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Primary Health Care......


  • The Primary Health Centre (PHC) is usually the first point of contact for health care. In our state there is a PHC in every mandal. All preventive care like immunization, care of pregnant women and children, and children, and family planning services are provided in the PHC. For most common ailments, the first place of consultation is the PHC.

  • If there is need for hospitalization or specialized care, patients will have to go to 30- bedded hospitals usually located in old taluk headquarters, or the 300- budded hospitals located in district headquarters or major towns.

  • For referral care of patients who need sophisticated investigations or treatment, the general hospitals attached to medical colleges are effective. For advanced treatment like cardiac surgery etc., the autonomous Nizam's Institute of Medical Sciences is appropriate in government sector.

  • There are many private medical practitioners, nursing homes and sophisticated diagnostic centre and corporate hospitals in Andhra Pradesh. Most medical care is now being provided by private practitioners and nursing homes.

  • As the primary care system (PHCs) is very weak and ineffective, people are losing faith in it. As a result, simple preventive care and early treatment of infections etc are neglected. Most patients tend to go to referral hospitals for simple ailments, as PHCs are not patronized by people.

  • In any society , primary care system (PHCs) is very weak and ineffective, people are losing faith in it. As a result , simple preventive care and early treatment of infections etc. are neglected. Most patients fend to go to referral hospitals for simple ailments, as people does not patronize PHCs.

  • In any society, primary health care system is most important. If PHCs are neglected, then no amount of expenditure will be adequate to meet the society's medical and health needs. the hospitals system will not be able to absorb the huge load of patients who are compelled to seek help in referral hospitals for simple problems.

  • In outpatient departments of government hospitals, often there will be 200 - 300 patients to be seen by doctors in each specialty every morning. It is humanly impossible to properly and provide proper care when such large numbers flock to the hospitals.

  • A similar situation of over crowding and inadequate care is private nursing homes and consultancies. In addition, if primary care is neglected, the cost of investigations and treatment increases tremendously. No country, not even the richest countries like the USA or Germany can provide sophisticated, high - cost medical care to all people. Even countries like the USA are now shifting emphasis to primary health care.

  • The quality of health can be improved significantly if we improve the functioning of PHCs. They are our institutions, paid for from our tax money. All staff -- doctors, nurses, health inspectors, compounders are paid salaries from our taxes. We are entitled to good quality primary health care in PHCs.

  • As PHCs are not monitored by the local community, and as their functioning is highly centralized, they became remote and ineffective in most cases. But where a doctor has taken special interest to improve the functioning of a PHC, the results have been extremely good, and the local people appreciate it a great deal.

  • The postings of doctors and other staff have been highly politicized. The local politicians and senior officials are often treating PHCs as their private estates and as shelters for employees who are their agents and henchmen. This situation will not improve until the local people take an active interest in the functioning of a PHC and monitor it closely.

  • Like every other public service , health care also is meant for the people. We, the people are the masters, and all health personnel , senior officials and all health personnel , senior officials and ministers are servants of the people. We should assert collectively to improve the functioning of PHCs. In order to do that we should have the basic knowledge of the structure and functioning of PHCs.

  • Even if a PHC is well -run , the resources are never enough for our needs. It is our duty to raise additional resources for the PHC to make it better for our own benefit. Citizens should take an active interest in the budget of local PHC, understand its needs and requirements for public good, and raise resources to meet those needs.

  • Your PHC is expected to provide the following services.
    • Medical treatment
    • Family planning
    • Sanitation
    • Prevention of communicable diseases
    • Collection of health statistics
    • Promotion of health awareness
    • Implementation of national programs
    • Training health personnel
  • Each PHC usually has two doctors and other supporting staff. In Andhra Pradesh in some of the new PHCs there may be only one doctor. Under each PHC, there are sub-centers, one for every 15 - 25000 population. The sub-centre has an Auxiliary Nurse and Midwife (ANM) in charge of it. The ANM provides most of the immunization and maternal and child care services.

  • The PHCs also participate in School Health Programme, whereby each school is visited by the doctors and nurses and the children are given a health examination and treatment. Where necessary, they are also given immunization at school.

  • The PHC staff are under the administrative control of the District Medical and Health Officer (DM & HO). The local communities or elected local governments have no role in monitoring and supervision the work of PHCs. In the process, primary health care in many places is inadequate. Doctors and other staff are not available in many PHCs.

  • The government is recently making efforts to form Hospital Advisory Committees at every level including PHCs. The local people served by the PHC should know who the members of the Advisory Committee for their PHC are, and should be in constant touch with them. They should bring constant pressure on the Advisory Committee and the PHC for better services either directly or through the gram panchayat or municipality.

  • Good primary health care is the key to good health in the society, and we have a right to it. We are all paying for these services, and we are entitled to proper service. Therefore all of us should collectively assert our right to primary care and ensure that the local PHC or sub-centre functions to our satisfaction.

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