Establishment of Public Health Management Cadre in India and guidelines for implementation - 2022

Abstract National Health Policy (NHP) 2017 (Para 11.8) proposed that a multi/interdisciplinary health workforce is necessary for managing programs under National Health Mission. National Health Policy 2017 considered creating Public Health Management Cadre (PHMC) in all States. In the 13th CONFERENCE of CENTRAL COUNCIL OF'HEALTH & FAMILY WELFARE (CCHFW), 2019 under the chairpersonship of Hon’ble central Health Minister of India the decision evolved to establish PHMC in all States by year 2022. The key objective of establishment of PHMC is best utilization of expertise and talent for ensuring health for all. To segregate clinical and public health functions among cadres with flexibilities as per requirement of the state. Four types of structures and frameworks are only suggestive, and the states have flexibility to modify the structures according to the local situation and context. Medical and Health professionals would form a major part, but professionals from diverse backgrounds like sociology, economics, anthropology, hospital management, communications, etc., who have undergone public health management training would also be considered. States could decide to locate public health managers (medical/non-medical) into same or different cadre streams belonging to Directorates of Health. In states like Bihar where there is lack of Directorates of Health the situation is very worse indicated by NITI Aayog Health Index reports. In such states the researcher found that untrained persons are posted on key public health management posts while the public health trained doctors are not posted for public health management. The specialists are not involved in PHM and it may be due to the fact that there is shortage of specialist at country and state levels. The public health cadre is a misnomer if they will also work for clinical treatments and the key goal of PHMC will be affected particularly in states like Bihar. This is the first ever decision at national level for establishing PHMC and the details of pay structure, transparency etc. are not available and although the objectives are quite clear; the PHMC cadre may be affected in states like Bihar where it seems that lack of Directorate and unscrupulous management have grabbed the health system.