Health Care Delivery Concepts and Issues

Shiv Chandra Mathur Professor of Public Health and Director State Institute of Health and Family Welfare, Rajasthan Jaipur, India

Issues

• Health is a fundamental human right • National Governments all over the World are striving to expand and improve their health care services.

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Current Criticism of Health Care Services (Provided by the Governments)

• Predominantly urban oriented • Mostly curative in nature • Limited Access 4/29/2020 Shiv Chandra Mathur 3

What is Health Care

• It is more than Medical Care • It embraces a multitude of services provided to individuals and families by health professionals to promote, monitor and uphold the status of their health.

• Medical care is a subset of health care.

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Levels of Health Care

• Primary Health Care • Secondary Health Care • Tertiary Health Care 4/29/2020 Shiv Chandra Mathur 5

Health Care Delivery - Changing Concepts • Comprehensive Health Care • Basic Health Services • Primary Health Care • Health Care System Development 4/29/2020 Shiv Chandra Mathur 6

Comprehensive Health Care

• Term coined by Bhore Committee(1946) in India • Provision of preventive, curative and promotional health services from “womb to tomb” to every individual residing in a defined geographic area.

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Basic Health Services

• Coined jointly by WHO/Unicef in 1975 • It is a network of coordinated, peripheral and intermediate health units capable of performing effectively a selected group of functions essential to the health of an area and assuring the availability of competent professionals and auxiliary personnel to perform these functions.

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Primary Health Care

• It is essential health care made universally accessible to individuals and acceptable to them, through their full participation and at a cost the community and country can afford .

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Principles of Primary Health Care

• Equitable Distribution • Community Participation • Intersectoral Coordination • Appropriate technology 4/29/2020 Shiv Chandra Mathur 10

Health For All

• Attainment of a level of health that wil enable every individual to lead a socially and economically productive life.

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Health Care Systems

• Public Systems: PHC and Subentries Rural Hospitals; District Hospitals; Teaching Hospitals ESI and CGHS Defense and Railways • Private Sector: Polyclinics and Nursing Homes GP’s and clinics • Indigenous Systems Ayurveda and Siddha Unani and Tibbi Homeopathy Naturopathy • Voluntary Health Agencies • National Health Programme 4/29/2020 Shiv Chandra Mathur 12

Components of Health System Development

• Quality Care component • Human Resources Development • NGO participation • Public-Private Participation • IEC 4/29/2020 Shiv Chandra Mathur 13

Health System Development

• It is a combination of management sector and involves organizational matters to translate policies into services • In India, Health System has three main links i.e. Central, State, and local or peripheral 4/29/2020 Shiv Chandra Mathur 14