Importance of Secondary Level Health Services

Synopsis: The load on tertiary health services can be reduced by strengthening the secondary level care health services. For rural areas, the focus should be on community health centres and for urban regions, peripheral hospitals at the secondary level.

Background:

• The Indian health system is generally divided into the primary, secondary and tertiary level.
• The second wave of Covid-19 has exposed the deficiencies in the current reactive approach of the government. 
• People are dying due to a lack of access to treatment facilities rather than inadequate solutions to treat the virus.

Reactive approach:

• Under this, the government transforms well-performing facilities at the tertiary level into state-of-the-art COVID-19 hospitals.
• Similarly, many temporary COVID-19 facilities are created by hiring buildings and open spaces providing only beds. 
• The government has also created many first-line treatment centres under this approach.
• This approach is being adopted in the majority of states.

Concerns associated with Reactive approach:

• People are unable to access their routine hospital services from these facilities. Because routine hospitals are turned into COVID facilities.
• The temporary structures without adequate infrastructure were unable to cater to the needs of patients in real-time situations.
• First-line treatment centres are failing to generate trust among people and were shut down when the cases went down.

Therefore, many experts are now advising the government to leverage the potential of the secondary level.

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New Approach of using Secondary Level Health Services:

• Under this, the functional facilities at the secondary level can be converted into exclusive COVID-19 care centres. It will be useful to treat those patients who don’t need ICU support.
• In rural areas, the Community Health Centre (CHCs) can cumulatively add up to 50000-75000 beds.
  • A CHC covers a population of 80,000-1,00,000 in rural areas.
  • It functions as the first referral unit for curative care services referred from primary health centres (PHCs).
• The PHC (Primary Health Centres) must be strengthened to cater to the needs of people for other curative care services.
• In urban areas, states must develop peripheral hospitals at the secondary level within the government sector. Ideally, 100-150 bedded hospitals for every 3 lakh population.

Benefits of the Secondary Level Health Services:

• Firstly, it will reduce the workload on tertiary care especially in states like Bihar, Uttar Pradesh and Chhattisgarh, which possess poor health infrastructure.
• Secondly, Specialists for these secondary centres can be easily directed from district hospitals or medical colleges. Thereby providing better feasibility.
• Thirdly, these new centres can be used for sample collection and vaccine delivery as well. As the centres are already functional and command a certain level of trust.
• Fourthly, post-pandemic, these facilities can return to their normal work and won’t be closed like temporary structures.

Way Forward:

• The states must leverage the potential of this new secondary level approach.
• They should provide the secondary level units with sufficient funds and personnel so that they can duly function as COVID-19 care centres.

In a nutshell, we can say that adoption of this new approach will improve delivery potential, augment people’s trust and contribute to strengthening health services in the long run.

Source: The Hindu