Five Year Plans

FIVEYEARPLANS

By: Ms. Priyanka BansalMsc. Nursing- I year

Rufaida College of nursing.

INTRODUCTION Before India attained independence on 15 August 1947, some of the provinces & princely states of India were parted to constitute Pakistan. This effected change in demographic, political & socio-economic aspects. The Government of India at that time faced a large number of socio-economic & public health problems.

In 1950, planning commission was constituted to help government to plan out integrated development plans for entire country within available recourses for a definite period of five years for its socio economic progress.

PLANNINGCOMMISION

The planning commission consists of a Chairman, Deputy Chairman and 5 members. The planning commission works through 3 major divisions – Programme advisers, general secretariat and Technical divisions which are responsible for sruitinising and analysing various schemes and projects to be incorporated in the five year plans. By its term of reference, the planning commission also reviews from time to time the progress made in the various directions and to make recommendations to government on problems and policies relevant to the pursuit of rapid and balanced economic development

HEALTH SECTOR PLANNING Since “health” is an important contributory factor in

the utilization of man power, the planning commission gave considerable importance to health programmes in the Five Year Plans. For purpose of planning, the health sector has been divided into the following sub- sectors:

Water supply and sanitation Control of communicable diseases Medical education, training and research Medical care including hospitals, dispensaries and

primary health centres Public health services Family planning Indigenous systems of medicine

FIVE YEAR PLANSThe following general Health objectives have been

considered in “Five Year Plans” right from the beginning:

Control and eradication of various communicable diseases, deficiency disease and chronic diseases.

Strengthening of medical and basic health services by establishing District Health Units, Primary Health Centres and Sub-Centres.

Population control Development of health manpower resources and

research. Development of Indigenous System of Medicine. Improvement of environmental sanitation. Drug control

(1950 – 1955)

THE FIRST FIVE YEAR PLAN

The aim: To fight against diseases, malnutrition, &

unhealthy environment. To built up health services for rural population

& for mothers 7 children in order to improve general health status of people.

The priorities: The areas in order of priorities included: Safe water supply & sanitation. Control of malaria. Health care of rural population. Health services of mother & children. Education, training & health education. Self sufficiency in drugs & equipments. Family planning & population control.

The Health Outlay:

A sum of Rs.140 crores was allocated for health programmes during first five year plan which was 2.9% of total outlay (Rs.2356 crores) for entire development plan.

The Major Developments: BCG vaccination programme to prevent & control

tuberculosis was launched. Primary health centers were set up by to render health

services in rural areas. The National Malaria Control Programme was launched. The National family planning Programme was launched. The National Leprosy Control Programme was launched. The National Water Supply & Sanitation Programme was

launched. The prevention of food Adulteration Act was enacted. The committee made various recommendations in general to

improve nursing care & nursing service condition of nurses. The national filaria control programme was launched. The minimum age of 18 year for boys & 15 year for girls was

prescribed by Hindu act marriage act.

(1956 – 1961)

THE SECOND FIVE YEAR PLAN

The aim : The aim of second five year plan was extend

existing health services to bring them with in reach of all people so as promote progressive improvement of nation’s health.

The priorities: Establishment of institutional facilities for rural

as well as for urban population. Development of technical manpower Control of communicable diseases. Water supply & sanitation. Family planning & other supportive

programmes.

The health outlay

An out play of 225 cores was allocated for second five year plan for health programmes which was 5.0 percent of entire outlay for total development plan. This proportionate outplay was less than the first year plan by 0.9 percent.

The major developments The Central Health Education Bureau was

established. The National Malaria Control Programme Was

converted into National Malaria Eradication Programme.

The Mudliar committee was set up by government of India .

Pilot project of small pox eradication was started. A National Nutrition Advisory committee was

formed to render services on nutrition policies. The School Health Committee was appointed by

the Union Ministry of health

(1961 – 1966)

THE THIRD FIVE YEAR PLAN

The aim : The aim of third year plan was to remove the shortage

& deficiencies which are observed at the end of second five year plan in the field of health .these were pertaining to institutional facilities especially in rural areas shortages of trained personnel & supplies lack of safe water in rural areas & inadequate drainage system.

  The priorities: Safe water supply in villages & sanitation especially the

drainage program in urban areas. Expansion of institutional facilities to promote

accessibility especially in rural areas Eradication of malaria & smallpox control of various

communicable diseases. Family planning & other supporting services for

improving the health status of people Development of manpower

The health outlay An outlay of Rs. 342 crores was

allocated for 3rd five year plan which was 4.3% of the total outlay for the entire development plan. Though the outlay for health plan in crores is more than the outlay for previous plan but the proportionate percentage of the total outlay of the development plan was much less than the previous plan.

