The Planning Commission has called for more capital investment in health for a prolonged period of time and a health policy that would address the special needs of different groups during the next five year plan period.

One of the major reasons for the poor quality of health services is the lack of capital investment in health for prolonged period of time. The National Rural Health Mission had sought to strengthen the necessary infrastructure in terms of Sub-Centres, Primary Health Centres and Community Health Centres. While some of the gaps have been filled, much remains to be done. There is shortage of 19,590 sub-centres; 4,252 PHCs and 2,115 CHCs in the country, the Planning Commission has noted.

“It is essential to complete the basic infrastructure needed for health delivery in rural areas by the end of the Twelfth Plan. This will require substantial Plan assistance to the states for infrastructural development including upgrading existing PHCs and CHCs to IPHS norms, building Labour rooms and operation theatres, which are critical to reducing maternal mortality and also building new PHCs. Government diagnostic services will have to be strengthened at the block and district levels. This would require not only infrastructural upgrades but also adequate human resource support and well developed service delivery protocols. States also lack infrastructure for ancillary services like drug storage and warehousing, medical waste management, surveillance and cold chain management. Such facilities will have to be ensured at the district level,” a paper by the Commission said.

“While the National Rural Health Mission (NRHM) has taken up the task of providing health infrastructure in rural areas, there is no such public health care infrastructure at the urban level available to the common person. A major challenge in the Twelfth Plan is to ensure that all urban slums and settlements are covered with Sub Centres and ICDS centres (co-located where possible) and PHCs, through NRHM. This infrastructure cannot be based on mechanical application of population based norms since many people in urban areas have access to private medical care. The Twelfth Plan will innovate by creating local, low-cost treatment centres around relevant disease groups rather than generic ones, thus using resources more efficiently,” it said.

“The health policy must focus on the special requirements of different groups, e.g., integrated geriatric health care and other needs specific to the elderly, ‘adolescent friendly’ health support services (and counselling) for victims of sexual or substance abuse, those infected with HIV/AIDS, those who are differently abled, and those who belong to the lesbian, gay, bisexual, and transgendered (LGBT) community. Regional disparities must be addressed especially with respect to maternal health and child under nutrition in the 264 high focus districts of the NRHM. The high rate of growth of the population, particularly in certain States, must also be addressed. Mental health services, including psychosocial care and counselling, should be prioritized, in settings of transition due to migration, areas of conflict and disturbances, especially in the NER and J&K and in areas of natural disasters/calamities,” the paper said.