Planning process, 5 year plan and commitee reports

DEFINTIONS
• Planning is a process of setting formal guidelines and constraints for
the behaviour of the firm – Ansof and Brundinburg
• Planning is a process of determining the objectives of administrative
effort and devising the means calculated to achieve them.
- Millet
• Health planning is an aid to political and administrative authorities to
decide how health services can be modernized and improved to
provide affective decent health care to the community.

Planning - PURPOSE
• The main purpose of planning is to develop process,
mechanisms and managerial attitudes in order to make
decisions with a better understanding of the future and to
make further decisions, more rapidly, more economically
and without disruption to the ongoing business.

CHARACTERISTICS
 Planning must focus on purpose
 Planning is a continuous and iterative process
 Planning is an integral part of the process of the
administrative system
 Planning is hierarchical in nature
 Planning must have an organizational identification
 Planning should be a pervasive activity covering the entire
organization with all its departments.
 Planning must be precise in its objective, scope and nature
 Planning should always be documented

ADVANTAGES
Planning saves time in the long run.
Planning leads to more effective and faster achievements.
Planning ensure unity of purpose, clear cut methods of doing things
and focuses on the objectives and targets to be achieved.
Planning minimizes the cost of doing a job and help to ensure that
resources are used carefully to achieve objectives.

Concept of health planning
 Health planning is a process to produce health.
 It creates an actionable link between health needs and resources.
 Its nature and scope will depend upon time allowable, number of answerable
questions to be addressed within the process, resources available to support the
process, and the broader political and social environment.

OBJECTIVES
 To clarify the nature of existing health problems within the
total social, cultural, economic and political context.
 To clarify interrelationships between the health sector, its
components and various social and economic factor.
 To identify national objectives, as far as possible in
quantifiable terms
 To identify new and existing program areas
 To help elaborate alternative strategies and to produce feasible
programs for choice by decision making
 To define mechanism for the formulation and implementation
of projects and to suggest procedures as a long term goal, for a
more rational allocation of resources in the field of health
 To identify program areas suitable for external assistance.

LEVELS OF PLANNING
• Central level - Directional planning / Policy Planning
• Intermediate level - Administrative planning
• Peripheral Level - Operational planning

CONSTRAINTS OF HEALTH PLANNING
• Lack of adequate health information system for planning and
monitoring and ultimately for evaluation
• Natural resistance to change
• The relatively low priority often accorded to health by political
decision makers and public
• Absence of trained health administrators and health planners
• Time lag between planning and implementation
• Lack of adequate interprofessional communication
• The inflexibility of educational system
• Inefficient administrative practices
• Inadequate coordination of planning between the different sectors of
socioeconomic development.

NATIONAL HEALTH PLANNING
• National Health Planning is the orderly process of defining national health
problems, identifying unmet needs and surveying the resources to meet
them, establishing the priority goals that are realistic and feasible and
projecting administrative action to accomplish the purpose of accomplished
programme. – WHO,1971

ELEMENTS
• Identifying the health vision and development goals
• Undertaking the strategic health plans
• Monitoring and evaluation

PURPOSES
• To improve the health services
• To match limited resources with many problems
• To eliminate wasteful expenditure and to avoid the
duplication of expenditure
• To develop the best course of action to achieve
defined objectives

STEPS IN HEALTH PLANNING
• Step 1 :Analysis of health situation ( What is)
This involves collection, assessment and interpretation of extensive
health information to determine the health or illness profiles or
experiences of the population of interest

Step 2 : Setting direction, objectives and goals
(What ought to be?)
• It involves setting goals and objectives
• It involves establishing the targets against which current health/
illness profiles or current organizational or system performance will
be compared.
• It is to identify the desirable future outcome may be in the form of
short term or long-term goals.

Step 3: Assessment of resources in term of health
problems and challenges. (Difference between
what is and what ought to be)
• It involves identifying and quantifying the shortfalls of resources
between what is and what ought to be.
• Resources include man, money, material and methods of monitoring,
skill and knowledge.

