PHC in India
Strong primary health care systems are associated with better access to health care and population health. Long before the 1978 Alma-Ata declaration, health system planners in India envisioned a publicly funded and administered primary health care system to provide affordable primary health care to all. The establishment of a primary health care system as a core component of India’s public health system was one of the primary recommendations of the Health Survey and Development Committee (popularly known as the Bhore Committee), chaired by Sir Joseph Bhore. Recommendations made under the report of the Committee, which was submitted in 1946, continue to be relevant for India even today. Yet today, India’s primary health care system remains highly fragmented and inadequate.
The public and private sectors
- preventive health services are mostly provided by the public sector
- curative care is largely provided by private (qualified and unqualified) providers
- limited provision of promotive health care services
Utilization of PHC
- government primary care facilities is mostly bypassed by patients
- evidence of poor quality of primary care by both public and private providers.
- high out of pocket expenditures for outpatient visits in private sector deters needed care for those who cannot afford it, and can lead to impoverishment, for the economically vulnerable