Union Budget 2018: Health sub-centres gear up for bigger role in preventive care

Published in Indian Express| On February 1, 2018 | By Abantika Ghosh

In a first, there is now a separate allocation of Rs 1,200 crore for preventive health care services — screening for hypertension, diabetes, and cancers — in health sub-centres, taking them beyond the reproductive health care that they have fulfilled until now.

Together with another Rs 800 crore allocation from states, this initial Rs 2,000 crore is the first real effort of the Centre to move away from a curative-focussed health system.

The Health Ministry is expecting a cumulative budget increase of about Rs 5,000 crore this year on the little over Rs 47,000 crore allocated to it last year. “We have been assured of an 11-per cent increase in allocation this year,” a source said.

The growing burden of non-communicable diseases such as diabetes, hypertension and cancer is the most stark feature of India’s changing disease burden. For long, experts have called for a comprehensive preventive model to tackle this feature.

The National Health Policy unveiled last year also stressed on prevention, and this is seen as the first step in that direction.

In its meeting last month, the empowered programme committee of the National Health Mission (NHM) approved Rs 1,200 crore for NHM for 2018-19, and Rs 1,600 crore for 2019-20 for comprehensive primary health care. This means health sub-centres, the lowest rung of the NHM structure, will, for the first time, move beyond providing antenatal and postnatal care such as vaccinations (but not deliveries).

The development means health sub-centres will have equipment and trained personnel for screening of cancers (cervical, oral and breast), hypertension, diabetes and cardiovascular diseases, and also provide a few basic medicines essential at that level.

According to the blueprint by the ministry, the new centres — to be called “health and wellness centres” — will provide comprehensive maternal health care services at sites equipped to service as “delivery point”, neonatal and infant health care services, childhood and adolescent health care, contraceptive services, reproductive health care, management of communicable diseases, screening and comprehensive management of non-communicable diseases, basic ophthalmic care services, basic ENT care, screening and basic management of mental health ailments, basic dental health and geriatric health care.

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