Step 4 : Range of Solutions and setting of priorities
(Ways to get from what is, to what ought to be )
• Set the priorities and identify the range of solutions or alternatives to
each identified the magnitude of health problem or challenge.
• It include assessing each possible solutions in terms of its feasibility,
cost and effectiveness so alternate solution can be compare with each
other.

Step 5: Selection of best alternative solutions and
preparation of plans (preferred ways to get to
what ought to be )
• This involves a choice of solutions or set of solutions, that should be
implemented to address the problems or challenges identified.
• Prepare a detailed operational and strategic health plan for the
execution.

Step 6 : Implementation of prepared plan ( Putting
in place the best solutions)
• This step involves implementation of the chosen solutions and often
begins with development of an implementation plan and approved by
the policy making authorities.
• This phase requires cooperation of all levels.

Step 7 : Monitoring ( Is everything going on as per
plan)
• Various ongoing managerial or monitoring methods are prepared to
continuously identify and assess the intended and unintended
consequence of implementation actions well in advance.

Step 8 : Evaluation ( Did we get from what is to
what ought to be)
• This is the final step of planning process
• It involves evaluation of the results of implementation to determine
whether the implemented solutions are effective in achieving their
health goals and targets.

Step 9 : Replanning (Overcoming the deficiencies)
• Based on the deficiencies or shortcoming reveals during any step of
planning process, the goals, strategies can be reassessed, modified
and planned in order to achieve the targets.

FIVE YEAR PLANS
 The pioneers of the Indian government formulated 5 years plan to
develop the Indian economy.
 The five years plan in India is framed, executed and monitored by the
Planning Commission of India.
 Jawahar Lal Nehru was the chairman of the first Planning Commission of
India.
 The duty of the chairman of the planning commission in India is served
by the Prime Minister of the country.

OBJECTIVES OF THE HEALTH PROGRAMME
DURING FIVE YEAR PLANS
 Control and eradication of major communicable diseases.
 Strengthening of basic health services through the establishment of
primary health centers and subcenters.
 Population control
 Development of health manpower resources.

Subhealth sectors under Five Year Plans
 Water supply and sanitation
 Control of communicable diseases
 Medical education, training and research
 Medical care including hospitals, dispensaries and PHCs
 Public health Services
 Family Planning and
 Indigenous system of Medicine

THE FIRST FIVE YEAR PLAN (1951- 56)
 Jawaharlal Nehru, 1951.
Objectives
 Agriculture, Community development, Communications, Land
rehabilitation.
 It was based on Harrod-Domar Model.
 The World Health Organisation with the Indian government, addressed
children’s health and reduced infant mortality, contributing to population
growth.
 Community Development program was launched in 1952.

7 point public health program
 Provision of water supply and sanitation
 Control of malaria
 Preventive health care of rural population through health units and
mobile unit
 Health services for mother and children
 Health education
 Self sufficiency in drugs and equipments
 Family planning and population control.

Achievements
 Increase in National Income: The per capita income increased by 11 per cent
and per capita consumption by 8 per cent over the same period.
 Agricultural Development: In the field of agriculture, total food-grains was
69.3 million tones against the target of 62.6 million tones.
 Industrial Production: Industrial production has recorded the increase to the
extent of 38 per cent
 Irrigation and Railway Development: Irrigation facilities were extended to 16
million acres of land. In rail transport, the traffic increased by about 8 per
cent.
 Education: The percentage of facilities of schooling for children in the age
group of 6-11 was 42.0 per cent which rise to 51.0 per cent from 1950-51 to
1955-56.

DISADVANTAGES
 Development of only a few industries and private industry had not
developed

THE SECOND FIVE YEAR PLAN (1956 -61)
 Mahalanobis Plan
 It focused on hydroelectric projects; steel mills, production of coal, railway
tracks.
 It sought to build up an industrial base for the country, particularly in the
public sector.
 The chief landmark reforms in the village power structure by the abolition
of the zamindari system and the creation of cooperatives to stimulate
agriculture growth.

OBJECTIVES
(i) Sizeable increase in the national income to raise the level of living.
(ii) Rapid industrialization with special emphasis on the development of
basic and heavy industries;
(iii) Large expansion of employment opportunities;
(iv) Reduction of inequalities in income and wealth and a more even
distribution of economic power.

