Health Policy Issues and Health Programmes in ... - Amazon S3

National Health Programmes: An OverviewEven if the programmes are not fully integrated horizontally at the district level, the concernedprogramme officials have to delineate the job charts for the different staff members under theirprogramme, and share them with officers of other programmes so that these activities can becoordinated. The staff can spell out the activities to be performed under each programme duringa home visit, and give appropriate training and orientation to the concerned staff, as done in theReproductive and Child Health (RCH) Programme for integrated skills training. Similarcoordination is required for clinic activities; maintenance of records and reports; information,education, and communication (IEC); resource planning and so forth.Need for Inter-sectoral CooperationAs already mentioned in the NHP 2002, the overall well-being of the people will depend on thesynergistic functioning of the various socio-economic sectors. This is true for the nationalhealth programmes. One example could be the control programmes against vector-bornediseases, particularly the mosquito. The use of insecticides and environmental control toprevent vector breeding are the anti-vector measures adopted under the programme. In this,the role of developmental projects is well known and project areas have been identifiedcorresponding to risk areas for malaria. Joint planning and consultation with health experts forhealth impact assessment of projects are extremely important for the success of malariacontrol activities.Another important aspect of vector-borne disease control is the use of insecticides. There is thedanger of vectors developing insecticide resistance as well as the apprehension about the effectsof insecticides on health through the contamination of food, water and soil. Different sectors,particularly agriculture, are using insecticides in varying strengths and quantities. Joint andcoordinated use of insecticides, keeping in mind the health effects, need to be considered for thefuture. Tapering off on the use of insecticides is already recommended.Need for More Health ResearchThe NHP 2002 has reiterated the need for focus on health research in general, and in particular,regarding the national health programmes. Research on new therapeutic drugs, vaccines,epidemiological characteristics of diseases, and applied research for developing operationalapplications are important. Vaccines already in the advanced stages of development need tobe tested in the field for efficacy, safety, and operational feasibility. Good examples ofprogrammes to demonstrate the utility of research include leprosy, TB, UIP, and iodinedeficiency disorder (IDD) control. Their strategies have been evolved based on the findings ofsound research studies. However, the need is now to promote operational research forexperimenting and standardizing operational and therapeutic practices in more nationalhealth programmes. Many programmes have support from research and traininginstitutions—the National Training Institute (NTI), the Leprosy Research and Training Centre,the RP Centre, the Filaria Research Centre, the Malaria Research Centre, and the CancerResearch Centre. Their roles need to be redefined and activities expanded to get betterprogramme results.26