CM17.3-4 | CM17.3-4 | Primary Health Care and Health Policies — Summary & Reflection

KEY TAKEAWAYS

Key takeaways from this module:

1. Primary Health Care (PHC), as defined at Alma-Ata 1978, is essential, universally accessible health care using appropriate technology with community participation — the response to global health inequity that drove the 'Health for All by 2000' call.

1. PHC comprises 8 elements (education, nutrition, safe water/sanitation, MCH/FP, immunisation, endemic disease control, essential drugs, common disease treatment) and 5 principles (equitable distribution, community participation, intersectoral coordination, appropriate technology, political commitment).

1. Selective PHC (GOBI-FFF) was a pragmatic subset proposed in 1979; India uses a hybrid — national vertical programmes (UIP, TB, RCH) alongside comprehensive PHC infrastructure (Sub-Centre/PHC/CHC + ASHA/ANM/MPW).

1. National Population Policy 2000 targets TFR 2.1, IMR ≤30, MMR ≤100 (medium-term); NHP 2017 targets IMR ≤28, U5MR ≤23, MMR ≤100, and 2.5% GDP health expenditure by 2025.

1. MDG 4 required two-thirds reduction in U5MR; MDG 5 required three-quarters reduction in MMR by 2015. SDG 3 targets MMR <70 and U5MR ≤25 by 2030.

1. Monitoring uses both process indicators (immunisation coverage, ANC attendance) and outcome indicators (IMR, MMR, TFR). India's TFR has reached replacement level; IMR and stunting remain above SDG targets.

REFLECT

You are posting as an intern at a CHC in a district where immunisation coverage is 52% and institutional delivery is 65%. Using the PHC framework from this module, identify: (a) which Alma-Ata elements are failing, (b) which national programme should be activated for each gap, and (c) which non-health-sector actors you would need to coordinate with to address the underlying determinants. How would you present this analysis to the District Collector in a 5-minute briefing?