ACHIEVEMENTS
 The main achievements are 5 steel plants, a hydro-electric power
project, production of coal increased , more railway lines, land reform
measures, improved the living standards of the people.
 In the field of education, additional schooling facilities at elementary
stage were provided to about 2 lakh children ending March, 1961.
 The centrally sponsored scheme for the expansion of girl education
and training of women teachers was implemented by almost all states.
 The total numbers of primary health units were recorded 2500 ending
March, 1960. The strength of doctors increased from 7000 to 68,000
during the same period.

Disadvantages
 Eliminate the importation of consumer goods
 High tariffs
 Low quotas or banning some items altogether
 License were required for starting new companies.This is when India got
its License Raj, the bureaucratic control over the economy
 When a business was losing money, the Government would prevent them
from shutting down

THIRD FIVE YEAR PLAN (1961- 66)
 The Third Five Year Plan was to provide India a self-generating and self-
reliance economy by 1975-76.
 The main objectives were defense, price stabilization, construction of
dams, cement and fertilizers plants, education etc.
 This plan was interrupted by the chines aggression (1962), Indo- Pak
War(1965), severe drought in 1965-1966.

 The plan focused on water supply environmental sanitation( rural and urban)
health care, control of communicable diseases, medical education, research
and training, other services- health education, school health, Mental health,
health insurance, integrated system of medicine and family planning
Problems
 Sino Indian War, India witnessed increase in price of products. The resulting
inflation

THREE ANNUAL PLANS (1966-68)
 During these plans a whole new agricultural strategy involving wide
spread distribution of High Yielding varieties of seeds, the extensive
use of fertilizers, exploitation of irrigation potential and soil
conservation was put into action to tide over the crisis in agricultural
production.
 The economy basically absorbed the shocks given during the Third
plan, making way for a planned growth.

FOURTH FIVE YEAR PLAN (1969- 74)
 The fourth five year plan is called for greater expenditure in the public
sector, but was not able to meet its national income growth target.
 It was the time of Green revolution.
 Main emphasis on agriculture’s growth rate so that a chain reaction can
start.
 It fared well in the first 2 years with record production, last three years
failure because of poor monsoon.

OBJECTIVES
 Certain objectives of the mudhaliar committee were the base for the fourth five year plan
in relation to health.
The objectives are:
 To provide an effective base for health services in rural areas by strengthening the
primary health centers,
 Strengthening of subdivisional and district hospitals to provide effective referral services
for primary health centre
 Expansion of the medical and nursing education and training of paramedical personnel
to meet the minimum technical manpower requirements.

 Public health and medical programmes are further divided into
Medical education, training and research, control of communicable
diseases, medical care, other public health services and indigenous
system of medicine.
Problems
 A gap was created between the people of the rural areas and those of
the urban areas. Due to recession, famine and drought, India did not
pay much need to long term goals

THE FIFTH FIVE YEAR PLAN (1974 -1979 )
 It is prepared and launched by D.D Dhar proposed to achieve two main
objectives
 Removal of Poverty (‘Garibi Hatao’) and attainment of self reliance.
 The emphasis of this plan was on removing imbalance in respect of
medical facilities and strengthening the health infrastructure in rural
areas

objectives
 Increasing accessibility of health services to rural areas,
 Correcting regional imbalance
 Further development of referral services by removing deficiencies, in district
and sub divisional hospitals,
 Integration of health, family planning and nutrition,
 Intensification of the control and eradication of communicable diseases
especially malaria and small pox ,
 Qualitative improvement in the education and training of health personnel
by converting uni purpose workers to multipurpose workers,
 Development of referral services by providing specialists attention to
common diseases in rural areas.

Problems
 The world economy was in a troublesome state.
 This had a negative impact on the Indian Economy.
 Prices in the energy and food sector skyrocketed and as a consequence
inflation became inevitable.

ROLLING PLAN
 2 plans.
 One by Janta Govt (1978-83) which was in operation for 2 years only
 Other by the congress government when it returned to power in 1980.

