1. Changing the face of primary
care in India
Sanjeev Bhoi, MD,FACEE
Addl Professor
Department of Emergency Medicine
AIIMS Trauma Centre

2. Total population 1,240,000,000
Gross national income per
capita (PPP international $)
3,590
Life expectancy at birth m/f
(years)
64/67
Probability of dying under
five (per 1 000 live births)
61
Probability of dying
between 15 and 60 years
m/f (per 1 000 population)
247/159
Total expenditure on health
per capita (Intl $, 2011)
141
Total expenditure on health
as % of GDP (2011)
3.9

3. Objectives
• Primary care of India
• Challenges
• Creating challenges in opportunity
• Ownership
• Leadership
• Team
• Changing the face of primary care

5. Primary care of India
• 23,109 PHCs in India
• Provision of medical care
• Maternal-child health including family
planning
• Safe water supply and basic sanitation
• Prevention and control of locally endemic
diseases
• Collection and reporting of vital statistics

6. Primary care of India
• Education about health
• National health programmes, as relevant
• Referral services
• Training of health guides, health workers, local
dais and health assistants
• Basic laboratory workers

7. Challenges
Survey shows poor state of PHCs in the state

8. Gaps in basic
emergency care in
India

9. Current Status of Emergency
care-Govt .Sector
• Care provided in so called Casualty.
• Free care, but quality varies from
center to centers.
• Manned by CMOs. Or Non trained staff of
junior grade.
• Lack of equipment and infrastructure
• University hospitals have reasonable care
Ramanujam et al JAPI 2007

10. Emergency care Rural Area
 Subcentre-PHC-CHC.
 Pvt. Clinics and Hospitals.
 General Practitioners-(basic to specialist)
 Lacks emergency skills.
 Lack of Diagnostic facility, communication
 Provide reasonably good Emergency care
Position Statement: Academic Emergency Medicine in India: JWG: JAPI 2008

11. CYCLE RICKSHAW TO AIR AMBULANCE
9/27/2013 Criticare 2012

12. CMO
 Casualty medical officer
 Acts as a Post man
 Usually a non trained Junior
Staff.
 Flying Birds
◦ Residents rotate in Other
specialty
◦ usually those who prepare
for PG.
Allagappan K et al
Ann Emerg Med1998
9/27/2013

13. Lack of Manpower
Training
and
Community participation

14. Creating challenges into opportunity

15. Ownership
Mine Ours

16. Leadership

17. Making a Team
Team- Team

18. Janani Suraksha yojana

20. AIIMS COMMUNITY
EMERGENCY CARE
INITIATIVE

21. objective
Primary objective:
To improve knowledge and skill of
primary health care workers as well as
laypersons towards basic emergency /
trauma care.
Secondary objective:
To develop a skilled set of trainers who
would be the resource persons in
imparting further trainings.

23. BECC 23
AIIMS BASIC EMERGENCY CARE
COURSE
For Healthcare workers and Laypersons

25. Visual session:
Audiovisuals

27. Skill Session:
Practical Skill
stations

29. Method of
Assessment of the
participants

31. CBSE Curriculum- 2011
School Systems to
consider “introducing a
fourth „R‟- resuscitation,”
to traditional 3R‟s of
reading, writing and
arithmetic

32. National Cadet Corps

33. Manipur Guwahati

34. Spreading across India

35. Mission with a vision
to
the face of primary care in India