LitCovid-sentences  

PMC:7340764 / 2002-8007 JSONTXT 8 Projects

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Id Subject Object Predicate Lexical cue
T13 0-220 Sentence denotes The primary health care system in India has evolved since independence and there is an elaborate network of nearly 200,000 Government Primary Health Care Facilities (GPHCFs), both in rural and urban areas (Box 1) [1–30].
T14 221-366 Sentence denotes The existing GPHCFs deliver a narrow range of services, due to variety of reasons including, at times, the non-availability of providers as well.
T15 367-587 Sentence denotes Thus, the GPHCFs in India are grossly underutilized & excluding for the mother and child health services, in 2013-14, only 11.5% of rural and 3.9% in urban people in need of health services used this vast network [1, 2].
T16 588-889 Sentence denotes People in India either choose higher level of government facilities for primary health care (PHC) needs (which results in an issue of subsidiarity) or attend a private provider (which results in the out of pocket expenditure or OOPE), both situations are not good for a well-functioning health system.
T17 890-976 Sentence denotes The challenge of weak PHC in India are increasingly being recognized and acknowledged.
T18 977-1256 Sentence denotes The National Health Policy (NHP) 2017 of India proposed to strengthen PHC systems, invest two-third or more government health spending on PHC, with an increase in overall government funding for health to 2.5% of Gross Domestic Product (GDP) by 2025, against 1.18% in 2015–16 [3].
T19 1257-1670 Sentence denotes Following on the NHP 2017, the Government in India announced Ayushman Bharat Program (ABP) in February 2018 with two components of (a) Health and Wellness Centres (HWCs) to strengthen & deliver comprehensive Primary Health Care (cPHC) services for entire population and (b) Pradhan Mantri Jan Arogya Yojana (PMJAY) for secondary and tertiary level hospitalization services for bottom 40% of families in India [4].
T20 1671-1816 Sentence denotes The details of ABP in the context of Universal Health Coverage (UHC) has been published earlier [1] and a schematic of ABP is provided as Fig. 1.
T21 1817-1957 Sentence denotes These two arms, hence onwards, in this article, have also been referred as AB-HWCs and AB-PMJAY, to indicate that both are component of ABP.
T22 1958-2014 Sentence denotes Box 1 Evolution of Government PHC system in India [1–30]
T23 2015-2122 Sentence denotes Primary Health Care (PHC) has always been considered a foundation of stronger and efficient health systems.
T24 2123-2332 Sentence denotes The efforts to strengthen health services, based upon stronger PHC in India started when the ‘Health Survey and Development Committee’ was established in 1943 under the chairpersonship of Sir Joseph Bhore [5].
T25 2333-2549 Sentence denotes India started setting up primary health centres (PHCs) in 1952, when the first few PHCs were established in Najafgarh (Delhi), Singur (West Bengal) and Poonammalle (Tamilnadu) under Community Development Program [6].
T26 2550-2666 Sentence denotes This was part of establishing a three-tier healthcare system in the country, which has evolved since then [2, 7, 8].
T27 2667-2897 Sentence denotes India started efforts to build health system around the same time when National Health Services (NHS) in United Kingdom was set up and the constitution of World Health Organization (WHO) came into force, both in year 1948 [9, 10].
T28 2898-3091 Sentence denotes The successive governments continued to expand the network of PHCs, which received a major boost through various committees, set up nearly one to three in every decade for first 4 decades [11].
T29 3092-3191 Sentence denotes The efforts to strengthen PHC system in rural India have been made over the years [1, 3, 4, 12–20].
T30 3192-3297 Sentence denotes With these initiatives, by mid Sept 2019, country had an extensive network of 158,417 Health Sub Centres:
T31 3298-3459 Sentence denotes 25,743 Primary Health Centres in rural areas; 5,624 Urban PHCs; 764 district hospitals; 539 medical colleges and hospitals and 1,741 mobile medical units [7, 8].
T32 3460-3585 Sentence denotes The annual admission capacity in medical colleges was 80,000 for graduate medical seats and 41,000 for post graduate courses.
T33 3586-3801 Sentence denotes The efforts to strengthen PHC network in India apparently received a boost after Alma Ata conference on primary health care in 1978 and then with the release of India’s first National Health Policy in 1983 [14, 21].
T34 3802-4030 Sentence denotes A major initiative to further strengthen & make rural PHC system functional, started in April 2005, with the launch of National Rural Health Mission (NRHM) in India [22] soon after the second national health policy in 2002 [23].
T35 4031-4114 Sentence denotes The urban component as National Urban Health Mission was launched in May 2013 [24].
T36 4115-4204 Sentence denotes Two missions together were, thereafter, renamed as National Health Mission (NHM) [22–24].
T37 4205-4300 Sentence denotes The NRHM/NHM has focused on PHC system strengthening to make it functional to deliver services.
T38 4301-4725 Sentence denotes NRHM/NHM had a few strategies to strengthen health systems and PHC services: decentralized health planning; communization (community processes, behavior change communication and addressing social determinants of health); social protection function of public health services; partnership for NGOs and civil society; human resource strengthening; flexible funding for states, public health management and many others [22, 25].
T39 4726-4944 Sentence denotes The NRHM/NHM in India is attributed to improving several services, though mostly Reproductive Maternal, Newborn, Child and Adolescent Health (RMNCH+A) services through Government Primary Health Care Facilities (GPHCF).
T40 4945-5193 Sentence denotes The reduction in Infant Mortality Rate (IMR) and Maternal Mortality Ratio (MMR), which these programs specifically targeted, were reduced at accelerated manner and India reached very close to achieve Millennium Development Goals (MDG) 4 and 5 [26].
T41 5194-5423 Sentence denotes Yet, it was increasingly being recognized that health services for emerging burden of diseases and changing epidemiological profile, i.e., Non-communicable diseases (NCDs) through GPHCFs were either not available or insufficient.
T42 5424-5490 Sentence denotes The need for a new approach to deliver comprehensive PHC was felt.
T43 5491-5603 Sentence denotes It was also the time when various discourses on Universal Health Coverage (UHC) were happening in India [27–29].
T44 5604-5814 Sentence denotes The ongoing & identified challenges of GPHCFs include a narrow range of services, insufficient infrastructure, shortage of healthcare providers; lack of medicines and diagnostics, and limited referral services.
T45 5815-5952 Sentence denotes These challenges have been documented in various review missions and also captured in situation analysis document of NHP 2017 [1, 3, 30].
T46 5953-6005 Sentence denotes Fig. 1 Ayushman Bharat Program in India: a schematic