Revision summary
Alma-Ata (1978) and the Bhore Committee make community primary care the core of Health for All. Article 47 and the Eleventh Schedule place public health with the State and with panchayats. NRHM/NHM, ASHA, VHSNC and IPHS are the Indian local architecture; vacancies and weak honoraria undermine them. Ayushman Bharat Health and Wellness Centres must carry NCD and primary care, or insurance only pays late hospital bills. Untied local grants, filled PHCs, and a strong ASHA–ANM front door are the practical path.
Model answer
Flow diagram
flowchart TD H[Health for All Alma-Ata] --> L[Local community care] L --> A[ASHA ANM VHSNC] L --> P[Sub-centre PHC HWC] P --> R[CHC and district referral] A --> H
Conclusion
- Complete Health and Wellness Centres with a Community Health Officer, diagnostics and NCD drugs, and publish IPHS vacancy data by block.
- Route a larger untied health grant through panchayats and municipalities, with VHSNC social audit.
- Keep hospital insurance as a backstop, not as a substitute for the ASHA–ANM–PHC front door.
- Health for All in India will be won or lost in the habitation: ASHA, sub-centre, PHC and the panchayat. National missions and insurance help only when that local community intervention is staffed, stocked and accountable, which is exactly what Alma-Ata and the Bhore design asked for.
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Students also ask
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E-governance in not only about utilization of the power of new technology, but also much about critical importance of the 'use value' of information. Explain.
Next question in the 2018 paper (Q8). View answer →
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Can hospital insurance alone deliver Health for All?
No. Insurance pays for admission. Immunisation, antenatal care, hypertension and TB need a local worker and a stocked primary centre first.
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Are panchayats legally linked to health?
Yes. The Eleventh Schedule lists health and sanitation. Many States still under-devolve staff and money, which is why the prerequisite is often missing.
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