NE-ED FOR STRENGTHENING OF PRIMARY-CARE - A NECESSITY~FOR UNIVERSAL HEALTH COVERAGE

In good
old days in a traditionai society like ours, the family doctor used to be first point of contact. In case :. of any illness, neighbourhood doctor was the consulting
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point in treating not only the illness as such but also he used to pertorm the role of family adviser/ counsellor. ~ Another significant aspect of this family doctor concept his clinical examination through use of-bare hand and at best stethoscope hanging from his neck. The confidence of the whole family was on such family doctor that he would bring miracle even of chronic

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illness as far as treatment is concerned. This is to be seen in the context of lack of corporate hospitals and multi discipline clinical centres as freely available now and importantly equipments oriented treatment of today to that of clinical examination

51 1'1 a run tip to high ended rreatmen; entailing COS!ly expenditure, It IS primary health care detection which Will not only reduce demand on limited resources available for tertiary care treatment but will also definitely ensure af ordable medical care With little ImprOVisation and support in the form of availability of a PhYSician and PediatriCian In a small place of 600 to 1000 Sq ft having nurSing and diagnostic services Such primary care cliniC IS not only cost eflec Ive both from Infras ructure and human resources point of view but also salis faction level as far as general public IS concerned. We may also go for mobile cunlc With a general practitioner and minimum Nursing/Para-medical staff having commonly used drugs, dreSSing and which can take instant blood sugar and ECG tests. With a fixed cost of 20 lakh and RS.2 lal<hs of runn.ng cost (an estimated Rgures taking cost afVan. equipments salary. mediCines and fuel cost etc) T';IS Will not only be acceSSible to all ru-al areas hitherto remaln)ng unto ched due to non-availability 0 DoclOr aro staff but also make eC:)'10ITlIC sense ThiS Will alsQ aCI as bu'fer 10 nea'est city d'strict hosp'tal both of Government a'ld Corporate level Th's one atlon towards onmary care may be responslb,e for su:cess of health care In the countries like MalaYSia, Thatland and China having concept of 'Barefoot Doctor' and to provide universal health coverage Since Planning Comrn'sslO a d Health MInistry a-e now 1:1searcn fer all answer to extend un\'e'sal ileaith care to me. thiS arra'1genent of rrlna;y ",ealt'1 ca'e concept whlc'; IS also a success in UK neall, care system IS the answer 10 ensure aforoao!e and reac able services to c'ores Of populat,on In 0 r country ThiS IS aso eaUally needed to be taken serIOl/S,y for any sC:la' security oriented sche'Tle I',ke ESI and other private Insurers so that benefiCiaries not only get hassle-free treatment but also t e rls!ng cost Of medical care is arrested to',,"'3rds utilization of limited resources or bnng a t new sc emes for qualitative and quantitative groW1h of any SOCial security scheme in the country. At he end of I would like to reiterate the saYing of some famous personality I;,a; There Is No Dearth Of Fund In The Country But Dearth Of Right Attitude To Imp/ement The Proposals. Coming together of Central and S;al Governme ts 'r oartnershlp \'..'t" Corporate and NGOs should ensure Health Care for Allin our country

rather

It is necessary to emphasis as to why such primary care oriented system treatment is emerging as most important health care institution in this world due to the following Medical science definitely reasons would be

globalized (1)

believes that tertiary care procedure

prevented by timely primary care. . (2) Almost 80% of our patients/ beneficiaries in a social security concept visit such family doctor in the form of dispensary or medical practitioner or primary health care centre whatever you may c~lI. This is also a fact almost 80% of our routine problems are effectively treated or managed by so called general practitioners or family physicians. . (3) Another important reason for increaSing emphaSIS on primary health care is due to the fact that it integrates preventive, promotive, curative and rehabilitative aspect of health care This may popularly be called 'All in One' concept which IS particularly to be seen in the context of our country where 76% of the population lives in rural areas having access (4) to 26% of doctors' population. Due to rising cost of medical care emphasis is now on primary health care because health care indicators such as maternal mortality. Infant mortality and life expectancy are better in European countries because 01 strong primary care set up unlike the U.S. where focus is more on tertiary care

B.K, Sahu
(Views Email: expressed are personal) bk_sahu04@yahoo.com