Policy framework

A health policy formulated first in 1947 was based on two broad principles i.e. no denial of care for want of ability to pay and that it was the state’s responsibility to provide healthcare to its people. However, with time it became necessary to revisit the principles of the premises taken in this policy. The first National Health Policy was formulated in 1983 which took a view that private sector initiative in healthcare was an imperative and that there was a need to increase publicly funded primary care access. Thereafter the National Health Policy was revised in 2002 with a view to providing increased access to decentralized public health system, enhancing public health investment and converging public programmes.
States, over the years, have formulated their own policies for promotion and expansion of health services with a view to expanding the public health system and also encouraging private sector investments. Gujarat has also formulated several policies in these regards. A brief overview of the policies has been provided in the following sections.

1) Public Health Act, 2007 (draft)

The public health act of 2007 has been formulated with a view to recognize and delineate the health rights of citizens, duties of the public health system and specifies broad legal and organizational mechanisms to operationalize these rights.
The act outlines the Duties of the State Government and the Public Health Authority and provides for the formulation of a State Public Health Board and preparation of Public Health Plans. It also defines the structures of Public Health System for rural and urban areas. It outlines the conditions of Public Health Importance, Notifiable Diseases and Locally Endemic Diseases, organization of public health management in situations of disasters, mitigation of outbreaks and the provisions during a public health emergency. The act also lays down the right and duties of functionaries and users of the health care establishments.

2) Population Policy

Gujarat is marked by socio-economic disparities within the state, among districts, between urban and rural areas. There is a need to reduce these disparities with area-specific approach to reach out to the indigent sections. The increasing population of the state puts pressures on natural resources with large part of the state being arid or semi-arid. Increasing urbanization and migration are also causing various social problems such as crime, poverty, destitution and spread of diseases like HIV/AIDS.
The objective of the State Population Policy is to provide integrated reproductive health care services, including addressing the unmet need for contraception. The state will strengthen health care infrastructure and support systems to improve access to these services to reduce the total fertility rate (TFR) from its current level of 3.0 to replacement level of fertility 2.1 by the year 2010. In achieving these objectives, an inter-sectoral approach will be adopted.

3) Mental Health Policy

The goal of the mental health policy is to develop effective, efficient and adequate provision and mechanisms for community based mental health including promotion, prevention, treatment and rehabilitation, supported by a network of primary, secondary and tertiary services in public and private sectors. The main directions through which the policy goal will be achieved are divided into four areas:

  • Service provision
  • Institutional development and finance (including policy formulation and planning capacity)
  • Organisational linkages
  • Boundary conditions
In order to facilitate innovations in the Mental Health Sector, the government is in the process of establishing an organisation which will stimulate, fund, and guide innovation projects in the sector. This organisation, the Gujarat Foundation for Mental Health and Allied Sciences – is registered as a not-for-profit company. The main tasks of the Mental Health Foundation will be:
  • Invite interested parties to submit project proposals within the scope of the policy directions
  • Monitor and evaluate project implementation
  • Prepare recommendations for policy decisions
  • Advise the Government on administrative reform issues
  • Promote multi-stakeholder cooperation in Mental Health Sector development
  • Set up a Mental Health documentation system