IPSI launched its inaugural issue of Primary Healthcare Matters series on World Health Day 2024. Through this series we aim to inform on innovations and best practices in primary health care in India.
Globally, non-communicable diseases (NCDs) account for 41 million deaths annually with most occurring in low- and middle-income countries (1). In India, NCDs contribute to 63% of deaths (2). The North-East Region carries a disproportionate burden, with 66% of deaths due to NCDs (3). Prevalence of diabetes (13.6%) (4) and hypertension (31.6%) (5) in the region is higher than national averages (9.6% and 31.1%) respectively(6,7).
Better quality of care (QoC) at primary health care facilities is essential for India to achieve Universal Health Coverage (1). Over the past decade, several national quality initiatives including the National Quality Assurance Standards (NQAS), Kayakalp, and Labour room quality improvement initiative (LaQshya)1 have been launched to standardize and elevate quality in healthcare delivery.
Multidisciplinary teams of health workers working together is associated with comprehensive and integrated primary health care (PHC) services. Responding to a wide range of community health needs requires a diverse skill mix among PHC workers. Exemplar PHC delivery models from countries like Brazil, Thailand and Costa Rica incorporate multidisciplinary teams which work as a unit to provide PHC services. Further, global health agencies like the World Health Organization (WHO) emphasize the importance of health worker teams to deliver services.
In the Ayushman Arogya Mandir program (AAM; formerly known as Health and Wellness Centres), primary health care facilities are mandated to deliver 12 service packages that together provides comprehensive health services to communities. Evaluating service readiness of health facilities to deliver these packages provides insights into their functional status and helps identify areas for improvement. In this note, we discuss findings from a service readiness assessment of AAMs in Kalahandi district of Odisha (Figure 1).
Evaluating service readiness of health facilities provides insights into their functional status and helps identify areas for quality improvement. In this note we discuss findings from a service readiness assessment of Sub-health centres in Bhavnagar district of Gujarat. Implications of the study findings for the Health and Wellness Center program to deliver comprehensive primary health care is discussed.
Previous Issue
Krishna D. Rao
Director IPSI, and Associate Professor, Johns Hopkins Bloomberg School of Public Health
Pandemics are highly inequitable. They impose a disproportionate burden of morbidity and mortality on countries and people at the lower end of the income distribution. Moreover, as in the case of COVID-19, control efforts through social distancing and population lockdowns have brought additional deprivations on vulnerable populations. In low- and middle- income countries (LMIC) and elsewhere, the slowdown in economic activity has resulted in rapidly rising unemployment, particularly in the informal sector, where the majority of workers are employed and without adequate social safety nets. The effects of COVID-19 and population lockdowns will have short and long term effects on health, human capital, and income of vulnerable populations. It is now increasingly clear that economically vulnerable groups are being forced to sacrifice disproportionately more for the better health of society. To mitigate the deprivation due to COVID-19 it is necessary for government safety net programs to provide long term support focused on specific vulnerable populations.
Dr. Baridalyne Nongkynrih, Dr. Mohan Bairwa
Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi
Globally, NCDs are responsible for about 70% of all deaths, resulting in nearly 15 million “premature” deaths globally (i.e., deaths between the ages of 30 and 69 years). The majority of these deaths at 85% occur in in low and middle-income countries (LMICs). NCDs (cancer, CVD, CRD, diabetes and mental health – can result in a cumulative output loss of US$ 47 trillion over the period 2011-2030 i.e. nearly 75% of the global GDP in 2010. CVDs and mental health diseases are the two main contributors to the global economic burden of NCDs. In India and other South-East Asian countries, NCDs affect a relatively younger population as compared to the western countries.
Harsha Joshi
Program Officer, India Primary Health Care Support Initiative (IPSI)
The year 2020 brought global attention to public health and health systems. Faced with the COVID-19 pandemic, governments across the world are prioritizing the health sector and its resource requirements. In India, recent developments such as the 15th Finance Commission (FC) report, and the Union Budget 2021-22 indicate increased government attention to the health sector. Importantly, there is a renewed focus primary health care reforms and increased financing for primary health care.