The humble PHC shows potential to be unlocked for COVID-19

In times of a pandemic like COVID-19, the primary health care system rises to meet the demands

Primary healthcare systems, coronavirus, COVID-19, coronavirus outbreak, coronavirus pandemic
Photo for representational purpose only: PTI

Primary health care workers across Tamil Nadu have a new task at hand, following the outbreak of COVID-19 — they will do contact tracing and follow up on people who are under home quarantine.

A source from the Directorate of Preventive Health and Medicine tells The Federal that the workers’ role is vital for intervention during the outbreak — they have to link up patients to the treatment options on case to case basis and aid in prevention of a spread.

There are over 1800 PHCs in the state and the idea is to take preventive measures through them, the source said, adding, “This is an existing initiative taken every time there an outbreak of a notifiable disease under the Tamil Nadu Public Health Act, 1939.”

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PHCs underutilised

In an attempt to strengthen access to healthcare, especially for the underprivileged sections of the society, a PHC is expected to cater to maternity care, children, immunisation, disease prevention and control, according to officials.

However, for long, PHCs — there are 29,899 PHCs in India — have either been underused or relegated as facilities not fit for consumption for some sections.

The FICCI Indian Healthcare Report 2019 illustrates the poor utilisation of PHCs in the country, with just about 9% of urban households and 26% of rural households utilising its services. In both the regions, the demand for private facilities and government hospitals are higher, though in varying degrees.

Aid in pandemic

However, their importance has come to the fore in the time of COVID-19 pandemic, says Ruchika Chugh Sachdeva, deputy director.

Ruchika, who is deputy director, Maternal, Newborn, Child Health and Nutrition at PATH, a global organisation, says that at a time like now where we are in the middle of COVID-19, it is like a normal flu for the general population.

“The need to bring in the district or government hospitals is for the elderly, who probably would need to be put on ventilator, considering their comorbidities like hypertension, diabetes and kidney issues that will make it critical for them. However, for the rest, especially with a focus on preventive care, a lot more can be achieved through them,” she says.

“For example, they (PHC staff) could be utilised for testing and contact tracing. The PHCs can contribute with campaigns for dos and don’ts during the pandemic. They can be linked to the nearest tertiary care facility through mobile vans,” she adds.

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Tracking becomes efficient

Ruchika also highlights that keeping a tab on suspected cases in the respective zones can expedite the procedure and make it more efficient to track their progress.

“An accredited social health activist (ASHA) or a community health worker instituted by the government of India’s Ministry of Health and Family Welfare, as part of the National Rural Health Mission can also be a part of this system, when there is a need, along with anganwadi workers,” she adds.

The bigger fear amid the pandemic is the burden on tertiary healthcare facilities that are scarce for a populous country like India, says Dr J Amalorpavanathan, a vascular surgeon.

“We can ease this burden by ensuring that we are judicious with our resources. Fever cases can be admitted to secondary care facilities, while primary healthcare workers can be entrusted with the task of door-to-door surveillance, screening of areas, etc. It is also possible to have isolation wards in the PHCs to take the load off the tertiary government sector,” he explains.

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