Primary Healthcare Centers

May 8, 2021 dilipnaik@bluerose-tech.com

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Health In India

The Indian Constitution makes the provision of healthcare in India the responsibility of state Governments, rather than Central Federal Government. Public healthcare is free and subsidised for those below poverty line.
Several reasons are cited for relying on the private rather than public sector. The main reason is the poor quality of care, reluctance of experienced healthcare providers to visit rural areas. Consequently, majority of public healthcare systems catering to the rural and remote areas rely on inexperienced and unmotivated interns who are mandatorily spend lives in public healthcare clinics as part of their curricular requirement. Other major reasons are long distances between hospital and residential areas, long wait times and inconvenient hours of operation.
There are 14 million doctors yet in India who have failed to reach its “Millennium Development Goals” to healthcare. The definition of access is the ability to receive services of certain quality at a specific cost and convenience. The healthcare system is lacking three factors – provision, utility and attainment. Provision or the supply of healthcare facilities can lead to utilisation and finally to good health. However, there currently exists a huge gap between these factors leading to a collapsed system.
Rural areas have shortages of medical professional. 74% of doctors are in urban areas catering to 28% of the population only.
The concept of Primary Health Centre (PHC) is not new to India. The Bhore Committee in 1946 led the model of a PHC as a basic health unit to provide as close to the people as possible, an integrated curative and preventive health care to the rural population with emphasis on preventive and promotive aspects of health care
The health planners in India have visualized the PHC and its Sub- Centers (SCs) as the proper infrastructure to provide health services to the rural population. The Central Council of Health at its first meeting held in January 1953 had recommended the establishment of PHCs in community development blocks to provide comprehensive health care to the rural population. These centers were functioning as peripheral health service institutions with little or no community involvement. Increasingly, these centers came under criticism, as they were not able to provide adequate health coverage, partly, because they were poorly staffed and equipped and lacked basic amenities
Good doctors tend to avoid go to rural areas due to lack of suitable housing, healthcare/education for children, drinking water, electricity, roads and transportation and also depending on the profession of the spouse.
The role of technology specifically in healthcare has also been explored as the India has the largest wireless communication base in the world, thus providing a potential window for mobile phones to serve in delivering healthcare. It can be used for reminders about vaccination, medication and general health awareness programme.

AYUSHMAN BHARAT PRADHAN MANTRI JANA AROGYA YOJANA

Features of PM-JAY include the following:
Provide health coverage for 10 Crore household or 50 crore Indians •Provide a cover of Rs 5L per family per year for medical treatment in empanelled hospitals with Public Private Partnership
Offering cashless payments and paperless record keeping through hospitals or doctors’ office
Using criteria from socio economic & caste census 2011 to determine eligibility for benefits

There has been a visible impact on the primary health system exposing its vulnerabilities associated in responding to severe disease outbreaks. An analysis of the recently released National Health Mission (NHM) data for the months of January to March this year, when compared with the 2019 data, shows a severe disruption of critical health care services.
A sharp decline in vital immunization for children, maternal health care and potential lifesaving medical treatment, TB treatment and screening for HIV/AIDS has also registered a decline. Treatment for non-communicable diseases and emergencies has fallen as well. Coverage of vaccinations against early childhood diseases – including BCG, Typhoid, Rotavirus1, MMR – has gone down.
The data indicates that many services for pregnant women, for instance providing iron and calcium supplements as well as tetanus injections continued in March, indicating that accredited social health activists (ASHA), and auxiliary nurse and midwives (ANMs) were largely able to continue their work.
An efficient primary health care system can reduce the burden from tertiary care and serve as a shield against any further strain on an already overburdened health system. Focus on comprehensive primary health services has always been part of India’s health strategy and policies.
In these evolving times, cultivating a culture of sharing knowledge and best practice models becomes a necessity. Optimizing communication to counter misinformation and to ensure people have the facts they need to stay healthy is essential.
A primary healthcare system that engages the community efficiently in the implementation process can pass the test of time at any given health emergency and will in turn lead to more feasible and sustainable socio – economic development of the community in the long term.

Four pillars of PH care:

a. Community participation

b. Inter sectoral coordination

c. Appropriate technology

d. Support mechanism and evaluation

PROPOSAL

It will be our pleasure to collaborate with your esteemed Organisation to improve the PHCs. We propose to refurbish and improve the PHCs with basic amenities like waiting rooms, consulting rooms, bath rooms, a signboard at entrance, drinking water. Special emphasis on examination table, BP apparatus and weighing scale. If there are facilities for in-patient admissions, clean cots, mattresses, bed sheets, pillows should be made available. Upgradation of accessories like bed pan, oxygen cylinder set etc.,
Minimum requirement of a working lab is important so that basic tests for common diseases can be done. A pharmacy catering to important drugs would be ideal as it would be convenient for patients to have a ‘one stop’ treatment. A good size refrigerator is important for storing blood, vaccine and drugs. X-ray unit, X-ray technician would be necessary, especially after Covid 19, to check lungs, fractures etc. A connect to a nearby larger hospital and specialists will help the General Physician at PHC to whatsapp, video conference, or through telemedicine to treat complicated cases.

THE PRESENT PROPOSAL OF THE ROTARY CLUB CONSISTS OF SEVERAL LAYERS .

To provide hardware like computers , refrigerators , UPS , medicine storage racks , lab equipment , Furniture washing machines etc. we can also consider some limited extent of building repairs like a toilet , hand washing station. The need of these items can be evaluated on a case to case basis and resolved. The focus of the Rotary club will be to provide direct infra or consumables rather than spend money on unproductive costs like gardening or compound wall etc.. Category A
To provide limited quantities of consumables for the near future like gloves , PPE sets , caps , bulbs , stethoscopes so that there is no gap between indenting and receiving the same from the government stores. This facility is extended more to maintain a steady supply of working consumables to protect the doctors / health workers and the patients and also ensure that the patients do not have to return disappointed… Category B
To provide soft services like arranging a monthly talk by a domain expert or a visiting doctor on topics like pregnancy , nutrition tips , children issues , geriatric issues , child birth etc. we could arrange to use the PHCs as a platform for all the necessary vaccinations that are required … Category C
RCB would like to engage with your organization in taking a small step towards providing basic infrastructure and some elementary consumables that are used on a day to day basis so that the efficiency of the PHCs is enhanced. In a sustaining model we would like to sensitize the community on various medical and home tips to stay on the top of illness
It is our endeavor to completely refurbish about 100 PHCs in and around Bangalore and to increase their efficiency so that the economically challenged community will have a better experience in the first step of the medical care in India
We would further like to locate 2 prominent and well visited PHCs and implement the new generation functions like tele medicine , health cards, wellness camps and many schemes for the new born babies… who would grow up into citizens of the country