Comprehensive Primary Health Care System for Diarrhea in India - Essay Example

Comprehensive Primary Health Care System for Diarrhea in India Diarrhea is one of the top childhood diseases in India. Annually, about 500,000 children below five years of age die from the dehydrating effects of this disease (Abt, 2007). Unsanitary and unhygienic practices, contaminated water supply, and improper use and preparation of oral rehydration salts are just some of the contributing factors that have made diarrhea a health crisis in India (Population Services International, 2007; Abt, 2007). This unfortunate situation has made India ripe for a comprehensive primary health care program. This paper shall discuss the constraints in the implementation of a comprehensive primary health care program for diarrhea in India. It shall also discuss the future potential of this program in India. Constraints in the Implementation There are different constraints or barriers in the implementation of a comprehensive primary health care system for diarrhea in India. Based on the initial plans and policies laid out for the implementation of the system in India, one of the main constraints in its implementation is the fact that primary health care is just being implemented to the primary level. Health reports and assessment by authorities reveal that there is no strong referral system beyond the primary level of care. The supposed linkage and multi-sectoral approach that should have been made part of the implementation process has not been planned and integrated into the primary health care system (Nundy, n.d). As a result, the health problems of the community in relation to diarrhea lack the necessary referral system to the secondary and tertiary levels of care. These levels of care are important in case complications (such as severe dehydration, diarrhea outbreak) from the ailment are developed by the child or the community. A multi-sectoral approach is also important in order to engage the cooperation of the private institutions and NGOs in matters of finance and promotional support. Without the necessary linkage to the multi-sectoral, secondary and tertiary levels of care, the comprehensive primary health care system for diarrhea in India will continually be an implementation failure. Another constraint in the implementation is the fact that the public health care system is severely underfunded. Shortage of funds prevents the purchase of necessary medicines and equipment to care for diarrhea patients; it limits the actions that health care authorities can take in order to ensure clean water supply for the community; and it limits the hiring of skilled persons in the rural areas – most of the skilled health workers opt for higher pay in the urban districts (Raman, n.d). Limited funds also limit the extent and the effectiveness of the comprehensive primary health care system. It severely constrains its goal of providing quality health care for all. One undesired result of compromised quality of public health centers is the fact that many patients are now opting to seek medical care from private health care professionals and medical centers (Indian Child, 2000). Patients often feel that the quality of health care services in the health centers are already compromised, so they often opt to sacrifice some of their hard-earned cash to avail of better health services from the private health centers. And their actions compromise the effectiveness of the comprehensive primary health care system in India. Health authorities also point out that the focus in the implementation of the comprehensive primary health care system seems to be more on the “clinical and curative concerns over the intended emphasis on preventive work…” (Indian Child, 2000). The focus of care now becomes more about the symptom and the physical manifestations of the illness, and not its cause. In this case, the problem in India is the contaminated water supply. The primary health care system is not bringing enough attention to the prevention of diarrhea. For this reason alone, even if the primary health care centers will manage to treat the thousands of children with diarrhea, these centers will never run out of diarrhea patients to cure. Future Potential The future potential of the comprehensive primary health care system for diarrhea in India relies heavily on its improved implementation. The basic concepts of primary health care system has to be continually kept alive by the implementers because a “market oriented partnership will only increase inequities” (Shiva, 2006). Control and proliferation of the private sectors in the health care system will only serve to increase the gap between the rich and the poor members of the community. The future potential of the comprehensive primary health care system was improved with the establishment of the People’s Health Movement (PHM). Some health experts claim that the PHM will be successful in improving the future prospects of the