Impetus on centre-state partnership for strengthening healthcare delivery in the country: Amitabh Kant

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Amitabh Kant is an IAS and is currently  the CEO, NITI Aayog (National Institution for Transforming India). He was a key driver of the “Make in India”, Startup India, “Incredible India” and “God’s Own Country” initiatives that positioned India and Kerala State as leading manufacturing and tourism destinations. He is the author of Branding India – An Incredible Story.

He was the National Project Director of the Rural Tourism Project of UNDP which created a paradigm shift in spreading tourism to Indian villages that had skills in handicrafts, handlooms and culture.

Until March, 2016 Kant was posted as national Secretary, Department of Industrial Policy and Promotion (DIPP). He was responsible for formulation and implementation of industrial policy and strategies for industrial development, monitoring the industrial growth and performance of specific industrial sectors, formulation of foreign direct investment (FDI) policy and FDI promotion and facilitation.

In an interview with Healthy India Chronicle, he talks about various initiatives in strengthening healthcare delivery, taking forward nutrition initiatives and drug regulatory system for public health.

Q. What is your Vision & Road Map of NITI Aayog for Healthy India? How NITI Aayog is taking forward the initiatives for the State Governments towards making Healthy India?

NITI Aayog recently published its 03 Year Action Agenda which has suggestions on all critical sectors including Health and Nutrition. To achieve the health goals articulated in the National Health Policy, 2017, and NITI Aayog’s 3-Year Action Agenda, the following have been proposed:

Increase expenditure on health

  • From around Rs. 30,000 Crore in 2015-16 to Rs. 1, 00,000 Crore by 2019-20, thereby increasing the sector’s share of total expenditure from 1.7% to 3.6%.

Prioritize public health

  • The aim is to have a focal point in the Union Health Ministry for monitoring of health status, disease surveillance, educating the public and enforcing public health regulation and impetus is being laid on the Centre partnering with State Governments for improving health sector.
  • Focus is now on development of Outcome Based Monitoring of Indicators and understanding in a granular manner how States and Districts are performing on these parameters.

Q. How National Medical Commission (NMC) will help for Health Professionals?

Initiatives by NITI to Strengthen the Health sector

  • a) For undertaking a comprehensive reform of medical education in India, the National Medical Commission Bill, 2016 has been drafted. Bills for replacing the Central Council for Indian Medicine and Central Council for Homoeopathy have also been drafted and placed in the public domain.
  • b) A Health Index has been developed for ranking states on their performance in health and nudging them towards transformative action in these areas. After an elaborate exercise including seeking feedback from the Ministry of Health and Family Welfare and the States through an iterative process, experts and a pre-test, NITI Aayog has developed the health index with technical assistance from the World Bank. A composite index would be calculated and disseminated annually, with a focus on measuring and highlighting annual incremental improvements of States.
  • c) For strengthening healthcare institutions in the public sector, a set of indicators has been developed for tracking the performance of district hospitals and ranking them on the basis of the same.
  • d) NITI is co-funding an effort to create best-practice models in health followed by dissemination across the country with states that have been selected through a challenge process.
  • e) The ‘Sustainable Action for Transforming Human Capital (SATH)’ has also been launched by NITI to provide technical support to the States of Assam, Uttar Pradesh and Karnataka for transforming their respective health sectors.

National Medical Commission

  • a) The National Medical Commission Bill, 2016 was drafted following extensive consultations with various stakeholders to enhance the quality of medical education in the country.
  • b) The salient features of the bill include selecting members on merit (instead of elections), separate boards for regulating under graduate and post graduate courses as well as boards for accreditation and assessment, registration of medical colleges and monitoring of ethics in the profession.
  • c) Similar reform efforts will be needed in the fields of nursing, dentistry and pharmacy education.

Q. What is NITI Aayog Road Map for strengthening drug regulatory and food regulatory system in the country?

Roadmap for strengthening the Drug Regulatory system in the country

One of the major challenges in the pharmaceutical sector is to ensure availability of high quality standard drugs to the last mile. The Indian pharmaceutical regulatory system is crippled with ambiguity in regulatory space due to lack of sufficient regulatory bandwidth as a result of serious shortfall of infrastructure and human resources.

A strengthened drug regulatory system is the key to ensure access to quality medicines. It will instill confidence amongst public in the indigenously manufactured drugs especially in propagating the use of generic drugs, whose quality is often doubted. India being one of the largest manufacturers of generic drugs globally, the use of generic drugs, which are much more affordable, can thereby reduce the out of pocket expense.

There needs to be quality check of imported drugs/ APIs, audit of foreign manufacturing plants in addition to the indigenous units and drugs available in retail. However, due to budgetary constraints alternate mechanisms need to be worked out for strengthening the drug regulatory system.

Nutrition Initiatives Underway

In recent times, India has taken several measures to tackle malnutrition of children and mothers. Some of the important measures are as follows:

  • 1. NITI Aayog in consultation with stakeholders has formulated and released National Nutrition Strategy emphasizing importance on interdepartmental convergence, setting up clear targets and real time monitoring.
  • 2. Following the announcement of Hon’ble PM, maternity benefit to pregnant women and lactating mothers (Pradhan Mantri Matru Vandan Yojana- PMMVY) has been initiated to provide Rs. 5,000 Cash Transfers on fulfillment of necessary conditions related to health and nutrition.
  • 3. The cost norms for supplementary nutrition have been increased. The Government has provided an additional Rs.12000 Crores to fight malnutrition over next three years in the country by revising cost norms for supplementary nutrition provided in Anganwadis and in the scheme for adolescent girls. The cost norms have now also been linked to the Food Price Index which will enable the Government to increase the cost norms annually without any hindrance.
  • 4. Fortification of food provided under Government welfare programmes like ICDS and MDM has been made mandatory.
  • 5. A joint letter signed by three Secretaries, from Ministry of Women and Child Development, Ministry of Health and Family Welfare and Ministry of Drinking Water and Sanitation advising on collective monitoring of programs related to them at field level to ensure the desired nutrition outcomes sent to the Chief Secretaries of States/UTs on 08.08.2017
  • 6. The Ministry of WCD has started digitalization of MIS and Monitoring under ICDS. In this regard, ICDS-CAS system has been developed and piloted.
  • 7. The ICDS-Systems Strengthening & Nutrition Improvement Project (ISSNIP) has been approved to extend it to 162 districts in next three years for real time monitoring of ICDS and its outcomes.
  • 8. In convergence with MNREGS under ICDS more than 1.1 lakhs of Anganwadi Centres constructed for effective delivery of ICDS services.
  • 9. 113 High Burden Districts (on nutrition parameters) have been identified for taking up action in Mission mode.
  • 10. National Nutrition Mission (NNM) has been conceptualized and sent for approval to bring in desired convergence among different Ministries/Departments and expand digital monitoring to all districts. It is proposed to constitute a Technical Secretariat under NITI Aayog to support in its monitoring and providing technical guidance.

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