Making Primary Health Care Visible, Accessible, and Affordable

General Studies Paper-2

Context: In India, the government has been working to transform primary health care through innovative policies and programs, addressing challenges such as accessibility, affordability, and visibility.

About the Primary Healthcare in India

• According to WHO, Primary Health Care (PHC) is a whole-of-society approach to effectively organize and strengthen national health systems to bring services for health and wellbeing closer to communities.
• It aims to provide accessible, affordable, and comprehensive services to all citizens.
• It focuses on promotive, preventive, curative, rehabilitative, and palliative care, ensuring equitable access to essential health services.
• Alma-Ata Declaration of 1978 identified PHC as essential health care based on scientifically sound and socially acceptable methods.

Key Concerns in Primary Healthcare

• Urban vs. Rural Divide: Urban slums, while geographically closer to tertiary care centers, still face issues of affordability and overcrowding.
  • Rural areas house over 65% of the population but suffer from shortage of PHCs and trained medical personnel, along with poor transport connectivity.
• Human Resource Shortages (2023–24):
  • Shortfall of 77% surgeons, 69% obstetricians, 70% physicians at Community Health Centres.
  • 10–25% staff nurse vacancies in many states.
• Burden of NCDs and Mental Health: PHCs are now expected to manage lifestyle diseases and mental health concerns.
• However, limited staff training and infrastructure often hinder effective response.

Key Government Initiatives

• National Health Mission: India has a vast network of Sub-Centres (SCs), Primary Health Centres (PHCs), and Community Health Centres (CHCs).
  • These facilities serve as the first point of contact for individuals seeking healthcare services.
  • According to the National Health Mission, there are 1.6 lakh sub-centres, 26,636 PHCs, and 6,155 CHCs across the country.
• Ayushman Bharat Program (2018): It aims to transform primary healthcare through Health and Wellness Centres (HWCs).
  • HWCs provide services related to non-communicable diseases, maternal and child health, mental health, and geriatric care.
• Comprehensive Primary Health Care (CPHC): The National Health Policy 2017 emphasizes universal health coverage through CPHC.
  • It integrates traditional medicine systems like Ayurveda, Yoga, Unani, Siddha, and Homeopathy (AYUSH) with modern healthcare.
• Focus on Underserved Areas: Initiatives like the Aspirational District Program (ADP) and Aspirational Block Program (ABP) aim to improve healthcare in underdeveloped regions.
• Pradhan Mantri Ayushman Bharat Health Infrastructure Mission (PM-ABHIM): It focuses on equipping India’s health system with the necessary infrastructure, with an outlay of ₹64,180 crore.
• Women Led Initiatives:
  • Role of Self Help Groups (SHGs): Over 1.9 crore women are empowered through SHGs that promote awareness on PHC services.

Global Initiatives

• Universal Health Coverage (UHC): It aims to ensure that all individuals have access to quality health services without financial hardship.
  • Scaling up primary healthcare interventions in low- and middle-income countries could save 60 million lives and increase average life expectancy by 3.7 years by 2030.
• Global Health Programs: Programs like the Global Fund to Fight AIDS, Tuberculosis, and Malaria focus on integrating primary healthcare with disease-specific interventions.
  • The Gavi Alliance supports immunization efforts, strengthening primary healthcare systems in developing countries.

Way Forward 

• Strengthening Infrastructure: Expanding the network of HWCs and ensuring their functionality in underserved areas is crucial.
  • Investments in telemedicine can bridge the gap between urban and rural healthcare access.
• Enhancing Awareness: Community outreach programs and health education campaigns can improve visibility and utilization of health services.
• Ensuring Affordability: Continued efforts to reduce out-of-pocket expenses and provide financial protection through schemes like PM-JAY are essential.