Effective Primary Health Care: Insights From Health Policy in India

Abstract

Health Care systems based on the principles of primary health care are found in some form or the other all over the world. India, however distinguishes itself by having a relatively better functional basket of state level health care systems based on these principles. The reason for such a state is because of the consistent principles followed by a series of committees formed from 1946 till date. These recommendations have driven the health care policy in India. Notwithstanding the case of India and despite the universal acclaim of these principles of primary health care, the rising tide of technological advances in health care has increasingly seen a tilt towards institution/hospital based health systems. To the extent, that in year 2008, WHO pushed for renaissance of the primary health care system as a universally accepted system? We believe that such a renaissance will succeed if the principles followed by the Indian health care system are replicated in other systems trying to adopt the primary health care system. 3 core ideas have been followed in India from 1946 till date — using workload as core measure of identifying administrative units for services delivery; creating intervening manning levels based on skill levels for delivering varied components of health care programmes and using community based approach for determining services basket for a given context. These three core principles are missing from the WHO based performance indicators for such systems and it is our firm belief that they must be part of the performance management system of any health care system.