Asymmetry in primary health-care system and its effects on prevention and early detection of non-communicable diseases in rural India

Abstract

Background: Primary health care is a foundation of public health system, but it lacks efficiency in serving the huge population in
India, consequently people prefer private health care over the public. Moreover, health services are unequally distributed among
rural and urban area while former has more than twice population as compared to later. There is a shift from communicable
diseases to non-communicable diseases (NCDs) which combined with increasing private health-care cost due to inadequacy
pushes people into poverty. The present study analyzes the asymmetric status of primary health care and assesses its effectiveness
in the prevention of NCDs which cause highest mortality and economic burden. Materials and Methods: The present study is
a descriptive cross-sectional study conducted in 12 primary health centers (PHCs) in 6 blocks of district Rampur, Uttar Pradesh.
Two-stage sampling was adopted. Data were collected from 874 patients through a pre-structured questionnaire with prior consent
and analyzed using SPSS 20v. Since the majority of the variables were qualitative, a reliability test was done to ensure the quality
of the data. Results: About 69.6% of respondents preferred private health care as the first choice. Reasons for not choosing
government hospitals were dissatisfaction with services (35.6%), long distance (14.8%), and limited time of O.P.D (10.1%). More
than 50% of respondents were unaware of NCDs and their risk factors. Conclusion: Primary health care is deficient resulting
in a shift of patients to private health care and incautious attempts toward the management of NCDs at the level of PHC. It is
imperative to strengthen primary health care to achieve universal health.