# National Health Policies and Programmes for NEET PG PSM: Alma-Ata, Health Committees, NHP 2017, PM-JAY and Leprosy 2025 Source: https://tracknation.in/story/national-health-policies-and-programmes-for-neet-pg-psm-alma-ata-health-committees-nhp-2017-pm-jay-and-leprosy-2025 (TrackNation β€” free UPSC notes with PYQs) > NEET PG Community Medicine: the Alma-Ata definition and elements of primary health care, what each health committee recommended, National Health Policy 2017 targets checked against the latest data, AB PM-JAY including the 70-plus cover, the revised leprosy classification and three-drug PB regimen from April 2025, and the mental health, elderly and tobacco programmes, from official documents, with a timeline, hooks, MCQs and cards. ## Start Here 🎯 **Exam priority: Medium–high.** *Committee-to-recommendation matching, the elements of primary health care and policy targets are classic. Leprosy changed in April 2025, so older notes on PB treatment are out of date.* CBME mapping: **CM 12.4, CM 15.3, CM 16.4, CM 17.3, CM 17.4**. Immunization, TB, malaria, HIV, NCDs, family planning and nutrition programmes have their own articles. ## Primary Health Care and Alma-Ata The **Declaration of Alma-Ata** came from the International Conference on Primary Health Care, 6–12 September **1978**. Primary health care provides promotive, preventive, curative and rehabilitative services. **The eight elements** ("at least"): - Education on prevailing health problems and how to prevent them - Food supply and proper nutrition - Safe water and basic sanitation - Maternal and child health, including family planning - Immunization against major infectious diseases - Prevention and control of locally endemic diseases - Appropriate treatment of common diseases and injuries - Provision of essential drugs **Its approach**: involving sectors beyond health (intersectoral coordination), community self-reliance and participation, and supportive referral systems. ## The Health Committees *Learn each committee by its single big idea, then the population norm it set.* | **Committee** | **Year** | **Formal name or focus** | **Remember it for** | | **Bhore** | 1946 | Health Survey & Development Committee | Integrating preventive and curative care; PHC for 40,000; the '3 million plan'; 'social physicians' | | **Mudaliar** | 1962 | Health Survey and Planning Committee | Strengthen existing PHCs before opening new ones; All India Health Service | | **Chadha** | 1963 | Malaria maintenance phase | Basic health worker, 1 per 10,000 | | **Mukherjee** | 1965 | Family planning review | Separate staff for family planning | | **Jungalwalla** | 1967 | Committee on Integration of Health Services | Unified cadre, equal pay, no private practice by government doctors | | **Kartar Singh** | 1973 | Multipurpose workers under Health and Family Planning | Multipurpose worker cadre; PHC 50,000; subcentre 3,000–3,500 | | **Shrivastav** | 1975 | Group on Medical Education and Support Manpower | Health workers from the community; referral services complex | | **Bajaj** | 1986 | Health Manpower Planning, Production and Management | Medical and health education policy, manpower policy | ## National Health Policy 2017 NHP 2017 aims at universal access to good quality care without financial hardship, with a preventive and promotive orientation. | **Goal** | **NHP 2017 target** | **Latest** | | Public health spending | 2.5% of GDP by 2025 (from 1.15%) | β€” | | Life expectancy | 70 by 2025 (from 67.5) | 70.6 (2020-24): met | | TFR | 2.1 by 2025 | 1.9 (SRS 2024): met nationally | | Infant mortality | 28 by 2019 | 24 (2024): met | | Under-five mortality | 23 by 2025 | 28 (2024): not met | | Neonatal mortality | 16 by 2025 | 18 (2024): not met | | Stillbirth rate | Single digit by 2025 | 7 (2024): met | | MMR | 100 by 2020 | 87 (2022-24): met | - **Money**: state health spending above 8% of their budgets; up to two-thirds or more of resources to primary care. - **Beds**: at least 2 per 1,000 population, accessible within the golden hour. - **Immunization**: over 90% of newborns fully immunized by one year of age by 2025. - **Tobacco**: relative reduction in current use of 15% by 2020 and 30% by 2025. ## Ayushman Bharat PM-JAY - Health insurance cover of **β‚Ή5 lakh per family per year**. - Since the 2024 Cabinet decision, **everyone aged 70 and above is eligible, irrespective of income**, with a distinct card. - Seniors