Prof Dileep Mavalankar, Director, Indian Institute of Public Health (IIPH) Gandhinagar, shares his institutions’s plans to strengthen India’s public health system, the need for an action plan to achieve UHC and recommendations to create a manifesto for a healthy India, in an interview with Lakshmipriya Nair
What are the major objectives of IIPH? How is it equipped to achieve them?
The main objective of IIPH is to address the limited capacity in public health in India via education, training, research and advocacy as well as help improve the overall health system in the country.
There are five IIPHs now, one each in Gandhinagar, Delhi, Hyderabad, Bhubaneshwar and Shillong with a total of about 75 faculty members. Each one works with the state government and acts as a regional hub for public health training and research. All IIPHs are supported by PHFI’s resources and expertise besides their own faculty and admin staff. IIPH Gandhinagar has become the first public health university via Gujarat State Act passed in 2015. It has a campus of 50 acres with a new building to teach 300 students. IIPHs offer MPH, PG Diploma in Public Health Management, Associate Fellow in Industrial Health, MSc and PhD via various campuses. IIPHs have many national and international collaborations for research and training. They also carry out many research projects and support central and the state governments in improving public health via health system support projects.
Tell us about the initiatives which will be undertaken by IIPH to strengthen the public health system in India?
IIPH Gandhinagar has helped the Gujarat government to improve the design and location of new primary health centres (PHCs) and community health centres (CHCs) using an analysis by geographic information system about the coverage and need for the centres in rural and remote areas. It has helped Ahmedabad city to develop South Asia’s first Heat Health Action plan to reduce mortality and morbidity during heat waves, which are increasing due to climate change. IIPHs provide policy and programme inputs as well as guidance to various state governments and the central government. IIPHs have done pilot projects in urban slums and rural areas to demonstrate how public health services can be improved. IIPHs also train government officers to improve the health system they are in charge of. Thus, IIPHs have contributed to improvement of the health system in many ways.
How will they help to negate or atleast lessen the current public health challenges caused by years of neglect?
The first and foremost role of IIPHs is training young professionals to take up jobs in the public health system. IIPHs also train government officers on-the-job and this contributes to further improvement of public health. They also do advocacy at various levels to strengthen the public health system. IIPHs also suggests new programmes and methods in public health to the government with an aim to improve the situation on the ground. IIPHs have also brought in many international experts and funds to help assess and enhance public health programmes.
A common complaint is that Indian healthcare institutions do not encourage research, especially in public health. How can IIPH help to reform this scenario?
All IIPH faculty are encouraged to take up research projects. We have international collaborations and national linkages which help build our research portfolio. IIPH faculty also apply for international and national research funds and that helps to do locally relevant research in public health. All faculty are evaluated on their research contribution as part of their annual evaluation. On various fora, IIPH and PHFI also advocate the need to increase research funding and efforts as well as evidence-based policy making which, in turn, help in increasing demand for research.
What should be our action plan to achieve Universal Health Coverage (UHC)? How can academic institutes like IIPH play a constructive role in making the action plan successful?
UHC is a long term goal for any country, including India. PHFI played a very vital role in the high level expert committee constituted by the last Planning Commission and produced a detailed report on UHC. IIPHs and PHFI have been convening meetings, making presentations at various fora and advocating UHC. They are also doing some research projects in a few states to determine the feasibility and need for UHC. What is needed to make UHC successful is a very high level political engagement leading to national and state level mandate as well as resources and systems to provide UHC. PHFI and IIPHs are committed to the goal of UHC.
Please share your plans for IIPH Gandhinagar in the near future. What would be the strategies to achieve these objectives?
We are planning to start a Master of Hospital Administration (MHA) course from July 2017 besides continuing with the MPH programme. We will also start PhD in public health. As IIPHG is the first public health university in the state, in future we will start more courses related to public health such as entemology, infectious diseases, medical social work, occupational and industrial health etc. IIPHG has recently received approval from the Department of Science and Technology, Government of India to set up a techno-business incubator under the National Initiative for Developing and Harnessing Innovations (NIDHI) scheme. This is will be the first such incubator for technology-driven solutions in the domain of public health. Other IIPHs are also planing to start new short and long courses related to public health. We will also develop our research and health system support portfolio in future. For this, we are looking for national and international funding opportunities, donations and grants. We will also hire faculty and research staff who have the passion and commitment to develop public health in India.
If we create a manifesto for a healthy India, what should the fundamentals of it?
A manifesto to create a healthy India is very much needed as health and public health has to become topics of political debate and action. It should include:
- Increase in public funding for health from the current one per cent to three to four per cent in five years.
- Creation of a public health and health management service on the lines of IAS or other central services.
- Adoption of UHC as crucial goal over the next 15 years and development of plans and programmes to achieve it.
- Improving access to free generic medicines to all citizens of India, irrespective of their paying capacity.
- Strengthening of health directorates in each state and district health offices.
- Improve health planning and health statistics to ensure accountability in the health system.
- Take steps to decrease tobacco and alcohol use as well as reduce accidents and injuries.
- Develop services for mental health and chronic diseases.