James Miahlung
Kum 1978 khan Soviet Union hun laia khawpui pakhat, tuna Kazakstan ram chhunga awm ta Alma Ata-ah World Health Organisation bultumin International Conference on Primary Healthcare neih niin, he conference-a tel ram hrang hrang aiawhte chuan hriselna lama a bul thut -a hmalakna (Primary health system)tihchak a nih theih nan hmachawp hrang hrang pawm in, thuchhuah intawm(Alma Ata declaration) an siam a. Alma Ata declaration hi ram hrang hrangte health policy kaihhruaitu pawimawh tak ni chho in, kum tam liam hnuah pawh lamrik a ni leh fo thin.
India hi Alma Ata declaration sign-tute zingah tel ve mah se, Alma Ata thuthlung atanga zawi zawia inhnuk kirin ram thang mekte zingah ram pum sum dehchhuah (GDP)atanga chhuta health lama sum hmang tlem ber pawl a ni mek a ni. Health ministry hnuaia hriselna lama sum sen dan(Health expenditure) zirchianna hnuhnung ber kumin April thlaa tlangzarh tak National Health Accounts(NHA) Estimate, 2019-20 in a chhinchhiah danin 2019-20 ah health lama sum sen zat chu GDP atangin 1.35% chauh niin, National Health Policy(NHP), 2017 in GDP atanga 2.5% tal seng tura a tih a la pha lo nasa hle.
Out of Pocket Expenditure sang
Health sector atan sum dah(Healthcare financing)a hniam avangin private sector(corporate) te healthcare lamah an lut nasa a, tunah chuan private healthcare system hian sawrkar damdawi in(Public health system)aiin mipui mamawh health service an pe chhuak nasa tawh zawk a ni. Health financing a chak tawk lok avangin ram dang nen khaikhin in India ramah damlo inenkawlna a mimal senso(Out of pocket expenditure/OOPE) a sang fal hle. Tun dinhmunah khawvel pum huapa OOPE chawhrual (Global average) chu 18% a nih mek laiin NHA estimates atanga a lan danin India-ah chuan 2019-20 a health expenditure pumpui atangin OOPE hi 52.00% a ni pha a ni.
Private healthcare nasa taka thang mek karah thingtlanga chengte innghahna leh mipui nen inngheng hnai ber tur(First point of contact) primary health system(CHC, PHC leh Sub centre)a nih tur anga thuam a nih loh avangin secondary level(District hospital)in damlo mamawh a phuhruk nasa zawk a. Primary healthcare system hi a nih tur angin kal se, secondary leh tertiary level (Medical college leh super specialty hospital)a health expenditure tam tak kal thin hi hum theih nia ngaih a ni. Public health expert-te ngaihdanah chuan natna tam zawk hi PHC/CHC level-a enkawl theih tur an nih laiin primary healthcare leh invenna lam(preventive care system) a chak tawk lo avangin mipuiin sum leh pai tha leh zung tam tak seng in district hospital leh a aia changtlung zawk damdawi in an pan a ngaih phah thin a ni.
Sawrkar laipuiin primary healthcare atan sum a sen zat pung hret hret angin lang mah se, thingtlang mipui tam zawk chu private health system-ah an la innghat tho a. Kum 2014-15 a Sawrkar health expenditure atanga primary health lamah kal zat 51.3% atangin 2017-18 ah 54.7 % ah a chho mahse National Sample Survey (NSS)75th round(2017-18)in a tarlan danin thingtlanga cheng zingah 52% chuan private damdawi inah tho enkawlna an dawng a ni. Hei hian primary healthcare atan tun aia sum tam zawk dah a pawimawhzia a tilang.
State/UT sawrkar health expenditure
Kum 2005-ah National Rural Health Mission(NHRM), a hnua National Health Mission(NHM) in a thlak tak chu kalpui tan niin, NHRM atangin rural health system tihchangtlun nan state sawrkarte hnenah sum tam zawk pek a ni. NRHM hian health infrastructure leh hriselna lama tehfung (health indicator) hrang hrangah hmasawnna a thlen rualin public health expert thenkhat chuan NRHM/NHM-in nu leh naupang hriselna, Reproductive & Child Health(RCH) lam a thlur bing lutuk nia lang te, state thenkhatin NRHM atanga sum hmuh te primary healthcare thuamchak nan hmang lova health insurance tana an pawhpen leh state sawrkarte ngaihpawimawh zawng ni lova sawrkar laipui duh dan leh ngaihpawimawh zawng mila ruahmanna kal thin nia langte avangin programme-in duhthu a sam tawk lo niin an ngai.
