INDIAN PRIMARY HEALTH CARE - SOCIAL JUSTICE

Indias primary healthcare

Changing nature of India's primary healthcare landscape

Importance of India’s primary health care for rural empowerment

Challenges nature of health care

Government initiatives for health care

Conclusion

Introduction:

Anchored in the principles of the1978 Alma-Ata Declaration, it emphasises preventive, promotive, curative, and rehabilitative services close to people’s homes. India’s network of Sub-Centres, Primary Health Centres (PHCs), and Health & Wellness Centres plays a critical role in reducing disease burden, improving maternal and child health, and ensuring universal health coverage

Strengthening this foundational tier is vital to achievingSDG 3: Good Health and Well-being and realizing the vision of Ayushman Bharat.

Changing nature of India’s primary healthcare landscape :

1.Shift from Curative to Preventive & Promotive Care :Focus is moving beyond treating illnesses to health promotion, early detection, and lifestyle modification.

Example:National Programme for Prevention & Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS) integrating NCD screening at the primary level.

2.Digital & Telemedicine Integration :Technology is bridging rural–urban gaps through e-Sanjeevani teleconsultations and AI-based diagnostics.

Example:Over 18 crore teleconsultations conducted under e-Sanjeevani by 2024.

3.Expansion of Health & Wellness Centres (HWCs) :PHCs/Sub-Centres upgraded into HWCs delivering comprehensive primary care, including mental health, palliative care, and physiotherapy.

Example:1.6 lakh HWCs operational under Ayushman Bharat (2024).

4.Integration of AYUSH & Holistic Care :Traditional medicine integrated with modern care for holistic health services.

Example:Co-location of AYUSH clinics within PHCs in states like Kerala and Gujarat.

5.Community-Centric and Decentralised Models :Greater involvement of ASHA workers, Village Health Sanitation & Nutrition Committees (VHSNCs), and Panchayati Raj in planning and delivery.

Example:Kerala’s Aardram Mission transforming PHCs into family health centres with local governance participation.

6.Focus on Non-Communicable Diseases (NCDs) :Primary healthcare now addresses rising NCD burden alongside infectious diseases.

Example:NCD screening for people aged 30+ as part of HWC services.

7.Public–Private Partnerships (PPPs): Collaborations for diagnostics, telemedicine, and supply chain strengthening.

Example:PPP-based diagnostic centres in PHCs in Andhra Pradesh and Gujarat.

Importance of India’s Primary Healthcare for Rural Empowerment :

Improved Access to Essential Services :Reduces rural–urban disparity by providing affordable, local healthcare close to villages.

Reduction in Out-of-Pocket Expenditure (OOPE) :Affordable primary care lowers the financial burden, preventing medical poverty.

Example:Tamil Nadu’s robust PHC network offers free diagnostics and medicines, keeping OOPE among the lowest in India.

Women’s Health & Empowerment :Maternal and child health services at PHCs enhance women’s survival, mobility, and participation in community life.

Employment & Skill Development :Primary healthcare generates rural jobs for ASHA workers, ANMs, lab technicians, and pharmacists.

Foundation for Universal Health Coverage (UHC) :Ensures rural citizens are not left behind in Ayushman Bharat’s vision of “health for all”.

Example:70% of beneficiaries under PM-JAY are from rural households, leveraging PHCs for referral.

Challenges nature of health care :

High Out-of-Pocket Expenditure (OOPE) :Over 48% of total health spending comes directly from households, leading to medical debt.

Poor Quality & Accountability in Public Healthcare :Infrastructure gaps, absenteeism, and low patient trust also creates healthcare concerns.

Rising Burden of Non-Communicable Diseases (NCDs) :Shift from infectious to chronic diseases, requiring long-term, costly treatment.

Inadequate Preventive Healthcare Focus :Overemphasis on curative services instead of prevention and health promotion.

Low Public Health Expenditure :India spends around 2% of GDP on health (2023), below the WHO-recommended 5%.

Human Resource Shortages :Deficit of doctors, nurses, and specialists in public facilities.

Government initiatives for health care:

Ayushman Bharat– Health and Wellness Centres (AB-HWCs): Provides primary healthcare services, including preventive, curative, and palliative care, in 150,000 Sub-Centres and PHCs across India.

National Health Mission (NHM):Seeks to enhance healthcare infrastructure and accessibility, focusing on maternal and child health, immunisation, family planning, and disease control.

Pradhan Mantri Ayushman Bharat Health Infrastructure Mission (PM-ABHIM): Enhances health infrastructure through Block Public Health Units and improved district health systems.

Indian Public Health Standards (IPHS): Standardises healthcare quality by defining minimum service norms and improving consistency in primary healthcare.

National Digital Health Mission (NDHM):Aims to digitise health records and improve healthcare efficiency and accessibility through digital platforms.

Jan Aushadhi Scheme:Provides affordable generic medicines through Jan Aushadhi Kendras, ensuring access for rural populations.

Conclusion:

Effective implementation of the National Health Policy 2017, integration of technology, and stronger public–private collaboration can bridge existing gaps. Achieving SDG 3: Good Health and Well-being will not only improve health outcomes but also empower communities and drive inclusive socio-economic growth