Health Care System and Health Delivery System in India Health is declared fundamental human right. Health care is a public right. This implies that the state has a responsibility for the health of its people. Health systems and polices have a critical role in determining the manner in which health services are delivered, utilized and affect health outcomes. In constitution of India, ‘Health’ is a state subject. The issuance of the guidelines and funds by the central government, but the final Prerogative on implementation of the initiatives lies with the states. In can be better understand with India’s health sector is shaped by its federal structure and the federal-state divisions of responsibilities and financing. The states are responsible for organizing and delivering health services to their residents. The central government is responsible for international health treaties, medical education, prevention of food adulteration, quality control in drug manufacturing, national disease control, and family planning programs. It also sets national health policy including the regulatory framework and supports the states. CONCEPT OF HEALTHCARE AND MEDICAL CARE Medical care is purely defined as personalized medical care of Patient by medical doctor. These cares are provided on demand by patients. But health care is much more than medical care, Health of individual is influenced by number of factors like availability of food, safe water supply, sanitation, availability of health services, good housing and many more aspects including medical care. Thus medical care is sub-set of health care Health System ~ The system through which health services are delivered to the community to meet the health needs of community. There are various models tested at world level to deliver the health care to community. Over last many Years, country learnt lesson on health system. The health care system should have health services which are targeting preventive, promotive, curative and rehabilitative cares for emily. These services should be available to all population and not to just group. The best tested Model for this is pimary health care model. 7 Scanned by CamScannerHealth Care System and Health Delivery System in India 143 SO INDIAN HEALTH CARE SYSTEM National level Ministry of Health and Family Welfare Supported by various programme department, Directors and research wing State level State Ministry of Health and Family Welfare Supported by various programme officers, Directors and training wing District level District Panchayat with District Health officer with various programme officers Block level Block Health Officer (Rural and Urban) PHC Medical Officer PHC (Rural) Urban Health Center (urban area) ‘The current model of health care services delivery in India is Primary Health Care with various defined health services in three levels. Lovel -1 Primary health care which is mainly deals and only small proportion of curative health s with preventive and promotive services ervices. These services are closer to community. Level - 2 Secondary health care which is eq care with curative care. These services are at the leve medical staff available. Level-3 Tertiary health care w1 of majority curative services only small portion o are situated at the level of district or urban area. This is the typical Indian government health care delivery model since there are various other types of people or system who are also providin; care services to community. The other health service providers are ually divided with preventive and promotive 1 of block or taluka level where more hich is also known as specialist health care services. It consists f preventive and promotive services. They long time. In India 1g medical or health 1. Private sector 2. AYUSH health system 3. Voluntary agencies (non-governmental agencies) Scanned by CamScannersh to Social and Prev 144 PU New Appt harmacy Primary Health Care - t The ‘Primary Health Care’ (PHC)is defined as “the ren “ nat? i based son scientifically sound and socially acceptable methods and iecbnolsgy tm © “universally accessible to individuals and families in the community throug] 7s afford to meanest is acceptable to them at a cost that the Se ation —— words: Peas every stages of their development in the spirit 0! ‘ is an approach to health beyond the traditional health ee on inet on eat equity-producing social policy. PHC includes all areas : hecits 4 * access to health services, environment and lifestyle. Thus, Primary healficare and Public health measures, taken together, may be considered as the cornerstones of universal health systems. ia ideal model of healthcare was adopted in the declaration of the International Conference on Primary Health Care held in Alma Ata, Kazakhstan in 1978 Gknown 38 the “Alma Ata Declaration’), and became a core concept of the World Health Organization's goal of Health for all. Since then many countries have started to follow the approach of PHC to reach rural communities where most of the health problems exist. The Alma-Ata Conference mobilized a "Primary Health Care movement" of professionals and institutions, governments and civil society organizations, researchers and grassroots organizations that undertook to tackle the "politically, socially and economically unacceptable" health inequalities in all countries. There were many factors that inspired PHC; a prominent example is the Barefoot Doctors of China. PHC focuses on disease prevention and health promotion. It is the type of healthcare delivery sometimes described as ‘by the people, of the people and for the people.’ It involves the community in the whole process of healthcare delivery and encourages them to maintain their own health. The role of the Health Extension Workers and Practitioners is to work with the community and help them acquire the knowledge and skills that enables them to ensure their own health. Primary health care is the entry level to the health system and, as such, is usually a perso" fist encounter with the health system. It includes a broad range of activities and services rom health promotion and i conditions, Prevention, to treatment and management of acute and chron Alma-Ata declaration has focused on 8 essential c Education on prevailin, Promotion of effective ‘omponents of primary health care health problems and how to prevent and control thet ‘cod supply and proper nutrition er supply and basic sanitation Maternal and child healthcare, indluding ¢. neo Immunization agai n a 7 8 famil i inst major infectious ily planning. diseases, Scanned by CamScannerHealth Care System and Health Delivery System in India 145 ee _____ 6. Prevention and control of local endemic diseases 7. Appropriate treatment of common diseases and injuries. 8. Provision of essential basic medication. These 8 elements are adopted by majority of countires including India. The sequence of 8 element is also important. If you look the initial 6 components do not have any curative elem ents. They are either preventive or promotive health services. If you target them, you will require less curative component and drugs which are on 7 and 8 position. Principles of Primary Health Care — There are four principles of primary health care. They are already imbibed in the definition of primary health care. 1 Equitable distribution —If you want to Provide service to all citizen of nation, Provide without any biases. Nation has to ensure that primary care services are available, affordable and provided equally to all individuals irrespective of their gender, age, ethnicity,caste, colour, urban/rural location and social class. According to this principle, primary care and other services to meet the main health problems in a community must be provided equally to all individuals.Here this Principle is targeting inequality in health service. There are areas which are still not covered under health services. . Public or community participation — Any health services cannot successful without the community participation. Community can participate in three different ways in health services, provide manpower for services, healing infrastructure building, sparing time for services, money and last utilize services. The best example of community Participation is ASHA workers, Anganwadi workers. They are selected locally, stay in local area, provide service in that local area. a Scanned by CamScanner