1

Tripura institute of paramedical sciences,

Nursing section

Subject: advance nursing practice

SEMINaR ON: Five years plan & NITI AAYOG

SUBMITTED TO SUBMITTED BY

MS. PRETTY SUJIT KUMAR NATH

DEBBARMA M.SC NURSING, 1ST
(ASST. PROFESSOR) SEMESTER
COMMUNITY HEALTH ROLL NO-13
NURSING
TIPS, NURSING
TIPS, NURSING

Date of submission: 18/10/2023

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INTRODUCTION:
Five-Year Plan is mechanism to bring about uniformity in policy formulation in programs of
national importance. Recognizing the HEALTH as an important contributory factor in the
utilization of man-power and in the upliftment of the economic condition of the country, the
planning commission gave considerable importance to health programs in the Five Year Plan.

The broad objectives of the health program, during Five-Year Plan, are as follows:

1. Control and eradication of major communicable diseases.

2. Strengthening of basic health services through the establishment of primary health
centers and sub centers.
3. Population control.
4. Development of health manpower resources.

For the purposes of planning, the health sector has been divided into the following
subsectors:

1. Water supply and sanitation.

2. Control of communicable diseases.
3. Medical education, training and research.
4. Medical care including hospitals, dispensaries and PHCS.
5. Public health services.
6. Family planning.
7. Indigenous system of medicine

All the above sub-sectors have received due consideration in the FYP. To give effect to
better coordination between Center and State Governments, a Bureau of Planning was
constituted in 1965 in the Ministry of Health, Government of India. The main responsibility of
the Bureau is compilation of "National Health Five-Year Plan". It is necessary to review briefly
the health policy and targets, investments and achievements during the planning period. The
National Five-Year Plan was implemented through the community development program which
includes the health plans of the Nation. Let us now discuss briefly community development
program prior to review Five-Year Plan (FYP).
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FIVE YEAR PLANS OVERVIEW:-

 Strategy of a planned approach to economic development.

 Planning commission is responsible for the formulation of five year plans
 Objective growth, employment, self-reliance and social justice
 Continual watch on trends and adjustments
 Systematic observation of technical, economic and social data.

Planning Commission:-

 Functions
 To estimate the physical, capital and human resources
 To prepare plans for making effective balanced utilization of HR
 To determine various stages of planning to propose the
 Allocation of resources on the priority basis
 To evaluate the economic progress and to suggest remedial measures.

First five year plan (1951-56):-

Prior to the commencement of the first Five Year Plan, the health status of the people of India
was very low and includes:

1. Lack of hygienic environment and sanitation conducive to healthful living.

2. . Low resistance due to lack of adequate diet.
3. Prevalence of malnutrition and poor Nutrition.
4. Lack of proper housing, safe supply of pure water & proper disposal of human wastes.
5. Lack of medical care.
6. Lack of general and health education.
7. Low economic status.
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Due to inadequate financial resources and lack of trained health personnel the whole program
of health developments was tied with a broader program of social development. While
considering these facts, a seven point public health program with the following priorities formed
the basis of the first Five-Year Plan:

1. Provision of water supply and sanitation.

2. Control of malaria.
3. Preventive health care of the rural population through health units and mobile units.
4. Health services for mothers and children.
5. Education and training in health.
6. Self-sufficiency in drugs and equipments.
7. Family planning and population control.

During this plan period, the public sector outlay was Rs. 2,356 crores of which Rs. 140
crores (5.9%) were allotted for health programs. The actual expenditure, however, amounted to
Rs. 1960 crores and Rs. 101 crores, respectively.

Second five years plan (1956-61):-

The Second Five Year Plan was continuation of the development efforts commenced in the
first plan. It included all communicable diseases in addition to control of malaria.

