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The Lancet regional health. Southeast Asia
Jun, 2023;13 100197.

In search of a fix to the primary health care chasm in India: can institutionalizing a public health cadre and inducting family physicians be the answer?

Allen Prabhaker Ugargol, Arnab Mukherji, Ritika Tiwari
Author Information
  1. Allen Prabhaker Ugargol: Centre for Public Policy, Indian Institute of Management Bangalore (IIMB), Bengaluru, India.
  2. Arnab Mukherji: Centre for Public Policy, Indian Institute of Management Bangalore (IIMB), Bengaluru, India.
  3. Ritika Tiwari: School of Human Sciences, Faculty of Education, Health & Human Sciences (FEHHS), University of Greenwich, UK.
PMID: 37383560 DOI: 10.1016/j.lansea.2023.100197

Abstract

India's woes with an underprioritized and hence underfunded and understaffed public health system continue to plague public healthcare delivery. Though the need for appropriately qualified public health cadre to lead public health programmes is well established, a well-meaning conducive approach to implementing this is lacking. As the COVID-19 pandemic brought back the focus on India's fragmented health system and primary healthcare deficiencies, we discuss the primary healthcare conundrum in India in search of a quintessential fix. We argue for instituting a well-thought and inclusive public health cadre to lead preventive and promotive public health programmes and manage public health delivery. With the aim being to increase community confidence in primary health care, along with the need to augment primary healthcare infrastructure, we argue for a need to augment primary healthcare with physicians trained in family medicine. Provisioning medical officers and general practitioners trained in family medicine can salvage community's confidence in primary care, increase primary healthcare utilization, stymie over-specialization of care, channelize and prioritize referrals, and guarantee competence in healthcare quality for rural communities.

Keywords

Family medicine Health policy Health systems Health workforce Primary health care Public health cadre

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