Private Sector in Rural Sector
A large number of unqualified practitioners are practicing in the rural areas throughout the country. Efforts should be made to upgrade their skills and limit the scope of their practices so that they discontinue exploiting the people.
It should be made mandatory for organised and qualified practitioners to provide immunisation and family welfare services. To ensure quality of services at reasonable costs in the private sector, a participatory regularity mechanism should be set up. There should be a total ban on the private practice of government doctors.
Voluntary Sector in Primary Health Care
The voluntary sector should be involved in providing primary health care in a more effective manner, particularly in the neediest areas. A special fund like CAPART should be set aside for this purpose. They will also play a very important role in imparting health education through schools and other fora. The services of qualified voluntary organisations should be utilised for training of community health workers as well as for giving continuing education to other health personnel of the government. Similarly, they should be partners in the programme of eradication of TB and malaria throughout the country. National and state level networks of voluntary organisations should be utilised for ensuring participation from a large number of voluntary organisations at the grassroots level.
Given the growing professional competency of the voluntary organisations and their successful experimentations on various aspects of health care, they should be involved in the process of planning and monitoring of health services both at the central as well as at state levels. In this area, the national networks of voluntary organisations can play particularly important role.
Health Systems Research
In order to find out successful approaches to implementation of key programmes of public health, there is a need to do systematic health systems research in the following areas:
- Community Participation
- Integration of Indian Systems of Medicine in PHC
- Appropriate and low-cost health management information systems for rural health care
- Financing of rural health systems
- Effective methods of health education
- Inter-sectoral coordination and mechanics of convergence of social development work in rural areas
- Simple and effective epidemiological surveillance at the district level.
Corner Stones of the PHC System
Corner stones for revamping the primary health care system in future should be:
- Active participation of the people in managing their own health and that of the communities where they live.
- Optimum utilisation of existing primary health care infrastructure to remove the current inertia and to gear them up to meet the present and future challenges of health care.
- Active participation of voluntary organisations in the planning, monitoring and implementation of health programmes, particularly in the vulnerable areas.
- Ensuring a disciplined and responsible growth of the private sector both in curative as well as preventive and promotive care.
- Revitalisation of local health traditions and strengthening of local practitioners so that they can play important roles in health promotion, throughout the country.
- Decentralised district level planning with flexibility to cater to the local needs and constraints.
- Handing over the responsibility of health services gradually to Panchayats and Zila Parishads with technical support, guidance and leadership from State Health Services.
- Increasing the outlay for health care to at least 5 per cent of Plan Budget.
- Special Sub-plan to uplift the health status of the vulnerable people.
Health is not everything but everything else is nothing without health.
