{"id":48847,"date":"2019-07-03T17:34:19","date_gmt":"2019-07-03T12:04:19","guid":{"rendered":"https:\/\/blogadmin.forumias.com\/?p=48847"},"modified":"2019-07-05T18:02:17","modified_gmt":"2019-07-05T12:32:17","slug":"7-pm-healthcares-primary-problem-3rd-july-2019","status":"publish","type":"post","link":"https:\/\/forumias.com\/blog\/7-pm-healthcares-primary-problem-3rd-july-2019\/","title":{"rendered":"7 PM | Bihar AES deaths -What&#8217;s ailing India&#8217;s primary healthcare? | 3rd July, 2019"},"content":{"rendered":"\n<p><strong><a href=\"https:\/\/drive.google.com\/open?id=1fVSaZ8A7FaEA_45yO_GnhljVe2h8Qhst\" target=\"_blank\" rel=\"noreferrer noopener\" aria-label=\"Read&nbsp;In-depth analysis of all the Editorials here (opens in a new tab)\">Read&nbsp;In-depth analysis of all the Editorials here<\/a><\/strong><\/p>\n\n\n\n<p><strong>Context: <\/strong>Issues\nwith the Primary Health Care in general in India and particularly in Bihar.<\/p>\n\n\n\n<p><strong>More in News: <\/strong>&nbsp;The outbreak of Acute\nEncephalitis Syndrome (AES) in Bihar and Uttar Pradesh.<\/p>\n\n\n\n<p><strong>Primary Health Care: <\/strong>According to World Health Organisation (WHO), Primary health\ncare is a whole-of-society approach to health and well-being centered on the\nneeds and preferences of individuals, families and communities.&nbsp; It\naddresses the broader determinants of health and focuses on the comprehensive\nand interrelated aspects of physical, mental and social health and\nwellbeing.&nbsp;<\/p>\n\n\n\n<p><strong>Outbreak of AES in Bihar: <\/strong>Recently 154 children in Bihar died due to AES. AES is largely\npreventable both before and after the onset of disease. The first signs of\noutbreak must prompt strong prevention measures. These include:<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>Replenishing\nprimary health care centres with essential supplies.<\/li><li>Extensive\ndeployment of peripheral health workers (ASHA).<\/li><li>Ambulance\nservices to facilitate rapid identification and management of suspected cases.<\/li><li>Scaling up of\nPoshan Abhiyan and supplementary nutrition at Anganwadis along with take home\nration for mothers, and distribution of ORS packets.<\/li><\/ul>\n\n\n\n<p>Due to lack of preventive measures, along with the issues of PHCs,\naggravated the out-break of AES.<\/p>\n\n\n\n<p><strong>Issues with Primary Health Care:<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\"><li><strong>Manpower: <\/strong>The manpower in Bihar is miserably low.<ul><li>Out of 1900 PHCs in Bihar, three fourth have just one doctor. The doctor-population ratio of Bihar was 1: 17,685 in 2018, which is about 60% higher than the national average.<\/li><li>There is one fifth shortage of ASHA workers.<\/li><li>Nearly one third of sub health centres have no worker at all.<\/li><\/ul><\/li><li><strong>Infrastructure: <\/strong>Generally 1 PHC caters about 30,000 people, but in Bihar, it caters to 1 lakh people. <\/li><li><strong>Behavioural factors: <\/strong>Even those PHCs with adequate supplies remain unutilised, primarily because of the behavioural perception that PHCs are inept for general health care and are primarily centres for family planning and immunisation.<\/li><li>With the decades of hospital-centric growth, people have lost faith in community based&nbsp; health care. <\/li><li>Also, the government health expenditure is about 1.15% of GDP. However, there is still scope of improvement in health expenditure. As done in most of the developing countries and developed countries. For example, China spends about 5.3% of its GDP on health. <\/li><\/ul>\n\n\n\n<p>Along with the issues of PHCs, there is issue with the supplementary\nnutrition programme. Recently a study found that around 71% and 38% of funds\nmeant for cooked meals and take home ration were stolen. <\/p>\n\n\n\n<p><strong>Solution: <\/strong>The solution to the problem doesn\u2019t lies in just strengthening the\ntertiary care sector, but also,<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li><strong>Ayushman Bharat-\nHealth and wellness centres: <\/strong>in order to\nexpand access to comprehensive health care, health and wellness centre (HWCs),\nsub health centres (SHCs) and primary health centres (PHCs) are being\nstrengthened. The HWCs are to provide preventive, promotive, rehabilitative and\ncurative care for an expanded range of services encompassing reproductive child\nhealth services, communicable diseases, non-communicable diseases and basic\nemergency care.