“The health of people is the foundation upon which all their happiness and all their powers as a state depend”
– Benjamin Disraeli, British Prime Minister.
National Health Center Week has been observed from 9 th to 15 th August in America for more than thirty years to acknowledge the work of Community, Migrant, Homeless, and Public Housing Health Centers. America’s Health Centers are celebrated for their continuous efforts among in providing access to affordable, quality, cost effective health care to medically vulnerable and underserved communities across the country.
Community health care centers have a lot of importance as they serve people from underprivileged and marginalized communities who do not have access to quality healthcare. These centers provide comprehensive primary healthcare services, and many offer other supportive services like transportation, etc. which promote access to healthcare. All community health centers contribute towards providing a broad range of services to everyone, catering to people who don’t have access to other healthcare institutions, which includes homeless people, low income groups, seasonal workers, and people belonging from racial and ethnic minority communities.
Even outside the American context, community and public healthcare plays a very important role in laying the foundation of any country. Contributing towards the health of people also includes working on the social parameters of health such as access to clean drinking water, education, safe living conditions, etc. which ensures that people from vulnerable and deprived groups also have equal access to a dignified life.
Community Health Workers act as community mobilisers and trusted links to the organised health services. Ethiopia employed “health extension workers” to provide better antenatal care and reduce maternal mortality. India started deploying Community Health Workers initially as mitanins in Chhattisgarh, and later built a nationwide army of accredited social health activists (ASHAs) as part of the National Rural Health Mission (Reddy, 2019).
Currently, India’s largest community health worker program, which started in 2005 has now been subsumed within the National Health, and it consists of nearly one million Accredited Social Health Activist, one for every 1000 people in rural villages and marginalized urban communities. India has adopted a grassroot level engagement approach which comprises of partnerships with local government- organized non- governmental organisations or hospitals.
Community healthcare in India however faces ongoing challenges, which includes lack of accountability, overcrowding of clinics, corruption, and lack of quality healthcare. These drawbacks further deepen socioeconomic inequalities, by creating barriers of access to healthcare, as a lot of these services might not be accessible to women, disabled or elderly people.
The causes of health inequalities lie in the social, economic and political mechanisms that lead to social stratification according to income, education, occupation, gender and race or ethnicity. Lack of adequate progress on these underlying social determinants of health has been acknowledged as a glaring failure of public health. The practice of public health has been dynamic in India and has witnessed many hurdles in its attempt to affect the lives of the people of this country. Since independence, major public health problems like malaria, tuberculosis, leprosy, high maternal and child mortality and lately, human immunodeficiency virus (HIV) have been addressed through a concerted action of the government (Lakshminarayanan, 2011).
It is crucial to acknowledge the role of community healthcare structures in shaping the well being and health of a vast majority of people in this country who cannot afford private health services. Therefore, it becomes necessary to witness a National Health Centre week even in India, so that we as a community can be reminded of the efforts put in by community health workers and we can appreciate their contribution. At the same time, it will also draw our attention to the drawbacks that currently surround our health system. We need to collectively work towards strengthening our public healthcare services by increasing the resources and funds allocated towards this sector, we need to build a framework which is based on community engagement and participation, and its highly important to make these healthcare services more accessible to people from all communities and social identities, such as making contraceptives and abortion facilities available to women.
To achieve the goal of building a developed nation, we must build a healthy nation, and this involves investing in our community healthcare system, so that it is able enough to reach out to every person in need.
- Whelan, E. (2010). The Importance of Community Health Centers. Center for American Progress. Retrieved 15 August 2020, from: https://cdn.americanprogress.org/wp-content/uploads/issues/2010/08/pdf/chc.pdf
- Reddy, S. (2019). Why we need community health providers. Hindustan Times. Retrieved 15 August 2020, from: https://www.hindustantimes.com/analysis/why-we-need-community-health-providers/story-ysLykhZAHFE7FDeUCuolFP.html.
- Lakshminarayanan, S. (2011). Role of government in public health: Current scenario in India and future scope. Journal Of Family And Community Medicine, 18(1), 26. http://www.jfcmonline.com/article.asp?issn=2230-8229;year=2011;volume=18;issue=1;spage=26;epage=30;aulast=Lakshminarayanan