SlideShare a Scribd company logo
1 of 104
Download to read offline
Health politics
Ashok Pandey
Associate Research Fellow
Policy Research Institute
Concept of Health politics
What is health ?
What is politics ? Is a means of political outlook or the science of government
Science : branch of knowledge involving systematized observation and experiment.
Government means :System by which a state is governed
Government act on control, rules, command, management, administration etc
Government should have citizens, territory , Rules and Sovereign
Health politics means attainment highest level of wellbeing of all citizens by means affairs of
state.
• Highest level of wellbeing
• means affairs of state.
What is political system?
Any collection of elements that interact in some way with one
another can be considered with system: a galaxy, a football
team, a legislature, a political party.
In thinking about what a political system is, it is helpful to keep
in mind several points that apply to any system.
A system is a frame work with which an observers or analyst
approaches or lens or perspective through which an observers
or analyst choose to view, some reality such as politics .
The political system of the United state of America includes
Congress, The president, the supreme Court, political Party,
interest groups, voters, new media and so forth.
Health politics means attainment highest level of
wellbeing of all citizens by means affairs of state.
• highest level of wellbeing
• means affairs of state.
• State : political community under one government
Health politics depends on
• Country's Socialistic model
• Country's well fare model
• Country's Capitalistic model
• International commitment and agreement
Characteristics Socialistic model
• Means of production
• State Responsibility
• Common Pool
• Social justice and Equity
• Citizens as assets
Characteristics Well fare state
• Basket fund
• Social /Private health insurance
• Community drugs programs
• Citizens as a liability/assets
• Act and regulation prepared by Governments
E.g Health, Education free in UK, manage
Family physician.
Capitalistic model
• Government prepare rules and regulation
• Competitive markets
• Quality control by GOVT
• Citizens as liability
• Various scheme to fulfill the people's needs
• Denmark
International Commitment and
agreement
• Bucharest conference 1974 well fare approach
• CEDAW 1979 : concerning against woman's
violence
• Earth summit
• Cairo conference 1994
• Beijing women's conference 1995
Political aspects.
• Slovakia, the former Communist country that shifted some
state health care costs to individuals a few years ago to reduce
its budget deficit, is rolling back some of those changes even
as its neighbors start to address costs in their own health care
systems.
• Regional governments also are evaluating Slovakia's 2004
decision to open the health insurance market to for-profit
companies.
• East European policy makers and officials from nonprofit
organizations focused on Slovakia's experience Wednesday at
a gathering in Prague that is examining ways to reduce
government spending on health care to cut budget deficits.
• One obstacle is the risk of losing voter support, as Dzurinda
did. Slovaks voted him out of office last year.
• "The problem is to tell people why it is good for them, if they
didn't pay in the past," he said.
• The countries are trying to reduce their budget deficits in an
effort to meet the requirements for adopting the euro, which
would eliminate currency fluctuations and ease trade within
the 27-country European Union. Slovakia may be able to
convert to the euro as early as 2009 because its budget deficit
and debts are under control, the Organization for Economic
Cooperation and Development
• Fico, while keeping most economic policies that improved
Slovakia's finances, last year abolished almost all regulatory
fees on medical services. Those charges included 20 koruny, or
81 U.S. cents, on prescriptions and doctor's visits, as well as
50 koruny per night in the hospital.
• With those fees, the money the state spent on prescription
drugs had fallen to 31.5 percent of the health care budget in
2005 from 36.3 percent in 2003, according to government
data.
• The Czech Republic wants its nine state-funded health insurance
providers to convert to joint stock companies to make their
accounting more transparent, said Lucie Antosova, an adviser at
the health ministry.
• "If they are in debt, we have to calculate it as public debt,"
Antosova said. That could hurt any attempt to adopt the euro, she
said.
• Hungary, which is trying to tackle the European Union's widest
budget deficit, this year imposed fees on doctor's visits, slashed
drug subsidies and ended a free drug program. The state-
monopoly health insurer, which had been in deficit since 1994,
announced its first-ever quarterly surplus of 17 billion forint, or
$94 million. The health ministry is arguing for opening the
market to private insurers.
• Last week, the Czech Health Ministry proposed charging patients
30 koruny for outpatient visits and prescriptions, 60 koruny for a
day in a hospital and 90 koruny for emergency services.
Politics means
1. Relationships involving powers rule, or authority ‘
lasswel”
2. Relationships involving territoriality
3. Relationships in associations capable of self
sufficiency
1 and 2 ; weber
1, 2 and 3 by Aristotle
Politics is simply the exercise of influences
Why individual participate in
politics
• Value the reward to be gained
• Think the alternative are important
• Are confident that they can help to change the
outcome
• Believe the outcome will be unsatisfactory if they do
not act
• Have knowledge or skill that bears on questions at
hand
• Most overcome fewer obstacle to act
• Are mobilized by others to participate
Political participation in 5 country
Relationship between health and
politics
Health Politics
Ends Means
State of physical.... Constitution, Vision,
mission
Policy, strategy
Plan
• For Health Professional : Health ends
• But Politician : Health means ?
• But Politician: Power ends or over all
development
World trend of health politics
It is difficult to define trend of world health politics. Because they are
not going onward in same pace and line, some times they are
changing their path dramatically eg USSR
Demography cycle
First stage high stationery
Second Stage : early expanding : High priority FP,
..................
Fifth stage : Declining : High priority birth, attraction scheme to
developing countries, Permanent resident from ....
• Change of disease pattern ;
communicable disease to non communicable disease
• Service demand by people ; quality of services, abortion care
Trends of health politics
• Welfare approach: Health facilities was
provided to women
• Right based approach : right to get Health
services
• Equity : justice
• Equality: equal opportunity
Trends of health politics
• The united nation conference on Human Right at Teheran in 1968
recognized family planning as a human right
• Bucharest conference in 1974 endorsed same view as above ; all couples
and individuals have basic human right to decide freely.
• The world conference of the international women's year in 1975 also
declared the right of women to decide freely
• Cairo conference 1994 ; component of reproductive health
• Beijing conference 1995. emphasis on equality,
• Minimum health services to maximum people
• Alma-Ata conference in 1978 : 134 country called revolutionary approach
to health care
• Health for all by the year 2000.
• Millennium Development Goal
• Users fee in health services
• Abolition of user's fee
• The majority of European nation have a national health
scheme that is administered federally.
• Developing countries tend to provide health services, although
not a level of sophistication available in developed countries.
• Voluntary health agencies have flourished in United state than
Europe.
• In the developing nation NGOs have played an even important
role in promoting health are constrained from specific
activities by political and economic limitation .
• Gaps between the ‘haves ‘ and ‘have-nots’
• Socialized public health : social dimension of public health
emerged
• Health for all movement ; Health for all by the year 2000.
• Primary Health care : restructuring of health system
• Health system reforms
• Eradication and elimination of disease
Small pox eradicated and poliomyelitis under
eradication and leprosy elimination
• Globalization of public health: Globalization
has been a phenomenon that is characteristics
by world wide interdependence in all aspects –
economic, political , social and cultural
New Philosophy of Health
• Health is a fundamental health right
• Health is the essence of productive life and not the of
ever increasing expenditure on medical care
• Health is an integral part of development
• Health is inter sectoral
• Health is central to the concept of quality of life
• Health involves individuals, state and international
responsibility
• Health and its maintenance is major social investment
• Health is world –wide social goal
Dimension of health
• Physical dimension – perfect functioning of the body
• Mental dimension- State of harmony between oneself
and others, e.g knowing or cognition
• Social dimension – wellbeing of the whole person in
the context of his social network.
• Spiritual dimension –It is intangible "some thing "that
transcends physiology and physiology.
• Emotional dimension- relate to feeling
• Vocational dimension – It is part of human existence .
Work are source of satisfaction and enhanced selfsteem.
Quality of life depend on
• Physical quality of life index ( IMR, life
expectancy at age one and literacy)
PQLI measures social, economic and political
policies
• Human development index
Longevity ( life expectancy at birth)
knowledge ( adult literacy rate and mean years
of schooling)and Income ( GDP per capita in
purchasing power –parity dollar)
Dimension of health
Political perspective in Primary Health
care
• It is a comprehensive approaches for health for
all It needs to be revitalized
• It is a selective approaches so can not fulfill
the people's health need
Miscellaneous
Highest unmet need of FP was found (37
%)among the adolescence ( both)
"There is social and economic inequalities that
lead to poverty, under nutrition and high child
Mortality. As a result , in spite of global
campaign for child survival, millions of
children continue to die from the disease of
poverty " by David werner and David Standers
In 1892 USA did not accept cholera in their
country so loose a lot of lives.
What is Constitution ?
/fHosf]Df'nsfg'gxf](Main regulation of
state)
Constitution
• Execution function
• Legislative function
• Judiciary function
Government by majority
Respect to minority
Constitution of Nepal 2004 (1948)
• Judiciary function
• High court
• Parliamentary judiciary committee
• Human right -symbolic
Constitution Nepal 1962(2019)
• Hindu State
• National Animal
• Active king
Constitution Nepal 1990(2047)
• District court
• Applete court
• Supreme court
Human right
Constitutional king
Health -Guiding principle
Constitution 2063 (interim)
• Federal system
• Social inclusion
• Religion
• Health : Basic health service as a fundamental
human right
• Public commission
• National security council
• Auditor General
2072 constitution
• New constitution implemented from 3rd
Ashwin, 2072.
• It has repealed Interim Constitution 2063.
• It has adopted federalism, first time in history
of Nepal.
• Power has been decentralized.
It includes
• Citizenship
• Fundamental Rights and Duties
• Structure of State and Distribution of State
Power
• Judiciary
• Appointment of President
• Appointment of Prime Minister
• Constitutional Commissions and Bodies
• Other Constitutional Clauses
35. Right relating to health:
(1) Every citizen shall have the right to free basic
health services from the State, and no one shall
be deprived of emergency health services.
(2) Every person shall have the right to
get information about his or her medical
treatment.
(3) Every citizen shall have equal access to
health services.
(4) Every citizen shall have the right of access
to clean drinking water and sanitation.
Mile stone -Constitution of Nepal
• 2004
• 2007 interim constitution
• 2015
• 2019
• 2047
• 2063 interim constitution
• 2072 constitution
Parliament
• Parliament/congress
Parliament : England, India, Canada, Austrlia,
Nepal
Congress: united state
• Upper house
• Lower house
Function of parliament
• Representative from people
• Preparation of Law
• Budget approved and monitoring
• Control activities of executive and make them
responsible to ward the people.
Authority parliam
entary
presidency Remarks
Prepare law Approved by
king or
president
Approved by
president
Budget approved Authority to
parliament
Authority to
parliament
Elect head of GOVT YES NO
To take action against
judge
YES YES dxfcleof]u
Appointment YES YES
Legislative Aspects in health
Function of parliament
• Approve Act, Regulation, Policy, Long-term-
periodic and short term plan
• Discussion, rejection and Approve budget and
program by majority of parliament members
• Formation of subject committee by involving the
parliament Members
• President, voice president, Pri-minister and
Chairmen and voice chairmen are elected by
majority of members
• Can withdraw to the pri-minister by their simple
majority
Characteristics of parliament members
• They are representative from Party so they are
more conscious about their party's manifesto.
• Directed and guided by party decision
• Are responsibility for Social sectors (Health
education, security etc)
• Are directly and indirectly elected by peoples
• They get facilities (Monthly salary with
allowance) from Government of Nepal
Prepared documents by parliament
• New Health Policy 2075/71/48
• Health services Act 2053
• Health Service Regulation 2054
• Long term Health Plan 2054-2074)
• Nepal health Sector Program - Implementation
Plan (2004-2009)
• Establishment of Nursing home and hospital
guideline 2061
Role of health advocacy and lobbing in
health policy formation
Advocacy by
• Electronic media Radio, TV etc
• Paper media : Gorkhapatra, Kantipur, Nagarik,
• Mass media
• Small group: Role play, street drama etc.
• Individual: counseling, interview, personnel
contract
Legislative Procedure related to health
Political aspects of executive health
Executive Function
• To determine policy and regulation
• To prepare the bills to submit at parliament
• To rise national income by tax and other means
• To distribute resource and expenditure management
• To establish foreign policy and relationship
• To establish regulatory mechanism
• Personnel Appointment for public affairs
Parliament and supreme court balance the
function of council of minister.
System of executive
Parliamentary system:
1. head of govt and head of state – different, In same
person in both institution –rarely.
2. England- King and Nepal- president, Pri-Minister-
head of GOVT but president - ceremonial , GOVT
responsible for parliament.
3. Pri-Minister - dismiss parliament
In Nepal
Under the Constitution, executive power is vested in a
Council of Ministers headed by a Prime Minister.
The Prime Minister and other members of the Council
of Ministers are chosen through a ‘political consensus’
among the main political parties, failing which a leader
commanding majority support in parliament is
appointed as the Prime Minister.
The Prime Minister and the Council of Ministers are
collectively responsible to Parliament while individual
ministers are responsible to both Parliament and the
Prime Minister.
Power and Functions of the
Executive
The function of executive is increasing day by
day in this modern age.
There is a lot of work that the executive has to
perform. It is the duty of the executive to
maintain law and order in the country.
Executive has to fulfil the basic needs of the
people like food, shelter, clothing, education and
health services.
The following are the major
functions of the executive:
• To run the administration of the country efficiently and provide basic
service to the people.
• Executive makes important appointments and transfers, and controls and
supervises all civil and military departments and their subordinates.
• To maintain law and order and protect the country from foreign invasion.
• To impose taxes and run various development works.
• To sign treaties and make good diplomatic relations, depute ambassadors to
foreign countries.
• To present the budget in the parliament and operate it after the approval of
the parliament.
• To summon, adjourn or postpone the session of the parliament.
• To table the draft bill in the parliament for appropriate laws.
Presidency system
1. Executive function by president
2. Directly elected president
3. Different – parliament and president
4. No member of parliament in council of minister