The specific objectives were:

1. Establishment of institutional facilities to serve as a basis from which services could

be rendered to the people both locally and in surrounding territories.
2. Development of technical manpower through appropriate training programs.
3. Intensifying measures to control widely spread communicable diseases.
4. Encouraging active campaign for environmental hygiene.
5. Provision of family planning and other supporting services for raising standard of
health of the people.
During this period the public sector outlay was Rs. 4,800 crores, of which 225 crores
were allotted to the health program. The actual expenditure, however, amounted to Rs.
4,672 crores and 215 crores, respectively.
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Third five year plan (1961-66):-

The objectives of the third Five-Year Plan were in tune with the first and second five year
plans except that integration of public health with maternal and child welfare, nutrition and
health education was planned. While continuing the programs initiated in the previous plan
period, greater emphasis was placed on preventive health services and on the eradication and
control of communicable diseases.

During this period the public sector outlay was Rs.7.500 crores, of which Rs. 341.80
crores were allotted for health programs. The actual expenditure, however, amounted to Rs.
8,577 crores and Rs. 357 crores, respectively.

Annual Plans (1966-69):-

The Fourth Five-Year Plan which was to commence from April 1966 was postponed till
1969 due to uncertain economic situation in the country (Due to Indo-Pak War). This intervening
period (1966-69) was covered by annual plans with an outlay of Rs. 6,756, crores in the public
sector of which the expenditure on health program was Rs. 316 crores (4.7%).

Fourth five year plan(1969-74):-

During this period, the revised estimate of public sector outlay was Rs. 16,774 crores, of which
Rs. 1,156 crores (7.2%) were allotted to health sector. Certain objectives of the Mudaliar
Committee were the base for the fourth Five-Year Plan in relation to health. These are as
follows:

1. To provide an effective base for health services in rural areas by strengthening the
primary health centers.
2. Strengthening of sub-divisional and district hospitals to provide effective referral services
for primary health center.
3. Expansion of the medical and nursing education and training of Para-medical personnel
to meet the minimum technical manpower requirements.
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In this period, efforts were made to strengthen the primary health center complex
in the rural areas for undertaking preventive and curative health services and for ensuring
the maintenance phase of the communicable diseases control and eradication programs.

Achievements from First FYP to Fourth FYP

During the past two decades, commendable improvements have taken place in the health
indices of the country. The mortality rates have declined from 140/1000 from 183/1000 in the
last 20 years. The number of hospital beds is expected to increase from 1, 13,000 in 1950-51 to
2, 81,600 in 1973-74. The bed: population ratio has gone up to 0.49/1000 from 0.32/1000. Over
100 medical colleges with an annual admission capacity of nearly 12,500 under graduates
functioning as against 30 medical colleges with an annual admission capacity of 2500 students in
1950-51.

Despite all these achievements, the status of health in India was unsatisfactory. The
recommended Mudaliar Committee norm of one bed per 1000 population and one doctor
per 3,000 to 3,500 populations is still not within reach. There are considerable regional
disparities in the country in the availability of medical services. In rural areas with 80 per
cent of population there were only 30 per cent of the hospital beds and 20 per cent of the
doctors in the country. The nurse and bed ratio is far below the recommended norms in
certain regions of the country.

Fifth five plan (1974-79):-

Fifth Five Year Plan (1974-79) The fifth Five-Year Plan was launched on 1 April, 1974,
with an outlay of Rs. 37,250 crores in the public sector, of which Rs 3277 crores were allotted to
health sector. The primary objective of this plan period was "to provide minimum public health
facilities integrated with family planning and nutrition for vulnerable groups especially children,
pregnant women and feeding mothers. It was hoped to consolidate the gains so far achieved in
the various fields of health such as communicable diseases, medical education and provision of
the infrastructure in the rural areas.
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The emphasis of the plan was on removing imbalance in respect of medical facilities and
strengthening the health infrastructure in rural areas. Specific objective to be pursued during the
plan were:

1. Increasing accessibility of health services to rural areas.

2. Correcting regional imbalances.
3. Further development of referral services by removing deficiencies in district and
sub-divisional hospitals.
4. Integration of health, family-planning and nutrition.
5. Intensification of the control and eradication of communicable diseases
especially malaria and smallpox.
6. Quantitative improvement in the education and training of health personnel by
converting uni purpose workers to multipurpose workers.
7. Development of referral services by providing specialists attention to common
diseases in rural areas.

