Rural Health

Introduction

The concept of Primary Health Centre (PHC) is not new to India. The "Bhore” Committee in 1946 gave the concept of a PHC as a basic health unit to provide as close to the people as possible, an integrated curative and preventive health care to the rural population with emphasis on preventive and promotive aspects of health care.

The health planners in India have visualized the PHC and its Sub-Centres (SCs) as the proper infrastructure to provide health services to the rural population. The Central Council of Health at its first meeting held in January 1953 had recommended the establishment of PHCs in community development blocks to provide comprehensive health care to the rural population.

The 6th Five year Plan (1980-85) proposed reorganization of PHCs on the basis of one PHC for every 30,000 rural populations in the plains and one PHC for every 20,000 population in hilly, tribal and desert areas for more effective coverage.

In the public sector, a Sub-Health Centre (Sub-centre) is the most peripheral and first point of contact between the primary health care system and the community. The Minimum Needs Program (MNP) was introduced in the country in the first year of the Fifth Five Year Plan (1974–79) with the objective to provide certain basic minimum needs and thereby improve the living standards of the people. In the field of rural health, the objective was to establish: one Sub-centre for a population 5000 people in the plains and for 3000 in tribal and hilly areas, one Primary Health Centre (PHC) for 30000 population in plains and 20000 population in tribal and hilly area, and one Community Health Centre (CHC/Rural Hospital) for a population of 120000 people in the plains and for 80000 in tribal and hilly areas.

A Sub-centre provides interface with the community at the grass-root level, providing all the primary health care services. It is the lowest rung of a referral pyramid of health facilities consisting of the Sub-centres, Primary Health Centres, Community Health Centres, Sub-Divisional/Sub-District Hospitals and District Hospitals. The purpose of the Health Sub-centre is largely preventive and promotive, but it also provides a basic level of curative care.

PHCs are the cornerstone of rural health services- a first port of call to a qualified doctor of the public sector in rural areas for the sick and those who directly report or referred from Sub-Centres for curative, preventive and promotive health care. It acts as a referral unit for 6 Sub-Centres and refers out cases to Community Health Centres (CHCs-30 bedded hospital) and higher order Public hospitals at sub-district and district hospitals. It has 6 indoor beds for patients.

The secondary level of health care essentially includes Community Health Centres (CHCs), constituting the First Referral Units (FRUs) and the Sub-district and District Hospitals. The CHCs were designed to provide referral health care for cases from the Primary Health Centres level and for cases in need of specialist care approaching the centre directly. Approximately 4 PHCs are included Under each CHC thus catering to approximately 80,000 populations in tribal/hilly/desert areas and 1,20,000 population for plain areas. CHC is a 30-bedded hospital providing specialist care in Medicine, Obstetrics and Genecology, Surgery, Paediatrics, Dental and AYUSH.

History

On 2nd October 1952, a two tier rural health care system came into existence throughout India, and in the state as well to fulfill these objectives. Under this system, one six bedded Primary Health Centre and four Sub Centres attached to it were established in each Community Development Block.

Following the World Health Summit at Alma Ata and declaration of the goal of ‘Health For All (HFA) –2000 AD the concept of "Three Tier” health care system was framed. Being a signatory to HFA-2000, the three tier system was rolled out in India under the rural services with the Fifth Five Year Plan in 1978. This system was based on the concept of primary health care, defined as "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.”

Organization Structure (Rural Health Branch)

Health Care Delivery Network

Under the Guidance of the Commissioner (Health) and Additional Director (Health) ,Deputy Director (Rural Health) organizes, implements and monitors rural health care services with the help of Regional Deputy Directors and other Programme officers. CDHOs with the help of other health officers and staff look after all health activities in their respective districts.

The three tier system following the Primary Health Care approach coupled with the various national health programmes, Including Epidemic, Malaria, Blindness and Tuberculosis Control, Leprosy elimination, Polio and Yaws eradication, Reproductive and Child health & Family welfare, Health education, School Health Programme etc. deliver health services to the remotest areas of the state.

The department is constantly working to promote and protect the health of the community through expansion of the health infrastructure, increased recruitment of health personnel, and integration of pro-motive, preventive, curative and rehabilitative health services.

Health Care Delivery Network in Gujarat

Primary Health Care is delivered in the state through the network of Sanctioned 9156 Sub centres, 1342 Primary Health Centres, 331 Community Health Centres,33 Sub District Hospitals and 22 District Hospitals distributed across the state as on 31st March 2016.

Primary Health Centre is the backbone of this Health Network. Each Primary Health Centre caters approximately 30,000 (20,000 in case of tribal region/hilly terrain) population through a team of health personnel under the leadership of Medical Officer. Under each Primary Health Center are around six subcentres manned by one female health worker and one male health worker covering approximately 5,000 (3,000 in case of tribal region/hilly terrain) people.

PHC's and SC are backed by the Community Health Centre covering approximately 1,00,000 population (80,000 in case of tribal region/hilly terrain) and First Referral Units for referral and special medical care. District Hospitals and other Government or Grant-in- aid hospitals are also supporting as tertiary care centres.

FY 2015-16 CHCwise and PHCwise OPD-IPD Report

Health Centres (CHCs, PHCs, SCs,MHUs,MMUs) in Gujarat as on 15th Aug 2018

Indian Public Health Standards (IPHS) Information.

Service Delivery Report of CHCs and PHCs

Important Government Resolution (Rural Health related)

Important Letters regarding Infrastructure of Health Centres.

List of Health Centres under Public Private Partnership Model

Sr.No. Health Centre Name Type of Health Centre Name of NGO/Trust
1 Sayla
Taluka-Sayla,Dist.-Surendranagar
CHC Shree Raj Saubhag Satsang Mandal Sayla
2 Mota Fofaliya
Taluka-Shinor Dist.Vadodara
CHC Shakti Krupa Trust Vadodara
3 Shamlaji
Taluka-Bhiloda Dist.Arravalli
CHC All Indian Movement for SEVA,Gandhinagar
4 Chansad
Taluka- Padra Dist.Vadodara
PHC Bochasanvasi Akshar Purshotam Charitable Trust,Vadodara
5 Dahej
Taluka- Vagara ,Dist.Bharuch
PHC Reliance Industries Limited,Bharuch

Click on below link for information of NHM Programme or activities under Rural Health

National Rural Health Mission, state health society Gujarat has created wide network of health and medical care facilities in the state to provides primary, secondary and tertiary health care atthe door step of every citizen of Gujarat with prime focus on BPL families, marginalized population and weaker sections in rural and urban slum areas. Department also takes appropriate actions to create adequate educational facilities for medical and paramedical manpower in the state of Gujarat.

For more information please visit - Gujarat NHM WebsiteLink Icon

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