The family must be at the heart of the Indian health system

GS Paper 2

Program: Issues relating to health, education, human resources.

Source: Indian Express

Direction: Go through it once to understand the problem.

The context: Assessing health care in India

Health system in India: multilevel structure.

  • PHC at village level: a community agent operates and provides services covering 12 diseases/needs.
  • At block level: there is a 30-bed community health center run by four specialists
  • Departmental level: Hospital/medical school

History of health reforms: Report of the Bhore Committee (1946)the Kartar Singh Committee Report (1973), the National Rural Health Mission (NRHM) of 2005 and the Ayushman Bharat Mission of 2019.

NRHM was outstanding as it established the Indian Public Health Standards (IPHS) for physical infrastructure, human resources and service delivery, and resulted in a three-fold budget increase.

NRHM results:

  • Institutional deliveries increased from 41% in 2005 to 89% in 2021,
  • Maternal Mortality Rate (MMR) increased from 407 per one lakh of women in 2,000 to 113 per one lakh of women in 2021,
  • The infant mortality rate reduced from 58/1,000 live births in 2005 to about 28/1,000 live births in 2021
  • Use of the health system has recorded impressive improvement in states like Bihar and UP.

Limits: The primary health care system continues to be plagued with shortcomings and loopholes,

overcrowding, poor facilities, small budget (just 1.1% of GDP)

The solution:

Case Study: The Kerala Model – Health Care System

It’s based on UK GP (General Practitioners) system. Kerela’s model emphasizes primary health care, a community-based delivery systema continuum of care (from birth to death) and patient-centred, protocol-based, evidence-based treatment.

Focus on family: Primary Health Center (PHC) facilities have been renamed Family Health Centers (FHC), emphasizing the centrality of the family to the business.

A series of coordinated interventions were made, such as changing schedules, redesigning centers and equipping them with facilities suitable for patients and peopleintensive training of staff to take on new functions and responsibilities, etc.

Other Solutions

  • National Policy must be agile and allow for differential strategies, as a single system may not fit the whole country.
  • The Center should adopt the principles of flexibility and decentralization and provides space for innovation for states and districts plan, design and implement primary care based on local needs. The role of central government should be limited to measuring results.

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Issues related to the health sector

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Q. Mention the problems with the public health system in India. How can these problems be solved? Explain. (250 words)

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