Planning process- health planning through five year plans

1. BY
S.KARTHIKA,ASST.PROF,
MMCON,MMU,MULLANA,
AMBALA,HARYANA

2.  PLANNING PROCESS -HEALTH IN FIVE YEARS
PLANS
 INTRODUCTION Five years plan is mechanism to
bring about uniformity in policy formulation in
programmes of national importance The specific
objectives of the health programme, during Five
years plan, are as follows:
 1. Control & eradication of major communicable
diseases.
 2. Strengthening of basic health services through the
establishment of the PHC & sub enters.
 3. Population control.
 4. Development of health manpower resources.

3. For the purpose of planning the health
sectors has been divided in two following
sub sectors.
1. Water supply & sanitation.
2. Control of communicable diseases.
3. Medical education, training & research.
4. Medical care including hospitals,
dispensaries & PHCs.
5. Public health services.
6. Family planning.
7. Indigenous system of medicine

4. 
 The first Indian Prime Minister, Jawaharlal
Nehru presented the first five-year plan to the
Parliament of India on 8 December 1951. The
first plan sought to get the country's economy
out of the cycle of poverty. The plan
addressed, mainly, the agrarian sector,
including investments indams and irrigation.
The agricultural sector was hit hardest by the
partition of India and needed urgent attention.

5. The total planned budget of 206.8 billion
was allocated to seven broad areas:
1) Irrigation and energy
2) Agriculture and community development
3) Transport and communications
4) Industry
5) Social services
6) Land rehabilitation
7) Other sectors and services

6.  The specific objectives were;
 1. Provision of water supply & sanitation.
 2. Control of malaria.
 3. Preventive health care of the rural population.
 4. Health services for mother & children.
 5. Education & training in health.
 6. Self sufficiency in drug & equipments.
 7. Family planning & population control.
 During this plan period the public sector outlay was
Rs. 2356 crore of which Rs. 140 crore were
allotted for health programs.

7. 
 The second five-year plan focused on industry,
especially heavy industry. Unlike the First plan, which
focused mainly on agriculture, domestic production of
industrial products was encouraged in the Second
plan, particularly in the development of the public
sector.
 The plan followed the Mahalanobis model, an
economic development model developed by the Indian
statistician Prasanta Chandra Mahalanobis in 1953.
The plan attempted to determine the optimal allocation
of investment between productive sectors in order to
maximize long-run economic growth.

8. The specific objectives were;
1. Establishment of institutional facilities to
serve as a basis from which service could
be render to the people both locally &
surrounding territory.
2. Development of technical man power
through appropriate training programmes.
3. Intensifying measures to control widely
spread communicable disease.

9. 4. Encouraging active campaign for
environmental hygiene.
5. Provision of family planning and other
supporting services.
During this plan period the public sector
outlay was Rs. 4,800 crore of which Rs.
225 crore were allotted for health
programs.

10.  The third plan stressed on agriculture and
improving production of rice
 Many primary schools were started in rural areas.
In an effort to bring democracy to the grassroots
level, Panchayat elections were started and the
states were given more development
responsibilities.
 State electricity boards and state secondary
education boards were formed. States were made
responsible for secondary and higher education.

11. The specific objectives were in tuned with
the 1st & 2nd five years plan except that
integration of public health with maternal &
child welfare, nutrition & health education
was planned. During this plan period the
public sector outlay was Rs. 7,500 crore of
which Rs. 341.8 crores were allotted for
health programs

12. 
 At this time Indira Gandhi was the Prime Minister. The Indira
Gandhi government nationalized Green Revolution in India
advanced agriculture Certain objectives of the Mudaliar
committee were the base for this plan in relation to health.
 1. To provide an effective base for health services in rural
areas by strengthening the PHCs.
 2. Strengthening of sub-division & district hospitals to provide
effective referral services for PHCs,
 3. Expansion of medical & nursing education & training of
Para –medical personnel to meet the minimum technical man
power requirements.
 During this plan period the public sector outlay was Rs. 16,774
crore of which Rs. 1,156 crore were allotted for health
programs.

13. 
Stress was laid on employment, poverty
alleviation, and justice. The plan also
focused on self-reliance in agricultural
production and defense. In 1978 the newly
elected Morarji Desai government rejected
the plan. Electricity Supply Act was
enacted in 1975

14.  The emphasis of the plan was on removing imbalance in
respect of medical facilities & strengthening the health
infrastructure in rural areas. Specific objectives to be pursued
during the plan were:
 1. Increase accessibility of health services to rural areas.
 2. Correcting regional imbalance.
 3. Further development of referral services.
 4. Integration of health, family planning & nutrition.
 5. Intensification of the control & eradication of communicable
diseases especially malaria & smallpox.
 6. Quantitative improvement in the education & training of
health personnel.

15.  During this plan period the public sector outlay was Rs. 37,250
crore of which Rs. 3,277 crores were allotted for health
programs.
 The sixth plan also marked the beginning of economic
liberalization. Price controls were eliminated and ration shops
were closed. This led to an increase in food prices and an
increase in the cost of living.
 Family planning was also expanded in order to prevent
overpopulation. In contrast to China's strict and binding one-
child policy, Indian policy did not rely on the threat of force.
More prosperous areas of India adopted family planning more
rapidly than less prosperous areas, which continued to have a
high birth rate.

