Comprehensive Community and Home-based Health Care
Projected deaths in India 2010 Source: ICMR Tenth Plan documents
Fig 2: Share in health care spending among the different sectors Source:National Health Accounts 2007, MoHFW
72.2% of the population lives in some 638,000 • villages • 27.8% in about 5,480 towns and urban . • The birth rate 22.22 births/1,000 population (2009 est.) • Death rate is 6.4 deaths/1,000 population.
Fertility rate is 2.72 children born/woman (NFHS-3, 2008) and Infant mortality rate is 30.15 deaths/1,000 live births (2009 estimated). India has the largest illiterate population in the world. The literacy rate of India as per 2001 Population Census is 65.38%, with male literacy rate at 75.96% and female at 54.28%. Kerala has the highest literacy rate at 90.86%, Mizoram (88.80%) is on the second position and Lakshadweep (86.66%) is on third.
The model for comprehensive community- and home-based health care (CCHBHC) has been developed to ensure better accessibility to health and quality community health care.
DEFINITION CCHBHC is defined as an integrated system of care designed to meet the health needs of individuals, families and communities in their local settings.
GOAL • Ensure better accessibility • Effective and efficient health care • To improve health and well-being • Contribute to morbidity and mortality reduction
OBJECTIVES • Promoting a healthy lifestyle and • preventing illness • Managing the consequences • Serving the needs of the vulnerable • and underprivileged • Supporting informal caregivers • Strengthening the community
PRINCIPLES • Quality - structures and processes of care are organized to ensure that the care delivered is holistic, integrated and continuous, and in accordance with the agreed standards • Partnership -appropriate opportunities and methods are made available to enable and empower all stakeholders, and work in an honest and open
Equity - equitable access is ensured to all services and resources with a focus on the vulnerable and underprivileed groups. Effectiveness- special efforts are made to ensure that an intervention or service provided for the patient/client yields the intended result. Efficiency -optimal use is made of the range and mix of available resources (e.g. financial, human, physical and technical resources) in support of the delivery of evidence-based practice. PRINCIPLES contd.
STRATEGIES • Political commitment and support • Resources building • Appropriate health information systems. • Empowerment
Implementation of the model in a country • requires • National policy and support • Local action • Involvement of all stakeholders throughout the • process • Initiation of small trials in selected areas to learn • lessons • Evaluation of experiences and lessons learned • for sustainable strategies • Coverage of and expansion to other areas
CONCLUSION This model provides one response to improve the equity of, and accessibility to, quality health services within a local community. It includes a particular emphasis on involving all members of the community in identifying their needs and agreeing on priorities. It acknowledges the contribution made by those outside the formal health system to health and health care, and provides additional support.
A group of students were asked to list what they thought were the present "Seven Wonders of the World." Though there were some disagreements,the following received the most votes:
1. Egypt's Great Pyramids2. Taj Mahal3. Grand Canyon4. Panama Canal 5. Empire State Building 6. St. Peter's Basilica 7. China's Great Wall
While gathering the votes, the teacher noted that one student had not finished her paper yet.
So she asked the girl if she was having trouble with her list. The girl replied, "Yes, a little. I couldn't quite make up my mindbecause there were so many."
"The girl hesitated, then read: "I think the 'Seven Wonders of the World' are:
The room was so quiet you could have heard a pin drop.The things we overlook as simple and ordinary and thatwe take for granted are truly wondrous!
That the Most precious things in life cannot be built by hand or bought by man.