Access to Public Health Care System: A Study of Primary Health Care in Delhi

Abstract

Background: The Primary Health Care System plays a critical role in providing basic healthcare as it is the an easy point of access for the deprived sections of the society. The skewed quality healthcare services impels the need for a robust community healthcare system.

Material & Methods: A household survey was conducted to identify the weaknesses in the health care setup at the primary level, covering 156 households comprising of 800 members across various parts of Delhi. A  detailed analysis of access to health services including consultation of doctors, medicines and diagnostic tests was carried out.

Statistical analysis used:    simple graphs and tables

Results: The average health expenditure is close to one-fourth of the income , with dominant proportion going into medicines. The marginalised sections reach out to the government and free primary health centres while 60% of the upper middle class mainly go to private health facilities. The gender bias is also observed in the provision of quality health care. For major ailments, households irrespective of social group, caste or gender, access private health facilities. Diabetes and hypertension in the chronic segments and acute ailments like infections and respiratory diseases form significant portion of disease incidence.

Conclusions: Discrimination on the basis of social grouping is found on a limited scale  but economic factors play a much more crucial role in access to quality health care. There is a need for large number of Primary Health Centres, much more than those that already exist. The diagnostic tests must be available at the health facilities for timely intervention  for both non-communicable and communicable diseases. For better health outcomes and to mitigate health disparities, special treatment and benefits through medical cards to  the disadvantaged sections including women , poor and Dalits must be offered.