Universalizing access to quality primary health care
An effort for change in
future by the future………..
TEAM DETAILS :
DAYANAND AYURVEDIC COLLEGE AND
UNIVERSAL COVERAGE is a term defined and understood differently by different people.
In this paper, we use the term ‘universal coverage’ to mean that ‘financing and organizational arrangements
are sufficient to cover the entire population, removing ability to pay as a barrier to accessing health services
and protecting people from financial risks . ‘Coverage’ of a population essentially means that when the
population seeks health care, they are assured of receiving at least a package of essential services at
affordable or no cost at the point of service delivery. Achieving universal coverage calls for progress in three
dimensions. One is expanding the extent of financial protection available to the population, principally
through reducing out-of-pocket expenditure. The second is putting in place organizational and financial
mechanisms so that an increasing proportion of the population gets financial protection. The third is
widening the range of services which are available at subsidized or no costs, so that services for which one
will have to pay out-of-pocket (and hence face financial risks) are gradually minimized.
PRIMARY HEALTH CARE often abbreviated as “PHC” has been defined as essential
health care based on practical, scientifically sound and socially acceptable methods & technology made
universally accessible to individual and families in the community through their full participation and at a
cost that the community and country afford to maintain at every stage of their development in the spirit of
self reliance and self determination.
In other words,
PHC is an approach to health beyond the traditional health care system that focuses on health equity
producing social policy.
It includes all areas that play a role in health, such as access to health services, environment and
The ideal model of health was adopted in the declaration of the international conference on primary
health care held in ALMA ATTA, KAZAKHISTAN in 1978 and become a core concept of the WHO’s goal of
health for all.
The key information regarding our problem as provided by the organizers………………
India is the World’s largest exporter of generic medicines but spends less than 0.1% in
publicly funded medicines.
Overall , Indian healthcare expenditure forms 3.87% of GDP compared to 7.2% of rest
of the BRICS countries.
India ranks 150 out of 214 countries in terms of infant mortality rates( per 1000 births).
60% of all health care expenditure is out of pocket.
This imposes a significant burden on marginalized sections.
Acc. To the united nations , 75% of India’s health care infrastructure caters to only 27%
In 2012 , India had a shortfall of 9,148 primary health centers.
The govt. operates the national rural health mission to strengthen and improve public
health delivery access to India.
The 12th 5 yr plan calls for universal health coverage but this target is unlikely to be
India needs to assign more priority to health concerns to improve its ranking on the
There are about 23,000 primary health care centers in small town and villages in the
country and many of them are not very active due to lack of expertise and
HEALTH SYSTEM IN INDIA :
The constitution charges every state with raising the level of nutrition and the standard of living of its people and the
improvement of public health as among its primary duties.
Parallel to the public health sector and indeed more popular than it is the private medical sector in india.
Both urban and rural indian households tend to use the private medical sector more frequently than the public sector, as
reflected in surveys.
India is also a signatory to the universal declaration of human rights that recognizes the right to a standard of living
adequate for the health and wellbeing of himself and of his family.
Access to quality medical care is limited or unavailable in most rural areas although rural medical practitioners are highly
sough after by residents of rural areas as they are more financially affordable and geographically accessible than practitioners
working in formal public health care centre.
Only 11% of indian rural families dispose off stools safely whereas 80% of population leave their stools in open or throw
them in garbage.
Access to quality medical care is limited or unavailable in most rural areas.
Most of the population lives in villages, most villages have no SHC’s at all and the area’s having SHC’s and PHC’s lacks quality
due to lack of sources, staff etc..
The funds provided are well used by medium due to lack of fairness at play.
The so called CORRUPTION is engulfing every part of our country so also the medical field.
Lack of quantity and quality in SHC’s and PHC’s.
No. of SHC’s and PHC’s are less as compared to the population. And the running centers have thousands of vacancies vacant
for many posts.
Medical education is going costly and costlier.
If you are not getting govt. college, rich people educate their children with money for money, they have nothing to do.
Lack of knowledge due to low informal sector.
Knowledge matters. And we should proud to have such population where a LECTURE matters a lot. Although govt. is doing
much but still a change is needed.
Lack of expertise and infrastructure.
Actually we don’t lack specialists in India, but most of them practice private and others go abroad due to the obvious reason
i.e. costly medical education.
