Lecture primary health care and delivery

Lecture primary health care and delivery

• 1.
  PRINCIPLES OF PRIMARY HEALTHCARE APPROACH • Equitable Distribution • Community Participation • Inter sectorial Coordination • Appropriate Technology • Focus on Prevention
• 2.
  PRIMARY HEALTH CAREin INDIA Bhore committee 1946: 1.PHC a basic health unit to provide an integrated preventive and curative services to rural population. 2.one PHC/10 to 20,000 population with 6 medical officers and 6 public health nurses and other supporting staff. Mudaliar committee,1962: 1.Strenthenig of existing PHCs and 2.One PHC for 40,00 population.
• 3.
  PRIMARY HEALTH CAREin INDIA--CONTINUATION • Shrivastav committee-1975: Community health care should be provided by health workers who are from the same community after proper training. So that peoples health is placed in peoples hands. • In 1977, the government of India had launched a Rural Health Mission, based on the principle of “placing the peoples health in peoples hands”. • It is a three tier system of health care delivery in rural areas, as per the recommendation of Shrivastave committee.
• 4.
  HEALTH FOR ALL •This movement was decided to launch in 1977 by the world health assembly. • The fundamental principle of HFA strategy is equity. • Health for all is defined As “attainment of a level of health that will enable every individual to lead a socially and economically productive life”. • In 1978,the Alma-Ata conference on primary health care reaffirmed HFA as the major social goal of governments. And stated that Provision of primary health care is the best approach to attain HFA.
• 5.
  1. HEALTH CAREDELIVERY SYSTEM IN INDIA PUBLIC SECTOR (a)Primary health care Community Health Centres Primary health centers sub-centers Village level –Anganwadi workers , MHG (b) Hospitals District hospital/health center Specialist hospitals Teaching hospitals (c) Health Insurances schemes Employees state insurance Central Govt. Health Scheme (d) Other agencies Defence services Railways
• 6.
  2. Private Sector (a)Private Hospitals, polyclinics, Nursing homes and Dispensaries. (b) General practitioners and clinics 3.Indigenous system of Medicine Ayurveda, Siddi, Unani and Tibbi, Homeopathy 4.Voluntary Health Agencies 5.National Health Programmes
• 7.
  7 Primary health care:- Launched in 1977 base on rural health scheme The principle is “placing people health in people hand” 1983 national health policy based on PHc approved by parliament 1)Village level a) village health guide scheme b) training of local dais c) ICDS scheme(Anganwadi worker) 2)Sub centre 3)P.H.C
• 8.
  8 a)Village level Village healthguides:- First level of contact with health care delivery system. a person with an aptitude for social services and it not full time government functionary. Local Dais Emphasize on elementary concepts of maternal and child health and sterilization Anganwadi worker One anganwadi for 1000 people popullation Under ICDS
• 9.
  9 Sub-center level:- One subcentre ……. Every 3000 population in hilly and tribal …… Each sub-center one male/female ANM Primary health center level In 1946 Bhore community put the concept of P.H.C. One P.H.C. for 30,000/25,000 One P.H.C. for 20,000/15,000 in hilly and tribal
• 10.
  Staffing pattern ofP.H.C Medical officer 1 Pharmacist 1 Nurse mid-wife 1 Health worker 1 Block extension educator 1 Health assistant 1 Health assistant 1 U.D.C. 1 L.D.C. 1 Lab technician 1 Driver 1 Class VI 4
• 11.
  11 Community health centers:- •31stmarch 2003 established by upgrading the primary centers •Covering 80,000 to 1.2 lack population •30 beds •Specialist surgery and other inpatient services Rural hospital :- •Covering 5 lacks population •P.H.C. patient are shifted for infusion level •Specialist surgery and other inpatient services
• 12.
  Staffing pattern atCHC:- 1) Existing clinical manpower:- General surgeon Physician DGO Pediatrician 2. Existing support manpower:- Nurses + midwifes (7+2) Dresser (certified by Red cross) Pharmacist Lab technician  radiographer Ophthalmic assistant Ward boy Sweeper
• 13.
  13 District hospital Hospital differsfrom health centre in the following respect  mostly curative services No catchment area Mix team work Specialist hospital :- The specialist hospital include:-  trauma centers Rehabilitation hospital Seniors (geriatric) care Psychiatric hospital Cardiac Oncology etc.
• 14.
  14 Other agencies healthinsurance scheme: Employee state insurance This act introduce in 1948 The act coves employees drawing wages not exceeding Rs. 10,000/month - Person with daily wages of less Rs 70 per day are exempted from making any payments Funeral benefit is up to Rs 5000 The State Government's share of expenditure on medical care is 1/8 of total cost of medical care; the ESI Corporation's share of expenditure on medical care is 7/8 of total cost of medical care. The employer contributes 4.75 % of total wage bill; the employee contributes 1.75 % of wages. 
• 15.
  Central Govt. healthscheme :- Introduced in Delhi in 1954 to provide comprehensive medical care to central govt. employees
• 16.
  16 Other agencies :- Defensemedical services:-  it is largest and almost best organization of health care delivery systems in the country Supported facilities:- 1. Ambulance 2. Mobile beds 3. Hospital (all) 4. Staff (doctors,nsg,co-workers) Health care of railway employee:- Through out railway hospital care are provide MCH School health services Specialist unique hospital Primary care Health check-up