Status of inequality of health facility at PHC level : A comparative study between Andhra Pradesh and India

Abstract

"The establishment of Primary Health Centre’s in India started as early as in 1952, and over the last six decades it has undergone several changes to meet the increasing demand for health care services. The National Health Policy stressed on the provision of preventive, promotive and rehabilitative health services to the people thereby making a shift from medical care to health care. The delivery of Primary Health Care is the foundation of the rural health care system and is an integral part of the national health care system. Individuals who are poor are most sensitive to the cost of health care; they are less likely than are those who are rich to seek care when they are ill, and this difference is more evident in rural than in urban areas (NSSO. The sub-centre is the most peripheral institution and the first contact point between the primary healthcare system and the community. Primary Health Centre’s (PHCs) comprise the second tier in rural healthcare structure envisaged to provide integrated curative and preventive healthcare to the rural population with emphasis on preventive and promotive aspects. (Promotive activities include promotion of better health and hygiene practices, tetanus inoculation of pregnant women, intake of IFA tablets and institutional eliveries.) Compared to District Hospitals or sub-divisional Hospitals, PHCs are accessible to a larger population, as one PHC is expected to serve 30,000 populations (NFS-RCH II 2003) in plain area and 20,000 in hilly and tribal area. However, just the availability of PHCS is not sufficient for the effective delivery of these services. They should also have essential infrastructure, staff, equipment and supplies. The PHCs surveyed at national level (9688) and Andhra Pradesh (380) with respect to the availability of selected facilities.