Community Health Nursing · Health care delivery system
Health Care Delivery in India
Sub-Centre
- 5,000 · 3,000 population
- 1 ANM + 1 male health worker
- most peripheral contact point
PHC – Primary Health Centre
- 30,000 · 20,000 population
- 6 beds · 1 Medical Officer
- referral unit for 6 sub-centres
CHC – Community Health Centre
- 1,20,000 · 80,000 population
- 30 beds · 4 specialists
- first referral unit for 4 PHCs
Rural 3-tier
(plain · hilly/tribal)
ASHA – Accredited Social Health Activist
- 1 per 1,000 population
- introduced under NRHM (2005)
- link between the village & the health system
What is primary health care?
- essential care, made universally accessible
- with the community's full participation
- at a cost the community & country can afford
- Alma-Ata declaration, 1978
Principles of PHC
- 1 – Equitable distribution
- 2 – Community participation
- 3 – Intersectoral coordination
- 4 – Appropriate technology
Tertiary
super-speciality care · ex) AIIMS, medical colleges
Secondary
specialist & referral care · ex) CHC, district hospital
Primary
first contact: prevention + basic treatment · ex) SC, PHC