In 2003, the World Health Organisation (WHO) said that the health system comprises all organisations, institutions and resources that produce actions whose primary purpose is to improve health. According to the WHO, the health care system refers to the institutions, people and resources involved in delivering health care to individuals.
Keeping in mind the WHO statements, there is a constant need to evaluate the progress made by the state in providing primary health services to the people while learning to adapt to the realities of complex health landscape.
We should note that health care providers are often involved in promoting health-enabling conditions of the community and that the relationship between patient care and public health functions are the defining characteristics of the primary health care approach.
Manipur can still bask under the sun and exhibit exceptional jubilation over its recent achievement in the health sector as it was recently adjudged the best among Northeast and hill states category and second in the all India ranking. It may be recalled that Manipur indeed fared well in infant mortality rate, maternal mortality ratio, total fertility and immunization achievement, availability of doctors and paramedical staff at primary health centres (PHCs) and operationalisation of 24×7 facility at PHCS.
However, there are certain realities we need to acknowledge. This has become even more imperative if we take the statement of the Member of Parliament (MP) representing Inner Manipur constituency RK Ranjan seriously. He had recently expressed deep concern over the condition of some of the government health centres in Manipur and had also appealed to the authority to equip all government hospitals with at least basic infrastructure.
Seeking special attention of the state health authorities, RK Ranjan pointed out that many government health centres in the state are in shambles, particularly those located in interior and peripheral parts of the state. He had indeed commented that most of the hospitals in the remote parts of the state are in a bad shape and informed that Chandel district hospital which was going to be upgraded as a medical college did not have a single ultrasound machine.
Against such backdrop, it would be wise to revisit the core principles of primary health care. Despite useful indications and pointers by the WHO, there is no universally applicable definition of primary health care. Even if there were ambiguities in the universal approach, taking cognizance of Manipur’s health care indeed needs special attention. While accepting this, we should also understand that primary health care system involves both the core principles expounded by world bodies and a variable set of basic activities at the local level.
Nevertheless, we should ensure access to health care and coverage on the basis of need; commitment to health equity as part of development oriented to social justice; community participation in defining and implementing health agendas; inter-sectoral approaches to health as envisaged by WHO decades ago.health system, health centres in Manipur, health care