The major developments: The central bureau of Health intelligence was established. The Mudliar Committee report was submitted &

published. As for nursing education was concerned the

committee recommended: Three grades of nurses: the basic nurse with 4 years of

course including 6 months in midwifery & 6 months in public health nursing.

Providing facilities for higher qualification & specialized courses.

Continue training of midwives who will gradually replace the dais working at central places

Replace health visitors by public health nurses who would have basic nursing & midwifery qualifications & one year further training in public health nursing.

The National Smallpox Eradication programme was launched & National Goiter Control Programme was launched.

The school health programme was started. The Applied Nutrition Programme was started by

the government of India, with the support of UNICEF, WHO, & FAO.

The drinking water board was established. The Chadha committee was appointed by the

government to study the arrangements necessary for the maintenance phase of National Malaria Eradication Programme.

A medical education committee was appointed to study the various aspects of medical education with in the frame work of national needs & recourses./

A bill on registration of births & deaths was passed by the parliament.

(1969 – 1974)

THE FOURTH FIVE YEAR PLAN

The aim: The main aim of this plan was to strengthened

primary health center in the rural area for undertaking preventive, curative, & family planning services & to take over the maintenance phase of communicable diseases.

  The priorities: Family planning programme Strengthening of PHC Strengthening of sub divisional & district hospital to

provide effective referral support of PHC. Intensification of control programmes. Expansion of medical & nursing education, training

of paramedical personnel to meet the minimum technical manpower requirements.

The health outlay

Of the total outlay of Rs.16, 774 crores on the entire development plan, Rs. 340 crores were allocated to health & Rs. 315 crores to family planning.

The major developments: The comprehensive legislation for control of

the river & water pollution form domestic & industrial wastage was drafted.

The Central Births & Deaths Registration Act (1969) was promulgated.

The Population Council of India was setup. All India Hospital (postpartum) Family

Planning Programme was launched. The MTP Act was implemented. The National Programme of Minimum Needs

Programme (MNP) was formulated. The Kartar Singh committee submitted its

report.

(1974 – 1979)

THE FIFTH FIVE YEAR PLAN

AIM To provide minimum level of well integrated health, MCH

and FP, Nutrition and immunization services to all with special reference to vulnerable group especially children, pregnant & nursing mothers

To remove imbalance in respect of medical facilities and strengthening the health infrastructure in rural and tribal areas.

PRIORITIES Increasing accessibility of health services in rural areas Correcting regional imbalance Further development of referral services by removing

deficiencies in district & subdivision hospitals. Intensification of the control and eradication of

communicable disease especially Malaria & Smallpox. Qualitative improvement in the education and training of

health personnel.

THE HEALTH LAYOUT

Total Outlay For Overall Development Plan Was Rs.32,382 crore. Out Of Which Rs.682 crore for Health Programs and Rs.497 crore were allocated to Family Planning.

MAJOR DEVELOPMENTS The year 1974 was declared as World

Population Year by United Nations. India became small pox free on 5th July 1975. Integrated Child Development Scheme was

launched on 3rd Oct 1975. The ESI act was amended. The Child marriage Restraint (Amendment) Bill

1978 fixing the minimum marriage age i.e. 21 years for boys & 18 years for girls was passed.

Alma Ata declared “Primary Health Care Strategy” to achieve the goal of “Health for all by the year 2000.

(1980 – 1984)

THE SIXTH FIVE YEAR PLAN

AIM AND OBJECTIVES Increasing the accessibility of health services to

rural areas. Correcting regional imbalances. Further development of referral services by removal

of deficiencies in District/Sub-divisional hopitals; Intensification of the control/eradication of

communicable diseases especially Malaria and Smallpox;

Qualitative improvement in the education and training of health personnel; and

Development of referral services by providing specialist attention to common diseases in rural areas.

THE HEALTH LAYOUT

The total outlay for the Health Sector was Rs. 3392.89 crores.

MAJOR DEVELOPMENTS 1980- Small pox was declared eradicated from

entire world by World Health Assembly

1981- India committed to the goal of providing safe drinking water and adequate sanitation for all by 1990.

Prevention and control of Air Pollution was introduced.

1982- National Health Policy announced.

1984- Bhopal gas Tragedy – An Industrial accident occurred in the union carbide Factory at Bhopal (M.P.)

