Why have primary health care services failed to win the trust of people as curative care centres?

We must distinguish people’s need for medical care (curative) and public health services (preventive and promotive). Curative care needs are more demanding as they are triggered by the severity of illness. There is an urgency and immediacy in seeking relief to alleviate suffering

Public health services comprise of preventive and promotive care. These services are generally delivered at the population level. Moreover, they may not have the demand and urgency among individuals as that of curative care needs. See: http://www.nmji.in/temp/NatlMedJIndia323171-5277802_143938.pdf

People give varied importance to preventative, promotive and curative health behaviours. This has become more apparent in the context of the pandemic. It was difficult for people to adopt preventive measures and they desperately sought curative measures when they tested positive.

Primary health care services comprise of both type of services. Hence, there needs to be a diverse approach to delivering these services. The target group for medical care are individuals. Whereas, public health services need to be operational at population scale to be effective.

Health and wellness centres (HWCs) reiterated similar images of "upgraded" health centres. HWCs failed to evoke the image of sarkari hospitals in the minds of people.

The "image" of hospitals is created based on people's experience while accessing services like delivery care, minor procedures, surgeries, and for treatment of infections. These are provided either by headquarter hospitals at the district level or by private facilities.

Institutions of primary health care (SC, PHC and CHCs) have never raised to the level of a hospital capable of providing primary and secondary level curative care. The trust deficit towards public sector health care is an outcome of poor experiences.

One of the ways to quickly regain the trust and inculcate a powerful image of sarkari hospitals among people is by strengthening the existing CHCs into full-fledged 30 bedded hospitals within the next 5-10 years.

Building trust among people towards the public sector by providing curative care at the grassroots level is comparatively easy and sustainable. It can create a conducive environment for effective public health action.

Join us at 6 pm today for a discussion with @george_matsajo about his @epw_in article "The Fragmentation and Weakening of Institutions of Primary Healthcare: A Prescription for Their Revival" https://www.epw.in/journal/2020/42/special-articles/fragmentation-and-weakening-institutions-primary.html. We look forward to your questions.