PRIMARY  HEALTH  CARE

Primary health care therefore became the major thrust of the WHO. It was also professed to be the Primary objective of the Indian health sector during the Sixth Five Year Plan (1980-85) and subsequent plans. The National Health Policy 2002 also accords primacy to preventive and first line curative initiatives at the Primary Health level (Govt. of India, 2002). The approach during the Ninth Five Year Plan (1999-2002) was to improve access to and enhance the quality of Primary Health Care in urban and rural areas by providing an optimally functioning primary health care system as a part of Basic Minimum Services (Govt. of India, 1999). ‘On Primary Health Care’, is the answer the WHO Chief gave when asked how he would spend the 20 dollars a head that he asked for (Walgate, 1988). Essentially speaking, Primary Health Care involves activities that prevent the occurrence of disease itself. This is in keeping with the philosophy of positive health, not just control or cure of sickness. Most of modern medicine has directed efforts and expertise at the secondary level, that is, after the disease has set in, to prevent distress and disability, and/or to rehabilitate. Primary health care seeks to obviate this need itself. If one can act before the disease sets in, if it is prevented, what need for medicine-diagnosis-treatment?

Even if it can never totally do so, it ensures a lesser need for such services. As should be obvious there is a major problem here. Although unobjectionable in theory, it creates practical difficulties. Apparently it seeks to undermine the clout of modern medicine and its appendages. This is hardly a situation that could arouse enthusiastic participation from either the medical establishment or the average professional medical man, though quite a few right thinking may accept it, even work for it. Secondly, it lays great faith in the people’s ability to mobilise activities for their own health care, of course with guidance from community health workers and active participation of a health conscious government. Obviously we are still far from either, in India as in many other third world countries.

For this the major need is mobilisation of community and people’s support to work for their own health. The emphasis is on disease prevention by immunisation, proper diet, hygienic living conditions and sewage disposal, greater health awareness and health education by educational institutions, more involvement of mass media, the governing bodies, and social and environmental activists, amongst health professionals as well as others.Primary health care is essentially health care made universally accessible to individuals and families in the community by means acceptable to them, through their full participation and at a cost the community and country can afford. Itforms an integral part both of the country’s health system of which it is the nucleus and of the overall social and economic development of the community (WHO/ UNICEF, 1978).