5. Appointment by president in vital post of public affair however
parliament approve these post with person.
6. Power with president (pocket veto)
7. Budget and law approved by parliament so there should be
coordination among them.
Mixed system
• Adopted sustainable and strengthened system found in
presidency model
• Adopted democratic and responsible characteristics system
found in parliamentary model France, Srilanka etc.
• President-direct
• Pri-minister by parliament
• Same party - Pri-mister and president or different
• Some time dispute in power sharing
Power sharing system
• Government is made on the basis of member
of parliament or percent of vote received by
party
Example Africa – national congress + National
party+ Inkatha = National government led by
Nelson Mandela.
Executive Aspects of health
Approved Act, regulation, policy and directive are implemented by
executive body of government. Main executive body of government
is Ministry of council headed by Pri-minister . Existing power of
ministry of council are delegated to concerning minister for
execution of Act, regulation, policy etc.
Some example the main role of MoHP is to deliver quality of health
services up to the rural level by mobilizing the governmental and
non governmental organization.
For the delivery of health services MoHP have to accomplish following
task
• Preparation of organo- gram from centre to district level
• Identify level and types of services on basis of approved act,
regulation and policy
• Recruit personnel on the basis of health Act and regulation as well
as public service commission
• Deputed on JOB
• Performance appraisal
• Carrier development
• Arrange training seminar from concerning
organization
• Transfer
• Retirement
• Carrot and stick
• Right person in right place
• PME
• Some level upgrading takes place by performance appraisal
and promotion by public commission
• Promotion takes place by free competition, internal
competition
• After 20 years health personnel can get pension (half of basic
salaries)
• All provision like recruitments, promotion, leave, job security,
penalty etc. are already mentioned in Act and regulation.
• The court decide on the basis of written act and regulation.
However there is no separate procurement act for health
services.
• Department of health service and District public health office have to
follow same procurement act as others sectors.
• Health sector has demanded separate Act and regulation in procurement .
Health politics
Health politics
Health politics
Unit 7. Political issues in Health
Political pressure, propaganda and public health
Pressure by
• Different sister organization of parties . Youth Force, YCL etc
• Self help groups
• Informal organization
• Civil society
Propaganda on
• Disaster
• Epidemic
• Voting
• Emergency services
• Medicine supply
• Available of human resources
• Death report
• Essential commodities Eg vaccine , vit A, Iron
• Free health services
Graham's hierarchy of disagreement
Basic types
Black: Propaganda that purports to emanate
from a source other than the true one.
Grey: Grey Propaganda is a type
of propaganda where the correct source of the
information is never directly credited and the
sponsor’s identity is concealed.
White: White propaganda is propaganda that
does not hide its origin or nature.
Public Health Mandates of political parties
• Introduce of new vaccine ?
• Introduce of new program ?
• Change of health policy
• Reforms and restructuring
• Health insurance ; voluntary or social
• Health service : Gon responsibility or social
marketing
• Federal or central GOV.
Political instability, war and their effect on health
public and health service system
• Health staffs retention –low
• Brain drain
• Low service utilization
• Low quality of health services
• High cost
• Low community participation
• Low social mobilization
• Increased morbidity and mortality rate
Issues of Health politics
• Political party’s manifesto and implementation
• Influence of neighboring country
• Severity between capitalistic countries and socialistic countries
• Destructive critic instead of Constructive critic
• Donor driven health program
• capacity building
• Globalization
• Equity ; uneven access to political resources
• Budget allocation to health
• Political culture
• Driving and restraining forces exist in community
• Diverse people and ideas
• Decision making
Challenges at implementation phase
• At the implementation phase the various obstacles does occur
that disturb the service are, Political challenges -political
propaganda, quality of political decision
• Security challenges-political instability, civil war,
• Social challenges- fooding, shelter, social norm
• Judicial challenges- low feasibility of Act, unavailable of
proper Act
• Environment challenges- pollution
• Religious & ethnic challenges- large ethnic group having
different value and norms
• Economical challenges- cost recovery problem
• Physical challenges-transportation, buildings
69
Structural adjustment program and their effect on
public health
• Policies to reform health care system
• Introduction private funding instruments
• Decentralization of health finance
• Reform of management structures
• Reforms of human resources
• Promoting cost effectiveness of the delivery system
Introduction
• International Monetary Fund (IMF or Fund)
• Structural Adjustment Programs (SAPs)
• The IMF and Health Spending
• In Focus: IMF Programs and Health Spending
in Low-Income Countries
International Monetary Fund
• IOs, global economic governance, and the IMF
• History and mandate
– Technical support
– Lending (‘lender of last resort’)
– 1980s and late-2000s lending boom
• Influence and legacy
– Fund programs (SAPs)
– ‘Conditionality’
Structural Adjustment
• Evolution of conditionality
– Core competencies
– Extension to non-core
– Country ownership and poverty reduction
• Controversial conditions
– Devaluation
– Trade liberalisation
– Fiscal discipline
– Consumption taxes
– Privatisation
Structural Adjustment
• Some general criticisms of Fund programs
– Poor track record
– ‘One size fits all’
– ‘Mission creep’
– Micro-management (e.g. size of bread loaf)
– ‘Loose coupling’ of discourse and practice
– Agents of neoliberalism and/or neoimperialism
IMF Programs and Health Spending
Core claims by critics IMF response (Gupta, 2010)
1. Health spending has decreased in
countries with IMF-supported programs
1. Previous analyses of Fund-supported
programs have already shown this claim to
be untrue
2. Countries are forced to decrease health
spending to meet rigid fiscal deficit
conditions
2. IMF-supported programs have been
very flexible by accommodating larger
fiscal deficits and continuing to protect
priority social expenditures
3. Conditions on wage ceilings imposed in
program countries prevent desirable
increases in health spending
3. There is no conditionality that limits
health spending in Fund-supported
programs
4. Increased aid intended for the health
sector has been diverted to repay domestic
debt or increase reserves
4. When faced with volatile sources of
finance, governments often attempt to
maintain a stable flow of social
expenditures by smoothing the use of
available financing.
Unit 8: Health Law and Act
Concept about judicial health
Structure and level of judicial body
Importance of health jurisprudence and law in public health aspects
Brief about law, Body of monitoring of law
Brief discussion about the Health service Act 2053, Local governance and
decentralization Act
Brief account of Act and Law related to
• - Health behavior modification through legal measures and challenges
• - Control of contra health products
• - Control of health hazards through health laws and regulation
• - Legal protection against the threats to physical
• - Mental and social health of public
• - Health law and preventive public health
• - Epidemics and health laws
Implementation strategy of health law for providing of social justice and challenges
Gofokflnsf
• sfg'gsf] ;jf]{Rrtf
• sfg'gsf] zf;g
• Jfbljjfbsf] km};nf
UN Declaration ( 13 dec,1985and 25nov 1985)
Principle for independent judiciary function
• Constitution as a main regulatory document for state
or country
• Evidence based impartial decision
• Supreme court should be capable to define their
owned role and responsibility by doing appropriate
decision at time
• Judiciary decision change –from high court
• Working procedure and salary of Judge should be
mentioned by law
Judicial Aspects of health
Executive body should have implemented Act, regulation, policy .
If not implemented properly, supreme court can rise the
question to executive body of government. Supreme court can
ask the questions, punish, dismiss etc.
Challenges in implementation strategy
Health Service Act 2053 is isolated from the other civil service
Act since 2054.2.14 So, Health service Act and regulation has
following characteristics
There is level system ( second level to twelve level ) of health
personnel who are working from sub health post to Ministry of
health and population
Health law
• Constitution, Health Act 2053, Regulation2055, health policy
1991 and revised health policy 2015, 2019
• Implementation to the MOHP and below concerning to health
workers.
• Strategy : To provide 24 hrs. health services to the people.
• Challenge : inadequate health workers, lack of social
responsible, untrained, lack of infrastructure, legal issues in
regulation personnel , regulation of health facilities
• Control of contra health product by self government Act 1999.
• Health behavior modification by carrot and stick
• Control of health hazards government Act and
regulation
• Legislation to mental illness
• Legislation on abortion
• Legislative approaches health prevention and
promotion
• Legislation to change smoking behaviour
• Tax and price policies
• Restricting smoking in public places
• Restricting smoking in public work place
• Mandating health education
Judicial aspect of health at the international
level
• The formally development of medical jurisprudence
at international from the establishment of UN and
WHO.
• The several conventions, seminar before the
establishment of WHO, play vital role for the
development of legal medicine etc.
• The principle and rule of the various conference and
organization keep the right of international
development of judicial aspect of health.
82
Judicial aspect of health at the
international level.......
• First international sanitary conference 1851
• Pan American sanitary bureau 1902
• Office international D ‘hygiene Poblique 1907
• The health organization of the league of Nations 1923
• The United Nation relief and rehabilitation
administration 1943
• WHO 1945
83
Implementation strategies of health Act, regulation and laws
84
Brief discussion about the Health service Act 2053,
Local governance and decentralization Act
Nepal medical council Act 2020: The person who pass the bachelor
level of medical science from the recognizes university called
doctors who should be associated with medical service.
Nepal health professional council Act 2053 (Public health, HA, CMA
etc): The person who passes the Intermediate, bachelor, master and
doctorate degree level of professional medical science from
recognizes university called health professional that should be
associated with health service provider.
85
Why Health Service Act in Nepal?
• Health service is different then other service it
is directly linked with the life of people.
• Health service required to people any time (24
hours)
• Health service is a emergency services
Objective of health service act of
Nepal
1. To fulfill the vacant post of health services
2. To Motivate employee of health service
3. To establish code of conduct and disciplinary
action of HRH
4. Provision of gratuity, pension for employee
after retirement
Amendments of Health Service Act of
Nepal
1. Nepal Health Service (1st Amendment) Act, 2055:
2055/10/27 (10th Feburary1999)
2. Health Related Some Nepal Acts Amendment Act, 2058 :
2058/5/6 (22nd August 2001)
3. Nepal Health Service (2nd Amendment) Act, 2058: 2058/7/22
(7th November 2001)
4. Nepal Health Service (3rd Amendment) Act, 2063: 2063/8/22
(8th December 2006)
5. Republic Strengthening and Some Nepal Laws Amendment
Act, 2066: 2066/10/7 (21st Jan 2010)
6. Nepal Health Service (4th Amendment) Act, 2070: 2070/12/12
(26th March 2014)
Chapter of health service act 2053
There are 11 chapter of health service act of Nepal:-
Chapter 1 Preliminary
Chapter 2 Constitution of health service (स्वास ्््य सेवा को गठन)
Chapter 3 Fulfillment of vacancy of health service
Chapter 4 Transfer, deputation (काज) and promotion
Chapter 5 Provisions relating to nomination for study and training
Chapter 6 Salary, allowance, festival expenses and other facilities
Chapter 7 Retirement, gratuity and pension
Chapter 8 Conduct (आचरण)
Chapter 9 Service security
Chapter 10 Punishment and appeal (सजाय र पुनरावेदन)
Chapter 11 Miscellaneous
I. Professional (MOH)
1. Nepal medical council act 2020
2. Nepal health professional council act 2053
3. Nepal nursing council act 2052
4. Nepal pharmacy council act 2057
5. Nepal ayurvedic council act 2045
90
Brief account of Act and Law related to health
II. Research/Service/Health manpower
production
1. Nepal health research council act 2047
2. BP Koirala institute of health science act 2049
3. BP Koirala memorial cancer hospital act 2053
4. Martyr Gangalal national heart centre act 2057
91
III. Administration
1. Nepal health service act 2053
2. Drugs act 2035
IV. Curative
1. Human organ transplantation act 2055
2. Drug act 2035
92
V. Protection
1. Environmental protection act 2053
2. Pesticides act 2048
VI. Consumer protection
1. Consumer protection act
2. Compensations for torture act 2053
3. Civil code 1963/64
4. Jail act
93
VII. Food
1. Food act 2023
2. Vehicular and transport act 2049
VIII.Welfare
1. The constitution act 1990
2. The labour act 1992
3. The child right act 1992
4. Disabled protection and welfare act 2039
94
IX. Epidemic and disaster
1. Infectious disease act 2020
2. Natural disaster act 2039
X. Manpower production
1. Universities' Acts
2. CTEVT
95
XI. Controlling
1. Police act 2012
2. Public offence and punishment act 2027
3. Black marketing and other social offence act
4. Drug abuse control act 2053
96
XII. Health behaviour modification through
legal measures
1. Ilaz Garne Ko or on medical practice I Muluki Ain
– The civil code (Muluki Ain 1963)
– The civil code (Muluki Ain 1976)
2. Some public offence and punishment act, 2027 BS
3. Black marketing and other social offences act 2032
BS
4. Drug abuse control act, 2033 BS
97
XIII.Health behaviour modification
through legal measures …
3. Drug act, 2035 BS
4. Consumer protection act, 2054 BS
5. Human organ transplantation act, 2055 BS
6. Food act, 2033 BS
98
XIV.Control of health hazard through
health laws and regulations
1. Black marketing and other social offences act,
2032 BS
2. Drug abuse control act, 2033 BS
3. Pesticides act
4. Breast milk substitutes (Marketing control) act
2049 BS.
5. Environmental protection act, 2053 BS
6. Animal slaughter house and meat examinations
act, 2044 BS
99
• Law and regulation prohibit conduct that is injurious to health
of individual and community.
• Health legislation authorizes program and services that
promote health of individual and communities
• Legislation regulates the production of resources for health
care
• Legislation provides for the social financing of health care
• Legislation authorizes surveillance over the quality of health
care
• Regulation food and drugs
• Licensure of health personnel
Implementation strategy of health law for providing of
social justice and challenges
Legal Protection against threat to physical,
mental and social health of public
• Insurance by GOV
• Voluntary insurance
• Consumer act 2054
• Service provider act in process
• Handicap pension
• Free treatment after injury during official
work.
Legal provision for health services
• Leave is facilities not right
• Civil servant are under government (24 hour)
• There is no one month barrier for deputation
during epidemic
• Upgrading and carrier development who work
in remote district
• Authority delegation to sub -ordinate
Control of health hazards through
health law and regulation
• Mention duty hour in the regulation
• EIA ( environment Impact assessment )
• Factory act 1991
• Point out lead jacket, apron, gloves etc
• Mention of delivery (Husband and wife) and other leave
• Health Insurance
• Smoking free zone declared
• Pre-placement medical checkup
• Medical treatment facilities
• Consumer act 2054
• service provider act in process
• Identified job description of different level of health worker
including nurses
• Level of health services and degree of
personnel identified
• Standard of drinking water
• Housing standard identified
• Access of health services
• Long term, midterm and short-term plan
prepared.

