The state of primary healthcare in India

Primary healthcare in India refers to the first level of contact that individuals have with the healthcare system. It is designed to provide preventive, promotive, and curative healthcare services to communities and individuals, and to address the most common health issues and needs of the population. Primary healthcare is an important component of the healthcare system in India because it is the first point of contact for many people seeking healthcare, and it can play a crucial role in preventing and managing common health problems.

However, the state of primary healthcare in India is generally considered to be inadequate. There are also significant disparities in the quality and availability of primary healthcare between different regions of the country.

There are several pathways that India could take to provide primary healthcare to all its citizens:

> Expand and improve the public healthcare system: This could involve increasing funding for the public healthcare system, hiring and training more healthcare workers, and improving the infrastructure and equipment at public healthcare facilities. The benefits of this approach include the fact that it would make healthcare more accessible and affordable for many people, especially those who are unable to afford private healthcare. Challenges may include the cost of expanding and improving the public healthcare system, and the time and resources required to make these improvements.

> Increase the role of private healthcare providers: This could involve encouraging private hospitals and clinics to provide more primary healthcare services, and potentially offering incentives to do so. The benefits of this approach include the fact that private healthcare providers may be able to provide higher quality care than the public healthcare system. Challenges may include the fact that private healthcare is often more expensive than public healthcare, which could be a barrier for many people, and there may be concerns about the potential for profit-seeking to take priority over patient care.

> Implement a universal healthcare system: This could involve establishing a system in which all citizens have access to healthcare services regardless of their ability to pay. The benefits of this approach include the fact that it would provide equal access to healthcare for all citizens and could potentially improve overall health outcomes. Challenges may include the cost of establishing and maintaining a universal healthcare system and the potential for it to be inefficient or overburdened.

> Encourage the use of traditional forms of medicine: This could involve promoting the use of traditional forms of medicine, such as Ayurveda and homoeopathy, as an alternative or supplement to modern Western medicine. The benefits of this approach include the fact that traditional forms of medicine may be more affordable and accessible than modern Western medicine, and they may be more culturally acceptable to some people. Challenges may include the lack of scientific evidence to support the effectiveness of some traditional forms of medicine and the potential for traditional and modern forms of medicine to conflict with each other.

One approach that India has taken is to expand and improve the public healthcare system. The government has made efforts to increase funding for the public healthcare system, hire and train more healthcare workers, and improve the infrastructure and equipment at public healthcare facilities. Data indicates that government expenditures on primary healthcare have increased from 51.1% in 2013-14 to 55.2% in 2018-19. Further, the government's per capita expenditure on healthcare has increased by 74% since 2013-14, from Rs. 1042 to Rs. 1815 in 2018-19.

India has also increased the role of private healthcare providers, encouraging them to provide more primary healthcare services and potentially offering incentives to do so.

What are some of the government's initiatives to improve healthcare in India?

The government of India has launched several programs to encourage and support primary healthcare in the country. Some examples of these programs include:

> Ayushman Bharat National Health Protection Mission: This program provides free healthcare services, including primary healthcare, to certain vulnerable populations, such as people living below the poverty line, elderly individuals, and women and children.

> National Rural Health Mission: This program aims to improve the availability and accessibility of healthcare services in rural areas, with a focus on primary healthcare. It includes initiatives such as the establishment of health and wellness centres, which provide a range of primary healthcare services, as well as training and capacity-building for healthcare workers.

> Rashtriya Swasthya Bima Yojana: This program provides health insurance coverage to people living below the poverty line, including coverage for primary healthcare services.

> Janani Suraksha Yojana: This program aims to reduce maternal and infant mortality by providing financial incentives to encourage pregnant women to deliver their babies at health facilities and to adopt healthy practices during pregnancy and childbirth.

> National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases, and Stroke: This program aims to prevent and control non-communicable diseases, such as cancer, diabetes, and cardiovascular diseases, through a combination of primary prevention measures and early detection and management of these conditions at the primary healthcare level.

Overall, these programs aim to improve the availability, accessibility, and quality of primary healthcare services in India, and to encourage the use of primary healthcare to prevent and manage common health problems.

(Disclaimer: The views of the writer do not represent the views of WION or ZMCL. Nor does WION or ZMCL endorse the views of the writer.)

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