in families already covered get a **separate top-up of up to β‚Ή5 lakh a year** that they do not share with younger family members. ## Leprosy (NLEP) **Leprosy** is caused by *Mycobacterium leprae* and spreads by droplets from the nose and mouth during close, frequent contact with untreated cases. **Cardinal signs** (any one): - Definite loss of sensation in a pale or reddish skin patch - Thickened or enlarged peripheral nerve with sensory loss or muscle weakness - Bacilli on slit-skin smear **Revised classification** (India, in force 1 April 2025): | **Type** | **Skin lesions** | **Nerve involvement** | **Slit-skin smear** | | **Paucibacillary (PB)** | 1–5 | None | Negative | | **Multibacillary (MB)** | More than 5 | One or more | Positive | **Revised treatment**: PB now gets the same **three drugs** as MB, replacing the two-drug regimen. Patients already on treatment on 31 March 2025 finish their old course. | **Adult** | **Duration** | **Dapsone** | **Clofazimine** | **Rifampicin** | | PB | **6 months** | 100 mg daily | 300 mg monthly + 50 mg daily | 600 mg monthly | | MB | **12 months** | 100 mg daily | 300 mg monthly + 50 mg daily | 600 mg monthly | - **Contacts**: single-dose rifampicin as post-exposure prophylaxis. - **Programme**: NLEP since 1983. Elimination as a public health problem means under **1 case per 10,000**, reached nationally in **December 2005**. - **Now** (2024-25): prevalence 0.57 per 10,000; child cases 4.68%; grade 2 disability 1.31 per million. Leprosy became a **notifiable disease in 2025**. - **Goal**: zero transmission, zero disability and zero discrimination by **2027**. ## Mental Health, Elderly Care and Tobacco - **National Mental Health Programme**: 1982. The **District Mental Health Programme** followed in 1996, based on the **Bellary model**: early detection and treatment, training of general physicians and health workers, public awareness and simple record keeping. - **National Programme for Health Care of the Elderly (NPHCE)**: 2010. Home visits by trained health workers, a weekly clinic at PHCs, dedicated services at CHCs and district hospitals, and Regional Geriatric Centres. - **National Tobacco Control Programme**: 2007-08. It enforces **COTPA 2003**, supports the WHO Framework Convention on Tobacco Control and sets up cessation facilities. Prevalence is tracked by the Global Adult Tobacco Survey. ## Traps the Examiner Sets - Bhore's PHC norm is 40,000; Kartar Singh's is 50,000. - Multipurpose workers: Kartar Singh, not Shrivastav. - Alma-Ata lists **eight** elements; essential drugs and safe water are both on the list. - PB leprosy treatment is now three drugs, still for 6 months. - Any nerve involvement makes a case multibacillary under the revised classification. - NHP 2017's target for public health spending is 2.5% of GDP. It has both a 2019 IMR target and a 2025 U5MR target; do not mix them. ## Memory Hooks & Shortcuts *Shortcuts to lock in this article's numbers and lists. Each one only re-packages facts proven above.* - 🧠 **Bhore 40, Kartar 50** β€” PHC population norms, in thousands - 🧠 **Kartar made them Multi** β€” Kartar Singh: multipurpose workers - 🧠 **ELEMENTS: 8 boxes, drugs last** β€” the Alma-Ata list ends with essential drugs - 🧠 **2.5 by 2025** β€” NHP 2017 health spending target - 🧠 **5 or a nerve** β€” more than 5 lesions, or any nerve, makes leprosy MB - 🧠 **6 and 12, same three drugs** β€” PB and MB durations since April 2025 - 🧠 **Bellary for the district** β€” DMHP model ## Rapid-Revision Cards - 1978; primary health care; eight elements. - Education, nutrition, water and sanitation, MCH and family planning, immunization, endemic disease control, treatment of common conditions, essential drugs. - Integration of preventive and curative care; PHC for 40,000. - Strengthen PHCs first; All India Health Service. - Basic health worker, 1 per 10,000. - Separate family planning staff. - Integration of health services; unified cadre. - Multipurpose workers; PHC 50,000; subcentre 3,000–3,500. - Community health workers; referral services complex. - Health manpower planning. - 2.5% of GDP by 2025; states over 8% of budget. - 70 by 2025. - IMR 28 (2019), U5MR 23, NMR 16 (2025), MMR 100 (2020). - At least 2 per 1,000. - β‚Ή5 lakh per family per year; all aged 70+ eligible. - Up to β‚Ή5 lakh a year, not shared with younger family members. - 1–5 lesions, no nerve, smear negative. - >5 lesions, or any nerve, or smear positive. - Three drugs for 6 months, from 1 April 2025. - Three drugs for 12 months. - Dapsone 100 mg daily; clofazimine 300 mg monthly + 50 mg daily; rifampicin 600 mg monthly. - Single-dose rifampicin. - <1 per 10,000; reached nationally December 2005. - Prevalence 0.57 per 10,000; G2D 1.31 per million; child cases 4.68%. - 1982 and 1996; Bellary model. - 2010; weekly clinic at PHCs; Regional Geriatric Centres. - 2007-08; COTPA 2003. ## Sources *Facts in this article were checked against these documents.