More Related Content

What's hot

National health policy, Pakistan National Health Policy 2009
National health policy, Pakistan National Health Policy 2009National health policy, Pakistan National Health Policy 2009
National health policy, Pakistan National Health Policy 2009Waseem Sajjad
 
Sector wide approaches (SWAps) in health
Sector wide approaches (SWAps) in healthSector wide approaches (SWAps) in health
Sector wide approaches (SWAps) in healthHari Krishna Bhattarai
 
National Health Policy (Nepal)
National Health Policy (Nepal)National Health Policy (Nepal)
National Health Policy (Nepal)SwikritiKoirala3
 
introduction-to-health-policy
introduction-to-health-policyintroduction-to-health-policy
introduction-to-health-policyNayyar Kazmi
 
Public health ethics
Public health ethicsPublic health ethics
Public health ethicsAshok Pandey
 
Health policy Pakistan
Health policy PakistanHealth policy Pakistan
Health policy PakistanDr Athar Khan
 
New Organogram of Nepalese Health System (Please check the updated slides on ...
New Organogram of Nepalese Health System (Please check the updated slides on ...New Organogram of Nepalese Health System (Please check the updated slides on ...
New Organogram of Nepalese Health System (Please check the updated slides on ...Prabesh Ghimire
 
Public Policy and Health Policy
Public Policy and Health PolicyPublic Policy and Health Policy
Public Policy and Health PolicyPrabesh Ghimire
 
Research Review on HRH of Nepal
Research Review on HRH of NepalResearch Review on HRH of Nepal
Research Review on HRH of NepalBasanta Chalise
 
Health policy and planning
Health policy and planning Health policy and planning
Health policy and planning Rizwan S A
 
Critics of national health policy 1991
Critics of national health policy 1991Critics of national health policy 1991
Critics of national health policy 1991RAVIKANTAMISHRA
 
Policy related to occupational health in Nepal
Policy related to occupational health in Nepal Policy related to occupational health in Nepal
Policy related to occupational health in Nepal Public Health Update
 
Sustained development goal and nepal
Sustained development goal  and nepalSustained development goal  and nepal
Sustained development goal and nepalz2jeetendra
 
Organogram/ Organization Structure of Nepalese Health System (Updated- Nov 2021)
Organogram/ Organization Structure of Nepalese Health System (Updated- Nov 2021)Organogram/ Organization Structure of Nepalese Health System (Updated- Nov 2021)
Organogram/ Organization Structure of Nepalese Health System (Updated- Nov 2021)Prabesh Ghimire
 
National Health Policy and Plan
National Health Policy and PlanNational Health Policy and Plan
National Health Policy and Planlal bahadur Kunwar
 

What's hot (20)

National health policy, Pakistan National Health Policy 2009
National health policy, Pakistan National Health Policy 2009National health policy, Pakistan National Health Policy 2009
National health policy, Pakistan National Health Policy 2009
 
Sector wide approaches (SWAps) in health
Sector wide approaches (SWAps) in healthSector wide approaches (SWAps) in health
Sector wide approaches (SWAps) in health
 
National Health Policy (Nepal)
National Health Policy (Nepal)National Health Policy (Nepal)
National Health Policy (Nepal)
 
introduction-to-health-policy
introduction-to-health-policyintroduction-to-health-policy
introduction-to-health-policy
 
Public health ethics
Public health ethicsPublic health ethics
Public health ethics
 
Health policy Pakistan
Health policy PakistanHealth policy Pakistan
Health policy Pakistan
 
National health policy 1991
National health policy 1991National health policy 1991
National health policy 1991
 
New Organogram of Nepalese Health System (Please check the updated slides on ...
New Organogram of Nepalese Health System (Please check the updated slides on ...New Organogram of Nepalese Health System (Please check the updated slides on ...
New Organogram of Nepalese Health System (Please check the updated slides on ...
 
