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Reforms in Public Health Management Systems

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October 16, 2017

What is the issue?

Constituting a Public Health Service (PHS) on the lines of IAS has been mooted again recently.   

Who has proposed it?

  • The idea of having dedicated carder for public health management was first advocated by the Mudaliar Committee in 1959.
  • The 1973 Kartar Singh Committee reiterated the same.
  • Recently, the 12th Five Year Plan and the National Health Policy - 2017 have also strongly vouched for it. 

Why PHS?

  • Doctors with no formal training in public health delivery systems were found to be ineffective in handling surveillance systems, data management and community health.
  • Also, they fared poorly in understanding rural social dynamics, managing logistics or draw up project budget estimates.
  • Hence, a need for an exclusive cadre trained to run public health facilities has been felt.
  • Recruiting doctors through the UPSC or their state equivalents has therefore been envisioned.

What is the current scenario?

  • As a proper public health delivery structures are lacking in most States, even anaesthetists are sometimes mandated to run programs for reproductive health or malaria control.
  • Also, at the ministry level, people with no formal training in the principles of public health tend occupy top posts.
  • Despite calls for a public health cadre in various reports, such a service at the national level doesn’t look possible any time soon.
  • Among states, Tamil Nadu has taken the lead in training a specialised cadre for health delivery, which is already showing results.
  • Recently, Odisha has notified the establishment of a dedicated cohort trained in public health.

What are the advantages?

  • Having a dedicated carder will help in reducing the need for deputing specialists for running public health programs.
  • This will enable them to attend to more important duties.
  • This will also enhance the quality of public health delivery and reduce the out-of-pocket health expenditure of the poor. 
  • Constituting an exclusive department will go a long way enhancing training and streamlining management procedures in public health delivery systems.
  • The reach of such cadre to positions within the ministry will have a profound impact on future health policies as it will reflect ground realities better.

 

Source: The Hindu

 

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