Making primary health care visible, accessible and affordable, Pg20

Modern public health challenges include AMR (antimicrobial resistance), non-communicable diseases (NCDs), zoonotic diseases, and mental health issues.

Shift needed from treating only diseases to a system that addresses social determinants of health, health-seeking behavior, and community interaction.

Ayushman Bharat Programme (2018)

A transformative initiative with 3 key arms:

PM-JAY: Largest public health insurance, covering secondary & tertiary hospitalization for 50 crore people.

Ayushman Bharat Health and Wellness Centres (AB-HWCs): Aim to deliver comprehensive primary healthcare at grassroots.

PM-ABHIM: Infrastructure mission to bolster public health facilities.

Healthcare Access & Budget Reality

As of Nov 2021, 1.75 lakh AB-HWCs operational, yet average annual outpatient consultations per centre is low.

National Health Accounts (2021-22): Public spending as share of GDP increased marginally, with out-of-pocket expenditure still high.

Healthcare workforce gaps: 40% of PHCs lack doctors; 70% lack laboratory technicians.

People's Trust & Health-Seeking Behavior

Many prefer private sector due to perceived quality and ease.

Need to strengthen trust in public health system through consistent care, accessible infrastructure, and community engagement.

Crucial to achieving SDG targets, particularly SDG 3 (Good Health and Well-being).

Public health systems must be reliable, accountable, and people-centric, especially for vulnerable populations.

Highlights need for quality assurance, universal access, and preventive focus.

Adopt Lancet Global Health Commission recommendations:

Build resilient systems with quality infrastructure, trained workforce, and accessible services.

Ensure free public services are as good or better than private care.

Implement Indian Public Health Standards (IPHS) and National Quality Assurance Standards (NQAS) rigorously.

Address last-mile issues: ensure medicines, diagnostics, human resources are predictably available.

Shift narrative to: "visible, available, and trusted" public care.

Mains Mock Question:

Access alone does not ensure utilization. Critically examine the role of trust, availability, and system quality in making primary healthcare effective in India.