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Five year plan community health nursing in short

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I now have enough content to compile a full, structured answer. Here is a comprehensive summary of India's Five Year Plans in the context of Community Health Nursing, based on Park's Textbook of Preventive and Social Medicine.

Five Year Plans - Community Health Nursing (India)

Background

India's Planning Commission (set up in 1950) formulated successive Five Year Plans to develop the country's health infrastructure. "Health" was recognized as a key sub-sector in every plan. The 12th Five Year Plan (2012-2017) was the last; NITI Aayog replaced the Planning Commission in January 2015.
The health sector was divided into sub-sectors across all plans:
  1. Water supply and sanitation
  2. Control of communicable diseases
  3. Medical education, training, and research
  4. Medical care (hospitals, dispensaries, PHCs)
  5. Public health services
  6. Family planning
  7. Indigenous systems of medicine

Plan-wise Summary

1st Five Year Plan (1951-1956)

  • Laid the foundation for health infrastructure in independent India
  • Established Primary Health Centres (PHCs) as the backbone of rural health delivery
  • Focus on communicable disease control (malaria, tuberculosis, smallpox)
  • Initiated training of health workers, including auxiliary nurse-midwives (ANMs)

2nd Five Year Plan (1956-1961)

  • Expanded the PHC network
  • Increased hospital beds and dispensaries
  • Emphasis on maternal and child health (MCH) services
  • Training of health manpower at grassroots level

3rd Five Year Plan (1961-1966)

  • Strengthened the sub-centre system under PHCs
  • Greater focus on family planning as a national programme
  • Expanded ANM training schools
  • Malaria eradication campaign strengthened

4th Five Year Plan (1969-1974)

  • MCH and Family Planning services were integrated for better effectiveness - both became an integral part of primary health care
  • Family planning infrastructure (PHCs, sub-centres, urban FP centres, district/state bureaus) was strengthened
  • National Programme for Prevention of Nutritional Anaemia launched
  • District hospitals linked with PHCs

5th Five Year Plan (1974-1979)

  • Launched the Minimum Needs Programme (MNP) - provided basic rural services including health
  • Introduced Community Health Workers (CHWs) scheme
  • Emphasis on rural health and reaching underserved populations

6th Five Year Plan (1980-1985)

  • Accelerated expansion of PHCs and sub-centres
  • Target: 1 PHC per 30,000 population in plains; 1 per 20,000 in tribal/hilly areas
  • 1 sub-centre per 5,000 population in plains; 1 per 3,000 in tribal/hilly areas
  • Voluntary sterilization and MCH services expanded

7th Five Year Plan (1985-1990)

  • Various MCH programmes converged and implemented - objective was to improve health of women and children
  • Universal Immunization Programme (UIP) launched in 1985
  • Oral Rehydration Therapy (ORT) promoted for diarrheal disease control
  • Training of Traditional Birth Attendants (Dais) continued

8th Five Year Plan (1992-1997)

  • Minimum Needs Programme targets: 1 PHC per 30,000 population in plains
  • Child Survival and Safe Motherhood (CSSM) programme integrated
  • National AIDS Control Programme strengthened
  • Focus on urban health

9th Five Year Plan (1997-2002)

  • Reproductive and Child Health (RCH) Programme launched in 1997 - major shift towards client-centered, need-based approach
  • National Family Health Survey-II (1998-99) conducted
  • Targeted interventions for vulnerable groups

10th Five Year Plan (2002-2007)

  • Targets for reducing IMR to 45/1000, MMR to 200/100,000 live births
  • Increased budgetary allocation for health
  • School health and adolescent health programs

11th Five Year Plan (2007-2012)

  • National Rural Health Mission (NRHM) launched in 2005 (overlapping) - key milestone in community health
  • ASHA (Accredited Social Health Activist) programme introduced - a community health volunteer per 1,000 population
  • Strengthened PHCs, CHCs, district hospitals
  • Janani Suraksha Yojana (JSY) to promote institutional deliveries

12th Five Year Plan (2012-2017) - LAST PLAN

  • Overarching goal: Universal Health Coverage (UHC)
  • UHC defined as equitable access to affordable, accountable health services regardless of income, gender, caste, or religion
  • Health expenditure target: increase government health spending from 1.15% to 2.5% of GDP
  • NRHM expanded to National Health Mission (NHM) covering both rural and urban areas
  • Key health goals under 12th Plan:
    • Reduce IMR to 25/1000 live births
    • Reduce MMR to 100/100,000 live births
    • Reduce TFR to 2.1
  • Ensure availability of paramedics and doctors as per IPHS norms
  • Increase community health volunteers per IPHS norms
  • Establish primary and secondary care facilities as per population norms

After the 5-Year Plans: NITI Aayog (2015 onwards)

The Planning Commission was replaced by NITI Aayog on January 1, 2015. The 12th Five Year Plan was the last. NITI Aayog introduced:
  • Three Year Action Agenda
  • Seven Year Strategy
  • Fifteen Year Vision Document
The National Health Policy 2017 set new targets including reducing IMR to 28/1000, MMR to 100/100,000, and increasing government health spending to 2.5% of GDP by 2025.

Key Milestones for Community Health Nursing Across Plans

PlanKey CHN Milestone
1stPHC establishment; ANM training begun
4thMCH + FP integration; Nutritional Anaemia Programme
5thCommunity Health Worker scheme; MNP launched
7thUIP launched; MCH convergence
8thCSSM programme; RCH approach
9thRCH Programme launched
11thASHA introduced; NRHM
12thUHC goal; NHM; RMNCH+A strategy
Source: Park's Textbook of Preventive and Social Medicine, Health Planning in India section (pp. 977-981)
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