During this plan period minimum needs program (MNP), to be operated through
the State Governments is considered to be of great importance and filled certain
targets like one PHC for 1, 00,000 population, one sub center for 10,000 population,
correcting deficiencies related to establishment of these health centers and up
gradation of one in every 4 PHC to the status of a 30 bedded rural hospital with
specialized services. These targets of the MNP could not be achieved due to changes
in national political systems.

Sixth five year plan(1980-85):-

The sixth Five-Year Plan was formulated against the background of a perspective covering
period of 15 years from 1980-81 to 1994-95. The main objectives were:

1. Progressive reduction in the incidence of poverty and unemployment.

2. To step up the rate of growth of the Indian economy.
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3. Promoting policies for controlling the population growth through voluntary acceptance
of the "small family norm".
4. To improve the quality of life of the people in general through "minimum needs
program."

Minimum Needs Program (MNP)-

MNP was first introduced in fifth Five-Year Plan to combat poverty. The State has a duty to
provide the basic needs of life to every citizen-need in terms of health, food, education, water,
shelter, etc. MNP is the expression of the commitment of the government for the socio-economic
development of the community particularly the underserved and underprivileged segment of
population. Government considers investment in health as investment in human resources
development and as such primary health care forms an essential and integral component of the
MNP. It is a broad intersectional, Master Plan for providing the minimum basic needs of the
people of land and includes the following aspects in revised MNP of 1978.

1. Elementary education
2. Adult education
3. Rural health
4. Rural water supply
5. Rural roads
6. Rural electrification
7. House sites/Houses for rural landless labourers
8. Environmental improvement of slums
9. Nutrition.

The basic principles to be observed in the implementation of the minimum needs program are:

A. The facilities and MNP are provided on priority basis first only in those areas which
are at present underserved so that the disparities from area to area are eliminated
and every segment of the population is assured of minimum essential facilities.
B. All the facilities under the MNP are provided as a package to a broad inter-sectoral
area. This would ensure a greater impact of the facilities provided. For this purpose it
is necessary to develop an effective interdepartmental coordination mechanism at
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state and district level to ensure that the various departments responsible for
implementation of MNP select common area for the implementation of that
component of MNP for which they are responsible.

Health Sector MNP

Health in its wider concept cannot be attained by the health sector alone. Economic
development, anti- poverty measures, food production and distribution, drinking water supply,
sanitation, housing, environmental protection and education contribute to health and have the
common goal of human development. Health services are an integral part of overall social and
economic development, and necessarily rest on proper co ordination at all levels between the
health and all other sectors concerned. The initiative, if already such mechanism does not exist,
may be taken by the health department of the state to ensure effective co-ordination with the
other departments concerned.

The various programs/schemes covered under the health sector MNP were conveyed to
state governments by the Central Government since then there has been some modifications in
the pattern of assistance of various schemes which have been conveyed to the state governments
separately with the changes made. The following schemes/programs are included in the health
sector MNP:

1. Centrally Sponsored Scheme (100 per cent):

 Health guide scheme.
 Establishment of sub-centers.
 Basic training of male-multipurpose workers.
 Training of specialists, technical and other paramedical staff required for
rural medical services.
 Training of community health officers.
2. Centrally Assisted Schemes (50-50 basis):
 Multipurpose workers scheme.
3. State Schemes:
 Subsidiary health centers.
 Primary health centers.
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 Community health centers/upgraded primary health centers.

Seventh five year plan (1985-90):-

The objectives of the seventh Five-Year Plan have been formulated as part of the long
term strategy which seeks by the year 2000 to virtually eliminate poverty and illiteracy, achieve
near full employment secure satisfaction of the basic needs of food, clothing, and shelter and
provide health for all.

Against this background, the current objective of the state and national health plans is to
continue the reorganization of the health services infrastructure, already begun in the state FYP
(1980-85) and strive towards the goal of health for all by the year 2000 through provision of
universal primary health care to all sections of the society.

