Foundations of Health Care and Health Systems
Overview
Foundations of Health Care and Health Systems tests whether you can place a patient in the right level of care and describe how India delivers services from village to district. Expect questions on the WHO health-system building blocks, the rural health pyramid, and the roles of ASHA, ANM and MPW.
The rural health pyramid (India)
- Sub-centre / Ayushman Arogya Mandir: one per 3,000–5,000 people in plains (5,000–8,000 in hills and tribal areas), staffed by an ANM and MPW; no inpatient beds.
- Primary Health Centre (PHC): one per 20,000–30,000 rural people (30,000–40,000 in hilly and tribal areas); 4–6 beds; first referral point with a medical officer.
- Community Health Centre (CHC): one per 80,000–1,20,000 people; 30 beds; specialist services in medicine, surgery, obstetrics and paediatrics.
- District hospital and medical college: secondary to tertiary referral.
WHO building blocks
Service delivery; health workforce; health information; access to essential medicines; financing; leadership and governance.
Worked example
A rural block of 25,000 people has no doctor and no beds. Which facility should it have? A PHC. The sub-centre population norm is far exceeded, and a CHC requires roughly 80,000 people, so a PHC is the correct match; the answer should also mention referral to a CHC for specialist care.
Traps that cost marks
- Confusing ASHA (a community-level link worker and volunteer) with the ANM, who is a salaried sub-centre staff member.
- Claiming the sub-centre has 30 beds - that is the CHC norm.
- Listing only one or two WHO building blocks when the question asks for all six.