THE SIXTH FIVE YEAR PLAN (1980 - 84)
 The Janatha government plan.
 This plan is marked a reversal of the Nehruvian Model.
 Objectives
 to increase in national income,
 modernization of technology,
 ensuring continuous decrease in poverty and unemployment,
 population control through family planning etc.

Problems
 The industrial development was the emphasis of this plan some opposed
it specially the communist groups, this slowed down the pace of progress.

THE SEVENTH FIVE YEAR PLAN (1985 - 89)
 The objectives of seventh five year plan were improving productivity by
upgrading technology.
 The plan emphasized policies and programs, which aimed at rapid growth
in food grains production, increased employment opportunities and
productivity within the framework of basic tenants of planning.
 It was a great success, the economy recorded 6% growth rate against the
targeted 5%.
 It laid a great emphasis on energy and social development.

ANNUAL PLANS (1990 and 1991)
 1989-91 was a period of political instability in India and hence no five year plan was
implemented.
 Between 1990 and 1992, there were only Annual plans. In 1991, India faced a crisis in
foreign exchange(Forex) reserves.
 P.V.Narasimha Rao also called Father of Indian Economic reforms was the twelfth
Prime minister of the republic of India and Head of Congress Party and led one of the
most important administrations in India’s modern history overseeing a major
economic transformations and several incidents affecting national security.
 It was the beginning of privatization and liberalization in India.

THE EIGHTH FIVE YEAR PLAN ( 1992 - 97)
 It was a landmark in the sense that it encouraged private investment in
major public sector undertakings, greater rural and agricultural
development and antipoverty and antiliteracy measures.
 It also continued the emphasis on food security and food grains were also
been exported.
 Modernization of industries was the main target of the eight five year
plans.

 India became a member of the World Trade Organisation on January 1995.
 The main economic performances were rapid economic growth, high
growth of agriculture and allied sector and manufacturing sector, growth
in exports and imports, improvement in trade and current account deficit.

THE NINTH FIVE YEAR PLAN ( 1997 -
2002)
 The main objective of the ninth five year plan were agriculture and rural
development, food and nutritional security, empowerment of women and
accelerating growth rates, providing the basic requirements such as
health, drinking water, sanitation etc.

It was developed in the context of four important dimensions :
Quality of Life,
generation of productive employment,
regional balance
self reliance.

THE TENTH FIVE YEAR PLAN ( 2002 -
2007)
 It is devised to complement and meet the United Nations Millennium
Development Goals (MDG) targets.
 The MDG were issued in 2000 to achieve eight targets to eradicate hunger
and poverty and raise the standards of living worldwide by the year 2015
through global cooperation.
 This plan highlighted the need for reduction of poverty ratio, increase in
literacy rates, reduction in infant mortality rate, economic growth, increase
in forest and tree cover etc providing gainful high quality employment.

TARGETS
1. To achieve the growth rate of GDP @ 8% and reduction of poverty to 20 %
by 2007 and to 10% in 2012,
2. Increased employment generation ,
3. Universal access to primary education by 2007 and literacy rate to 72%
within the plan period and to 80% by 2012,
4. Reduction in gender gaps in literacy and wage rates by atleast 50% by 2007,
5. Reduction in population growth between 2001 and 2011 to 16.2%,
6. Reduction in infant mortality to 45/1000 live birth by 2007 and to 28 by
2012 and maternal mortality to 2/1000 live births,
7. Universal availability of drinking water, cleaning of all major polluted
rivers and
8. Increase in forest cover to 25 percent and a lot of work still needs to be
done in the health sector.

THE ELEVENTH FIVE YEAR PLAN (2007 –
2012)
 The major objectives are income generation, poverty alleviation,
education, health, infrastructure , environment.
Income and poverty
 Accelerate GDP growth from 8% to 10% and then maintain at 10 % in
the 12th plan in order to double per capita income by 2016-17.
 Increase agriculture GDP growth rate to 4%/ year
 Create 70 million new work oppurtunities
Education
 Reduce dropout rates of children from elementary school.
 Increase literacy rate for persons of age 7 yrs or more to 85%
 Lower gender gap in literacy to 10 percentage points.