primary health care system if it can initiate changes and improvements on water, food, and livelihood; if it can highlight these problems and concerns in order to catch the attention of concerned health authorities and government officials; and if it can influence these government officials to increase the health budget for public health services (Shiva 2006). The future potential of the comprehensive primary health care system for diarrhea in India will also be improved if adequately trained health care professionals are assigned in the primary health centers. The Public Health Foundation is already participating in the moves to improve the training of health workers in the rural areas (Pasricha, 2006). With their support, health care centers may attain an improved level of quality to ensure that patients are adequately cared for during their consult. The future prospect of the comprehensive primary health care system for success is also dependent on improved urbanization for the community. The government commitment in achieving this goal is very much important. Urbanization can be good for the community, it can bring about the modernization of health services and community facilities; it can bring about increased funding and improved endorsement process to the higher levels of care; and it can also bring about improved infrastructure like access roads and transportation to remote areas. Modernization and urbanization will help ensure that water supplies will pass through the filtration process; that sewage and disposal systems will be modernized; and the people will have access to quality medicines and updated medical technologies. The modernization and urbanization process will primarily help in reducing and ultimately preventing the incidence of diarrhea in India. “Ensuring that urbanization is beneficial for health and a driver of positive health outcomes requires good and innovative governance, which includes empowering individuals and communities to achieve collective social action” (Kumaresan, 2008, pp. 8-9). The government authorities must have a strong political will to ensure that opportunities for participation by the different sectors of the community are available. Their ability to encourage investments in the public health services will have a deep and long-lasting impact on the comprehensive primary health care system. Finally, the future potential for success in the implementation of the comprehensive primary health care system in India can be improved when concerned authorities will consider using the existing potentials of the system and make the necessary structural changes needed by the system. Primary health care works and is working in the primary level; the next step would be to include and explore the secondary, generalist, and the specialist levels of care (Patel, 2001). This will now ensure and ultimately achieve the comprehensiveness that the primary health care system is aiming for. Works Cited Health care in India, 2000, Indian Child, viewed 17 June 2009 from http://www.indianchild.com/health_care_in_india.htm Kumaresan, J., 31 July 2008, Health System Strengthening using Primary Health Care Approach, Southeast Asia Regional Office World health Organization, viewed 17 June 2009 from http://www.searo.who.int/LinkFiles/Conference_Panel-A3.pdf Nundy, M. (n.d) Primary Health Care in India: Review of Policy, Plan and Committee Reports, World Health Organization, viewed 17 June 2009 from http://www.whoindia.org/LinkFiles/Commision_on_Macroeconomic_and_Health_Primary_Health_Care_in_India_Review_of_Policy_Plan_and_Committee_Reports.pdf Patel, N., 2001, Evaluating the role of Primary Health Centers in India, Express Health Care Management, viewed 17 June 2009 from http://www.expresshealthcaremgmt.com/20050831/ruralhealthcare01.shtml Pasricha, A., 3 May 2006, India Offers Both Best, Worst of Health Care, Voice of America News, viewed 17 June 2009 from http://www.voanews.com/english/archive/2006-05/2006-05-03-voa32.cfm?CFID=238314769&CFTOKEN=98867209&jsessionid=de30c9c20d22817c2caa3416532d7713695d Popular Street Theater Promotes Home Diarrhea Management to save Children’s Lives in India, 2007, Abt Associates, viewed 17 June 2009 from http://www.abtassociates.com/Page.cfm?PageID=40509 Rama, S. (n.d) Reaching affordable, quality health care to the poorest households in the remotest regions, Ministry of health and Family Welfare, viewed 17 June 2009 from  http://www.mohfw.nic.in/NRHM/Presentations/NRHM_Paradisgm_Shift_by_Dr_Sundar_Raman.pps Safe Water Comes to India, 1 August 2007, Psi.org, viewed 17 June 2009 from http://www.psi.org/news/062102a.html Shiva, V., January 2006, Health for all-built up from below, Medicus Mundi Schweiz, viewed 17 June 2009 from http://www.medicusmundi.ch/mms/services/bulletin/bulletin200601/kap02/99shiva.html Sivakumar, S., 25 August 2003, Fixing Indias healthcare system, Rediff, viewed 17 June 2009 from http://www.rediff.com/money/2003/aug/25spec.htm Read More