Underdeveloped rural areas.
Improper sanitation , bad infrastructure.
THE THING WE REQUIRED IS :
EQUITABLE DISTRIBUTION OF HEALTH CARE :
Acc. To this principle, primary care and other services to meet the main health problems in a community must be
provided equally to all individuals irrespective of their gender, age, caste, color, urban/rural location and social
COMMUNITY PARTICIPATION :
In order to make the fullest use of local national and other available resources, community participation was
considered sustainable due to its grass root nature and emphasis on self sufficiency as opposed to targeted (or
vertical) approaches dependent on international development assistance.
HEALTH WORKFORCE DEVELOPMENT :
Comprehensive health care relies on adequate no. and distribution of trained physicians, nurses, allied health
professionals, community health workers and other working as a health team and other supported at the local
and referral levels.
USE OF APPROPRIATE TECHNOLOGY :
Medical technology should be provided that is accessible, affordable, feasible and culturally acceptable to the
community like refrigerators for vaccines’ cold storage.
Use appropriate could include in many settings, body scanners or heart lung machines, which benefit only a small
minority concentrated in urban areas, are generally not accessible to the poor but draw a large share of
MULTI SECTORIAL APPROACH :
Recognition that health can’t be improved by intervention within just the formal health sector; other sectors are
equally important in promoting the health and self reliance of communities. These sectors include at least
agriculture (food security) education; communication (e.g. concerning prevailing health problems and the
methods of preventing and controlling them); housing; public works (e.g. ensuring an adequate water supply of
safe water and basic sanitation); rural development; industry; community organizations (panchayat, local govts.,
voluntary organizations etc.)
WHAT WE HAVE AND WHAT IS NEEDED…………………….
Biggest youth power.
Its glad to know that we have more than 50% of our population young.
Large no. of doctors and good quality of specialists.
Appx. 60,000 – 70,000 doctors graduate every year including AYUSH.
It is a golden factor that we have every doctor whether who was a dumb in his
student life is a good physician.
The honour DOCTOR itself enables a person.
It is the profession of service and dedication and the worker is by heart related
to the same.
We have dedication.
We have resources.
World’s largest exporter of generic medicine. And world’s biggest producer of
Ayurvedic medicines and other therapies like Yoga, naturopathy, etc. .
We have service.
Indians need just 1 command and they are ready to serve.
A proper assistance and that’s all.
Yes we lacks some other things like money, but that doesn’t matter, we could
also do much with the present sources just by a proper management.
Everybody, even a child could gave such type of data, the
reasons for failure. We have to concentrate on the solution.
ACTUALLY SOLUTION EXISTS BUT THE NEED IS TO ASSIST.
The major areas to cover are :
Medical service at affordable cost includes use of generic
To cover most of the population.
NOW IF I WOULD SAY THAT I COULD DO WITH THE PRESENT SOURCES…………..
YES. I CAN………………………..
First of all not only MBBS but also AYUSH doctors should be utilized.
There is difference in pathy but they all are good physicians to serve the society.
To cover the difference b/w them and to provide quality health care, the period of their internship should
be utilised properly.
It could be managed as:
•4 months at own college from where the graduation has been taken by the student.
•3 months total at SHC’s which could be in intervals results in service to govt. and adaptability in
•1 month at PHC.
•1 month at CHC.
•Experience total no. of 20 deliveries and pregnancy cases under a specialist.
•20 lectures at informing sector.
This could prove a weapon to us. Because in india it works
•All these should be the duty of campus management to provide in practice.
•Deserving styphan should also be provided to the internees by college management.
•It should be made compusary.
A doctor should be provided at each SUBCENTRE, results in quality at SHC’s and low
workload at PHC’s.
More no. of SHC’s . Provided with 1 Cabin, 1 doctor, 1 female assistant and 1 male
assistant, which is affordable.
At present, SHC is the first point of contact b/w a common man and the medical
access. And this service is provided by paramedical staff and this creates the big
difference. People preferably goes to a private doctor instead of SHC providing them
services free of cost, reason behind this is a proper doctor is not appointed. After all a
doctor is a doctor.
If we provide a doctor at each sub health center than it would lower the burden at
PHC and increases the quality at SHC.
PROBLEMS OR THE CHALLENGES IN
• Mentality of the server and as well as of
• Proper implementation at each and