Health
 Reduce infant mortality rate to 28 and maternal mortality rate to 1 per
1000 live births.
 Reduce total fertility rate to 2.1
 Provide clean drinking water for all by 2009
 Reduce anemia and malnutrition
Women and Children
 Raise the sex ratio for age group 0-6 by 935 by 2011-12 and to 950 by
2016-17.
 Ensure that at least 33 percent of the direct and indirect beneficiaries
of all government schemes are women and girl children
 Ensure that all children enjoy a safe childhood, without any
compulsion to work.

Infrastructure
 Ensure electricity connection to all villages and BPL households by
2009 and round the clock power.
 Ensure all weather road connection to all habitation with population
1000 and above by 2009 and ensure coverage to all habitation by 2015.
 Connect every village by telephone by 2007 and provide broadband
connection to all villages by 2012.
Environment
 Increase forest and tree cover by 5 % points
 Attain WHO standards of air quality in all major cities by 2011- 2012.
 Treat all urban waste water by 2011-12 to clean river water3.

THE TWELFTH FIVE YEAR PLAN (2012 –
2017)
 The Twelfth Five-Year Plan of the Government of India has been decided to
achieve a growth rate of 8.2%
 The Strategies are Strengthening of public sector health care, substantially
increase in health care expenditure, efficient Financial and managerial
systems, coordinated delivery of services, cooperation between the public
and private sector, expansion of skilled human resource, prescription drugs
reforms, Effective regulation through a Public Health Cadre, Inclusive
agenda and Pilots on Universal Health Care.

GOALS
 Reduce Maternal Mortality from 212 to 100,
 Reduce IMR from 44 to 25,
 Reduce underweight children below 3 years from 40% to 23%
 Increase child sex ratio from 914 to 950
 Reduce levels of anemia among women from 55% to 28%
 Reduce Total Fertility Rate from 2.5 to 2.1
 Reduce poor households out-of-pocket expenditure on health.

objectives
 To create 50 million new work opportunities in the non farm sector.
 To remove gender and social gap in school enrolment.
 To enhance access to higher education.
 To reduce malnutrition among children aged 0-3 years.
 To provide electricity to all villages.
 To ensure that 50% of the rural population have accesses to proper
drinking water.
 To increase green cover by 1 million hectare every year.
 To provide access to banking services to 90% of households.

NITI Aayog
(National Institution for Transforming India)
 It is a policy think tank of the Government of India, established with the
aim to achieve Sustainable Development Goals and to enhance
cooperative federalism by fostering the involvement of State Governments
of India in the economic policy-making process using a bottom-up
approach.
 A three-year 'Action Agenda' from 2017-18 to 2019-20.

INITIATIVES
 "15 year road map", "7-year vision(2017 - 2024) , “Strategy and Action plan"
AMRUT,
 Digital India,
Atal Innovation Mission,
Medical Education Reform,
Agriculture reforms (Model Land Leasing Law, Reforms of the
Agricultural Produce Marketing Committee Act, Agricultural Marketing
and Farmer Friendly Reforms Index for ranking states),

Indices Measuring States Performance in Health, Education and Water
Management,
Sub-Group of Chief Ministers on Rationalization of Centrally Sponsored
Scheme
Sub-Group of Chief Ministers on Swachh Bharat Abhiyan
Sub-Group of Chief Ministers on Skill Development,
Task Forces on Agriculture and Elimination of Poverty,
Transforming India Lecture Series

 It was established in 2015, by the NDA government, to replace the
Planning Commission which followed a top-down model.
 The Prime Minister is the Ex-officio chairman.
 The permanent members of the governing council are all the state
Chief Ministers, along with the Chief Ministers of Delhi and
Puducherry, the Lieutenant Governor of Andaman and Nicobar, and a
vice chairman nominated by the Prime Minister.
 The temporary members are selected from leading universities and
research institutions

ACTION AGENDA REGARDING HEALTH
 Focus on public health through significantly increasing government
expenditure on it, establishing a focal point and creating a dedicated
cadre.
 Generate and disseminate periodic, district-level data as per uniform
protocols.
 Formulate a model policy on human resources for health, implement a
bridge course for nurses/AYUSH practitioners in primary care.
 Reform IMC Act and the acts governing homeopathy and Indian systems
of medicine
 Launch the National Nutrition Mission; develop a comprehensive
Nutrition Information System.