* - Declaration of Alma-Ata β€” WHO, 1978 (link) - National Health Committees β€” National Institute of Health and Family Welfare, accessed November 2026 (link) - National Health Policy 2017 β€” MoHFW, 2017 (link) - Cabinet approves health coverage to all senior citizens of 70 years and above under AB PM-JAY β€” Prime Minister's Office, 2024 (link) - Revised treatment regimen for PB and MB cases in India (D.O. letter) β€” Director General of Health Services, 6 March 2025 (link) - National Leprosy Eradication Programme β€” DGHS, MoHFW, accessed November 2026 (link) - Leprosy fact sheet β€” WHO, accessed November 2026 (link) - National Mental Health Programme; NPHCE; National Tobacco Control Programme β€” National Health Mission, accessed November 2026 (link) ## Test Yourself: Practice Questions Twenty-five questions in NEET PG style. ## Practice Questions (NEET PG pattern) *Original questions written in the style of the exam: +4 for a correct answer, βˆ’1 for a wrong one. Every answer was checked against the sources listed above. NEET PG papers are not published by NBEMS, so these are not past-paper questions.* **Q1.** The Declaration of Alma-Ata was adopted in - (a) 1946 - (b) 1986 - (c) 2000 - (d) 1978 **Answer: (d)** β€” International Conference on Primary Health Care, Alma-Ata, 6–12 September 1978. **Q2.** Which of the following is NOT among the elements of primary health care in the Alma-Ata declaration? - (a) Provision of specialist surgical care - (b) Safe water and basic sanitation - (c) Provision of essential drugs - (d) Immunization against major infectious diseases **Answer: (a)** β€” The eight elements cover education, nutrition, water and sanitation, MCH with family planning, immunization, endemic disease control, treatment of common conditions, and essential drugs. **Q3.** A district officer brings the agriculture, education and public works departments together to reduce child malnutrition. This reflects which primary health care principle? - (a) Tertiary referral - (b) Vertical programming - (c) Appropriate technology only - (d) Intersectoral coordination **Answer: (d)** β€” Primary health care involves all related sectors besides health and demands their coordinated effort. **Q4.** Integration of preventive and curative services at all administrative levels was recommended by the - (a) Bajaj Committee - (b) Kartar Singh Committee - (c) Mukherjee Committee - (d) Bhore Committee **Answer: (d)** β€” Bhore (Health Survey & Development Committee), 1946. **Q5.** Which committee recommended that existing PHCs be strengthened before new ones are opened? - (a) Chadha Committee - (b) Shrivastav Committee - (c) Mudaliar Committee - (d) Bhore Committee **Answer: (c)** β€” Mudaliar, 1962, also recommended an All India Health Service. **Q6.** The concept of multipurpose workers came from the - (a) Kartar Singh Committee - (b) Jungalwalla Committee - (c) Bhore Committee - (d) Mudaliar Committee **Answer: (a)** β€” The 1973 Committee on Multipurpose Workers under Health and Family Planning. **Q7.** Under the Kartar Singh Committee, one PHC was to cover a population of - (a) 50,000 - (b) 1,00,000 - (c) 40,000 - (d) 30,000 **Answer: (a)** β€” One PHC per 50,000, divided into 16 subcentres of 3,000–3,500. **Q8.** The Jungalwalla Committee is remembered for - (a) family planning staffing - (b) multipurpose workers - (c) the 3 million plan - (d) integration of health services **Answer: (d)** β€” The Committee on Integration of Health Services: unified cadre, common seniority, abolition of private practice by government doctors. **Q9.** The Shrivastav Committee was set up as the - (a) Expert Committee for Health Manpower Planning - (b) Group on Medical Education and Support Manpower - (c) Committee on Integration of Health Services - (d) Health Survey and Planning Committee **Answer: (b)** β€” It proposed health workers from the community and a referral services complex. **Q10.