PHC's in India

Statistics of PHC's (Primary Health Center) in India:

There is 1 PHC for every 25,000 population
PHC for - Promotive, Preventive, Curative and Rehabilitative Care
This implies offering a wide range of services such as health education, promotion of nutrition, basic sanitation, the provision of mother and child family welfare services, immunization, disease control and appropriate treatment for illness and injury.

Each PHC is a hub for 5-6 Sub-Centers.
Each PHC is covers 3-4 Villages.
Each PHC is coordinated by a ANM (Auxiliary Mid Wife)

PHC's will be referral centers for Community Health Centers (CHC), which is a minimum 30 bedded-hospital or higher at the Taluk or District Levels.

WHO Report
According to WHO, PHC's in India specifically attribute to deterioration of quality services due to parameters like - lack of political commitment, inadequate allocation of financial resources to PHC's and stagnation of inter-sectoral strategies and community participation. Also in the list of reasons are bureaucratic approach to HealthCare implementation, lack of accountability and responsiveness from general public.

Key Points to observe:
1. PHC's through out the country have the same number of ANM's even though the fertility rate varies in different parts of the country.
2. Political interference in creating PHC's.
3. Government departments are more involved in ensuring government norms are implemented, salaries are paid and minimum facilities are available rather than concentrating on measuring Health System Performance.
4. The DHO (District Health Officer), responsible for implementation of Public Health Systems are not adequately trained.

Strengthening the capacity for Public Health Management at the District and Taluk level is crucial to improving public sector performance.

Why the system is not working as required?
1. Lack of accountability in the system.
2. No formal feedback mechanism to ensure proper implementation of the system.
3. No incentives for Doctors to work in the Rural areas.
4. Irresponsible mind-set of ANM's (this happens as there is no feedback mechanism)
5. Lack of resources (staff).
6. Current budget allocation of Rs. 75,000 / PHC / Annum is very less when considering the population each PHC has to cater to (5000 people).

What do we do?
1. Periodic HealthCare Education in Schools, Panchayat/Taluk Offices - NGO, Private Institutions and Social Entrepreneurs.
2. Community involvement - Government / Private Partnership
3. Public Health Training programs for DMO's and other staff - Government / Private Partnership.
4. Appropriate and functioning feedback mechanism to ensure people understand that they are cared for and their feedback is valued for betterment of the system - Government

I will revisit this topic of what we can do better in my forthcoming writings.

Due credits to Neesha Patel, author of Evaluating the role of Primary Health Centers in India.

India HealthCare Project

India HealthCare Project, is an initiative of CMC which designs and develops PDA (Personal Data Assistant) systems to ANM (Auxiliary Nurse Midwife) who works at the grass-root level of delivering HealthCare. This project has been piloted and implemented in the Nalgonda District of Andhra Pradesh.

Read more on this project at http://www.iimahd.ernet.in/egov/ifip/jun2003/article4.htm.

Independence Day

India, today is celebrating 60 years of independence. Is that old or young? If we look at the average life god has given a human being, then we need to say that the country has just attained Senior Citizenship status. But, as the country is made when mother earth is born, I don't think we can even say our country is even an infant :)

What has been good?
- Liberalization
- Globalization
- Quality of Life

What needs to improve?
- Education
- HealthCare
- Sense of Ownership

I will write more in detail on the points above in my following posts, but for today, I would stop here, praying to God to give peace and prosperity to each and every one living on this planet :)

7 Types of Poverty

Bhagavatula Charitable Trust (BCT), runs Innovative Experimental Primary Schools (IEP) in 72 Villages in Visakhapatnam District, Andhra Pradesh, India.

What is the difference between IEP and regular Government Schools?
IEP schools, apart from regular academics, work towards education children in the age group 11-15 on the 7 types of Poverty which are required to uplift the quality of life. Our usual assumption of Poverty is only Economic Poverty. However, this is just one of the kinds. We have to even look at the following types to ensure quality of life improved:

1. Economic Poverty
2. Bodily Poverty
3. Mental Poverty
4. Cultural Poverty
5. Spiritual Poverty
6. Political Poverty
7. Societal Poverty

Now, it makes more interesting to understand these aspects. Even though the above are talked about in the BCT Project homepage, I will write again here in my own words and understanding.

Economic Poverty - Lack of monitory demands for providing themselves with Food, Cloth and Shelter. Please note that money need for only the mentioned attributes falls under this category.

Bodily Poverty - Lack of property physical health and access to health living conditions.

Mental Poverty - Lack of thinking, which is resultant of lack of access to education and knowledge.

Cultural Poverty - Lack of coming together in a society. No collaborative activities taking place which leads to disconnect between people.

Spiritual Poverty - surprising right? Yes, lack of feeling of togetherness/brotherhood plays an important role in bringing people together.

Political Poverty - Lack of understanding of how system works. The basic problem is the understanding of how to cast one's vote and elect their leader.

Societal Poverty - Lack of social connectivity.

Dazasya is Born

I wrote about "Web NGO" earlier. After thinking through various thoughts which came across my mind I identified three areas which need collaborated work - Society, Technology, Entrepreneurship.

Read more about Dazasya at its official blog.

This blog will continue to focus on Social Entrepreneurship.