(1986 – 1991)

THE SEVENTH FIVE YEAR PLAN

OBJECTIVES, GOALS AND STRATEGY Nutrition, safe drinking water supply and sanitation,

housing, education information and communication and social welfare will be made as part of the package for achieving the goal of Health for all by 2000 AD.

Urban health services, school health services and mental and dental health services also need special efforts to ensure comprehensive coverage.

For the control and eradication of communicable diseases, programme implementation at all levels needs strengthening with strict adherence to the sharing of the costs of the programme by State Government.

Medical training must be need-based, problem-centered and community-oriented.

THE HEALTH LAYOUT

The outlays for the family welfare programme are being stepped up to Rs. 3,256 crores

MAJOR DEVELOPMENTS 1985- Universal Immunization Programme was launched

1986- The environment Protection Act was promulgated.

1987- National Aids control programme started. The Government of India appointed a High Power Committee

on Nursing Profession to go into the working conditions of nurses, nursing education and other related matter.

1989- Blood Safety Programme was launched

1990- Control of acute respiratory infections (ARI) programme initiated as a pilot project in 14 districts.

1991- India stages the last decadal census of the country.

(1992 – 1997)

THE EIGHTH FIVE YEAR PLAN

OBJECTIVES Eight Plan priority is for the

development of the social sector with particular stress on human development.

MAIN THRUSTS Health facilities must reach the entire

population by the end of plan. “Health for under privileged” will be

promoted consciously and consistently. Health for high risk vulnerable groups

i.e. mothers and children.

OUTLAY The size of the State's Eighth Five Year Plan (1992-97)

was kept at Rs. 11500.00 crores. Compared with the size of the Seventh Five-Year Plan, it was higher by 283 per cent. This substantial step up was necessary in view of the comparative backwardness of the State. Sector-wise, the highest priority had been assigned to the Power sector, for which 28.31 per cent of the total Plan size had been earmarked. Social and Community Services (21.41 per cent), Irrigation and Flood Control (16.70 per cent), Agriculture and Allied Activities (11.19 per cent) and Rural Development (8.88 per cent) followed. Among other sectors, Transport claimed 6.82 per cent, Industry and Minerals 4.66 per cent, Special Area Programmes 0.73 per cent and Economic and General Services and Scientific Services 1.30 per cent.

MAJOR DEVELOPMENTS 1992: Child survival and safe motherhood programme (CSSM) was

started .

1993: A revised strategy for National Tuberculosis Programme with (DOTS) was introduced.

1994: The first Pulse Polio immunization programme for child under 3 years

was organized. Post-Basic three year B.Sc. Nursing programme was launched

through distance education by Indira Gandhi National Open University (IGNOU).

1995: Integrated child development scheme (ICDS) was changed to

Integrated Mother and Child Development (IMCD) services.

1996: Prenatal Diagnostic Techniques (Regulation and Prevention of

Misuse) Act 1994 came into force form January.

(1997 – 2002)

THE NINTH FIVE YEAR PLAN

The aim- attaining objectives like speedy industrialization, human development, full-scale employment, poverty reduction, and self-reliance on domestic resources.

  The priorities: The areas in order of priorities included: To prioritize agricultural sector and emphasize on the rural

development To generate adequate employment opportunities and promote

poverty reduction To stabilize the prices in order to accelerate the growth rate of the

economy To ensure food and nutritional security To provide for the basic infrastructural facilities like education for

all, safe drinking water, primary health care, transport, energy To check the growing population increase To encourage social issues like women empowerment, conservation

of certain benefits for the Special Groups of the society To create a liberal market for increase in private investments

MAJOR DEVELOPMENTS 1997: Reproductive and Child Health Programme launched.

1998-99: National Malaria Eradication Programme renamed as National Anti-

Malaria Programme. National Policy for older persons announced.

2000: Government of India announced National Population Policy- 2000. Declared guinea worm free country. Signatory to UN Millennium Declaration. National Commission on Population constituted.

2001: National Policy for empowerment of women launched on 20th March

2001.

2002: National Health Policy 2002 announced. Govt. announces National AIDS Prevention and control Policy 2002.

(2002 - 2007)

THE TENTH FIVE YEAR PLAN

OBJECTIVES: Attain 8% GDP growth per year. Reduction of poverty ratio by 5 percentage

points by 2007; Providing gainful and high-quality employment

at least to the addition to the labour force;*All children in India in school by 2003; all children to complete 5 years of schooling by 2007;

Reduction in gender gaps in literacy and wage rates by at least 50% by 2007;*Reduction in the decadal rate of population growth between 2001 and 2011 to 16.2%;*Increase in Literacy Rates to 75 per cent within the Tenth Plan period (2002 to 2007).

