Health ministry issues draft national list of essential assistive products

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The Union health ministry has released the draft National List of Essential Assistive Products (NLEAP).

The list is aimed to provide assistive technologies (ATs) and devices for elderly, persons with disabilities (PwDs), patients with non-communicable diseases (NCDs) such as stroke, diabetes, congenital birth defect associated disabilities and people in humanitarian crisis and disasters.

The ministry has invited suggestions and comments on the list from the stakeholders by October 10, 2020.

Earlier, the Indian Council of Medical Research (ICMR) had initiated steps to prepare a list of assistive products on the pattern of WHO’s Priority Assistive Products List (WHO-APL). A total of 383 assistive products (APs) have been included in the NLEAP through a consultative process. As India already has a National List of Essential Medicines (NLEM), hence during various Expert Group meetings by ICMR, it was agreed that the list may be termed as NLEAP.

In January 2020, Director General (DG), ICMR, Balram Bhargava constituted a National Expert Committee (NEC) under the leadership of Dr R K Srivastava, Ex. DGHS, to assist in preparation of a list of assistive products.

The NEC recommended creation of 4 sub-groups, each representing their specialties like public health, physical medicine & rehabilitation (PMR), geriatrics and engineering. Each of the specialties had one leader with involvement of two more members.

These Sub-Groups were: public health specialists led by Dr Harshad Thakur, Director, National Institute of Health and Family Welfare (NIHFW), physical medicine and rehabilitation professionals led by Rajendra Sharma, Consultant, Dr Ram Manohar Lohia Hospital, Delhi, geriatric medicine experts led by Dr A B Dey and engineering professionals led by Dr PVM Rao, IIT-Delhi.

Lead Expert of each sub-group was given liberty to include more members. Dr Sanjiv Kumar, Ex. National Health Systems Resource Centre (NHSRC) ; Dr Arvind Mathur, renowned geriatrician; Dr. S.L. Yadav, AIIMS; Dr. Balakrishnan, IIT-Delhi; Dr Shipra Chaudhary, RML Hospital; Dr Shweta Bhandari, and Dr Suman Badhal, Safdarjang Hospital; Dr Monika Saini, Dr Rajni Bagga, Dr Manoj and Dr Niraj –NIHFW; contributed towards finalisation of the complete master list of assistive products. In addition to this Prakash Bachani, Scientist, Bureau of Indian Standards (BIS) and Dr Sangeeta Abrol, Ministry of Health & Family Welfare contributed by providing BIS-ISO standards and health ministry perspectives. Each sub-group met many times to discuss the assistive products from their specialty angles.

During its meetings, NEC and Sub-Groups felt the need to go beyond simple list to classify them age-wise (different requirements in different age groups), disability-wise (21 disabilities as per RPwD Act 2016 or Visual, Hearing, locomotor, Cognitive, Communication, Self-Care), system-wise (Primary, Secondary or Tertiary Health Care Systems), cost-wise (Low, Medium or High), provision-wise (Govt., Private, Insurance, Welfare, NGO), Indigenous vs. Imported (available in India or to be imported),BIS-ISO Standards, and Technology-wise (Simple, complex, advanced including softwares).

Current list was prepared after Expert Group consultations and referring to Safdarjung list, CGHS list, ALIMCO list, Mobility India list, EU list, BIS-ISO list, textbooks, and National Trust (with a network of more than 700 NGOs).

ICMR aims to deliberate, contribute and guide the way forward towards building a National list of Essential Assistive Products (NLEAP) -India, with focus on the principal themes of appropriateness, quality, affordability, accessibility and standardization of ATs and strategies for strengthening and service provision.

By 2022, existing 1,50,000 Sub Centres and Primary Health Centres will be converted to HWCs. Ministry of Social Justice and Empowerment(MoSJE), Government of India is the nodal agency for care of persons with disabilities. An overarching legal provision in form of Rights of Persons with Disabilities Act 2016 (RPwD Act, 2016) was enacted by MoSJE.

RPwD Act has clearly delineated the steps for provision of assistive products. It directs every Ministry to develop their own systems for care of PwDs. Health and healthcare has been mentioned more than 25 times in the said act.

Subsequently, Union health ministry has included the assistive products under the list of health products vide notification dated February 11, 2020.

The Assistance to Disabled Persons for Purchase/Fitting of Aids/Appliances (ADIP) Scheme under MoSJE is providing ATs to the PwDs. It was conceived in 1981 to provide “durable, sophisticated, scientifically manufactured modern, standard aids and appliances” to disabled persons. Since that period the ATs like sticks, walkers, spectacles, wheelchairs, tricycles, smart cane, cochlear implants are being extended to the needy people. The NLEAP will facilitate ADIP scheme to provide better products to those who need them.

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