Reiterating the Importance of Publicly Funded and Provided Primary Healthcare for Non-communicable Diseases: The Case of India Comment on "Universal Health Coverage for Non-communicable Diseases and Health Equity: Lessons From Australian Primary Healthcare"

Abstract

India has established Health and Wellness Centres (HWCs) and appointed Mid-level Healthcare Providers (Community Health Officers) to provide free and comprehensive primary health care, through screening, prevention, control, management and treatment for non-communicable diseases (NCDs), in addition to existing services for communicable diseases, and reproductive and child health. The range of services being provided and the number of people accessing ambulatory care in these government centres have increased, leading to more equitable healthcare access and financial protection. In policy debates, contestations exist prioritising between primary health care or hospital services, and between publicly-provided healthcare or privatised and "purchased" services. Nationally and globally the influence of industries and corporations in health governance has weakened the response against NCDs. Primary health care initiatives for NCDs must be publicly funded and provided, located within communities, and necessitate action on the determinants of health. The experiences from Australia (a High-Income Country) and India (a Low-and Middle-Income Country) amply illustrate this.

Universal Health Coverage for Health Equity: From Principle to Practice; A Response to the Recent Commentaries

“…We proposed that countries seeking to implement UHC to tackle NCDs and advance equity could learn from Australia’s nearly 40 years of experience. 3 In general, the commentaries affirmed this proposition, examining the concordance of the issues we raised with similar concerns globally and in other jurisdictions, including low- and middle-income countries 7 and countries beginning to implement UHC systems. Among other things, mature systems show that early choices about system design are crucial, because they will do much to determine long-term performance and, once in place, are difficult to change.…”

“…However, most also argued that, to optimise benefits, policy makers must go beyond financial coverage and shift to a more holistic and rights-based view of UHC 10 encompassing inter alia PHC systems, models of care, public health regulation and action on social determinants of health. 5 - 7 , 9 , 10 …”

Assessing competence of mid-level providers delivering primary health care in India: a clinical vignette-based study in Chhattisgarh state

“…In 2015, a task-force was set up by the central ministry of health to provide recommendations for rolling out comprehensive PHC in India [ 4 ]. It was also a key proposal in India’s national health policy, 2017 [ 5 ]. In order to deliver PHC, an architectural correction was conceptualized in the design of public health system in India.…”

“…In order to deliver PHC, an architectural correction was conceptualized in the design of public health system in India. It involved introducing health and wellness centres (HWCs), one at every 5000 population, as the hub for PHC [ 5 ]. The emergence of HWC marks a very significant development for PHC in India because of the following reasons [ 5 – 8 ]: It brings primary curative services closer to people.…”

“…It involved introducing health and wellness centres (HWCs), one at every 5000 population, as the hub for PHC [ 5 ]. The emergence of HWC marks a very significant development for PHC in India because of the following reasons [ 5 – 8 ]: It brings primary curative services closer to people. An HWC can be reached within half an hour by any of the families it covers.…”