination against polio started in 1978 with 

Expanded Program on Immunization (EPI1995 Pulse Polio program is launched by the

government to eradicate poliomyelitis by vaccinating all children under the age of five years

The last reported cases of wild polio in India were in West Bengal and Gujarat on 13 January 2011.

 On 27 March 2014, the World Health Organization (WHO) declared India a polio free country, since no cases of wild polio had been reported in for three years

HEALTH INURNCELaunched in 1986. According to the World Bank ,by 2010, more

than 25% of India’s population had access to some form of health insurance. There are standalone health insurers along with government sponsored health insurance providers. Until recently, to improve the awareness and reduce the procrastination for buying health insurance.

2000 Insurance Regulatory and Development Act (IRDA) opens up the market with the invitation for registration applications

, the General Insurance Corporation of India and the Insurance Regulatory and Development Authority had launched an awareness campaign for all segments of the population

Aim; to cut Catastrophic Health Expenditure (CHE) which can be defined as health expenditure that threatens a household's capacity to maintain a basic standard of living

Life style Preventive policy2002–2005 Tobacco cessation clinic program

(later renamed as Tobacco Cessation Centers) is launched by the World Health Organization (WHO) and the Ministry of Health of India. Until 2005, 18 facilities are created. The services offered at the clinics include individual intervention in the form of behavioral counseling, medication, and nicotine replacement therapy

State health policy2004 Deen Dayal Antyoday Upchar Yojna

scheme is launched by the government of Madhya Pradeshto provide free health care to poor families

2007 Government of Andhra Pradesh launches the Aarogyasri program in order to provide no cost coverage of hospitalization for all those below the poverty line

2005 Janani Suraksha Yojana scheme is launched by the Government of India with aims at decreasing the neonatal and maternal deaths happening in the country by promoting institutional delivery of babies

2009 Rashtriya Swasthya Bima Yojana (RSBY) scheme is launched with the objective of providing affordable healthcare to the poor

NATIONAL HEALTH POLICYendorsed by Parliament in 1983,committed to providing health services to all

by 2000  according to a 1995 World Bank study. Of

these proportions, 58.7 percent goes toward primary health care (curative, preventive, and primitive) and 38.8 percent is spent on secondary and tertiary inpatient care. The rest goes for no service costs.

National rural health mission2005Program launch  

National Rural Health Mission (NRHM) is launched by the government of India

2005 Accredited Social Health Activist (ASHAs) is launched as a program of community health workers instituted by the Ministry of Health and Family Welfare

NATIONAL RURAL HEALTH MISSION TO address the health needs of

under-served rural area initially tasked with addressing the health

needs of 18 states that had been identified as having weak public health indicators.

Primary health centers are the cornerstone of the rural health care system.

AIM

2011Program launch (healthcare coverage)The National Programme for the Health Care of the Elderly (NPHCE) scheme is launched with the objective of providing the elderly an easy access to primary healthcare

NATIONAL URBAN HEALTH MISSION2013 MAY 1ST National Urban Health Mission (NUHM)

as a sub-mission of National Health Mission (NHM) has been 1st May 2013.

OBJ: to meet health care needs of the urban population with the focus on urban poor,

essential primary health care services reducing their out of pocket expenses for treatment. strengthening the existing health care service

delivery system, targeting the people living in slums converging with various schemes relating to wider

determinants of health like drinking water, sanitation, school education, etc.

CHALENGESUrban India is fast becoming a disease capital with the increase in lifestyle diseases like cardiovascular complaints, diabetes mellitus and cancer.

Rural India is seeing a sharp increase in non-communicable life style diseases like Respiratory Tract Infections.

urban and rural India are faced with communicable diseases like tuberculosis, Sexually Transmitted Diseases (including HIV/AIDS), dysentery and typhoid.

Health care is a basic Human Right.

Healthy living conditions and access to good quality health care for all citizens are not only basic human rights, but also essential prerequisites for social and economic development