Primary/Rural Health Care System and Hospital Administration
Contents: Preface. 1. Administration of primary/rural health care. 2. National Rural Health Mission (NRHM). 3. Inter-sectoral co-ordination for health promotion. 4. Community participation and health development. 5. Financial administration for primary health care. 6. Personnel administration for primary health care. 7. Appropriate technology and research for primary health care. 8. Trained Birth Attendants (TBAs). 9. Community Health Centres. 10. Organisation and working of Primary Health Centres. 11. Organisation and working of sub-centres. 12. Working of primary health care--a case study of Punjab. Annexes: i. Declaration of Alma-Ata. ii. Alma-Ata recommendations. Bibliography. Index.
"Rural Health Care in India faces a crisis unmatched by any other sector of the economy. To mention just one dramatic fact, Rural Medical Practitioner (RMP), who provides 80% of outpatient care, have no formal qualifications for it. They sometimes lack even a high-school diploma. While the dilapidated state of infrastructure and poor supply of drugs and equipment are partly to blame, the primary culprit is the rampant absenteeism at rural health centers.
To reach a more equitable distribution of health resources, it is necessary to pay greater attention to those least served, the social periphery, the disease ridden majority. The guiding principle should be the greatest health benefit to the greatest number of people at the lowest cost.
Health service infrastructure at the primary level needs to be reoriented to take new roles in line with primary health care approach. As primary health care approach is people oriented approach, thus the organisation of health care starts with the people, individuals and families, and communities. These need to be connected with the health facilities at primary level, secondary level, and tertiary level with effective system of referral.
To improve the primary health care system, the 11 plan firstly emphasises on integrated district health plans and secondly, on block specific health plans. These plans will ensure involvement of all health-related sectors and emphasize partnership with NGOs. The NRHM has already been launched to ensure quality health care in rural areas. The next step should be to extend this to make it a Sarva Swasthya Abhiyan that also covers the health needs of the urban poor, particularly the slum-dwellers by investing in high calibre health professionals and appropriate technology.
India has its own well developed indigenous systems of health care like Ayurveda, Yoga, Siddha, Unani, etc, along with diverse ecosystem specific, local health traditions. These traditional systems could be used to complement the allopathic system in rural and primary health care as they could be more useful in certain areas of curative/preventive health care. This would enhance the quality and outreach of public health services, which are currently unable to meet the health needs of our people." (jacket)
