ealth promotion is the process
of enabling people to increase control over, and to improve, their
health. It was 30 years ago that World Health Organization (WHO) had
conducted its first conference on health promotion. At its conclusion,
they adopted ‘Ottawa charter for health promotion’. It was a hinge
between past and future as it pooled the principles and ideas that were
evolving around five major strategies and expressed a vision of the
future.
The practice of public health has been dynamic in
India. The major public health problems like malaria, tuberculosis,
leprosy, high maternal and child mortality and human immunodeficiency
virus (HIV) have been addressed well, leading to decrease in the
mortality rates [1]. However, there are multiple problems yet to be
focused on. As people are divided into various social strata as per
their income, occupation, education, race or ethnicity, the inequalities
in health are also seen. To meet the formidable challenges, there is an
urgent call for revitalizing primary health care based on the principles
outlined at Alma-Ata in 1978: Universal access and coverage, equity,
community participation in defining and implementing health agendas, and
intersectoral approaches to health. Attempts to achieve "Health for All"
have been carried forward in the form of "Millenium Development Goals"
[1]. However, the role of government is crucial for addressing these
challenges and achieving health equity. The Ministry of Health and
Family Welfare (MOHFW) plays a key role in guiding India’s public health
system. Contribution to health of a population derives from systems
outside the formal health care system, and this potential of
intersectoral contributions to the health of communities is increasingly
recognized worldwide. Thus, the role of government in influencing
population health is not limited within the health sector but also by
various sectors outside the health systems [1].
Health System Strengthening
Important issues that the health systems must
confront are: lack of financial and material resources, health workforce
issues and the challenge of implementing health policies in a
pluralistic environment [1]. The National Rural Health Mission (NRHM)
launched by the Government of India is a leap forward in establishing
effective integration and convergence of health services, and affecting
architectural correction in the health care delivery system in India.
Mechanisms to monitor epidemiological challenges like mental health,
occupational health and other environment risks are yet to be put in
place.
Conclusion
Promotion of multisectoral approach within the health
system and with other ministries is seen as an important measure for
effective implementation. Strengthening communication is one of the key
requisites for ensuring multisectoral coordination [2]. Social
determinants of health and economic issues must be dealt with a
consensus on ethical principles – universalism, justice, dignity,
security and human rights.
It is true that a lot has been achieved in the past.
The milestones in the history of public health that have had a telling
effect on millions of lives – launch of Expanded Program of Immunization
in 1974, Primary Health Care enunciated at Alma-Ata in 1978, eradication
of smallpox in 1979, launch of polio eradication in 1988, and COTPA Act
of 2005, etc. It was a glorious past, but the future of a healthy
India lies in mainstreaming the public health agenda in the framework of
sustainable development.
References
