Hey guys.......welcome to abmbbs.....todays
topic is PRIMARY HEALTH CARE.....now this
is a topic which is quite complicated in the
PARK TEXTBOOK but in this video we have condensed
the chapter & given only the must know points.
First up...what is the definition of Primary
Health Care??
Primary Health Care is the essential health
care made universally accessible to individuals
& acceptable to them , through their full
participation & at a cost the country & community
can afford.
Now, the definition in itself is pretty complicated
& is bound to make you nauseous. But if you
break it down to just the main points then
it gets pretty simple..........Remember that
Primary Health Care consists only of the bare
essentials of our health care needs.It is
the bare minimum which needs to be given in
any medical condition.........….Secondly
Primary Health Care must be accessible to
the people to whom it is being given.A big
tertiary care hospital located 20kms away
from the patients home cannot be considered
as Primary Health Care............Thirdly
the Primary Health Care that is given must
be acceptable to the patients.A rectal exam
or a colonoscopy might not be acceptable to
the majority of the population & hence should
not be considered as Primary Health Care..............The
community to whom the Primary Health Care
is being given must actively take part in
the process.Without their full participation
Primary Health Care cannot be truly given.............................Finally,the
healthcare that is given in Primary Health
Care must be in accordance to the economic
condition of the country.
Next we come to the Principles of Primary
Health Care...........Number 1 is Equitable
Distribution.......the majority of the healthcare
services in India are concentrated in the
towns & cities.... whereas the rural areas
which need healthcare services more hardly
have any.....Primary Health Care aims to redress
this imbalance by focussing on the rural areas
& bringing these services as close to people's
home as possible.
Number 2 is Community Participation …....As
mentioned earlier, without the full participation
of the local population, discharging healthcare
needs is not possible...So Government of India
is training village health guides & local
dais from the local community itself.....these
people, being localites, can overcome the
cultural & communication barriers more easily.
Number 3 is Intersectoral Coordination...Government
of India has realised that Primary Health
Care cannot be provided by the healthcare
sector alone.The different wings of the government
must come together & work in an integrated
fashion.
Number 4 is Appropriate Technology....
Now it goes without saying that the government
spending on healthcare is extremely low & our
our public healthcare institutions do not
have the money for doing costly diagnostic
tests & treatments...So Primary Health Care
in India must rely on low budget technologies..One
such technology is ORS...it is a low cost
treatment for diarrhoea & dehydration..it
can be stored anywhere & hardly has any side
effects.
Next we come to the levels of Primary Health
Care....First is the Primary level...it is
the first level of contact between the healthcare
setup & the patient.It includes Subcentre
&....Primary Health Centre.
The secondary level or the 1st referral level
is the Community health centre.
Finally comes the Tertiary level which is
the 2nd referral level.It includes Medical
colleges & hospitals.
So......now lets talk about Subcentre in detail....this
one...It is the most peripheral & 1st contact
point between the healthcare facility & the
patient.It has 3 employees.....the health
worker male, the health worker female & voluntary
worker.Also the ministry of health & family
welfare provides 100% funding for subcentres.
Next we talk of Primary Health Centre....it
is the 1st point of contact between the village
community & the doctor.It has a staff strength
of 15 people including a medical officer,
a health assistant male & health assistant
female among others.The medical officers is
considered to be the leader of the team at
the PHC.Each PHC acts a referral centre for
6 subcentres. & they have a bed strength of
4 to 6 beds.
Next we talk of community health centre. Here
the staff strength is 30 including 4 specialist
doctors which include a physician, a surgeon,
gynaecologist & a paediatrician.3 additional
new posts have been created under the NRHM.They
include an ophthalmic surgeon, an anaesthetist
& a public health programme manager.Each CHC
acts as a referral centre for 4 PHCs & they
have a bed strength of 30.
So.......lets consolidate what we have learnt
so far in a table.The level of care in subcentre
& PHC is primary whereas in CHC is secondary.Each
subcentre caters to a population of 5000 in
the plains & 3000 in the hills.Each PHC caters
to a population of 30,000 in the plains & 20,000
in the hills.Finally each CHC caters to a
population of 1,20,000 in the plains & 80,000
in the hills.The total number of staff in
a subcentre is 3, in a PHC is 15 & in a CHC
is 30.Finally we should remember that the
subcentre is under the central government
whereas the other 2 are under the state government.
Next we come to some population norms...this
topic is not a must know...but it falls under
,what I call as good to know category...Government
of India recommends that there should be 1
doctor per 3500 population....1 nurse per
5000....1 health worker per 5000 people in
the plains & 3000 people in the hills.....1
health assistant per 30,000 people in the
plains & 20,000 people in the hills......1
pharmacist per 10,000 people.....1 lab technician
per 10,000.......1 ASHA per 1000.....1 Trained
birth assistant per 1000.....1 village health
guide per 1000....finally 1 anganwadi worker
per 400 to 800 people in the plains & 300
to 800 people in the hills.......Now you might
be what an ASHA or Anganwadi worker is.....I
will discuss about them in my next video...I
will end this video by talking about trained
birth asssistant & village health guide.
Now remember a village health guide is not
a government employee.She is a person with
an aptitude for social service.She must be
a resident of the concerned village where
she is working & must be a female.She must
be educated atleast till 6th standard.She
receives training at the local PHC for 200
hours spread out over 3months. During this
time she receives an honararium of 200 rupees
per month.After her training is over, she
receives a working manual & drugs worth 600
rupees.She must devote 2 to 3 hours per day
for this work & she is payed Rs 50 per month
for her efforts.
Next we come to the topic of Trained birth
assistant or Trained dai, as they are popularly
known...trained dais undergo training for
30 working days...during this time, 2 days
a week they undergo training at the local
PHC & the rest 4 days they accompany the health
worker female for field work...She must conduct
atleast 2 deliveries under guidance during
this period & she is paid Rs 300.
After her training is over she receives a
delivery kit & a certificate.
Finally , coming to an important question
from this chapter that teachers often love
to ask.
What does the Medical officer in a PHC do??
Well.....The medical officer is the captain
of the PHC team.He attends the outdoor in
the morning & does field work in the afternoon.He
plans & impliments the Universal Immunization
Programme or UIP & ensures cold chain for
vaccines.He impliments the IMNCI. He regularly
visits schools& subcentres in his area & organizes
medical camps.He also organizes training of
health personnel like ASHA, Anganwadi Worker,
trained dais.
This brings us to the end of this video.You
can also watch the other videos in this channel.The
link is available right here.
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