Public Policy and Health Policy
Public Policy and Health PolicyPublic Policy and Health Policy
Public Policy and Health Policy
 
Research Review on HRH of Nepal
Research Review on HRH of NepalResearch Review on HRH of Nepal
Research Review on HRH of Nepal
 
Health policy and planning
Health policy and planning Health policy and planning
Health policy and planning
 
Health policies
Health policiesHealth policies
Health policies
 
Health system of nepal
Health system of nepalHealth system of nepal
Health system of nepal
 
Critics of national health policy 1991
Critics of national health policy 1991Critics of national health policy 1991
Critics of national health policy 1991
 
Health System of Nepal
Health System of NepalHealth System of Nepal
Health System of Nepal
 
International health
International healthInternational health
International health
 
Policy related to occupational health in Nepal
Policy related to occupational health in Nepal Policy related to occupational health in Nepal
Policy related to occupational health in Nepal
 
Sustained development goal and nepal
Sustained development goal  and nepalSustained development goal  and nepal
Sustained development goal and nepal
 
Organogram/ Organization Structure of Nepalese Health System (Updated- Nov 2021)
Organogram/ Organization Structure of Nepalese Health System (Updated- Nov 2021)Organogram/ Organization Structure of Nepalese Health System (Updated- Nov 2021)
Organogram/ Organization Structure of Nepalese Health System (Updated- Nov 2021)
 
National Health Policy and Plan
National Health Policy and PlanNational Health Policy and Plan
National Health Policy and Plan
 

Similar to Health politics

Chapter 2Policy and the Policymaking Process.docx
Chapter 2Policy and the Policymaking Process.docxChapter 2Policy and the Policymaking Process.docx
Chapter 2Policy and the Policymaking Process.docxwalterl4
 
Health 2020 Achieving health and development in today's Europe
Health 2020 Achieving health and development in today's EuropeHealth 2020 Achieving health and development in today's Europe
Health 2020 Achieving health and development in today's EuropeWHO Regional Office for Europe
 
Social determinants & Global Health
Social determinants & Global HealthSocial determinants & Global Health
Social determinants & Global HealthJoyce Browne
 
1-A-Define the health system and describe the functions and elements of healt...
1-A-Define the health system and describe the functions and elements of healt...1-A-Define the health system and describe the functions and elements of healt...
1-A-Define the health system and describe the functions and elements of healt...NeerajOjha17
 
Health systems strengthening 19 jan mph
Health systems strengthening 19 jan mphHealth systems strengthening 19 jan mph
Health systems strengthening 19 jan mphThurein Naywinaung
 
LECTURE 3-ALMATA.pptx
LECTURE 3-ALMATA.pptxLECTURE 3-ALMATA.pptx
LECTURE 3-ALMATA.pptxAYONELSON
 
International nurses day 2019
International nurses day 2019International nurses day 2019
International nurses day 2019subhasarada1977
 
Introduction to community health by Imran Ahmed Abdulkadir BSPH, MSc. PTH
Introduction to community health by Imran Ahmed Abdulkadir  BSPH, MSc. PTHIntroduction to community health by Imran Ahmed Abdulkadir  BSPH, MSc. PTH
Introduction to community health by Imran Ahmed Abdulkadir BSPH, MSc. PTHAbdiwali Abdullahi Abdiwali
 
Public health introduction.ppt
Public health introduction.pptPublic health introduction.ppt
Public health introduction.pptssuser59bb22
 
Health system development & National health policy
Health system development & National health policyHealth system development & National health policy
Health system development & National health policyAccra School of Hygiene
 
Health care system germany
Health care system germanyHealth care system germany
Health care system germanydeepak belbase
 
Unit 7 Primary Health Care.pptx
Unit 7 Primary Health Care.pptxUnit 7 Primary Health Care.pptx
Unit 7 Primary Health Care.pptxGraceT12
 
Universal health coverage concept and vision for india
Universal health coverage   concept and vision for indiaUniversal health coverage   concept and vision for india
Universal health coverage concept and vision for indiaVikash Keshri
 

Similar to Health politics (20)

Chapter 2Policy and the Policymaking Process.docx
Chapter 2Policy and the Policymaking Process.docxChapter 2Policy and the Policymaking Process.docx
Chapter 2Policy and the Policymaking Process.docx
 
Health 2020 Achieving health and development in today's Europe
Health 2020 Achieving health and development in today's EuropeHealth 2020 Achieving health and development in today's Europe
Health 2020 Achieving health and development in today's Europe
 
Charles Hongoro, Human Sciences Research Council, South Africa
Charles Hongoro, Human Sciences Research Council, South AfricaCharles Hongoro, Human Sciences Research Council, South Africa
Charles Hongoro, Human Sciences Research Council, South Africa
 
Social determinants & Global Health
Social determinants & Global HealthSocial determinants & Global Health
Social determinants & Global Health
 
Policy Framework.pptx
Policy Framework.pptxPolicy Framework.pptx
Policy Framework.pptx
 
Health care
Health careHealth care
Health care
 
1-A-Define the health system and describe the functions and elements of healt...
1-A-Define the health system and describe the functions and elements of healt...1-A-Define the health system and describe the functions and elements of healt...
1-A-Define the health system and describe the functions and elements of healt...
 
Public health
Public healthPublic health
Public health
 
Health systems strengthening 19 jan mph
Health systems strengthening 19 jan mphHealth systems strengthening 19 jan mph
Health systems strengthening 19 jan mph
 
APPA555
APPA555APPA555
APPA555
 
PH_PHC.pptx
PH_PHC.pptxPH_PHC.pptx
PH_PHC.pptx
 
LECTURE 3-ALMATA.pptx
LECTURE 3-ALMATA.pptxLECTURE 3-ALMATA.pptx
LECTURE 3-ALMATA.pptx
 
Social determinants of health
Social determinants of healthSocial determinants of health
Social determinants of health
 
International nurses day 2019
International nurses day 2019International nurses day 2019
International nurses day 2019
 
Introduction to community health by Imran Ahmed Abdulkadir BSPH, MSc. PTH
Introduction to community health by Imran Ahmed Abdulkadir  BSPH, MSc. PTHIntroduction to community health by Imran Ahmed Abdulkadir  BSPH, MSc. PTH
Introduction to community health by Imran Ahmed Abdulkadir BSPH, MSc. PTH
 
Public health introduction.ppt
Public health introduction.pptPublic health introduction.ppt
Public health introduction.ppt
 
Health system development & National health policy
Health system development & National health policyHealth system development & National health policy
Health system development & National health policy
 
Health care system germany
Health care system germanyHealth care system germany
Health care system germany
 
Unit 7 Primary Health Care.pptx
Unit 7 Primary Health Care.pptxUnit 7 Primary Health Care.pptx
Unit 7 Primary Health Care.pptx
 
Universal health coverage concept and vision for india
Universal health coverage   concept and vision for indiaUniversal health coverage   concept and vision for india
Universal health coverage concept and vision for india
 

More from Ashok Pandey

Overview of strategies of public health services in a typical.pptx
Overview of strategies of public health services in a typical.pptxOverview of strategies of public health services in a typical.pptx
Overview of strategies of public health services in a typical.pptxAshok Pandey
 
Internationalhealth.ppt
Internationalhealth.pptInternationalhealth.ppt
Internationalhealth.pptAshok Pandey
 
A review of GLOBALIZATION, A Very Short Introduction by Manfred B. Steger
A review of GLOBALIZATION, A Very Short Introduction by Manfred B. StegerA review of GLOBALIZATION, A Very Short Introduction by Manfred B. Steger
A review of GLOBALIZATION, A Very Short Introduction by Manfred B. StegerAshok Pandey
 
Advocacy (वकलात).pptx
Advocacy (वकलात).pptxAdvocacy (वकलात).pptx
Advocacy (वकलात).pptxAshok Pandey
 
Research Hypothesis and Variables
Research Hypothesis and VariablesResearch Hypothesis and Variables
Research Hypothesis and VariablesAshok Pandey
 
National Conference on Comprehensive Sexuality Education 24 – 25 May 2023, Ka...
National Conference on Comprehensive Sexuality Education 24 – 25 May 2023, Ka...National Conference on Comprehensive Sexuality Education 24 – 25 May 2023, Ka...
National Conference on Comprehensive Sexuality Education 24 – 25 May 2023, Ka...Ashok Pandey
 
Finalizing and Reviewing the Health Research Proposal_Ashok.pptx
Finalizing and Reviewing the Health Research Proposal_Ashok.pptxFinalizing and Reviewing the Health Research Proposal_Ashok.pptx
Finalizing and Reviewing the Health Research Proposal_Ashok.pptxAshok Pandey
 
Ashok_Health_Status_of_Arghakhanchi_Ashok.pptx
Ashok_Health_Status_of_Arghakhanchi_Ashok.pptxAshok_Health_Status_of_Arghakhanchi_Ashok.pptx
Ashok_Health_Status_of_Arghakhanchi_Ashok.pptxAshok Pandey
 
Perspectives of Cannabis
Perspectives of CannabisPerspectives of Cannabis
Perspectives of CannabisAshok Pandey
 
Research Idea Generation and Research Question Formulation.ppt
Research Idea Generation and Research Question Formulation.pptResearch Idea Generation and Research Question Formulation.ppt
Research Idea Generation and Research Question Formulation.pptAshok Pandey
 
Overview of strategies of public health services in a typical rural and urban...
Overview of strategies of public health services in a typical rural and urban...Overview of strategies of public health services in a typical rural and urban...
Overview of strategies of public health services in a typical rural and urban...Ashok Pandey
 
Rural health (Public health)
Rural health (Public health)Rural health (Public health)
Rural health (Public health)Ashok Pandey
 
Project management
Project managementProject management
Project managementAshok Pandey
 
समुदाय मैत्री कानुनी सेवा: सन्दर्भ र सम्भावना (Community Lawyering: Context &...
समुदाय मैत्री कानुनी सेवा: सन्दर्भ र सम्भावना (Community Lawyering: Context &...समुदाय मैत्री कानुनी सेवा: सन्दर्भ र सम्भावना (Community Lawyering: Context &...
समुदाय मैत्री कानुनी सेवा: सन्दर्भ र सम्भावना (Community Lawyering: Context &...Ashok Pandey
 
Public Opinion and Compliance Survey on Tobacco Control and Legislations in N...
Public Opinion and Compliance Survey on Tobacco Control and Legislations in N...Public Opinion and Compliance Survey on Tobacco Control and Legislations in N...
Public Opinion and Compliance Survey on Tobacco Control and Legislations in N...Ashok Pandey
 
Spss and software Application
Spss and software ApplicationSpss and software Application
Spss and software ApplicationAshok Pandey
 
Research types designs
Research types designs Research types designs
Research types designs Ashok Pandey
 

More from Ashok Pandey (20)

Sampling
SamplingSampling
Sampling
 
Overview of strategies of public health services in a typical.pptx
Overview of strategies of public health services in a typical.pptxOverview of strategies of public health services in a typical.pptx
Overview of strategies of public health services in a typical.pptx
 
Internationalhealth.ppt
Internationalhealth.pptInternationalhealth.ppt
Internationalhealth.ppt
 
A review of GLOBALIZATION, A Very Short Introduction by Manfred B. Steger
A review of GLOBALIZATION, A Very Short Introduction by Manfred B. StegerA review of GLOBALIZATION, A Very Short Introduction by Manfred B. Steger
A review of GLOBALIZATION, A Very Short Introduction by Manfred B. Steger
 
Advocacy (वकलात).pptx
Advocacy (वकलात).pptxAdvocacy (वकलात).pptx
Advocacy (वकलात).pptx
 
Dengue Awareness
Dengue AwarenessDengue Awareness
Dengue Awareness
 
Research Hypothesis and Variables
Research Hypothesis and VariablesResearch Hypothesis and Variables
Research Hypothesis and Variables
 
National Conference on Comprehensive Sexuality Education 24 – 25 May 2023, Ka...
National Conference on Comprehensive Sexuality Education 24 – 25 May 2023, Ka...National Conference on Comprehensive Sexuality Education 24 – 25 May 2023, Ka...
National Conference on Comprehensive Sexuality Education 24 – 25 May 2023, Ka...
 
