Question – If the primary healthcare system of a country is not functioning well, it is symptomatic of problems in its democracy itself. Comment.

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Question – If the primary healthcare system of a country is not functioning well, it is symptomatic of problems in its democracy itself. Comment. – 29 May 2021


Under the Directive Principles of State Policies in the Constitution of India, Article 47 states that it is the duty of the State to raise the level of nutrition and standard of living and to improve public health. ‘Health for all’ refers to the continuous availability of quality and affordable health care, from which better results can be expected. This can be ensured by strengthening local community level health services. Making progress in this direction, the government has recently introduced Ayushman Bharat to strengthen the primary health care system through well functional health and wellness centers.

Role of local community level health care interventions to achieve ‘proper health for all’:

  • Local community-level interventions are the first source of comprehensive and accessible health care, serving the immediate needs of individuals. Addressing issues at this level, including early disease detection, will be helpful in reducing the overall disease burden of the country.
  • Provision of preventive services such as vaccination and family planning, nutrition and maternal care at the local level may reduce the need for secondary and tertiary health services.
  • Management of chronic health conditions and locally palliative care can reduce people’s out-of-pocket expenses.
  • Maintaining the doctor-patient ratio at the ground level can ensure the availability of doctors for all. Reducing dependence on quacks can be reduced, and preventable causes such as inaccurate treatment can be eliminated.
  • Community health care will serve as a record register for nearby designated patients. This record will be especially useful in cases where the government needs data related to formulating new schemes for the poorer sections of the society.
  • Health care interventions at the local community level should be complemented by infrastructure upgrades, technological advancements and capacity building of health workers.

The reason for the primary health system not being properly functional –

  • Financial Constrains
  • Crumbling public health infrastructure
  • High Out-of-the Pocket Expenditure
  • Insurance
  • Low Doctor density ratio
  • Shortage of medical personnel
  • Social inequality

Thus we see that, decentralized policymaking, involving local community health workers, can effectively address local health care needs. The principles of the PHC approach of the Alma Ata Declaration (1979) need to be applied to the health care system overall, which is ‘closest to home’ health care, effective, safe, affordable and easy to use. If the primary health system of a country is not working properly then it is, then it will become a problem of an incurable problem for the present as well as the future. Therefore, it is important to pay special attention to primary health facilities.

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