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4th March- The Hindu Editorial - Part-2 (in Hindi)
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Subhodeep Das
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  2. The basics are vital Making hospitalisation affordable will spell relief but there is no alternative to strengthening primary health care UBHODESP

  3. Primary healthcare refers to "essential health care" that is based on "scientifically sound and socially acceptable methods and technology, which make universal health care accessible to all individuals and families in a community ATTRIBUTES OF PRIMARY HEALTH CARE Initial approach to a medical practitioner or clinic for advice or treatment .Essential health care Universally accessible PATIENT AMILY CENTERED . Acceptable Community based First point of contact Affordability ATINOU CCOUSTABLE UBHODESP

  4. In 2011, a high-level expert group on universal health coverage reckoned that nearly 70% of government health spending should go to primary health care. The National Health Policy (NHP) 2017 also advocated allocating resources of up to two-thirds or more to primary care as it enunciated the goal of achieving "the highest possible level of good health and well-being, through a preventive and promotive healthcare orientation". Last year, an outlay of 1,200 crore was proposed to transform 1.5 lakh sub-health centres into health and wellness.centres by 2022, which would provide a wider range of primary care services than existing sub- and primary health centres (PHC) UBHODESP

  5. Government's own estimate, in 2017, it would cost health centre into a health and wellness centre. 16 lakh to convert a sub- This year, the outlay is 1,600 crore (a 33% increase) clubbed under the National Health Mission (NHM) budget. Everytime, the outlay is less than half the estimate -buildingrate of health and wellness centres not achieved The overall situation with the NHM, India's flagship programme in primary health care, continues to be dismal. The NHM's share in the health budget fell-from 73% in 2006 to 50% in 2019 in the absence of uniform and substantial increases in health spending by States. UBHODESP

  6. The medium-term expenditure projection statement presented by the Ministry of Finance to Parliament in August 2018 projected a 17% increase in allocation for the NHM in 2019-20. However, there has only been only an increase of 3.4% this year. On the other hand, the Centre looks fairly committed to increasing access to hospitalisation care, predominantly through private players. recent steps to incentivise the private sector to open hospitals in Tier II and Tier Ill cities. UBHODESP

  7. Primary health infrastructure: shortage of PHCs (22%) and sub-health centres (20%), only 7% sub-health centres and 12% primary health centres meet Indian Public Health Standards (IPHS) norms. Primary-level facilities need complete building reconstruction, as they operate out of rented apartments and thatched accommodations, and lack basic facilities such as toilets, drinking water and electricity. Shortage of medical and paramedical staff at all levels of care: 10,907 nurse and 3,673 doctors are needed at sub- health and primary health centres, while for community health centres the figure is 18,422 specialists UBHODESP

  8. While making hospitalisation affordable brings readily noticeable relief, there is no alternative to strengthening primary health care in the pursuit of an effective and efficient health system Their role shall also be critical in the medium and long terms to ensure the success and sustainability of the PMJAY insurance scheme, a weak primary health-care system will only increase the burden of hospitalisation. Apart from an adeauate emphasis on primary health care, there is a need to depart from the current trend of erratic and insufficient increases in health spending and make substantial and sustained investments in publichealth over the next decade. UBHODESP