Finalizing and Reviewing the Health Research Proposal_Ashok.pptx
Finalizing and Reviewing the Health Research Proposal_Ashok.pptxFinalizing and Reviewing the Health Research Proposal_Ashok.pptx
Finalizing and Reviewing the Health Research Proposal_Ashok.pptx
 
Ashok_Health_Status_of_Arghakhanchi_Ashok.pptx
Ashok_Health_Status_of_Arghakhanchi_Ashok.pptxAshok_Health_Status_of_Arghakhanchi_Ashok.pptx
Ashok_Health_Status_of_Arghakhanchi_Ashok.pptx
 
Perspectives of Cannabis
Perspectives of CannabisPerspectives of Cannabis
Perspectives of Cannabis
 
Research Idea Generation and Research Question Formulation.ppt
Research Idea Generation and Research Question Formulation.pptResearch Idea Generation and Research Question Formulation.ppt
Research Idea Generation and Research Question Formulation.ppt
 
Overview of strategies of public health services in a typical rural and urban...
Overview of strategies of public health services in a typical rural and urban...Overview of strategies of public health services in a typical rural and urban...
Overview of strategies of public health services in a typical rural and urban...
 
Rural health (Public health)
Rural health (Public health)Rural health (Public health)
Rural health (Public health)
 
Project management
Project managementProject management
Project management
 
समुदाय मैत्री कानुनी सेवा: सन्दर्भ र सम्भावना (Community Lawyering: Context &...
समुदाय मैत्री कानुनी सेवा: सन्दर्भ र सम्भावना (Community Lawyering: Context &...समुदाय मैत्री कानुनी सेवा: सन्दर्भ र सम्भावना (Community Lawyering: Context &...
समुदाय मैत्री कानुनी सेवा: सन्दर्भ र सम्भावना (Community Lawyering: Context &...
 
Public Opinion and Compliance Survey on Tobacco Control and Legislations in N...
Public Opinion and Compliance Survey on Tobacco Control and Legislations in N...Public Opinion and Compliance Survey on Tobacco Control and Legislations in N...
Public Opinion and Compliance Survey on Tobacco Control and Legislations in N...
 
Spss and software
Spss and softwareSpss and software
Spss and software
 
Spss and software Application
Spss and software ApplicationSpss and software Application
Spss and software Application
 
Research types designs
Research types designs Research types designs
Research types designs
 

Recently uploaded

A3 Thinking: A Structured Approach to Problem Solving
A3 Thinking: A Structured Approach to Problem SolvingA3 Thinking: A Structured Approach to Problem Solving
A3 Thinking: A Structured Approach to Problem SolvingCIToolkit
 
Analyzing and Monitoring Processes through Time Value Mapping
Analyzing and Monitoring Processes through Time Value MappingAnalyzing and Monitoring Processes through Time Value Mapping
Analyzing and Monitoring Processes through Time Value MappingCIToolkit
 
Value Stream Map: A Visual Approach to Process Optimization
Value Stream Map: A Visual Approach to Process OptimizationValue Stream Map: A Visual Approach to Process Optimization
Value Stream Map: A Visual Approach to Process OptimizationCIToolkit
 
Applying the PDCA Cycle: A Blueprint for Continuous Improvement
Applying the PDCA Cycle: A Blueprint for Continuous ImprovementApplying the PDCA Cycle: A Blueprint for Continuous Improvement
Applying the PDCA Cycle: A Blueprint for Continuous ImprovementCIToolkit
 
HR for Non HR_Learning and Development.
HR for Non HR_Learning  and Development.HR for Non HR_Learning  and Development.
HR for Non HR_Learning and Development.azischin
 
Performance Management Notes for MBA Students
Performance Management Notes for MBA StudentsPerformance Management Notes for MBA Students
Performance Management Notes for MBA StudentsManickam Gajapathy
 
Empowering Resilience & Strategic Growth: Insights for Emerging Leaders
Empowering Resilience & Strategic Growth: Insights for Emerging LeadersEmpowering Resilience & Strategic Growth: Insights for Emerging Leaders
Empowering Resilience & Strategic Growth: Insights for Emerging LeadersMahmoud Rabie
 
The Role of Fishbone Diagram in Analyzing Cause and Effect
The Role of Fishbone Diagram in Analyzing Cause and EffectThe Role of Fishbone Diagram in Analyzing Cause and Effect
The Role of Fishbone Diagram in Analyzing Cause and EffectCIToolkit
 
Making Sense of Multiple Ideas with Affinity Diagrams
Making Sense of Multiple Ideas with Affinity DiagramsMaking Sense of Multiple Ideas with Affinity Diagrams
Making Sense of Multiple Ideas with Affinity DiagramsCIToolkit
 
Improving Operations through Observation and Gemba Walks
Improving Operations through Observation and Gemba WalksImproving Operations through Observation and Gemba Walks
Improving Operations through Observation and Gemba WalksCIToolkit
 
Organizations in a Future with Generative AI
Organizations in a Future with Generative AIOrganizations in a Future with Generative AI
Organizations in a Future with Generative AIKye Andersson
 
Roadway to GDSC- Session 1 Powerpoint Presentation
Roadway to GDSC- Session 1 Powerpoint PresentationRoadway to GDSC- Session 1 Powerpoint Presentation
Roadway to GDSC- Session 1 Powerpoint Presentationgdscghrcem
 
ANIn Coimbatore March 2024 | Agile & AI in Project Management by Dhilipkumar ...
ANIn Coimbatore March 2024 | Agile & AI in Project Management by Dhilipkumar ...ANIn Coimbatore March 2024 | Agile & AI in Project Management by Dhilipkumar ...
ANIn Coimbatore March 2024 | Agile & AI in Project Management by Dhilipkumar ...AgileNetwork
 
From Command Line to Reporting Line: The Diary of a First-Time EM
From Command Line to Reporting Line: The Diary of a First-Time EMFrom Command Line to Reporting Line: The Diary of a First-Time EM
From Command Line to Reporting Line: The Diary of a First-Time EMGloria Chow
 
Forget Fiverr : Fractional Employment the ins and outs
Forget Fiverr : Fractional Employment the ins and outsForget Fiverr : Fractional Employment the ins and outs
Forget Fiverr : Fractional Employment the ins and outsStephan Koning
 
How the Heck do you Teach Level Design? Educating in the Studio
How the Heck do you Teach Level Design? Educating in the StudioHow the Heck do you Teach Level Design? Educating in the Studio
How the Heck do you Teach Level Design? Educating in the StudioChristopher Totten
 
An Important Step Toward Process Improvement
An Important Step Toward Process ImprovementAn Important Step Toward Process Improvement
An Important Step Toward Process ImprovementCIToolkit
 
Tackling Fake Agility w/ Johanna Rothman
Tackling Fake Agility w/ Johanna RothmanTackling Fake Agility w/ Johanna Rothman
Tackling Fake Agility w/ Johanna RothmanStefan Wolpers
 
Test_document_upload_SQL_minimum_fourteen
Test_document_upload_SQL_minimum_fourteenTest_document_upload_SQL_minimum_fourteen
Test_document_upload_SQL_minimum_fourteenolgaz9
 

Recently uploaded (20)

A3 Thinking: A Structured Approach to Problem Solving
A3 Thinking: A Structured Approach to Problem SolvingA3 Thinking: A Structured Approach to Problem Solving
A3 Thinking: A Structured Approach to Problem Solving
 
Analyzing and Monitoring Processes through Time Value Mapping
Analyzing and Monitoring Processes through Time Value MappingAnalyzing and Monitoring Processes through Time Value Mapping
Analyzing and Monitoring Processes through Time Value Mapping
 
Value Stream Map: A Visual Approach to Process Optimization
Value Stream Map: A Visual Approach to Process OptimizationValue Stream Map: A Visual Approach to Process Optimization
Value Stream Map: A Visual Approach to Process Optimization
 
Applying the PDCA Cycle: A Blueprint for Continuous Improvement
Applying the PDCA Cycle: A Blueprint for Continuous ImprovementApplying the PDCA Cycle: A Blueprint for Continuous Improvement
Applying the PDCA Cycle: A Blueprint for Continuous Improvement
 
HR for Non HR_Learning and Development.
HR for Non HR_Learning  and Development.HR for Non HR_Learning  and Development.
HR for Non HR_Learning and Development.
 
Performance Management Notes for MBA Students
Performance Management Notes for MBA StudentsPerformance Management Notes for MBA Students
Performance Management Notes for MBA Students
 
Empowering Resilience & Strategic Growth: Insights for Emerging Leaders
Empowering Resilience & Strategic Growth: Insights for Emerging LeadersEmpowering Resilience & Strategic Growth: Insights for Emerging Leaders
Empowering Resilience & Strategic Growth: Insights for Emerging Leaders
 
The Role of Fishbone Diagram in Analyzing Cause and Effect
The Role of Fishbone Diagram in Analyzing Cause and EffectThe Role of Fishbone Diagram in Analyzing Cause and Effect
The Role of Fishbone Diagram in Analyzing Cause and Effect
 
Making Sense of Multiple Ideas with Affinity Diagrams
Making Sense of Multiple Ideas with Affinity DiagramsMaking Sense of Multiple Ideas with Affinity Diagrams
Making Sense of Multiple Ideas with Affinity Diagrams
 
Improving Operations through Observation and Gemba Walks
Improving Operations through Observation and Gemba WalksImproving Operations through Observation and Gemba Walks
Improving Operations through Observation and Gemba Walks
 
Organizations in a Future with Generative AI
Organizations in a Future with Generative AIOrganizations in a Future with Generative AI
Organizations in a Future with Generative AI
 
Roadway to GDSC- Session 1 Powerpoint Presentation
Roadway to GDSC- Session 1 Powerpoint PresentationRoadway to GDSC- Session 1 Powerpoint Presentation
Roadway to GDSC- Session 1 Powerpoint Presentation
 
ANIn Coimbatore March 2024 | Agile & AI in Project Management by Dhilipkumar ...
ANIn Coimbatore March 2024 | Agile & AI in Project Management by Dhilipkumar ...ANIn Coimbatore March 2024 | Agile & AI in Project Management by Dhilipkumar ...
ANIn Coimbatore March 2024 | Agile & AI in Project Management by Dhilipkumar ...
 
