Relevance : GS Paper II
Theme of the Article
Making hospitalisation affordable will spell relief, but there is no alternative to strengthening primary health care.
Why has this Issue Cropped Up?
In 2011, a high-level expert group on universal health coverage reckoned that nearly 70% of government health spending should go to primary health care. The National Health Policy (NHP) 2017 also advocated allocating resources of up to two-thirds or more to primary care.
Is India on the Path of Providing Primary health Care?
- Going by the government’s own estimate, in 2017, it would cost ₹16 lakh to convert a sub-health centre into a health and wellness centre. The current expenditure outlay is less than half of this conservative estimate.
- Building health and wellness centres at the given rate (15,000 per year) can fulfil not even half the proposed target of 1.5 lakh health and wellness centres till 2022. Picture of extremes
- The overall situation with the NHM, India’s flagship programme in primary health care, continues to be dismal. The NHM’s share in the health budget fell from 73% in 2006 to 50% in 2019 in the absence of uniform and substantial increases in health spending by States.
- Today, the condition of our primary health infrastructure is lamentable: there is a shortage of PHCs (22%) and sub-health centres (20%), while only 7% sub-health centres and 12% primary health centres meet Indian Public Health Standards (IPHS) norms.
- Further, numerous primary-level facilities need complete building reconstruction, as they operate out of rented apartments and thatched accommodations, and lack basic facilities such as toilets, drinking water and electricity.
- There is a staggering shortage of medical and paramedical staff at all levels of care: 10,907 auxiliary nurse midwives and 3,673 doctors are needed at sub-health and primary health centres, while for community health centres the figure is 18,422 specialists.
Significance of Primary Health Care
- While making hospitalisation affordable brings readily noticeable relief, there is no alternative to strengthening primary health care in the pursuit of an effective and efficient health system.
- It’s role shall also be critical in the medium and long terms to ensure the success and sustainability of the PMJAY insurance scheme, as a weak primary health-care system will only increase the burden of hospitalisation.
Conclusion
Apart from an adequate emphasis on primary health care, there is a need to depart from the current trend of erratic and insufficient increases in health spending and make substantial and sustained investments in public health over the next decade. Without this, the ninth dimension (‘Healthy India’) of “Vision 2030” will remain unfulfilled.