16.  The main objectives of the 7th five year plans
were to establish growth in the areas of
increasing economic productivity, production
of food grains, and generating employment
opportunities. The thrust areas of the 7th Five
year plan have been enlisted below:
 Social Justice
 Removal of oppression of the weak
 Using modern technology
 Agricultural development
 Anti-poverty programs

17.  The objectives were
 1. Eliminate poverty & illiteracy by 2000
 2. Achieve near full employment secure satisfaction of the
basic needs of food, cloth, shelter
 and provide health for all.
 3. To provide an effective base for health services in rural
areas by strengthening the PHCs.
 4. universal immunization programme
 5. Promotion of voluntary acceptance of contraceptives
 During this plan period the public sector outlay was Rs.
1.80.000 crores of which Rs. 3,392 crores were allotted for
health programs

18. Period between 1989 -91
P.V. Narasimha Rao was the twelfth Prime
Minister of the Republic of India and head
of Congress Party
1989-91 was a period of political instability
in India and hence no five year plan was
implemented. Between 1990 and 1992,
there were only Annual Plans.

19.  India became a member of the World Trade Organization on 1 January
1995.This plan can be termed as Rao and Manmohan model of
Economic development. The major objectives included, containing
 1. population growth,
 2. poverty reduction,
 3. employment generation,
 4. strengthening the infrastructure,
 5. Institutional building,tourism management,
 6. Human Resource development,
 7. Involvement of Panchayat raj,
 8. Nagarapalikas,
 9. N.G.O‘s and
 10. Decentralization and people's participation.

20.  It is based on the national health policies. 1.
Human development is the ultimate goal of
this plan. 2. Employment generation,
population control literacy, education, health,
drinking water & provision of adequate food
&basic infrastructure. 3. Towards health for
the underprivileged‖ was the of the aim of this
plan. The PHCs were strengthened staff
vacancies, by supplying essential equipment
&drugs.

21.  Ninth Five Year Plan India runs through the
period from 1997 to 2002 with the main aim of
attaining objectives like speedy industrialization,
human development, full-scale employment,
poverty reduction, and self-reliance on domestic
resources. Background of Ninth Five Year Plan
India: Ninth Five Year Plan was formulated
amidst the backdrop of India's Golden jubilee of
Independence.

22.  The main objectives of the Ninth Five Year Plan
India are:
 to prioritize agricultural sector and emphasize on
the rural development
 to generate adequate employment opportunities
and promote poverty reduction
 to stabilize the prices in order to accelerate the
growth rate of the economy
 to ensure food and nutritional security
 to provide for the basic infrastructural facilities
like education for all, safe drinking water, primary
health care, transport, energy

23.  During this plan, vertical health program were
integrated horizontally with general health
services. The Reproductive & child health
program was improved under following
guidelines;
 1. Decentralize RCH to the level of PHCs.
 2. Base planning for RCH services on
assessment of the local needs.
 3. Meet the needs of contraceptives
 4. Involve the general practitioners &
industries in family welfare work.

24.  Reduction of poverty ratio by 5 percentage points by
2007;
 Providing gainful and high-quality employment at
least to the addition to the labour force;*All children in
India in school by 2003; all children to complete 5
years of schooling by 2007;
 Reduction in gender gaps in literacy and wage rates
by at least 50% by 2007
 This plan has laid down the following targets
 Bring down the decadal growth rate by 16.2% in the
decade from 2001 to 2011

25.  Reduce infant mortality rate to 35/1000 live births by
2007 & to 28/1000 live births by 2012
 Reduce maternal mortality rate to 2/1000 live births
by 2007 & 2/1000 live births by 2012.
 To achieve the above, the government is planning to
do the following
 1. Restructure existing health infrastructure.
 2. Upgrade the skills of health personnel
 3. Improve the quality of reproductive & child health‘
 4. Improve logistic supplies.
 5. carry out the research on nutritional deficiency
 6. Promote rational drug use.

26.  1. Income & Poverty
 o Create 70 million new work opportunities.
 o Reduce educated unemployment to below 5%.
 o Raise real wage rate of unskilled workers by 20 percent.
 2. Education
 o Reduce dropout rates of children from elementary school
from 52.2% in 2003-04 to 20% by 2011-12
 o Develop minimum standards of educational attainment in
elementary school, and by regular testing monitor
effectiveness of education to ensure quality
 o Increase literacy rate for persons of age 7 years or above to
85%

27.  3. Health
 o Reduce infant mortality rate to 28 and
maternal mortality ratio to 1 per 1000 live
births
 o Reduce Total Fertility Rate to 2.1
 o Provide clean drinking water for all by 2009
and ensure that there are no slip-backs
 o Reduce malnutrition among children of age
group 0-3 to half its present level

28.  4. Women and Children
 o Raise the sex ratio for age group 0-6 to 935 by 2011-12 and to 950 by
2016-17
 o Ensure that at least 33 percent of the direct and indirect beneficiaries of all
government schemes are women and girl children
 o Ensure that all children enjoy a safe childhood, without any compulsion to
work
 5. Infrastructure
 o Ensure electricity connection to all villages and BPL households by 2009
and round-the-clock power.
 o Ensure all-weather road connection to all habitation with population 1000
and above (500 in hilly and tribal areas) by 2009, and ensure coverage of all
significant habitation by 2015
 o Connect every village by telephone by November 2007 and provide
broadband connectivity to all villages by 2012
 o Provide homestead sites to all by 2012 and step up the pace of house
construction for rural poor to cover all the poor by 2016-17

29. 6. Environment
o Increase forest and tree
o Attain WHO standards of air quality in all
major cities by 2011-12.
o Treat all urban waste water by 2011-12
to clean river waters.
o Increase energy efficiency by 20
percentage points by 2016-17.