Capacity2 - Briefing and Facilitation training slides
Capacity2 - Briefing and Facilitation training slidesCapacity2 - Briefing and Facilitation training slides
Capacity2 - Briefing and Facilitation training slides
 
From Command Line to Reporting Line: The Diary of a First-Time EM
From Command Line to Reporting Line: The Diary of a First-Time EMFrom Command Line to Reporting Line: The Diary of a First-Time EM
From Command Line to Reporting Line: The Diary of a First-Time EM
 
Forget Fiverr : Fractional Employment the ins and outs
Forget Fiverr : Fractional Employment the ins and outsForget Fiverr : Fractional Employment the ins and outs
Forget Fiverr : Fractional Employment the ins and outs
 
How the Heck do you Teach Level Design? Educating in the Studio
How the Heck do you Teach Level Design? Educating in the StudioHow the Heck do you Teach Level Design? Educating in the Studio
How the Heck do you Teach Level Design? Educating in the Studio
 
An Important Step Toward Process Improvement
An Important Step Toward Process ImprovementAn Important Step Toward Process Improvement
An Important Step Toward Process Improvement
 
Tackling Fake Agility w/ Johanna Rothman
Tackling Fake Agility w/ Johanna RothmanTackling Fake Agility w/ Johanna Rothman
Tackling Fake Agility w/ Johanna Rothman
 
Test_document_upload_SQL_minimum_fourteen
Test_document_upload_SQL_minimum_fourteenTest_document_upload_SQL_minimum_fourteen
Test_document_upload_SQL_minimum_fourteen
 

