Primary Health Care in India

1. PRINCIPLES OF PRIMARY
HEALTH CARE APPROACH
• Equitable Distribution
• Community Participation
• Inter sectorial Coordination
• Appropriate Technology
• Focus on Prevention

2. PRIMARY HEALTH CARE in INDIA
Bhore committee 1946:
1.PHC a basic health unit to provide an integrated
preventive and curative services to rural population.
2.one PHC/10 to 20,000 population with 6 medical officers
and 6 public health nurses and other supporting staff.
Mudaliar committee,1962:
1.Strenthenig of existing PHCs and
2.One PHC for 40,00 population.

3. PRIMARY HEALTH CARE in INDIA--CONTINUATION
• Shrivastav committee-1975:
Community health care should be provided by health workers who
are from the same community after proper training. So that peoples
health is placed in peoples hands.
• In 1977, the government of India had launched a Rural Health
Mission, based on the principle of “placing the peoples health in
peoples hands”.
• It is a three tier system of health care delivery in rural areas, as per
the recommendation of Shrivastave committee.

4. HEALTH FOR ALL
• This movement was decided to launch in 1977 by the world health
assembly.
• The fundamental principle of HFA strategy is equity.
• Health for all is defined As “attainment of a level of health that
will enable every individual to lead a socially and
economically productive life”.
• In 1978,the Alma-Ata conference on primary health care reaffirmed
HFA as the major social goal of governments. And stated that
Provision of primary health care is the best approach to attain HFA.

5. 1. HEALTH CARE DELIVERY SYSTEM IN INDIA
PUBLIC SECTOR
(a)Primary health care
Community Health Centres
Primary health centers
sub-centers
Village level –Anganwadi workers , MHG
(b) Hospitals
District hospital/health center
Specialist hospitals
Teaching hospitals
(c) Health Insurances schemes
Employees state insurance
Central Govt. Health Scheme
(d) Other agencies
Defence services
Railways

6. 2. Private Sector
(a) Private Hospitals, polyclinics,
Nursing homes and Dispensaries.
(b) General practitioners and clinics
3.Indigenous system of Medicine
Ayurveda, Siddi, Unani and Tibbi, Homeopathy
4.Voluntary Health Agencies
5.National Health Programmes

7. 7
Primary health care :-
Launched in 1977 base on rural health scheme
The principle is “placing people health in
people hand”
1983 national health policy based on PHc
approved by parliament
1)Village level
a) village health guide scheme
b) training of local dais
c) ICDS scheme(Anganwadi worker)
2)Sub centre
3)P.H.C

8. 8
a)Village level
Village health guides:-
First level of contact with health care delivery system.
a person with an aptitude for social services and it not full time
government functionary.
Local Dais
Emphasize on elementary concepts of maternal and
child health and sterilization
Anganwadi worker
One anganwadi for 1000 people popullation
Under ICDS

9. 9
Sub-center level:-
One sub centre …….
Every 3000 population in hilly and tribal ……
Each sub-center one male/female ANM
Primary health center level
In 1946 Bhore community put the concept of
P.H.C.
One P.H.C. for 30,000/25,000
One P.H.C. for 20,000/15,000 in hilly and tribal

10. Staffing pattern of P.H.C
Medical officer 1
Pharmacist 1
Nurse mid-wife 1
Health worker 1
Block extension educator 1
Health assistant 1
Health assistant 1
U.D.C. 1
L.D.C. 1
Lab technician 1
Driver 1
Class VI 4

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Community health centers:-
•31st march 2003 established by upgrading
the primary centers
•Covering 80,000 to 1.2 lack population
•30 beds
•Specialist surgery and other inpatient
services
Rural hospital :-
•Covering 5 lacks population
•P.H.C. patient are shifted for infusion
level
•Specialist surgery and other inpatient
services

12. Staffing pattern at CHC:-
1) Existing clinical manpower:-
General surgeon
Physician
DGO
Pediatrician
2. Existing support manpower:-
Nurses + midwifes (7+2)
Dresser (certified by Red cross)
Pharmacist
Lab technician
 radiographer
Ophthalmic assistant
Ward boy
Sweeper

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District hospital
Hospital differs from health centre in the following
respect
 mostly curative services
No catchment area
Mix team work
Specialist hospital :-
The specialist hospital include:-
 trauma centers
Rehabilitation hospital
Seniors (geriatric) care
Psychiatric hospital
Cardiac
Oncology etc.

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Other agencies health insurance scheme:
Employee state insurance
This act introduce in 1948
The act coves employees drawing wages not exceeding Rs.
10,000/month - Person with daily wages of less Rs 70 per day
are exempted from making any payments
Funeral benefit is up to Rs 5000
The State Government's share of expenditure on medical
care is 1/8 of total cost of medical care; the ESI Corporation's
share of expenditure on medical care is 7/8 of total cost of
medical care.
The employer contributes 4.75 % of total wage bill; the
employee contributes 1.75 % of wages.


15. Central Govt. health scheme :-
Introduced in Delhi in 1954 to provide
comprehensive medical care to central govt.
employees

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Other agencies :-
Defense medical services:-
 it is largest and almost best organization of
health care delivery systems in the country
Supported facilities:-
1. Ambulance
2. Mobile beds
3. Hospital (all)
4. Staff (doctors,nsg,co-workers)
Health care of railway employee:-
Through out railway hospital care are provide
MCH
School health services
Specialist unique hospital
Primary care
Health check-up