Reserve Bank of India(RBI)in state leh UT sawrkarte sum hman dan a zirchianna atanga a lan danin 2022-23(Budget Estimate)ah state leh UT ten GDP atanga health atana sum an sen zat chawhrual chu 1.1% a ni a. National Health Policy(NPH), 2017 in kum 2020 ah state/UT sawrkar budget atangin 8% aia tam health sector lama kal tawh tura a rawt laiin, 2022-23(BE) state/UT ten an state budget pumpui atanga health sector lama sum an hman ral zat chawhrual chu 5.7 % chauh a ni.
India hmarchhak state pariatte zingah Assam(7.2%), Meghalaya(7.3%) leh Nagaland(7.5%), Mizoram leh Tripura(6.9% ve ve)te 2021-22(Revised Estimate)ah budget pumpui atanga health lama sum hmang tam pawl an ni. NHA estimate, 2019-20 ah Mizoramin state sum dehchhuah(GSDP) atangin 3.4% chu hriselna atan a hmang a, Arunachal Pradesh nen GDSP atanga health lama sum kal tir hnem ber state kan ni a, chutihrual chuan Mizoram State Health Policy, 2022 target(GDP atanga 5% health sector atana hman) kan phak theih nan health financing lamah tun aia nasa zawka tanlak erawh a ngai.
Preventive care leh Health promotion
Indian health system-ah primary level a preventive care leh health promotion lamin ngaihsak a hlawh tawk lo nia sawi a ni thin. NHA estimate-in a chhinchhiah danin 2019-20 a health expenditure pumpui atangin 23.85% , 10.09%, leh 15.81% chu damdawi ina inenkawlna (generalized in patient curative care), natna khirh zual inenkawlna (Specialised in patient curative care) leh in lama inenkawlna (outpatient curative care) atan sen a nih laiin natna hmuhchhuah hmah theihna tura hmalakna (Early disease detection programme), hriselna lam hawi inzirtirna(Information, Communication & Education) leh hrih darh dan zirchianna leh natna thununna lam hawi hmalakna ( Epidemiological surveillance & disease control programme)lamah erawh health expenditure pumpui atangin 0.07%, 0.60% leh 2.77% chauh a kal ve thung.
Inkaichhawn theih loh natna non communicable disease chi hrang hrang-cancer, thisen sang, zun thlum leh adt- avanga phurrit(disease burden) sang zel leh hmelhriat ngaih loh natna hlauhawm tak tak, covid-19 leh ramsa atanga kaih theih (zoonotic disease) hrang hrang lo hluar chho zelah tun aiin public health/health promotion leh Epidemiological surveillance tan sum tam zawk dah a tul.
Mizoram State Health Policy, 2022 in NCD lama hmalakna kalpuina kawnga harsatna tawh a tarlan zingah screening tih hnua case chhutzui tlem te, community level awareness tha tawk lo te, district thenkhatah PHC level-ah tobacco control chak tawk lo leh cancer screening district level-ah chauh kalpui theih te hi a langsar zual te an ni. Kum 2022-23 Mizoram state NHM Record of Proceeding (RoP)a tarlan a nih danin RCH tan nuai 1400.58, NCD lama hmalakna (NPCDCS) atan nuai 176.24, tleirawl kum 10-19 inkar zinga hmalakna (RKSK) leh school health programme atan nuai 221.87 leh awareness/ inzirtirna (IEC) atan nuai 34.53 te pawm an ni.
NCD avanga thihna titlem tur leh health ministry “75-25” target( 2025 ah PHC kaltlangin mi maktaduai 75 te thisen sang leh zunthlum screening leh enkawlna pek vek) tihhlawhtlin a nih theih nan ram pum huapa department/agency, NGO leh civil society te tanrualna (Multi sectoral approach)a ngai a. Damdawi hmanga inenkawlna (Biomedical intervention) bakah mipuiin ei leh in leh khawsak phung thlakthleng an mamawh a, hemi atan hian khawtlanga inzirtirna leh natna hmuhchhuah(screening & diagnosis) lamah chak lehzualin hmalakna a awm a ngai a, sum pawh tun aia tam zawk dah a tul hial ang.
Mipui a bikin thingtlanga chengte hriselna dinhmun chawikanna tur leh damlo inenkawlna senso(OOPE)sang lutuk tihniam turin health care scheme/health insurance lama hmalak chiam emaw secondary health system tihchangtlun ringawt a tawk dawn lova, primary healthcare leh invenna lamah chak zawka hmalakna tur sum tam zawk dah nise, health sector-ah tun aiin kan dinhmun a that zawk ngei a rinawm.
(Thu ziah hi mimal ngaihdan a ni)