There has been a paradigm shift in the approach from the first National Health Policy, 1983 which emphasized on promotive, preventive curative and rehabilitative services. The National Health Policy, 2002 shifted its emphasis towards the provision of healthcare through private sector and opening up secondary and tertiary level healthcare for private investment.The spirit and principles of Primary healthcare was compromised by shirking the responsibility for health by the public sector. This resulted in a setback to the equitable distribution of health for the people.The National Rural Health Mission was launched in 2005. It was later extended to urban areas also as National Urban Health Mission in 2011. Consequently, the two were merged as National Health Mission in year 2013. However, implementation of national health mission remained fragmentary and half-hearted.The National Health Policy (NHP) 2017 however made a leap forward to corporate-centric and insurance-based healthcare system. It also highlighted on strategic purchase of non govt. secondary and tertiary care services. Insurance system was further strengthened and as a result public funds are diverted to the private insurance and healthcare sector.As a result, 75 per cent of healthcare expenditure comes from the pockets of households – 80 per cent for OPD care and 60 per cent for Indoor care. Every year 6.3 crore population of India is pushed towards poverty due to out-of-pocket expenditure. This catastrophic healthcare cost is an important cause of impoverishment which further adds to poor health.India has roughly 20 health workers per 10,000 population, with 39.6 per cent doctors, 30.5 per cent nurses and midwives, and 1.2 per cent dentists. Of all doctors, 77.2 per cent are allopathic and 22.8 per cent are ayurvedic, homeopathic or Unani.Total doctor-population ratio 1:1445. It is to be noted that Govt doctor-population ratio is 1:11,926 in contrast to the desired 1:1,000. This is a major cause of in equality in healthcare to the marginalized sections who are dependent solely on state healthcare system.
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