MAJOR DEVELOPMENTS 2003: Parliament approves the Cigarettes and other Tobacco Products

Act. National Vector Borne Disease Control Programme approved as

umbrella programme for prevention of vector borne diseases viz. malaria, filarial, Kala-azar, Dengue and Japanese Encephalitis.

2004: Vandemataram Schedule launched. Revised Programme of Nutritional support to primary education

(Mid-day meal scheme launched). Low osmolarity oral rehydration salt replaces the existing

formula. Integrated Disease Surveillance project launched. National guidelines on Infant and Young Child Feeding

formulated.

2005: RCH II launched. Janani Suraksha Yojana launched. National Rural Health Mission launched. Indian Public Health Standards for CHCs formulated. India achieved leprosy elimination target. National Plan of Action for Children 2005 formulated.

2006: WHO releases new pediatric growth chart based on breast fed children. Ban on child labour as domestic servant. RNTCP covers whole country since March 2006. National Family Health Survey III conducted. Ministry of women and Children development carved out of the

Ministry of human resources and development. IMNCI was launched in 16 states.

2007: Indian Public Health Standards for PHC and Sub- centers formulated. Maintenance and welfare of parents and senior citizen bill 2007

passed.

(2007 - 2012)

THE ELEVENTH FIVE YEAR PLAN

OBJECTIVES:

Reduce infant mortality rate to 28 and maternal mortality ratio to 1 per 1000 live births

Reduce Total Fertility Rate to 2.1 Provide clean drinking water for all by 2009

and ensure that there are no slip-backs Reduce malnutrition among children of age

group 0-3 to half its present level Reduce anaemia among women and girls by

50% by the end of the plan Raising the sex ratio for age group 0-6 to 935

by 2011-12 and 950 by 2016-17.

The thrust areas to be pursued during the 11th FYP :

1. Improving health equity NRHM NUHM

2. Adopting a systemic-centric approach rather than a disease-centric approach:

Strengthening health system through upgradation of infrastructure and PPP.

Converging all programs and not allowing vertical structures below district level under different programs

3. Increasing survival: Reducing MMR and improving child sex ratio through gender

responsive health care. Reducing infant and child mortality through HBNC and IMNCI.

Taking full advantage of local enterprise for solving local health problems:

Integrating AYUSH in health system. Increasing the role of RMPs Training the TBAs to make them SBA Propagating low cost and indigenous technology

Preventing indebtedness due to expenditure on health/protecting the poor from health expenditures:

Creating mechanisms for health insurance Health insurance for the unorganized sector

Establishing E-health: Adapting IT for governance. Establishing E-enabled HIMS Increasing role of tele-medicine

Enhancing efforts at disease reduction:

Reversing trend of major diseases Launching new initiatives

Providing focus to health system and bio-medical research:

Focusing on conditions specific to our country.

Making research accountable.

Five year plans are basis for economic development of the country. Health is an important factor for manpower utilization and thus is a part of FYP. Many sub-sectors were under consideration for the health sectors. Health program are main feature of five year plan. Despite achievements under plans, health status was still unsatisfactory.

SUMMARY

CONCULUSION Five year plans made to have uniform

policy for sectors. After every five year, Planning Commission of India plans for the development of country which includes health sector. Many health programs are introduced and recommended under five year plan. For the development of any country in any sector, five year plans are necessary.

REFERENCES BOOKS: Gulani, K.K, COMMUNITY HEALTH NURSING, PRINCIPLES

& PRACTICES, 1st edition, Kumar Publishing House, new Delhi, 2005, 65-73

Basavanthappa, B.T., “NURSING ADMINISTRATION” , 1st edition, Jaypee brothers, New Delhi, 2005, 232-236

Basavanthappa, B.T., “COMMUNITY HEALTH NURSING” , 1st edition Jaypee brothers, New Delhi, 2005,: 613- 615

Park. K , “PREVENTIVE & SOCIAL MEDICINE” , 20th edition ,Banarsidas Bhanot publishers, Jabalpur,2009: 778- 780

WEB LINKS: http://ddws.nic.in/popups/xiplan_bharat%20nirman.pdf http://en.wikipedia.org/wiki/Five-year_plans_of_India

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