Gambhir Ramandeep S, Kumar Raman, Aggarwal Amit, Goel Richa, Anand Samir, Bhardwaj Arvind
Department of Public Health Dentistry, BRS Dental College and Hospital, Panchkula, India.
President Academy of Family Physicians of India, New Delhi, India.
J Family Med Prim Care. 2018 Sep-Oct;7(5):845-851. doi: 10.4103/jfmpc.jfmpc_49_18.
Many people in India, especially the poor, face the hurdle of seeking effective health care at an affordable cost, at a distance they can travel, and with the dignity they deserve. According to reports from across the world, it is evident that countries having a strong primary health care system, have better health outcomes, lower inequalities, and lower costs of care. Primary care requires a team of health professionals, workers, and volunteers having a judicious skill mix. Some initiatives have been taken by the government in states like Kerala, Assam, Chhattisgarh, etc., to strengthen the primary health care infrastructure and provide primary care as close to their homes as possible. Staff deficiencies were addressed and training was also provided to the untrained staff. The current review focuses on several other primary care organizations that are working in different parts of the country (rural and urban), for e.g. Healthspring, MeraDoctor, Swasth India, Rashtriya Swasthya Bima Yojna (RSBY) Outpatient Pilot Program, etc. The current review also throws spot light on the type of primary health care system existing in countries like China, South Africa and Brazil. Some lacunae in service delivery are also identified and addressed so that changes can be incorporated at the policy and program level.
印度的许多人,尤其是穷人,面临着以可承受的成本、在可及的距离内并以应有的尊严获得有效医疗保健的障碍。从世界各地的报告来看,显然拥有强大初级卫生保健系统的国家,健康结果更好、不平等程度更低且医疗成本更低。初级保健需要一支具备合理技能组合的卫生专业人员、工作者和志愿者团队。喀拉拉邦、阿萨姆邦、恰蒂斯加尔邦等邦的政府已采取一些举措,加强初级卫生保健基础设施,并尽可能在民众家门口提供初级保健。解决了人员短缺问题,还为未受过培训的工作人员提供了培训。本次综述聚焦于在该国不同地区(农村和城市)开展工作的其他几个初级保健组织,例如健康之源、我的医生、健康印度、国家健康保险计划门诊试点项目等。本次综述还重点介绍了中国、南非和巴西等国现有的初级卫生保健系统类型。同时也识别并解决了服务提供方面的一些缺陷,以便在政策和项目层面进行改进。