Community Health Services and functions of PHC

🔹 5.1 INTRODUCTION TO COMMUNITY HEALTH & SERVICES

• Community: A group sharing common geography and values.
• Community Health: Health status of the community and factors affecting it.
• Public Health: Organized efforts to prevent disease, promote health, and prolong life.
• Community Service: Work done for community benefit, voluntary or compulsory.

🔹 5.1.1 OBJECTIVES OF COMMUNITY HEALTH

Health services are divided into three levels of prevention:

1.     Primary Prevention – Health promotion and protection

• Safe water, waste disposal, hygiene, immunization, nutrition, health education

2.     Secondary Prevention – Early diagnosis and treatment

• Mass screening, school checkups

3.     Tertiary Prevention – Disability control and rehabilitation

🔹 5.2 HEALTH CARE SYSTEM IN INDIA

India’s health care system includes five major sectors:

1. Public Health Care System
2. Private Health System
3. Indigenous Systems of Medicine
4. Voluntary Health Agencies
5. National Health Programmes

🔹 5.2.1 Public Health Care System

Divided into 4 parts:

·        Primary Health Care

• Primary Health Centres (PHCs), Sub-centres (SCs)

·        Hospitals/Health Centres

• CHCs, District/Rural hospitals, Specialist & Teaching hospitals

·        Health Insurance Schemes

• ESI, CGHS

·        Other Agencies

• Railways, Defence services

🔹 5.2.2 Private Sector

Includes:

• Private hospitals, nursing homes, clinics, dispensaries
• General practitioners

🔹 5.2.3 Indigenous System of Medicine

Traditional systems of healing:

• Ayurveda, Siddha
• Unani, Tibbi
• Homeopathy
• Unregistered local practitioners

🔹 5.2.4 Voluntary Health Agencies

Examples:

• Indian Red Cross
• Kasturba Memorial Fund
• Hind Kusht Nivaran
• Family Planning Association of India
• Indian Council for Child Welfare
• Bharat Sevak Samaj
• Central Social Welfare Board

🔹 5.2.5 National Health Programmes

Government-run programs addressing specific health issues like:

• TB, Malaria, Leprosy, AIDS
• Family welfare, immunization, blindness control

🔹 5.3 PRIMARY HEALTH CENTRES (PHC)

• Introduced under Alma-Ata Declaration (1978) by WHO & UNICEF.
• Aim: "Health for All by 2000 A.D."
• Definition: Essential health care accessible and acceptable to all.
• PHC provides:
• Preventive, promotive, and curative care
• Based on a three-tier rural structure depending on population size

📊 Table 5.1: Population Norms for Health Facilities

Health Facility	Plain Area	Hilly/Tribal Area
Sub-Centre	5,000	3,000
Primary Health Centre	30,000	20,000
Community Health Centre	1,20,000	80,000

🎯 5.3.1 Objectives of PHC

• Deliver comprehensive primary health care
• Ensure quality standards
• Provide community-responsive services

🏥 5.3.2 Levels of Health Care

1.     First Level (Primary Care)

• First contact with the system
• Handled at: Sub-Centre, PHC, CHC (rural), dispensaries, MCH centers (urban)

2.     Second Level (Secondary Care)

• First referral level
• Complex cases managed at district hospitals

3.     Third Level (Tertiary Care)

• Super-specialty care
• Provided at regional/central institutions
• Also serve as training and referral centers

🔹 Major Functions of Primary Health Centre (PHC)

1.     Medical Care

• OPD (morning & evening)
• 24×7 emergency care (e.g., injuries, bites, stabilization)
• Referral & inpatient care (6 beds)

2.     Maternal & Child Health Care

• Antenatal, intranatal, postnatal, and newborn care

3.     Family Planning Services

• Counseling, infertility referral, vasectomy/tubectomy

4.     MTP Services

• Medical termination of pregnancy via MVA

5.     Health Education

• RTI/STI prevention and management

6.     Nutrition Services

• Treat malnutrition, anemia, vit. A deficiency (coordination with ICDS)

7.     School & Adolescent Health Care

8.     Disease Surveillance & Epidemic Control

9.     Vital Event Reporting

• Births, deaths, other records

10.  Sanitation Promotion

• Toilet use, waste disposal, water testing & disinfection

11.  Implementation of National Health Programmes

12.  Referrals & Transport for Critical Cases

13.  Training and Capacity Building

14.  Basic Laboratory Services

15.  Monitoring, Supervision, & Record Maintenance

16.  Minor Surgical Procedures

• Vasectomy, MTP, cataract, hydrocele (in O.T.-equipped PHCs)

17.  AYUSH Integration

• Promoting traditional medicine systems

Reference 

Malviya K, Sahoo S, Dasadiya D, Acharya V. Social and Preventive Pharmacy. 1st ed. Pee Vee (Regd.); 2021

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