National

Focussed primary health care can transform lives: Haines

NEW DELHI: The National Rural Health Mission (NRHM) will have global significance if it achieves targets, and it will also have an impact on the primary health care systems across the world if it fails, Professor Andrew Haines, Director, London School of Hygiene and Tropical Medicine, said on Saturday.

He was delivering the Second Public Health Foundation of India (PHFI) Foundation Day Lecture on “Revitalising Primary Health Care: From Evidence to Action” here.

Prof. Haines said primary health care could transform the lives of millions of people if it was backed by sufficient resources and focussed on locally relevant problems.

In this context, he appreciated the role of Accredited Social Health Activists (ASHAs) employed under the NRHM as an important link between the people and an institutional health facility in rural areas.

Pointing out the immense potential in India to scale up the public health policy and strategies, he said it had the power to deliver improved health outcomes, as demonstrated by a growing number of national and international experiences. However, supportive policies needed to be put in place in order to change traditional determinants of health.

Prof. Haines said primary health care was especially relevant in a scenario of escalating burden of non-communicable diseases, which created new demands for long-term care and strong community support. It promoted a multisectoral approach to health that makes prevention as important as care.

Though primary health care traditionally addressed child health care, it had over the years evolved to tackle chronic adult problems such as mental health and even met with some success in tackling cardiovascular diseases in some higher income countries.

Recent years saw a renewed interest in primary health care in low and middle income countries for a range of reasons including profound inequities in health, inadequate progress towards the Millennium Development Goals, a major shortfall in the human resource required, and the fragmented and weakened state of health systems in many countries. The need for renewal of primary health care was crucial now, more than ever, owing to widespread social stress, caused by an increasingly globalised economy and the limited ability of health systems to deliver efficiently and equitably.

Highlighting the importance of effective public health policies, Prof. Haines said basic interventions and aggressive treatment could save many lives from non-communicable chronic diseases such as diabetes, cardiovascular ailments and tobacco-related diseases, and even mental disorders.

“We are creating more vertical programmes by focussing on a single disease, whereas the results could be better if there was integration of programmes,” he said.

Expressing concern that rising India had not done well enough in providing a quality health care and health schooling system to address the basic needs of the people, N. Ram, Editor-in-Chief of The Hindu, who was the guest of honour, said major political parties that led coalition governments should be shamed if they did not deliver on their promises. The Prime Ministers have not had the clout to deliver on the promises made every five years. “In this election season, health care can be put on the political agenda,” he said.

Mr. Ram said primary health care was an enormous challenge and subsequent governments had disappointed people with their lack of will in delivering in this sector. India should do much better than it had done so far in tackling mass deprivation, especially in the fields of health, education and nutrition, that blighted the lives of hundreds of millions of people. He said the media had a big role to play in reporting, including with investigative stories, on the state of health in the country.

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