<\/li><li>Scaling up the cadres of ASHA workers; salary hikes,\nas recently done in the state of Andhra Pradesh can be helpful.<\/li><li><strong>Efficient\nimplementation of PDS system<\/strong> as done in\nChhattisgarh. In Chhattisgarh model, digitization and automation with\nappropriate intervention of ICT made it to work efficiently and equitably. <\/li><li><strong>Strict\nmonitoring of nutrition programme <\/strong>as\nimplemented in Andhra Pradesh: the government focussed on better monitoring of Integrated\nChild Development Services (ICDS) Systems Strengthen And Nutrition Improvement\nProject (ISSNIP) by creating an APP, which is being tracked on cell phones\ndistributed by the government, behavioural change at community level and\nregular counselling by organising community based events such as \u2018Sree\nMantams\u2019 and \u2018Anna Prasanams\u2019.<\/li><li><strong>Addressing the\nmal-distribution of doctors and medical colleges:<\/strong> Under Pradhan Mantri Swasthya Suraksha Yojana (PMSSY), government is\nplanning to set up 20 AIIMS across country. Passing of National Medical\nCommission Bill, 2017 as soon as possible to replace Medical Council of India (MCI)\nwith National Medical Commission (NMC).<\/li><li>Need to work on inculcating confidence in community\nbased care.<\/li><\/ul>\n\n\n\n<p><strong>Way forward: <\/strong>With the implementation of the above strengthening measures, will result\ninto robust primary care system that can be geared towards being more\nresponsive to future outbreaks. At the same time community should be made aware\nof the preventive measures of such diseases, as it is known that \u201cPrevention is\nfar better than Cure\u201d.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Read&nbsp;In-depth analysis of all the Editorials here Context: Issues with the Primary Health Care in general in India and particularly in Bihar. More in News: &nbsp;The outbreak of Acute Encephalitis Syndrome (AES) in Bihar and Uttar Pradesh. Primary Health Care: According to World Health Organisation (WHO), Primary health care is a whole-of-society approach to health&hellip; <a class=\"more-link\" href=\"https:\/\/forumias.com\/blog\/7-pm-healthcares-primary-problem-3rd-july-2019\/\">Continue reading <span class=\"screen-reader-text\">7 PM | Bihar AES deaths -What&#8217;s ailing India&#8217;s primary healthcare? | 3rd July, 2019<\/span><\/a><\/p>\n","protected":false},"author":61,"featured_media":3567,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"jetpack_post_was_ever_published":false,"footnotes":""},"categories":[130],"tags":[],"class_list":["post-48847","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-7-pm","entry"],"jetpack_featured_media_url":"https:\/\/i0.wp.com\/forumias.com\/blog\/wp-content\/uploads\/2017\/07\/brief-image.jpg?fit=1000%2C500&ssl=1","views":{"total":68,"cached_at":""},"jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/forumias.com\/blog\/wp-json\/wp\/v2\/posts\/48847","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/forumias.com\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/forumias.com\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/forumias.com\/blog\/wp-json\/wp\/v2\/users\/61"}],"replies":[{"embeddable":true,"href":"https:\/\/forumias.com\/blog\/wp-json\/wp\/v2\/comments?post=48847"}],"version-history":[{"count":0,"href":"https:\/\/forumias.com\/blog\/wp-json\/wp\/v2\/posts\/48847\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/forumias.com\/blog\/wp-json\/wp\/v2\/media\/3567"}],"wp:attachment":[{"href":"https:\/\/forumias.com\/blog\/wp-json\/wp\/v2\/media?parent=48847"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/forumias.com\/blog\/wp-json\/wp\/v2\/categories?post=48847"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/forumias.com\/blog\/wp-json\/wp\/v2\/tags?post=48847"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}