UPSC Daily Editorial Analysis | 20 May 2022

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What the article is about?

  • Talks about the importance and measures to increase the effectiveness of public health management.

Syllabus: GS-II Health, Government policies and initiatives

Public health:

  • Recently, the Union government released a guidance document on the setting up of a ‘public health and management cadre’ (PHMC) as well as revised editions of the Indian Public Health Standards (IPHS) — for ensuring quality health care in government facilities.
    • The ‘public health and management cadre’ follows the recommendations made in India’s National Health Policy 2017.
  • At present, most Indian States have a teaching cadre (of medical college faculty members) and a specialist cadre of doctors involved in clinical services. This structure does not provide similar career progression opportunities for professionals trained in public health.
    • It is one of the reasons for limited interest by healthcare professionals to opt for public health as a career choice.
  • With the release of guidance documents, the States have been advised to formulate an action plan, identify the cadre strengths, and fill up the vacant posts in the next six months to a year.
  • Increasing access to health services and improving the quality of care were perceived as a sequential process: first focus on increasing access and then a thought may be given to ensuring quality (which rarely happened). 

Role and Relevance:

  • In 2017, India’s National Health Policy 2017 proposed the formation of a public health cadre and enacting a National Public Health Act.
  • It became clear that ‘epidemic’ and ‘pandemic’ required specialised skills in a broad range of subjects such as epidemiology, biostatics, health management and disease modelling, to list a few.
  • In the absence of trained public health professionals at the policy and decision making levels, India’s pandemic response ended up becoming bureaucrat steered and clinician led.
  • A trained public health workforce ensures that people receive holistic health care, of preventive and promotive services (largely in the domain of public health) as well as curative and diagnostic services (as part of medical care)
  • In the 15 years since the first release of the IPHS, only a small proportion — around 15% to 20% — of government health-care facilities meets these standards.
  • Opportunities such as a revision of the IPHS should also be used for an independent assessment on how the IPHS has improved the quality of health services. 

Way Ahead:

  • The effective part of implementation is interplay: policy formulation, financial allocation, and the availability of a trained workforce.
    • In this case, policy has been formulated. The 15th Finance Commission grant for the 5 year period of 2021- 26 and PM-ABHIM allocations are available for strengthening public health services and could be used as catalytic funding.
  • The idea of mapping and analysis of human resources for public health and then scaling up of recruitment are logical.
  • Setting up these two new cadres should be used to improve and standardise the quality of training in public health institutions. 
  • The public health and management cadres and the revised IPHS can help India to make progress towards the NHP goal.



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