Mains Marathon 2024

Approach Briefly introduce the concept of primary healthcare Highlight its role in the healthcare system. Identify the key challenges in the primary healthcare system in India. To conclude, suggest strategies for strengthening primary healthcare.

Introduction

As per the World Health Organisation (WHO), Primary health care is a whole-of-society approach to health and well-being centered on the needs and preferences of individuals, families, and communities. It addresses the broader determinants of health and focuses on the comprehensive and interrelated aspects of physical, mental, and social health and well-being.

Body

Role of Primary Healthcare

• Accessibility and Affordability: Primary healthcare (PHC) in India aims to enhance accessibility, particularly for underserved and rural populations.
  • Health and Wellness Centers (HWCs) established under the Ayushman Bharat scheme aim to offer comprehensive healthcare services, including preventive, promotive, and curative care, at an affordable cost.
• Preventive and Promotive Care: One of the core functions of primary healthcare is the promotion of health and prevention of diseases
  • As recognized in the 2018 Astana Declaration, Primary Health Care (PHC) approach is the most effective way to sustainably solve today’s health and health system challenges.PHC system can tackle up to 80% of health needs and can reduce the need for specialized health care services.
• Continuity of Care: Primary healthcare ensures continuity of care for individuals with chronic conditions.
  • This continuity is vital for managing conditions like diabetes, hypertension, and heart disease, which require regular monitoring and lifestyle adjustments.

Key Challenges in the Primary Healthcare System in India

• Inadequate Infrastructure: Many primary healthcare centers (PHCs) lack adequate infrastructure, including basic amenities, equipment, and medical supplies. This hampers the delivery of quality care.
  • According to the National Health Profile 2021, there are about 25,000 primary healthcare centers (PHCs) in India, which are often under-resourced and lack basic amenities and medical equipment
• Shortage of Healthcare Professionals: There is a significant shortage of trained healthcare professionals, including doctors, nurses, and allied health workers, particularly in rural and underserved areas.
  • India has only 0.7 doctors per 1,000 population, which is significantly lower than the World Health Organization's recommended ratio of 1.5 doctors per 1,000 people
  • Every allopathic doctor in India, caters to at least 1,511 people, much higher than the WHO norm of one doctor for every 1,000 people.
  • The shortage of trained nurses is more dire, with a nurse-to-population ratio of 1:670 against the WHO norm of 1:300.
• Limited Funding and Resources: Insufficient funding for primary healthcare affects infrastructure development, human resources, and the availability of essential medications and supplies.
  • Despite being the world's fifth-largest economy, India's healthcare expenditure stands at a mere 2.1% of GDP for FY23, significantly lower than the 5-12.5% typically spent by most countries.
• Dependence on Out-of-Pocket Expenditure: A significant proportion of healthcare costs in India is borne by patients themselves, leading to financial hardship and discouraging individuals from seeking care
  • The NHA estimates that 47% of total health expenditures in India are out-of-pocket, placing a significant financial burden on families
• Urban-Rural Divide: Urban areas may have better access to healthcare services compared to rural regions, exacerbating health inequities.
  • A report by the United Nations highlights that nearly 75 percent of health-related infrastructure, medical workforce, and other health resources are concentrated in urban areas, where only 27 percent of the population resides.

Conclusion

Addressing these challenges requires comprehensive policy reforms, increased funding, community engagement, and a focus on building a robust primary healthcare infrastructure that prioritizes accessibility, quality, and equity. By investing in primary healthcare, India can improve health outcomes and ensure a healthier future for its population.