Introduction to Health Care and the Health Care System
What this domain tests
The Introduction to Health Care and the Health Care System domain checks whether you understand health as a positive state, can describe how care is organised from village to district level, and can place health workers in the team. Questions often ask you to classify a situation as primary, secondary or tertiary care.
Core rules and concepts
- WHO (1948) defines health as complete physical, mental and social well-being, not merely the absence of disease or infirmity.
- Primary care is first contact, close to home: sub-centres, primary health centres (PHCs), community outreach and ASHA workers. It covers promotion, prevention and common illness.
- Secondary care is specialist care at district hospitals, usually after referral.
- Tertiary care is advanced specialist care, such as cardiac surgery or intensive care.
- The team includes doctors, nurses, ANMs, ASHAs, pharmacists, laboratory technicians and NSQF-trained health care assistants.
- National programmes for immunisation, tuberculosis, maternal health and vector-borne disease are mainly delivered through primary care.
Worked example. A villager with fever and body ache first visits the sub-centre. The ANM finds danger signs and refers the patient to the district hospital, where a physician admits him. Reasoning: the sub-centre episode is primary care because it is first contact and community-based; the district hospital admission is secondary care because it needs specialist assessment and inpatient facilities. If he were later sent to a medical college for cardiac surgery, that would be tertiary care.
Traps that cost marks
Do not call every hospital visit primary care. Do not describe health only as not being ill. Do not confuse secondary care with tertiary care. Do not list ASHA as a doctor; ASHA is a community health worker.