UPSC MainsGENERAL-STUDIES-PAPER-I201215 Marks150 Words
Q7.

There is an urgent need for the Planning Commission to revise the chapter on health in the 12th Plan document." Comment.

How to Approach

This question requires a critical assessment of the relevance of the Planning Commission’s (now NITI Aayog) 12th Plan document’s health chapter in the context of evolving health challenges and policy changes. The answer should highlight the shortcomings of the 12th Plan’s approach, focusing on areas like financing, public health infrastructure, disease burden, and emerging health issues. A structure focusing on the context of the 12th Plan, its limitations, and the need for revision is recommended.

Model Answer

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Introduction

The Planning Commission of India, prior to its replacement by NITI Aayog in 2015, played a crucial role in formulating five-year plans that guided the nation’s economic and social development. The 12th Plan (2012-2017) aimed for faster, sustainable, and more inclusive growth, with a dedicated chapter on health. However, the rapidly changing health landscape of India, characterized by a rising burden of non-communicable diseases, increasing healthcare costs, and the emergence of new health threats, necessitates a thorough revision of the health chapter. This is particularly relevant given the shortcomings identified in the plan’s implementation and the subsequent policy shifts in the health sector.

Context of the 12th Plan’s Health Chapter

The 12th Plan document recognized the importance of health as a critical component of human capital and economic growth. It focused on strengthening the public health system, improving access to healthcare services, and addressing key health challenges like maternal and child health, communicable diseases, and nutritional deficiencies. The plan proposed increasing health expenditure to 1.75% of GDP by the end of the 12th Plan period.

Limitations of the 12th Plan’s Approach

Insufficient Financial Allocation

Despite the proposed increase, the actual health expenditure remained significantly below the target of 1.75% of GDP. According to the National Health Profile (2018), public health expenditure in India was around 1.15% of GDP. This underfunding hampered the effective implementation of various health programs and initiatives.

Focus on Communicable Diseases

The 12th Plan largely focused on communicable diseases like HIV/AIDS, tuberculosis, and malaria, while the rising burden of non-communicable diseases (NCDs) – cardiovascular diseases, cancer, diabetes, and chronic respiratory diseases – received relatively less attention. The National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS) was launched in 2010, but its implementation faced challenges due to limited resources and inadequate infrastructure.

Weak Public Health Infrastructure

The plan did not adequately address the critical gaps in public health infrastructure, particularly in rural areas. Shortages of healthcare professionals, inadequate diagnostic facilities, and poor supply chain management hindered the delivery of quality healthcare services. The Rural Health Statistics (2018) revealed significant shortages of doctors and nurses in Primary Health Centres (PHCs) and Community Health Centres (CHCs).

Limited Focus on Universal Health Coverage (UHC)

While the 12th Plan acknowledged the need for UHC, it lacked a concrete roadmap for achieving it. The National Health Policy 2017, formulated after the 12th Plan, explicitly emphasized UHC as a key objective, aiming to provide affordable and quality healthcare to all citizens.

Emerging Health Challenges

The 12th Plan did not adequately anticipate or address emerging health challenges like antimicrobial resistance (AMR), climate change-related health impacts, and the increasing prevalence of mental health disorders. The National Action Plan on Climate Change and Human Health (2019) highlights the growing threat of climate change to public health.

Need for Revision

A revised health chapter is crucial to address these shortcomings and align with the current health priorities of the nation. The revision should prioritize:

  • Increased investment in health: Raising public health expenditure to at least 2.5% of GDP, as recommended by the National Health Policy 2017.
  • Strengthening primary healthcare: Focusing on strengthening PHCs and CHCs as the first point of contact for healthcare services.
  • Addressing NCDs: Developing comprehensive strategies for prevention, early detection, and management of NCDs.
  • Promoting UHC: Implementing schemes like Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana (PMJAY) to provide financial protection to vulnerable populations.
  • Investing in health infrastructure: Improving the availability of healthcare professionals, diagnostic facilities, and essential medicines.
  • Addressing emerging health threats: Developing strategies to combat AMR, mitigate the health impacts of climate change, and address mental health disorders.

Conclusion

The 12th Plan’s health chapter, while a step in the right direction, fell short of addressing the evolving health challenges facing India. A comprehensive revision is urgently needed to align with the current health priorities, increase investment in the sector, strengthen public health infrastructure, and promote UHC. This revision should be informed by evidence-based research, stakeholder consultations, and a long-term vision for a healthy and prosperous India. The transition to NITI Aayog provides an opportunity to build a more responsive and effective health planning framework.

Answer Length

This is a comprehensive model answer for learning purposes and may exceed the word limit. In the exam, always adhere to the prescribed word count.

Additional Resources

Key Definitions

Universal Health Coverage (UHC)
UHC means that all people have access to the health services they need, when and where they need them, without facing financial hardship.
Non-Communicable Diseases (NCDs)
NCDs are chronic diseases that are not infectious, such as cardiovascular diseases, cancer, diabetes, and chronic respiratory diseases.

Key Statistics

India’s public health expenditure was 1.15% of GDP in 2018.

Source: National Health Profile, 2018

NCDs are responsible for approximately 63% of all deaths in India (2019).

Source: World Health Organization (WHO) data, 2019 (knowledge cutoff)

Examples

Ayushman Bharat – PMJAY

Launched in 2018, PMJAY provides health insurance coverage of up to ₹5 lakh per family per year to over 10 crore vulnerable families.

Frequently Asked Questions

What were the main goals of the 12th Five Year Plan regarding health?

The 12th Plan aimed to strengthen the public health system, improve access to healthcare, reduce infant and maternal mortality rates, and control communicable diseases. It also proposed increasing health expenditure and addressing nutritional deficiencies.

Topics Covered

EconomyHealthHealthcare PolicyPublic HealthEconomic PlanningSocial Sector