• The goal of National Health Planning in India is to attain Health for all by
the year 2000.
• The reports of these committees have formed an important basis of health
planning in India.

BHORE COMMITTEE, 1946.
• The Health Survey & Development Committee
• It appointed Sir Joseph Bhore as its Chairman, 1943.
• It laid emphasis on integration of curative and preventive medicine at all levels.
• It made comprehensive recommendations for remodeling of health services in
India.
• The report, submitted in 1946, had some important recommendations like :-
1.Integration of preventive and curative services of all administrative levels.
2. Development of Primary Health Centres in 2 stages :

a. Short-term measure
• one primary health centre as suggested for a population of 40,000.
• Each PHC was to be manned by 2 doctors, one nurse, four public
health nurses, four midwives, four trained dais, two sanitary
inspectors, two health assistants, one pharmacist and fifteen other
class IV employees.
• Secondary health centre was also envisaged to provide support to
PHC, and to coordinate and supervise their functioning.

b. A long-term programme (also called the 3 million plan)
To set up primary health units with 75 – bedded hospitals for each
10,000 to 20,000 population and secondary units with 650 – bedded
hospital, again regionalised around district hospitals with 2500 beds.
3. Major changes in medical education which includes 3 - month
training in preventive and social medicine to prepare “social
physicians”.

MUDALIAR COMMITTEE, 1962.
• “Health Survey and Planning Committee”
• Dr. A.L. Mudaliar, was appointed to assess the performance in health
sector since the submission of Bhore Committee report.
Recommendations:
• Strengthening of existing PHC before opening of new ones.
• Strengthening of sub divisional and district hospitals was also advised.
• A PHC should not be made to cater to more than 40,000 population .
• PHC should provide the curative, preventive and promotive services.
• An All India Health service should be created to replace the erstwhile
Indian Medical service.

CHADAH COMMITTEE, 1963
• Dr. M.S. Chadha, Director General of Health Services, to advise about the
necessary arrangements for the maintenance phase of National Malaria
Eradication Programme (NMEP).
RECOMMENDATIONS
• Basic health workers (one per 10,000 population) should carried out the
NMEP activity
• The basic health workers would function as multipurpose workers and
would perform, in addition to malaria work, the duties of family planning
and vital statistics data collection.
• They would work under supervision of family planning health assistants

MUKHERJEE COMMITTEE, 1965
• Shri Mukherjee, Secretary of Health to Government of India.
• The recommendations of the Chadha Committee, when implemented,
were found to be impracticable because the basic health workers, with
their multiple functions could do justice neither to malaria work nor to
family planning work.
• The committee was appointed to review the performance in the area of
family planning.

RECOMMENDATIONS
• Separate staff for the family planning programme.
• The family planning assistants were to undertake family planning
duties only.
• The basic health workers were to be utilised for purposes other than
family planning.
• To delink the malaria activities from family planning.

MUKHERJEE COMMITTEE, 1966
• Multiple activities of the mass programmes like family planning, small pox,
leprosy, trachoma, NMEP (maintenance phase), etc. were making it difficult for
the states to undertake these effectively because of shortage of funds.
• A committee of state health secretaries, headed by the Union Health Secretary,
Shri Mukherjee, was set up to look into this problem.
• The committee worked out the details of the Basic Health Service which should
be provided at the Block level, and some consequential strengthening required
at higher levels of administration.

JUNGALWALLA COMMITTEE, 1967
• “Committee on Integration of Health Services” was set up in 1964
under the chairmanship of Dr. N Jungalwalla, Director of National
Institute of Health Administration and Education (currently NIHFW).
• It was asked to look into various problems related to integration of
health services, abolition of private practice by doctors in government
services, and the service conditions of Doctors.

• The committee defined “integrated health services” as :-
a. A service with a unified approach for all problems instead of a
segmented approach for different problems.
b. Medical care and public health programmes should be put under
charge of a single administrator at all levels of hierarchy.