** National Health Policy 2017 aims to raise public health expenditure to - (a) 2.5% of GDP by 2025 - (b) 8% of GDP by 2025 - (c) 5% of GDP by 2030 - (d) 1.15% of GDP by 2020 **Answer: (a)** β€” From 1.15% to 2.5% of GDP by 2025. The 8% figure refers to state budgets. **Q11.** The NHP 2017 target for the under-five mortality rate by 2025 is - (a) 16 - (b) 23 - (c) 100 - (d) 28 **Answer: (b)** β€” U5MR 23 by 2025; IMR 28 by 2019; neonatal mortality 16 by 2025; MMR 100 by 2020. **Q12.** Comparing NHP 2017 targets with SRS 2024, which has NOT yet been reached? - (a) MMR of 100 - (b) Neonatal mortality of 16 - (c) TFR of 2.1 - (d) Infant mortality of 28 **Answer: (b)** β€” NMR is 18 against a target of 16. IMR is 24, TFR 1.9 and MMR 87, all past their targets. **Q13.** NHP 2017 proposes how many hospital beds per 1,000 population? - (a) At least 5 - (b) At least 10 - (c) At least 1 - (d) At least 2 **Answer: (d)** β€” At least two beds per thousand, accessible within the golden hour. **Q14.** A 72-year-old from a well-off family has no health insurance. Under AB PM-JAY he - (a) must wait until 80 - (b) is eligible, irrespective of income - (c) is ineligible because of income - (d) is eligible only if below the poverty line **Answer: (b)** β€” All senior citizens aged 70 and above are eligible irrespective of income. **Q15.** A patient has 3 hypopigmented anaesthetic patches, no nerve involvement and a negative smear. Under India's revised classification this is - (a) multibacillary, treated for 12 months - (b) paucibacillary, treated for 6 months with two drugs - (c) not leprosy - (d) paucibacillary, treated for 6 months with three drugs **Answer: (d)** β€” PB: 1–5 lesions, no nerve, smear negative. From 1 April 2025 PB gets three drugs for 6 months. **Q16.** A patient has 3 skin patches and one thickened ulnar nerve. Under the revised classification this case is - (a) indeterminate - (b) tuberculoid, needing no drugs - (c) multibacillary - (d) paucibacillary **Answer: (c)** β€” One or more nerves involved makes the case MB. **Q17.** The monthly supervised dose of rifampicin in adult leprosy is - (a) 600 mg - (b) 100 mg - (c) 450 mg - (d) 300 mg **Answer: (a)** β€” Rifampicin 600 mg monthly, clofazimine 300 mg monthly with 50 mg daily, dapsone 100 mg daily. **Q18.** Contacts of a new leprosy patient are offered - (a) six months of dapsone - (b) no intervention - (c) BCG revaccination only - (d) single-dose rifampicin **Answer: (d)** β€” Single-dose rifampicin as post-exposure prophylaxis. **Q19.** Leprosy elimination as a public health problem means a prevalence of less than - (a) 1 per 10,000 - (b) 1 per 1,000 - (c) 1 per 1,00,000 - (d) 10 per 10,000 **Answer: (a)** β€” Below 1 per 10,000, reached nationally in December 2005. **Q20.** Leprosy spreads mainly through - (a) sexual contact - (b) droplets from the nose and mouth during close contact - (c) mosquito bites - (d) contaminated water **Answer: (b)** β€” Droplets during close and frequent contact with untreated cases. **Q21.** Which is a cardinal sign of leprosy? - (a) Loss of sensation in a pale skin patch - (b) Fever - (c) Weight loss - (d) Lymph node enlargement **Answer: (a)** β€” Sensory loss in a patch, thickened nerve with loss of function, or bacilli on skin smear. **Q22.** The District Mental Health Programme was based on the - (a) Kerala model - (b) Bhore model - (c) Bellary model - (d) Alma-Ata model **Answer: (c)** β€” DMHP, 1996, was based on the Bellary model. **Q23.** The National Mental Health Programme began in - (a) 1982 - (b) 1975 - (c) 2010 - (d) 1996 **Answer: (a)** β€” NMHP 1982; DMHP 1996. **Q24.** Under NPHCE, weekly geriatric clinics are held at - (a) subcentres only - (b) PHCs - (c) medical colleges only - (d) Regional Geriatric Centres only **Answer: (b)** β€” Regular monitoring through a weekly clinic at PHCs. **Q25.** The law enforced under the National Tobacco Control Programme is - (a) COTPA 2003 - (b) the Clinical Establishments Act - (c) the PC-PNDT Act - (d) the Factories Act **Answer: (a)** β€” The Cigarettes and Other Tobacco Products Act, 2003. ### Active Recall From memory: list the eight elements of primary health care; match each committee to its year and main idea; give the NHP 2017 targets and say which are met; explain PM-JAY's 70-plus cover; classify and treat leprosy under the 2025 rules; and give the start years of NMHP, DMHP, NPHCE and NTCP.