Gaps in Goals: The history of Goal-setting in Health Care in India.

K. R. Nayar  Centre of Social Medicine and Community Health Jawaharlal Nehru University, New Delhi. E-mail: [email protected] There are several instances where specific targeted programs and goals have wreaked havoc with the health services system in several countries. After the family planning program and the small-pox eradication drive, the recent case of such diversion happened due to the pulse-polio program. We have sufficient evidence now regarding the distortions the pulse-polio program created in the health services with its uni-focal and intensive drives which affected the total coverage of immunization.1 The Millennium Development Goals (MDGs) is the new target which is being thrust on the Indian health services although not as directly as some of the earlier targeted activities.2 When we examine the history of Goal-setting in India which we attempt in this editorial with respect to some select policies, programs and strategies such as the recommendations of the Bhore committee, the family planning program, the Health For All strategies and the RCH program, it is possible to understand the weaknesses in such exercises. However, these experiences could serve as valuable lessons for the health planning process especially given the emphasis on Millennium Development Goals.