The following steps were recommended for the integration at all levels of
health organisation in the country
1 Unified Cadre
2 Common Seniority
3 Recognition of extra qualifications
4 Equal pay for equal work
5 Special pay for special work
6 Abolition of private practice by government doctors
7 Improvement in their service conditions

SHRIVASTAV COMMITTEE, 1975
• This committee was set up in 1974 as "Group on Medical Education
and Support Manpower" to determine steps needed to
• reorient medical education in accordance with national needs &
priorities and
• develop a curriculum for health assistants who were to function as a
link between medical officers and MPWs.

RECOMMENDATIONS
1. Creation of bonds of paraprofessional and semiprofessional health workers from
within the community itself.
2. Establishment of 3 cadres of health workers namely – multipurpose health workers
and health assistants between the community level workers and doctors at PHC.
3. Development of a “Refferal Services Complex”
4. Establishment of a Medical and Health Education Commission for planning and
implementing the reforms needed in health and medical education on the lines of
University Grants Commission.
Acceptance of the recommendations of the Shrivastava Committee in 1977 led to the
launching of the Rural Health Service

BAJAJ COMMITTEE, 1986
• An "Expert Committee for Health Manpower Planning, Production and
Management" was constituted in 1985 under Dr. J.S. Bajaj, Professor at
AIIMS.
Major recommendations are :-
1. Formulation of National Medical & Health Education Policy.
2. Formulation of National Health Manpower Policy.
3. Establishment of an Educational Commission for Health Sciences
(ECHS) on the lines of UGC.

4. Establishment of Health Science Universities in various states and
union territories.
5. Establishment of health manpower cells at centre and in the
states.
6. Vocationalisation of education at 10+2 levels as regards health
related fields with appropriate incentives, so that good quality
paramedical personnel may be available in adequate numbers.
7. Carrying out a realistic health manpower survey.

HIGH POWER COMMITTEE (1987)
RECOMMENDATIONS
• To look into the existing working conditions of nurses with particular
reference to the status of the nursing care services both in the rural
and urban areas.
• To study and recommend the staffing norms necessary for providing
adequate nursing personnel to give the best possible care, both in the
hospitals and community.

• To look into the training of all categories and levels of nursing,
midwifery personnel to meet the nursing manpower needs at all
levels of health services and education.
• Clear job description of nurses was laid down and clear cut guidelines
for performance appraisal
Besides various recommendations to strengthen nursing structure,
positions, job profile and career growth along with incentives, the
implementation has been very scarce.

National commission on Macroeconomics and Health (2005)
• Government of India announced the formation of its own national
commission on macroeconomics and health.
• The commission, to be co-chaired by India's health and finance
ministers, will look into areas needing attention and try to find ways
of increasing investment in health.

RECOMMENDATIONS
Increasing human resources for health.
Expand use of information technology for health management and
medical care
Tele health in public information

The impact on nursing include
• Reregistration of nurses was introduced which is to be done every 5 years,
but the same has not been streamlined in each state.
• Continuing nursing education is given importance
• Private hospitals have taken initiative to maintain quality and standards of
care by way of hospital accreditation system as NABH, JCI, ISO.
There is however, a long way ahead to really implement HR strategies for
empowering nursing and midwifery in India by having a strong leadership in
the profession.

JOURNAL ABSTRACT
1. Women education and five year plan of India
The First Year Plan (1951-1966) designs welfare measures for the benefits of
poor women.
The Second Five Year Plan (1956-61) given importance on agricultural
development, the welfare approach to women's issues was determined
recognizing women as workers.
The Third Five Year Plan (1961-66) sincerely give importance of education
for women work and provisions for training to enable women to compete for
higher jobs which has been a major welfare strategy for women.

 The Fourth Five Year Plan (1969-1974) also emphasised the promoting
women's welfare as the base of operation.
 The Fifth Five Year Plan, (1974-78) stressed the need for training
women in respect of income generating activities and their protection.
 The Sixth Five Year Plan (1980-85) stressed the need of economic
independence educational advance and access to health care and
family planning as essential for women's development.
 The Seven Five Year Plan (1985-90) sought to generate awareness
among women about their rights and privileges.
 The Eight Five Year Plan (1992-97) given the importance on the
benefits of development from different sectors did not bypass women
and special programmes were implemented to complement the
general programmes.