Health politics

  • 1. Health politics Ashok Pandey Associate Research Fellow Policy Research Institute
  • 2. Concept of Health politics What is health ? What is politics ? Is a means of political outlook or the science of government Science : branch of knowledge involving systematized observation and experiment. Government means :System by which a state is governed Government act on control, rules, command, management, administration etc Government should have citizens, territory , Rules and Sovereign Health politics means attainment highest level of wellbeing of all citizens by means affairs of state. • Highest level of wellbeing • means affairs of state.
  • 3. What is political system? Any collection of elements that interact in some way with one another can be considered with system: a galaxy, a football team, a legislature, a political party. In thinking about what a political system is, it is helpful to keep in mind several points that apply to any system. A system is a frame work with which an observers or analyst approaches or lens or perspective through which an observers or analyst choose to view, some reality such as politics . The political system of the United state of America includes Congress, The president, the supreme Court, political Party, interest groups, voters, new media and so forth.
  • 4. Health politics means attainment highest level of wellbeing of all citizens by means affairs of state. • highest level of wellbeing • means affairs of state. • State : political community under one government
  • 5. Health politics depends on • Country's Socialistic model • Country's well fare model • Country's Capitalistic model • International commitment and agreement
  • 6. Characteristics Socialistic model • Means of production • State Responsibility • Common Pool • Social justice and Equity • Citizens as assets
  • 7. Characteristics Well fare state • Basket fund • Social /Private health insurance • Community drugs programs • Citizens as a liability/assets • Act and regulation prepared by Governments E.g Health, Education free in UK, manage Family physician.
  • 8. Capitalistic model • Government prepare rules and regulation • Competitive markets • Quality control by GOVT • Citizens as liability • Various scheme to fulfill the people's needs • Denmark
  • 9. International Commitment and agreement • Bucharest conference 1974 well fare approach • CEDAW 1979 : concerning against woman's violence • Earth summit • Cairo conference 1994 • Beijing women's conference 1995
  • 10. Political aspects. • Slovakia, the former Communist country that shifted some state health care costs to individuals a few years ago to reduce its budget deficit, is rolling back some of those changes even as its neighbors start to address costs in their own health care systems. • Regional governments also are evaluating Slovakia's 2004 decision to open the health insurance market to for-profit companies. • East European policy makers and officials from nonprofit organizations focused on Slovakia's experience Wednesday at a gathering in Prague that is examining ways to reduce government spending on health care to cut budget deficits. • One obstacle is the risk of losing voter support, as Dzurinda did. Slovaks voted him out of office last year.
  • 11. • "The problem is to tell people why it is good for them, if they didn't pay in the past," he said. • The countries are trying to reduce their budget deficits in an effort to meet the requirements for adopting the euro, which would eliminate currency fluctuations and ease trade within the 27-country European Union. Slovakia may be able to convert to the euro as early as 2009 because its budget deficit and debts are under control, the Organization for Economic Cooperation and Development • Fico, while keeping most economic policies that improved Slovakia's finances, last year abolished almost all regulatory fees on medical services. Those charges included 20 koruny, or 81 U.S. cents, on prescriptions and doctor's visits, as well as 50 koruny per night in the hospital. • With those fees, the money the state spent on prescription drugs had fallen to 31.5 percent of the health care budget in 2005 from 36.3 percent in 2003, according to government data.
  • 12. • The Czech Republic wants its nine state-funded health insurance providers to convert to joint stock companies to make their accounting more transparent, said Lucie Antosova, an adviser at the health ministry. • "If they are in debt, we have to calculate it as public debt," Antosova said. That could hurt any attempt to adopt the euro, she said. • Hungary, which is trying to tackle the European Union's widest budget deficit, this year imposed fees on doctor's visits, slashed drug subsidies and ended a free drug program. The state- monopoly health insurer, which had been in deficit since 1994, announced its first-ever quarterly surplus of 17 billion forint, or $94 million. The health ministry is arguing for opening the market to private insurers. • Last week, the Czech Health Ministry proposed charging patients 30 koruny for outpatient visits and prescriptions, 60 koruny for a day in a hospital and 90 koruny for emergency services.
  • 13. Politics means 1. Relationships involving powers rule, or authority ‘ lasswel” 2. Relationships involving territoriality 3. Relationships in associations capable of self sufficiency 1 and 2 ; weber 1, 2 and 3 by Aristotle Politics is simply the exercise of influences
  • 14. Why individual participate in politics • Value the reward to be gained • Think the alternative are important • Are confident that they can help to change the outcome • Believe the outcome will be unsatisfactory if they do not act • Have knowledge or skill that bears on questions at hand • Most overcome fewer obstacle to act • Are mobilized by others to participate
  • 16. Relationship between health and politics Health Politics Ends Means State of physical.... Constitution, Vision, mission Policy, strategy Plan
  • 17. • For Health Professional : Health ends • But Politician : Health means ? • But Politician: Power ends or over all development
  • 18. World trend of health politics It is difficult to define trend of world health politics. Because they are not going onward in same pace and line, some times they are changing their path dramatically eg USSR Demography cycle First stage high stationery Second Stage : early expanding : High priority FP, .................. Fifth stage : Declining : High priority birth, attraction scheme to developing countries, Permanent resident from .... • Change of disease pattern ; communicable disease to non communicable disease • Service demand by people ; quality of services, abortion care
  • 19. Trends of health politics • Welfare approach: Health facilities was provided to women • Right based approach : right to get Health services • Equity : justice • Equality: equal opportunity
  • 20. Trends of health politics • The united nation conference on Human Right at Teheran in 1968 recognized family planning as a human right • Bucharest conference in 1974 endorsed same view as above ; all couples and individuals have basic human right to decide freely. • The world conference of the international women's year in 1975 also declared the right of women to decide freely • Cairo conference 1994 ; component of reproductive health • Beijing conference 1995. emphasis on equality, • Minimum health services to maximum people • Alma-Ata conference in 1978 : 134 country called revolutionary approach to health care • Health for all by the year 2000. • Millennium Development Goal • Users fee in health services • Abolition of user's fee
  • 21. • The majority of European nation have a national health scheme that is administered federally. • Developing countries tend to provide health services, although not a level of sophistication available in developed countries. • Voluntary health agencies have flourished in United state than Europe. • In the developing nation NGOs have played an even important role in promoting health are constrained from specific activities by political and economic limitation . • Gaps between the ‘haves ‘ and ‘have-nots’ • Socialized public health : social dimension of public health emerged • Health for all movement ; Health for all by the year 2000. • Primary Health care : restructuring of health system
  • 22. • Health system reforms • Eradication and elimination of disease Small pox eradicated and poliomyelitis under eradication and leprosy elimination • Globalization of public health: Globalization has been a phenomenon that is characteristics by world wide interdependence in all aspects – economic, political , social and cultural
  • 23. New Philosophy of Health • Health is a fundamental health right • Health is the essence of productive life and not the of ever increasing expenditure on medical care • Health is an integral part of development • Health is inter sectoral • Health is central to the concept of quality of life • Health involves individuals, state and international responsibility • Health and its maintenance is major social investment • Health is world –wide social goal
  • 24. Dimension of health • Physical dimension – perfect functioning of the body • Mental dimension- State of harmony between oneself and others, e.g knowing or cognition • Social dimension – wellbeing of the whole person in the context of his social network. • Spiritual dimension –It is intangible "some thing "that transcends physiology and physiology. • Emotional dimension- relate to feeling • Vocational dimension – It is part of human existence . Work are source of satisfaction and enhanced selfsteem.
  • 25. Quality of life depend on • Physical quality of life index ( IMR, life expectancy at age one and literacy) PQLI measures social, economic and political policies • Human development index Longevity ( life expectancy at birth) knowledge ( adult literacy rate and mean years of schooling)and Income ( GDP per capita in purchasing power –parity dollar)
  • 27. Political perspective in Primary Health care • It is a comprehensive approaches for health for all It needs to be revitalized • It is a selective approaches so can not fulfill the people's health need Miscellaneous Highest unmet need of FP was found (37 %)among the adolescence ( both)
  • 28. "There is social and economic inequalities that lead to poverty, under nutrition and high child Mortality. As a result , in spite of global campaign for child survival, millions of children continue to die from the disease of poverty " by David werner and David Standers In 1892 USA did not accept cholera in their country so loose a lot of lives.
  • 29. What is Constitution ? /fHosf]Df'nsfg'gxf](Main regulation of state)
  • 30. Constitution • Execution function • Legislative function • Judiciary function Government by majority Respect to minority
  • 31. Constitution of Nepal 2004 (1948) • Judiciary function • High court • Parliamentary judiciary committee • Human right -symbolic
  • 32. Constitution Nepal 1962(2019) • Hindu State • National Animal • Active king Constitution Nepal 1990(2047) • District court • Applete court • Supreme court Human right Constitutional king Health -Guiding principle
  • 33. Constitution 2063 (interim) • Federal system • Social inclusion • Religion • Health : Basic health service as a fundamental human right • Public commission • National security council • Auditor General
  • 34. 2072 constitution • New constitution implemented from 3rd Ashwin, 2072. • It has repealed Interim Constitution 2063. • It has adopted federalism, first time in history of Nepal. • Power has been decentralized.
  • 35. It includes • Citizenship • Fundamental Rights and Duties • Structure of State and Distribution of State Power • Judiciary • Appointment of President • Appointment of Prime Minister • Constitutional Commissions and Bodies • Other Constitutional Clauses
  • 36. 35. Right relating to health: (1) Every citizen shall have the right to free basic health services from the State, and no one shall be deprived of emergency health services. (2) Every person shall have the right to get information about his or her medical treatment. (3) Every citizen shall have equal access to health services. (4) Every citizen shall have the right of access to clean drinking water and sanitation.
  • 37. Mile stone -Constitution of Nepal • 2004 • 2007 interim constitution • 2015 • 2019 • 2047 • 2063 interim constitution • 2072 constitution
  • 38. Parliament • Parliament/congress Parliament : England, India, Canada, Austrlia, Nepal Congress: united state • Upper house • Lower house
  • 39. Function of parliament • Representative from people • Preparation of Law • Budget approved and monitoring • Control activities of executive and make them responsible to ward the people.
  • 40. Authority parliam entary presidency Remarks Prepare law Approved by king or president Approved by president Budget approved Authority to parliament Authority to parliament Elect head of GOVT YES NO To take action against judge YES YES dxfcleof]u Appointment YES YES
  • 42. Function of parliament • Approve Act, Regulation, Policy, Long-term- periodic and short term plan • Discussion, rejection and Approve budget and program by majority of parliament members • Formation of subject committee by involving the parliament Members • President, voice president, Pri-minister and Chairmen and voice chairmen are elected by majority of members • Can withdraw to the pri-minister by their simple majority
  • 43. Characteristics of parliament members • They are representative from Party so they are more conscious about their party's manifesto. • Directed and guided by party decision • Are responsibility for Social sectors (Health education, security etc) • Are directly and indirectly elected by peoples • They get facilities (Monthly salary with allowance) from Government of Nepal
  • 44. Prepared documents by parliament • New Health Policy 2075/71/48 • Health services Act 2053 • Health Service Regulation 2054 • Long term Health Plan 2054-2074) • Nepal health Sector Program - Implementation Plan (2004-2009) • Establishment of Nursing home and hospital guideline 2061
  • 45. Role of health advocacy and lobbing in health policy formation
  • 46. Advocacy by • Electronic media Radio, TV etc • Paper media : Gorkhapatra, Kantipur, Nagarik, • Mass media • Small group: Role play, street drama etc. • Individual: counseling, interview, personnel contract
  • 48. Political aspects of executive health
  • 49. Executive Function • To determine policy and regulation • To prepare the bills to submit at parliament • To rise national income by tax and other means • To distribute resource and expenditure management • To establish foreign policy and relationship • To establish regulatory mechanism • Personnel Appointment for public affairs Parliament and supreme court balance the function of council of minister.
  • 50. System of executive Parliamentary system: 1. head of govt and head of state – different, In same person in both institution –rarely. 2. England- King and Nepal- president, Pri-Minister- head of GOVT but president - ceremonial , GOVT responsible for parliament. 3. Pri-Minister - dismiss parliament
  • 51. In Nepal Under the Constitution, executive power is vested in a Council of Ministers headed by a Prime Minister. The Prime Minister and other members of the Council of Ministers are chosen through a ‘political consensus’ among the main political parties, failing which a leader commanding majority support in parliament is appointed as the Prime Minister. The Prime Minister and the Council of Ministers are collectively responsible to Parliament while individual ministers are responsible to both Parliament and the Prime Minister.
  • 52. Power and Functions of the Executive The function of executive is increasing day by day in this modern age. There is a lot of work that the executive has to perform. It is the duty of the executive to maintain law and order in the country. Executive has to fulfil the basic needs of the people like food, shelter, clothing, education and health services.
  • 53. The following are the major functions of the executive: • To run the administration of the country efficiently and provide basic service to the people. • Executive makes important appointments and transfers, and controls and supervises all civil and military departments and their subordinates. • To maintain law and order and protect the country from foreign invasion. • To impose taxes and run various development works. • To sign treaties and make good diplomatic relations, depute ambassadors to foreign countries. • To present the budget in the parliament and operate it after the approval of the parliament. • To summon, adjourn or postpone the session of the parliament. • To table the draft bill in the parliament for appropriate laws.
  • 54. Presidency system 1. Executive function by president 2. Directly elected president 3. Different – parliament and president 4. No member of parliament in council of minister 5. Appointment by president in vital post of public affair however parliament approve these post with person. 6. Power with president (pocket veto) 7. Budget and law approved by parliament so there should be coordination among them.
  • 55. Mixed system • Adopted sustainable and strengthened system found in presidency model • Adopted democratic and responsible characteristics system found in parliamentary model France, Srilanka etc. • President-direct • Pri-minister by parliament • Same party - Pri-mister and president or different • Some time dispute in power sharing
  • 56. Power sharing system • Government is made on the basis of member of parliament or percent of vote received by party Example Africa – national congress + National party+ Inkatha = National government led by Nelson Mandela.
  • 57. Executive Aspects of health Approved Act, regulation, policy and directive are implemented by executive body of government. Main executive body of government is Ministry of council headed by Pri-minister . Existing power of ministry of council are delegated to concerning minister for execution of Act, regulation, policy etc. Some example the main role of MoHP is to deliver quality of health services up to the rural level by mobilizing the governmental and non governmental organization. For the delivery of health services MoHP have to accomplish following task • Preparation of organo- gram from centre to district level • Identify level and types of services on basis of approved act, regulation and policy • Recruit personnel on the basis of health Act and regulation as well as public service commission • Deputed on JOB
  • 58. • Performance appraisal • Carrier development • Arrange training seminar from concerning organization • Transfer • Retirement • Carrot and stick • Right person in right place • PME
  • 59. • Some level upgrading takes place by performance appraisal and promotion by public commission • Promotion takes place by free competition, internal competition • After 20 years health personnel can get pension (half of basic salaries) • All provision like recruitments, promotion, leave, job security, penalty etc. are already mentioned in Act and regulation. • The court decide on the basis of written act and regulation. However there is no separate procurement act for health services. • Department of health service and District public health office have to follow same procurement act as others sectors. • Health sector has demanded separate Act and regulation in procurement .
  • 63. Unit 7. Political issues in Health Political pressure, propaganda and public health Pressure by • Different sister organization of parties . Youth Force, YCL etc • Self help groups • Informal organization • Civil society Propaganda on • Disaster • Epidemic • Voting • Emergency services • Medicine supply • Available of human resources • Death report • Essential commodities Eg vaccine , vit A, Iron • Free health services
  • 64. Graham's hierarchy of disagreement
  • 65. Basic types Black: Propaganda that purports to emanate from a source other than the true one. Grey: Grey Propaganda is a type of propaganda where the correct source of the information is never directly credited and the sponsor’s identity is concealed. White: White propaganda is propaganda that does not hide its origin or nature.
  • 66. Public Health Mandates of political parties • Introduce of new vaccine ? • Introduce of new program ? • Change of health policy • Reforms and restructuring • Health insurance ; voluntary or social • Health service : Gon responsibility or social marketing • Federal or central GOV.
  • 67. Political instability, war and their effect on health public and health service system • Health staffs retention –low • Brain drain • Low service utilization • Low quality of health services • High cost • Low community participation • Low social mobilization • Increased morbidity and mortality rate
  • 68. Issues of Health politics • Political party’s manifesto and implementation • Influence of neighboring country • Severity between capitalistic countries and socialistic countries • Destructive critic instead of Constructive critic • Donor driven health program • capacity building • Globalization • Equity ; uneven access to political resources • Budget allocation to health • Political culture • Driving and restraining forces exist in community • Diverse people and ideas • Decision making
  • 69. Challenges at implementation phase • At the implementation phase the various obstacles does occur that disturb the service are, Political challenges -political propaganda, quality of political decision • Security challenges-political instability, civil war, • Social challenges- fooding, shelter, social norm • Judicial challenges- low feasibility of Act, unavailable of proper Act • Environment challenges- pollution • Religious & ethnic challenges- large ethnic group having different value and norms • Economical challenges- cost recovery problem • Physical challenges-transportation, buildings 69
  • 70. Structural adjustment program and their effect on public health • Policies to reform health care system • Introduction private funding instruments • Decentralization of health finance • Reform of management structures • Reforms of human resources • Promoting cost effectiveness of the delivery system
  • 71. Introduction • International Monetary Fund (IMF or Fund) • Structural Adjustment Programs (SAPs) • The IMF and Health Spending • In Focus: IMF Programs and Health Spending in Low-Income Countries
  • 72. International Monetary Fund • IOs, global economic governance, and the IMF • History and mandate – Technical support – Lending (‘lender of last resort’) – 1980s and late-2000s lending boom • Influence and legacy – Fund programs (SAPs) – ‘Conditionality’
  • 73. Structural Adjustment • Evolution of conditionality – Core competencies – Extension to non-core – Country ownership and poverty reduction • Controversial conditions – Devaluation – Trade liberalisation – Fiscal discipline – Consumption taxes – Privatisation
  • 74. Structural Adjustment • Some general criticisms of Fund programs – Poor track record – ‘One size fits all’ – ‘Mission creep’ – Micro-management (e.g. size of bread loaf) – ‘Loose coupling’ of discourse and practice – Agents of neoliberalism and/or neoimperialism
  • 75. IMF Programs and Health Spending Core claims by critics IMF response (Gupta, 2010) 1. Health spending has decreased in countries with IMF-supported programs 1. Previous analyses of Fund-supported programs have already shown this claim to be untrue 2. Countries are forced to decrease health spending to meet rigid fiscal deficit conditions 2. IMF-supported programs have been very flexible by accommodating larger fiscal deficits and continuing to protect priority social expenditures 3. Conditions on wage ceilings imposed in program countries prevent desirable increases in health spending 3. There is no conditionality that limits health spending in Fund-supported programs 4. Increased aid intended for the health sector has been diverted to repay domestic debt or increase reserves 4. When faced with volatile sources of finance, governments often attempt to maintain a stable flow of social expenditures by smoothing the use of available financing.
  • 76. Unit 8: Health Law and Act Concept about judicial health Structure and level of judicial body Importance of health jurisprudence and law in public health aspects Brief about law, Body of monitoring of law Brief discussion about the Health service Act 2053, Local governance and decentralization Act Brief account of Act and Law related to • - Health behavior modification through legal measures and challenges • - Control of contra health products • - Control of health hazards through health laws and regulation • - Legal protection against the threats to physical • - Mental and social health of public • - Health law and preventive public health • - Epidemics and health laws Implementation strategy of health law for providing of social justice and challenges
  • 77. Gofokflnsf • sfg'gsf] ;jf]{Rrtf • sfg'gsf] zf;g • Jfbljjfbsf] km};nf
  • 78. UN Declaration ( 13 dec,1985and 25nov 1985) Principle for independent judiciary function • Constitution as a main regulatory document for state or country • Evidence based impartial decision • Supreme court should be capable to define their owned role and responsibility by doing appropriate decision at time • Judiciary decision change –from high court • Working procedure and salary of Judge should be mentioned by law
  • 79. Judicial Aspects of health Executive body should have implemented Act, regulation, policy . If not implemented properly, supreme court can rise the question to executive body of government. Supreme court can ask the questions, punish, dismiss etc. Challenges in implementation strategy Health Service Act 2053 is isolated from the other civil service Act since 2054.2.14 So, Health service Act and regulation has following characteristics There is level system ( second level to twelve level ) of health personnel who are working from sub health post to Ministry of health and population
  • 80. Health law • Constitution, Health Act 2053, Regulation2055, health policy 1991 and revised health policy 2015, 2019 • Implementation to the MOHP and below concerning to health workers. • Strategy : To provide 24 hrs. health services to the people. • Challenge : inadequate health workers, lack of social responsible, untrained, lack of infrastructure, legal issues in regulation personnel , regulation of health facilities • Control of contra health product by self government Act 1999. • Health behavior modification by carrot and stick
  • 81. • Control of health hazards government Act and regulation • Legislation to mental illness • Legislation on abortion • Legislative approaches health prevention and promotion • Legislation to change smoking behaviour • Tax and price policies • Restricting smoking in public places • Restricting smoking in public work place • Mandating health education
  • 82. Judicial aspect of health at the international level • The formally development of medical jurisprudence at international from the establishment of UN and WHO. • The several conventions, seminar before the establishment of WHO, play vital role for the development of legal medicine etc. • The principle and rule of the various conference and organization keep the right of international development of judicial aspect of health. 82
  • 83. Judicial aspect of health at the international level....... • First international sanitary conference 1851 • Pan American sanitary bureau 1902 • Office international D ‘hygiene Poblique 1907 • The health organization of the league of Nations 1923 • The United Nation relief and rehabilitation administration 1943 • WHO 1945 83
  • 84. Implementation strategies of health Act, regulation and laws 84
  • 85. Brief discussion about the Health service Act 2053, Local governance and decentralization Act Nepal medical council Act 2020: The person who pass the bachelor level of medical science from the recognizes university called doctors who should be associated with medical service. Nepal health professional council Act 2053 (Public health, HA, CMA etc): The person who passes the Intermediate, bachelor, master and doctorate degree level of professional medical science from recognizes university called health professional that should be associated with health service provider. 85
  • 86. Why Health Service Act in Nepal? • Health service is different then other service it is directly linked with the life of people. • Health service required to people any time (24 hours) • Health service is a emergency services
  • 87. Objective of health service act of Nepal 1. To fulfill the vacant post of health services 2. To Motivate employee of health service 3. To establish code of conduct and disciplinary action of HRH 4. Provision of gratuity, pension for employee after retirement
  • 88. Amendments of Health Service Act of Nepal 1. Nepal Health Service (1st Amendment) Act, 2055: 2055/10/27 (10th Feburary1999) 2. Health Related Some Nepal Acts Amendment Act, 2058 : 2058/5/6 (22nd August 2001) 3. Nepal Health Service (2nd Amendment) Act, 2058: 2058/7/22 (7th November 2001) 4. Nepal Health Service (3rd Amendment) Act, 2063: 2063/8/22 (8th December 2006) 5. Republic Strengthening and Some Nepal Laws Amendment Act, 2066: 2066/10/7 (21st Jan 2010) 6. Nepal Health Service (4th Amendment) Act, 2070: 2070/12/12 (26th March 2014)
  • 89. Chapter of health service act 2053 There are 11 chapter of health service act of Nepal:- Chapter 1 Preliminary Chapter 2 Constitution of health service (स्वास ्््य सेवा को गठन) Chapter 3 Fulfillment of vacancy of health service Chapter 4 Transfer, deputation (काज) and promotion Chapter 5 Provisions relating to nomination for study and training Chapter 6 Salary, allowance, festival expenses and other facilities Chapter 7 Retirement, gratuity and pension Chapter 8 Conduct (आचरण) Chapter 9 Service security Chapter 10 Punishment and appeal (सजाय र पुनरावेदन) Chapter 11 Miscellaneous
  • 90. I. Professional (MOH) 1. Nepal medical council act 2020 2. Nepal health professional council act 2053 3. Nepal nursing council act 2052 4. Nepal pharmacy council act 2057 5. Nepal ayurvedic council act 2045 90 Brief account of Act and Law related to health
  • 91. II. Research/Service/Health manpower production 1. Nepal health research council act 2047 2. BP Koirala institute of health science act 2049 3. BP Koirala memorial cancer hospital act 2053 4. Martyr Gangalal national heart centre act 2057 91
  • 92. III. Administration 1. Nepal health service act 2053 2. Drugs act 2035 IV. Curative 1. Human organ transplantation act 2055 2. Drug act 2035 92
  • 93. V. Protection 1. Environmental protection act 2053 2. Pesticides act 2048 VI. Consumer protection 1. Consumer protection act 2. Compensations for torture act 2053 3. Civil code 1963/64 4. Jail act 93
  • 94. VII. Food 1. Food act 2023 2. Vehicular and transport act 2049 VIII.Welfare 1. The constitution act 1990 2. The labour act 1992 3. The child right act 1992 4. Disabled protection and welfare act 2039 94
  • 95. IX. Epidemic and disaster 1. Infectious disease act 2020 2. Natural disaster act 2039 X. Manpower production 1. Universities' Acts 2. CTEVT 95
  • 96. XI. Controlling 1. Police act 2012 2. Public offence and punishment act 2027 3. Black marketing and other social offence act 4. Drug abuse control act 2053 96
  • 97. XII. Health behaviour modification through legal measures 1. Ilaz Garne Ko or on medical practice I Muluki Ain – The civil code (Muluki Ain 1963) – The civil code (Muluki Ain 1976) 2. Some public offence and punishment act, 2027 BS 3. Black marketing and other social offences act 2032 BS 4. Drug abuse control act, 2033 BS 97
  • 98. XIII.Health behaviour modification through legal measures … 3. Drug act, 2035 BS 4. Consumer protection act, 2054 BS 5. Human organ transplantation act, 2055 BS 6. Food act, 2033 BS 98
  • 99. XIV.Control of health hazard through health laws and regulations 1. Black marketing and other social offences act, 2032 BS 2. Drug abuse control act, 2033 BS 3. Pesticides act 4. Breast milk substitutes (Marketing control) act 2049 BS. 5. Environmental protection act, 2053 BS 6. Animal slaughter house and meat examinations act, 2044 BS 99
  • 100. • Law and regulation prohibit conduct that is injurious to health of individual and community. • Health legislation authorizes program and services that promote health of individual and communities • Legislation regulates the production of resources for health care • Legislation provides for the social financing of health care • Legislation authorizes surveillance over the quality of health care • Regulation food and drugs • Licensure of health personnel Implementation strategy of health law for providing of social justice and challenges
  • 101. Legal Protection against threat to physical, mental and social health of public • Insurance by GOV • Voluntary insurance • Consumer act 2054 • Service provider act in process • Handicap pension • Free treatment after injury during official work.
  • 102. Legal provision for health services • Leave is facilities not right • Civil servant are under government (24 hour) • There is no one month barrier for deputation during epidemic • Upgrading and carrier development who work in remote district • Authority delegation to sub -ordinate
  • 103. Control of health hazards through health law and regulation • Mention duty hour in the regulation • EIA ( environment Impact assessment ) • Factory act 1991 • Point out lead jacket, apron, gloves etc • Mention of delivery (Husband and wife) and other leave • Health Insurance • Smoking free zone declared • Pre-placement medical checkup • Medical treatment facilities • Consumer act 2054 • service provider act in process • Identified job description of different level of health worker including nurses
  • 104. • Level of health services and degree of personnel identified • Standard of drinking water • Housing standard identified • Access of health services • Long term, midterm and short-term plan prepared.

