To avoid duplication of efforts, all health, population, and women and children related welfare programmes at the rural level should be converged to ensure optimum resource utilisation. This will mean that uni-purpose workers will be gradually converted into multi-purpose workers with smaller a population to take care of. It is expected that with adequate supply of wherewithal at the primary level, enforcement of strict referral services will be possible. This will help avoid overcrowding at the sub-divisional and district hospitals.

The current unfortunate growth of various vertical intervention programmes like TB, Malaria or special programme on Sexually Transmitted Diseases and AIDS should be gradually curtailed and brought under the Primary Health Care, in order to stop the lopsided management of health problems. A more rational and practical health management information system should be introduced for the country to ensure good quality, uniform national health data, based on epidemiological findings. But it should not overburden the personnel of the health care systems.

At the Community Level
In the last few centuries, the rich Indian health culture has gone through serious neglect. Every effort should be made to revitalize local health traditions by supporting the efforts of existing local/traditional health practitioners. This will provide about half a million traditional health functionaries to contribute towards taking care of people’s health at low-cost in their own community settings. The Department of Indian Systems of Medicine should be encouraged to work out a programme for upgrading the skills and knowledge of these practitioners as well as weeding out malpractices that have crept into this system.

Local health practitioners should be further strengthened with the introduction of ‘Community Health Workers’ throughout the country. The nucleus of this scheme should be a motivated social person from the village itself. He/she should be named as the Panchayat Swasthya Sahayak and be selected by the village Panchayat. He/she has to assist the Panchayat in meeting the basic health needs and act as a strong link between the Government Health Agencies and the people. There should be one PSS for every 1000 population in plain areas, and one PSS for around 700 population in hill tribal and/or difficult areas. The entire country should be covered in a phased manner.

There should be a massive effort in health education in the entire country, through school teachers, panchayat members, youth clubs, Mahila Mandals and health workers to help people inculcate a more rational and scientific understanding of health. As a part of this process, it must be ensured, with support from the Ministry of Education, that every village school has adequate sanitation and safe drinking water facilities.

At the District Level
There should be a District Health Plan for all the districts of the country done at the district level itself. This should be supplemented by a Panchayat Health Plan. In the district level plan, there should be adequate flexibility for specific areas like the Desert and the Hill areas where a strong base-hospital supported by a mobile service must be provided.

Given the fact that lack of safe drinking water is a major cause of morbidity, it should be ensured that every citizen of this country has access to a reasonable quantity of safe drinking water. This programme should be implemented in collaboration with the Ministry of Rural Development and Employment. To ensure that the sources of safe drinking water are maintained properly, communities should be involved right from the beginning, from the installation to maintenance of these sources