By the end of seventh FYP, it is envisaged (as laid down in the NHP) that the
infrastructure of primary health care as required on present population norms would be fully
operational with regard to village health guides, primary health centers and sub centers using
multipurpose health workers. Programs for the control of communicable diseases, of health
services research and of health education will be strengthened. The plan envisages universal
immunization of expectant mothers and all eligible children by the year 1990. The family
welfare program will be implemented with greater vigor so as to achieve couple protection rate
of 42 per cent by the end of the seventh plan period with increased emphasis on female education
and MCH services.

In keeping with the objectives of the International Drinking Water Supply and Sanitation
Decades (1988- 91) the seventh plan aims to provide adequate drinking water facilities for the
entire population both in urban and in rural areas and sanitation facilities for 80 per cent of the
urban population and 25 per cent of the rural population.

The public sector outlay of Rs. 1, 80,000 crores represent a massive public investment.
Out of this national cake nearly Rs. 3,392 crores are earmarked for health, Rs. 3,922 crores for
water supply and sanitation and Rs. 3,256 crores for family welfare program. The targets to be
achieved are laid down in National Health Policy.
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During Seventh Five-Year Plan, the Expanded Program on Immunization was changed to
Universal Immunization Program. Under the new Program all pregnant women were given
tetanus toxoid and all infants were immunized against the vaccine preventable diseases.

Voluntary acceptance of contraceptives was promoted. The aim was to increase the
couple protection rate to 42%.

During this Plan period, the central government took steps to improve the following:
primary health care, control of communicable diseases, health education, health service research,
water supply and the control of cancers and mental diseases.

Eighth Five-Year Plan (1991-95)

The eighth five year plan is based on the National Health Policies. Human development
will be the ultimate goal of their plan. In the eighth plan employment generation, population
control, literacy, education, health, drinking water and provision of adequate food and basic
infrastructure are listed in priorities.

Keeping in view the achievements in the health sector and HFA goals, the Working
Group of the Planning Commission for the eighth Five-Year Plan (1989), the physical
infrastructure, laid emphasis on operational zing these health facilities so as to reach the entire
population by the end of the eighth plan. The HFA paradigms must take account not only of the
high-risk vulnerable groups, i.e. mother and children, but must also of the underprivileged
segments within vulnerable groups. Then the need to shift from 'Health for All' paradigm to
"Towards Health for the the was the aim of the eighth Five-Year Plan. Thus plan pointedly
emphasizes the need for an underprivileged" major thrust in improving qualitative aspects of
personnel, such as motivation, skills, and managerial abilities of personnel, community
participation and intersectoral coordination for health.

The thrust during the Eight FYP was on human development through
the following:

 Employment generation measures.

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 Population control measures. Universal water supply.

 Literacy enhancement measures.
 Provision of adequate food at affordable cost.

"Health for All" was redefined as "Health for the Underprivileged." Under this, steps
were initiated for improving the health of the high risk and under- privileged sections of
population.

The primary health centers were strengthened by filling up staff vacancies, by

supplying essential equipment and drugs, and by providing necessary physical facilities.

At the same time, the government augmented secondary health care services at the
district, and the tertiary care services at the medical college level.

AIDS Control Program was initiated during this FYP. Under this, AIDS surveillance
among the high risk groups, advanced blood banking facilities, and target- specific
information, education and communication activities were started. Government involved
social welfare, youth and sports organizations in AIDS control.

Ninth Five-Year Plan (1997-2002):-

During the Ninth FYP, vertical health programs were integrated horizontally with the
general health service.

The Reproductive and Child Health (RCH) Program was improved under the
following guidelines:

 Decentralize RCH to the level of primary health centers.

 Base planning for RCH services on assessment of the local needs.
 Meet the needs of contraceptives.
 Involve the general practitioners and industries in family welfare work.

For improving health care and medical education, the Ninth FYP prescribed the
following:
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a) Ensure optimal functioning of primary health care.

b) Strengthen primary health institutions and improve referral linkage.
c) Explore cheaper modalities of tertiary care.
d) Organize periodic sessions of continuing education for doctors.

Disease surveillance received boost during the Ninth FYP with the establishment of a
district mechanism for surveillance and rapid response, and the operationalization of health
management information system.

