NICE International has been providing technical assistance to the Ministry of Health and Family Welfare (MoHFW) at central and state level since 2009. Through the International Decision Support Initiative (iDSI) it is active in three areas:
1. Health Technology Assessment
Under the terms of the partnership MoU between NICE and the MoHFW Department of Health Research (DHR), and linking to the bilateral India-UK MoU, a Joint Steering Committee (JSC) linking with the Medical Technology Advisory Board (MTAB) has been established. The Committee is comprised of senior members from DHR , the India Council of Medical Research (ICMR), the National Health Systems Resource Centre (NHSRC), iDSI and NICE. The JSC provides strategic guidance and advice on how India can implement a system for health technology assessment (HTA) and priority setting and strengthen evidence-informed healthcare policy and practice. A work programme has now been defined for 2016, including training (Health Economics) and HTA demonstration projects on HTAs. This will be a significant step for India towards Universal Health Coverage, improving the way that the heath budget is spent by prioritising cost effective practices. Prime Minister Narendra Modi and Prime Minister David Cameron acknowledged this valuable partnership in a Joint Statement following a recent UK visit by the Indian Prime Minister: “The two Prime Ministers welcomed the cooperation in the health sector between the two countries and the on-going Memorandum of Understanding covering areas including Medical Education and Training, Universal Health Coverage, containment of Anti-Microbial Resistance (AMR), improving patient safety through quality, safe and efficacious drugs and the collaboration between NICE International, UK and the Department of Health Research in India on medical technology assessment
2. Standard Treatment Guidelines (STGs)
As a part of its efforts towards Universal Health Coverage the National Health Mission (NHM) has established an STG Task Force, one of four coordinated by NHSRC. Its aim is to oversee the development of authoritative, national STGs for healthcare services, including those covered by existing large scale insurance schemes (RSBY), and to help expand access to care that is affordable, equitable and effective. NICE International is helping NHSRC and the ten Clinical Subgroups, both from the public and private sectors that have been convened to develop STGs in 12 prioritized topics, based on robust evidence and using a transparent and inclusive process. STGs on hypertension and the diabetic foot have been sent to the MoHFW for public consultation before approval by the Directorate General of Health Services (DGHS). As part of this engagement, NICE International is a member of the Working Group (including AIIMs, WHO, NHSRC) that is developing the process and methods manual underpinning the STGs and associated Quality Standards for India. The manual aims to guide the STG developers in producing STGs that are inclusive, of high quality and relevant to India
3. STG Implementation and Primary Care
NICE International is working closely with the Primary Care Task Force to implement the STGs at state-level. It is a member of the Primary Care Implementation Group responsible for designing the action plan and prioritising topics for implementation, focusing on better management of non-communicable diseases (NCDs) in primary care. NICE International brings in its experience of working in partnership with the Government of Kerala (National Health Mission) and the Kerala Federation of Obstetricians & Gynecologists (KFOG) to help reduce maternal mortality through Quality Standards for maternal care, and specifically on post-partum haemorrhage and hypertensive disorders in pregnancy. The Government developed quality measures to improve the care mothers receive during delivery, in both public and private hospitals, and these have been implemented in several hospitals in Kerala leading to improvement of care and outcomes.
In addition to these three work packages, NICE International has engaged with policy makers in Bihar and Odisha and hosted delegations from Karnataka, ICMR, NHSRC, MTAB and the main health insurers at NICE. RSBY also contributed to an international workshop held under iDSI on the development of Health Benefit Packages.
NICE International work in India is funded by DFID and the Bill and Melinda Gates Foundation.