Editor's Notes

  1. The IMF is one of the ‘big three’ global economic governance organisations, the others being the World Bank and the World Trade Organisation World Bank and IMF initiated in 1944 at the Bretton Woods Conference, formally established in 1944 (WB, then known as the International Bank for Reconstruction and Development) and 1945 (IMF) World Bank deals with sectoral issues and big infrastructural projects (but shifted into economy-wide programs in 1980s for a couple of decades) IMF is central to the functioning of the world economy (i.e. global financial stability) ‘Washington Consensus’ term is based on policy prescriptions of the IMF and WB (both located in Washington DC). World Trade Organisation is involved in trade liberalisation, formed in 1995 Fund was established in 1945 with a mandate to safeguard global financial stability Achieved via technical support – an uncontroversial and little-studied component Achieved via provision of short-term loans to countries with balance of payment difficulties IMF loans often used to repay external debt that the country is unable to service (i.e. in order to avoid default); they carry lower interest rates than private loans. In 1980s, countries were becoming indebted with balance of payment crisis and rundown of foreign reserves due to: end of the mid 1970s commodity boom; macroeconomic mismanagement; oil shocks through the 1970s; perhaps the model was unsustainable in any case. In late-2000s global financial crisis. In exchange for low-cost financing, borrowing countries agree on a list of policy reforms (i.e. ‘adequate safeguards’ for Fund finances) SAPs refer to both the World Bank SALs (early-80s) and IMF’s SAF-family (mid-80s), but should in fact (and often do) refer to SBAs, EFFs as well The Fund has had programs through the 50s and 60s but in the mid-80s – following in the footsteps of the WB’s SALs - came the idea that programs needed to address the underlying perverse institutions featuring in many borrowing countries. Thus, structural conditions were introduced (where previously were just quantitative ones). It is the country’s choice to select into a program, and it is usually coordinated through the Ministry of Finance Countries sign an MoU that they will undertake X policies and meet Y targets in order to get tranche payments of credit, i.e. IMF credit is given out in tranches, with dispersal of subsequent credit tranches dependent on achieving certain conditions Through these, IMF has had a decisive role in the long-term developmental trajectory of middle- and low-income countries (and now some high-income countries, e.g. Ireland, Portugal, Greece), and has come to influence a wide range of policy areas, including public health Programs/conditions can be tough on a country, but the alternative – defaulting on external debt – can have even worse consequences Programs can catalyze aid and private flows; failure for programs to materialize (i.e. IMF ‘stamp of approval’) can mean the government is cut off from other credit sources, including the WB, regional development banks, and private creditors – thus the IMF has huge leverage in pushing highly indebted countries to adopt its economic formula. Most SSA countries – my region of interest - were on consecutive IMF/WB SAPs throughout the 1980s and 90s (and even to today).
  2. Fund programs generally require borrowers to implement a set of reforms – known as ‘conditions’ – consisting of primarily austerity measures aimed at addressing current account imbalances. Core competences: Conditions attached were limited and predictable, requiring reforms to fiscal and monetary policy and exchange rate adjustments, with the aim of reaching a sustainable balance of payments position. Quantitative floors/ceilings on fiscal deficit, international reserves, money circulation (credit to government, credit to public sector, net domestic assets), external debt These had deleterious implications for countries’ economies, but nevertheless left the underlying economic system in-tact. Extension to non-core: In the mid-80s, the IMF started including in its programs an increasing number of ‘structural’ conditions that would later become known as Washington Consensus policies SOE reform and pricing, SOE privatization, Labour issues, Social policy, Good governance, Legal reforms, Anti-corruption, Private sector development Brought in to bring about long-lasting change in borrowing countries, a ‘lock-in’ Country ownership and poverty reduction: In the 2000s came a rebranding of ESAF into PRGF (Poverty Reduction and Growth Facility) Requirement for PRSPs (Poverty Reduction Strategy Papers) Introduction of Redistributive conditions and rhetoric around country ownership of program Currency devaluation: A) Exports become cheaper and therefore more competitive in global markets B) Imports become more expensive C) This combination replenishes international reserves to use in repaying external creditors D) Poor people who have savings in local currencies lose out, while the rich who hold foreign currencies win E) Problematic for manufacturing and agriculturalists who rely on imported fertilizers and chemicals F) Problematic where IMF has already pushed countries into export-oriented agriculture thus diminishing self-sufficiency and many basic food stuffs imported where they were previously grown locally, and so currency devaluation increases the price of these basic – now imported – foodstuffs. Trade liberalisation: A) Removal of quotas and reduction of tariffs B) Rationale that the market can allocate more efficiently than the state C) Domestic producers unable to compete with foreign players Fiscal discipline: A) Expenditure ceilings B) Removal of subsidies C) Cost-sharing D) Controversy where subsidies are for basic needs goods (food, water, heating) Consumption taxes: A) VAT, GST, and so on (regressive taxes) B) Controversy where they have increased the price of basic needs goods C) In Rwanda they had a condition to decrease corporate taxes but incorporate a VAT tax, so there is a double standard. D) Appear to be no conditions calling for progressive taxes Privatisation: A) Sell-off government owned enterprise on the rationale that private sector is more efficient B) But... Private sector has no incentive to provide to poorer households C) Increase in prices for water, electricity, housing, and in many cases poorer service, has been controversial D) Privatisation used as tool to enrich the elite (e.g. Russia)
  3. Poor track record: On growth in particular (little or negative growth in SSA for most of 80s/90s despite near-constant IMF presence), but it does better on inflation One size fits all: The same policies are applied to completely different countries, with differing institutional histories, current environment, and so on (I’m not fully convinced, though they are all certainly ‘neoliberal’ in character) Mission creep: Fund creeping into areas they have no expertise in (e.g. governance, sectoral issues, perhaps even structural adjustment in general) Micro-management: Egypt’s 1991 SBA has a prior action on “the reduction in the size of the "popular" bread loaf” Agents of neoliberalism and/or neoimperialism: See condition controversies
  4. Past inquiries into how the IMF affects public health spending have produced mixed results: Analysts connect to IMF find positive impact Analysts unconnected find negative impact