The other measures undertaken during the Ninth FYP were the development of
integrated control program against non-communicable diseases and augmentation of
occupational health services.

Tenth Five-Year Plan (2002-07)

During the Tenth FYP, the focus of planning has shifted from expansion of services to the
enhancement of human well-being.

The Tenth FYP has laid down the following targets:

 Bring down the decadal growth rate by 16.2% in the decade from 2001 to 2011.
 Reduce infant mortality rate to 35/1000 live births by 2007, and to 28/1000 live births
by 2012.
 Reduce the maternal mortality rate to 2/1000 live births by 2007 and to 1/1000 live
births by 2012.

To achieve the above, the government is planning to do the following:

1. Restructure existing health infrastructure.

2. Upgrade the skills of health personnel.
3. Improve the quality of reproductive and child health.
4. Improve logistic supplies.
5. Ensure effective intersectional cooperation.
6. Increase the affectivity of IEC activities.
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7. Carry out research on nutritional deficiencies and on the optimum daily

requirement of nutrients for Indian men and women.
8. Promote rational drug use.

Eleventh Five Year Plan (2007-2012):-

In the Context of the formulation of Eleventh five year plan (2007-2012) the following
sector wise working groups/steering committees/task forces have been setup by planning
commission to make recommendations on various policy matters.

1. Agriculture
2. Backward Classes
3. Communication and Information
4. Development policy
5. Education
6. Environment and Forests
7. Financial Resources
8. Health and Family Welfare
9. Housing and Urban Development
10. Industry and Minerals
11. Labour, Employment and Manpower
12. Multi level planning
13. Programme Evaluation Organization
14. Rural Development
15. Women and Child Development
16. Water Resources
17. Science and Technology
18. Social Justice and Women Empowerment
19. Tourism
20. Transport
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Among all the departments let us see the taskforce in the Department of Health and
Family welfare and Women and child development.

The recommendation Contained in the working group will be formed up and expressed in
the 11th five year document.

The Financial outlay has been allocated to the following working groups under Health
Family welfare and Women child development.

Twelfth five year plan(2012-2017):-

 The union cabinet approve the twelfth five year plan with its in to renew Indian economy.
 The plane would infuse the huge fund of 47.7 lacks cror. And this will help to accomplish
the economic growth to an average level of 8.2%

OBJECTIVES:-

 Better performance in agriculture faster creation of job in manufacturing.

 Wider industrial growth
 Stronger affords at health education and skill development
 Reforming the implementation of flagship programme
 Special challenges focused on vulnerable group and back word section
 Economic stability

VISION OF TWELTH FIVE YEAR PLAN:-

 12th five year plan focused on growth with which is faster inclusive and sustainable
 Economic growth
 Poverty and employment
 Education
 Health
 Infrastructure
 Environment
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ECONOMIC GROWTH:-

 Real GDP growth at 8%

 agriculture growth at 4%
 Manufacturing growth at 10%
 Every state must attain higher growth rate that the rate achieved during 11 th five year
plan

POVERTY AND EMPLOYMENT:-

 Poverty rate to be reduce by 10%. Than the rate at the end of eleventh five year plan
 Five Crore new work opportunities and skilled certification in nonfarm sector

EDUCATION:-

 Reduce gender gap and social gap in school's environment

HEALTH:-

 Reduce IMR 25% and MMR to 1% and increase child sex ratio 950
 Reduce total fertility rate to 2.1
 Reduce under nutrition mal nutrition of children in age group 0-3 years

INFRASTRUCTURE:-

 Provide electricity to all villages

 Connect villages with all road whether national highway or state highway to a minimum
of two lane standard
 Increase the rural Tele-density to 70%

ENVIRONMENT

 Increase the green cover by the 1million hectare every year 30,000 mega Watt energy
during 12th five year plan should be provided
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SERVICE DELIVERY

 Banking services to 90% of Indian households.

