Primary Health Care and National Health Programs
This domain covers the architecture of India's public health delivery - from Alma-Ata to Ayushman Bharat Health and Wellness Centres - and the NHM programmes a Community Health Officer must actually run, screen for and report.
Foundations
- Alma-Ata 1978 gave five principles (equitable access, community participation, intersectoral coordination, appropriate technology, health promotion) and eight elements including maternal and child care, immunisation and essential drugs.
- Ayushman Bharat has two pillars: PM-JAY (₹5 lakh per family per year) and Health and Wellness Centres delivering 12 expanded service packages - NCD care, maternal and child health, TB, eye, ENT, oral, mental health, palliative and elderly care, emergency care, yoga and teleconsultation through eSanjeevani.
Population norms (IPHS)
- Sub-centre/HWC-SC: 5,000 in plains; 3,000 in hilly, tribal and difficult areas.
- PHC/HWC-PHC: 30,000 in plains; 20,000 in hilly and tribal areas.
- CHC: 1,20,000 in plains; 80,000 in hilly and tribal areas.
Programmes to recognise by name
JSY (cash incentive for institutional delivery), JSSK (free services for mother and newborn), PMSMA (9th of every month), SUMAN, LaQshya, RBSK (0–18 years), RKSK, NTEP, NCVBDC, NPCDCS, NPHCE, NMHP, Kayakalp.
Worked example
A plains block has 1,20,000 people, of whom 90,000 live in plains villages and 30,000 in tribal hamlets. Applying a flat 1:5,000 rule gives 24 sub-centres. Correctly splitting by terrain gives 90,000/5,000 = 18 plus 30,000/3,000 = 10, i.e. 28. Always separate the terrain category before dividing.
Traps
- Using 5,000 for hilly or tribal populations.
- Confusing JSY (cash incentive) with JSSK (free drugs, diagnostics, diet, transport - no cash).
- Mixing PHC and CHC population norms.