Introduction

• Public health policies are crucial for addressing diverse population needs.
• Recent critiques target the inadequate focus on public health in the Union Budget.
• Policies over the last decade reflect a paralysis in addressing people’s health needs.

Felt Needs in Public Health

1. Diseases of Poverty
   • Includes tuberculosis, malaria, undernutrition, and food/water-borne diseases.
   • Focus on prevention clashes with challenges of livelihood and basic rights.
2. Middle-Class and Environmental Health Issues
   • Pollution, waste management, and unhealthy foods affect urban populations.
   • Other concerns include road accidents, climate change, and chronic illnesses.
3. Curative Care Needs
   • Primary, secondary, and tertiary care are critical.
   • Poor populations depend on public health institutions, but secondary care remains neglected.

Historical Public Health Policies

• The National Rural Health Mission (NRHM, 2005) and National Health Mission (NHM, 2013) focused on public sector health care.
• Strengthened primary health care infrastructure with sub-centres, PHCs, and CHCs.

Shift to Private Sector Focus

• Recent focus on publicly funded health insurance schemes (PFHI), such as PMJAY, benefits private health care.
• Private sector dominates secondary and tertiary care, leading to expensive health services for those not covered by government schemes.

Challenges in the Public Health System

• Transformation of sub-centres, PHCs, and CHCs into Health and Wellness Centres (HWCs) has diluted the original mandate.
• Introduction of community health officers providing minimal curative care affects trust in public institutions.
• The recent renaming of HWCs to “Ayushman Arogya Mandir” raises questions of relevance, especially in non-Hindi speaking regions.

Conclusion

• Public health challenges require tailored responses for different social groups.
• The weakening of the public health system, favouring the private sector, risks the effectiveness of health programmes.
• Strengthening secondary and tertiary public health care is essential to restore trust and ensure accessibility for all sections of society.