THE STRATEGY,CHALLENGES AND APPROACHES OF 12TH

FIVE YEAR PLAN:-

 Enhancing the capacity for growth and development

 Enhancing the skill and faster generation of employment.
 Managing the environment marked for efficiency and inclusion.
 Decentralization improvement and information
 Technology and innovation.
 Securing the energy for future of India
 Accelerated development of transport infrastructure
 Rural transformation and sustained growth of agriculture
 Managing the urbanization
 Improvement of education system in India
 Betterment of preventive and curative health care services

Niti aayog:-

BRIEF HISTORY OF PLANNING COMMISSION--

 Planning commission was an institution formed in March 15, 1950 by govt. of India.
 It was established in accordance with article 39 of the constitution which is a part of
directive principles of state policy.
 It formulated India's five year plans.

INTRODUCTION TO NITI AYOG:-

 NITI Aayog is formed via executive action by the union cabinet on january1,2015.
 It is a government of India Think-Tank policy. It is a non-statutory body.
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 The stated aim for NITI Aayog's creation is to foster involvement and participation in the
economic policy-making process by the state government of India.
 One of the important mandates of NITI Aayog is to bring co-operative competitive
federalism and to improve centre-state relation.

BASIC FEATURES OF NITI AYOG:-

 NITI Aayog basically represents the economic interest of state governments and union
territories of India, which the previous planning structure commission structure lacked.
 Instead of being in a controlling seat; it is going to be a provider of both directional and
policy inputs.
 'NITI blogs' provides public access to articles, field reports as well as published opinions
of the officials.

PRESENT MEMBERS:-

 Chairperson: PMO India: Shri Narendra Modi.

 Vice-Chairman: Rajiv Kumar.
 CEO: Amitabh Kant.
 Members:
(1) Bibek Debroy (Economist).
(2) V.K. Saraswat (Former DRDO Chief).
(3)Ramesh Chand (Agriculture Expert)
 Special Invitees: Nitin Gadkari, Smriti Zubin Irani and Thawar Chand Gehlot.
 Governing Council: All Chief Ministers and Lieutenant Governors of Union Territories.

FUNCTIONS & ROLES OF NITI AAYOG:-

 To evolve a shared vision of national development with the active involvement of States.
 To develop credible plans at the village level and aggregate these at higher levels of
government.
 To foster cooperative federalism with the States on a continuous basis, recognizing that
strong States make a strong nation.
 To focus on technology up gradation and implementation of programs and initiatives.
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 To encourage partnerships between national and international like-minded 'Think-tanks',

as well as educational and research institutions.
 To create innovation and entrepreneurial support system through national and
international experts.
 To pay special attention to the sections of our society that may not be adequately
benefiting from economic progress.
 To offer a platform for resolution of inters departmental issues.
 To maintain a state-of-the-art Resource Centre.
 To actively monitor the implementation of program and initiatives.
 To undertake activities necessary for national development agenda.

ACHIEVEMENTS & ACCOMPLISHMENT OF NITI AAYOG:-

Compared to Planning Commission, which was 64 years old when replaced by NITI Aayog
which is in infancy. But the expectations from a high profile institution, irrespective of its
age(tenure) are always high. Some of its achievements in this two years of working are stated
below.

 On Innovation and entrepreneurship.

 On Infrastructure and Energy Sector.
 On co-operative federalism.
 On agricultural development.
 Digitalization Movement.
 Increase in FDI.
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CONCLUSION

 However, it is too early to comment on the efficacy of the new institution related to
planned development; something is possible when it shifts gears and moves into
operation seriously. However, the present move to decentralize planning and allowing
inputs from states to guide it, appears to be positive and effective steps.
 But NITI Aayog will always remain a hotbed political topic with ambiguous opinions.
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2. kamalam s. “ESSENTIAL IN COMMUNITY HEALTH NURSING PRACTICE”. 2 nd
Edition. J.P. Publication .2012 page no- 67 to 91.
3. kaur N.J. Singh simran. “COMMUNITY HEALTH NURSING -1” for B.Sc nursing
student. 1st edition. Lotus Publishers. 2017. Page no-643 to 647
4. Basavanthappa. B T . “COMMUNITY HEALTH NURSING for B.Sc & PBB.Sc nursing
student”. 3rd edition., J P Brothers 2016. Page no -456 to 458