 The Ninth Five Year Plan (1997-2002) focus on empowerment of
women and people's participation in planning and implementation of
strategies.
 The Tenth Five Year Plan (2002-2007) aims at empowering women
through translating the recently adopted National Policy for
Empowering of Women into action and ensuring “survival” protection
and development of children through rights based approach.
 The Eleventh Five Year Plan (2007-2012) gives recommendation to raise
the sex ratio for the age groups 0-6 to 935 by 2011-12 and to 950 by 2016-
2017.
 The Twelfth Five Year Plan (2012-2017) had given importance on social
and political development of women in India

2. Analysis of five year plan in India
First five year plan
(1951 - 1956)
Targets and objectives more or less achieved. With active role of
state in all economic sectors. Five Indian institutes of
technology were
started as major technical institution
Second five year plan
(1956 - 1961)
Could not be implemented fully due to shortage of foreign
exchange. Targets had to be pruned, Yet Hydroelectric power
projects and five steel mills at BHILAI, DURGAPUR and
ROURKELA were established.
Third five year plan
(1961 - 1966)
Establishment of a droughts. Yet, Panchayat election was started.
State electricity boards and state secondary education boards
were formed.

Annual plan
(1966 -1969)
A new agricultures strategy was implemented. It involved
distribution of high yielding varieties of seeds, extensive use
of fertilizers, exploitation of irrigation potential and soil
conservation measures.
Fourth five year plan
(1969 - 1974)
Was ambitious. Big failure, achieved growth of 3.5 percent
but was marred by inflation. The INDIRA GANDHI
government nationalized 14 major India banks and the green
revolution in India advanced agriculture.
Fifth five year plan
(1974 - 1979)
High inflation was terminated by the Janta government. Yet,
the national highway system was introduced for the first time.

Sixth five year plan
(1980 - 1985)
Most targets achieved. Growth 5.5 percent. Family planning
was also expanded in order to prevent over population.
Seventh five year
plan (1985 - 1990)
With growth rate of 6 percent, this plan was proved successful
in spite of severe drought conditions for first three year
consecutively. This plan introduced programs like JAWAHAR
ROZGAR YOJANA.
Annual plan (1989 -
1991)
It was the beginning of privatization and liberalization in
India
Eighth five year
plan (1992 - 1997)
Partly success. An average annual growth rate of 6.78 percent
against the target 5.6 percent was achieved.

Nine five year plan
(1997 - 2002)
It achieved a GDP growth rate of 5.4 percent lower than target. Yet,
industrial growth was 4.5 percent which was higher than targeted 3
percent. The service industry had a growth rate of 7.8 percent. An
average annual growth rate of 6.7 percent was reached.
Tenth five year plan
(2002 - 2007)
It was successful in reducing poverty ratio by 5 percent, increasing forest
cover to 25 percent increasing literacy rates to 75 percent and the
economic growth of the country over 8 percent.
Eleventh five year
plan (2007 - 2012)
India has recorded an average annual economic growth rate of 8 percent
farm sector grew at an average rate of 3.7 percent as against 4 percent
targeted. Industry grew with annual average growth of 7.2 percent
against 10 percent targeted.
Twelfth five year
plan (2012 – 2017)
Growth in saving and investment rate, growth in social services. Increase
in inflation. Slow growth in industrial sectors. Less growth in agriculture
sector.

ASSIGNMENT
• “Impact of health committtes on nursing growth”.

REFERENCES
 Vati J. Nursing Management and administration.
Newdelhi: Jaypee Brothers Publication; 2013.
 K. Deepak, Chandran S, Kumar M. Textbook on Nursing
Mangement. Bangalore:Emmess Publishers;2013.
 Basvanthappa B T. Nursing Administration. 2nd edition.
Newdelhi: Jaypee Brothers Publication; 2009.
 Park. K. Preventive and Social Medicine. 23rd edition.
India: Banarsidas bhanot publishers; 2015.

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