Health Policy of Andhra Pradesh - APPSC (Andhra Pradesh) PDF Download

Health, Health Infrastructure, and Health Policy of Andhra Pradesh

• Overview of Andhra Pradesh
  • Andhra Pradesh is the fifth largest state in India, covering nearly 278,000 square kilometers and accounting for 8.4% of India's territory.
  • It is the fifth most populous state with a population of 76 million, divided into 23 districts, 79 revenue divisions, 1,123 mandals, around 27,000 villages, and 264 towns.
  • Over 75% of its land is covered by river basin, and the state's economy is heavily reliant on agriculture.
• Healthcare System
  • The Department of Health, Medical and Family Welfare (DoHMFW) was established in 1922 to provide primary and secondary healthcare services.
  • Primary objectives include ensuring quality, accessible, equitable, affordable, and guaranteed health services for the poor in rural and urban areas.
  • The system integrates Indian traditional medicine like Ayurveda and Homoeopathy alongside allopathic medicine.
• Organizational Structure
  • The health system in Andhra Pradesh involves various entities collaborating for effective health service delivery.
  • The Department of Health, Medical, and Family Welfare comprises ten organizations working together.

• Healthcare Delivery System in Andhra Pradesh:
  • Andhra Pradesh Vaidya Vidhana Parishad
  • Andhra Pradesh Health Medical Housing and Infrastructure Development Corporation
  • Andhra Pradesh State AIDS Control Society
  • Commissionerate of Family Welfare
  • Directorate of Health Services
  • Directorate of Medical Education
  • Institute of Preventive Medicine
  • Andhra Pradesh Yogadhyana Parishad
  • Drugs Control Authority
  • Ayurveda, Yoga, Naturopathy, Unani, Siddha (AYUSH)
• Autonomous Bodies overseen by the Department:
  • Sri Venkateswara Institute of Medical Sciences (SVIMS)
  • NTR University of Health Sciences
  • MNJ Cancer Hospital
  • Andhra Pradesh Aromatic Plants Board
• Andhra Pradesh Health Sector Reform Programme:
  • Strategic Planning and Innovation Unit (SPIU)
  • State Program Management Unit (SPMU)
• Public Sector Service Delivery Units:
  • Sub-Centers
  • Primary Health Centers
  • Community Health Centers
  • District Hospital

Sub-Centers, also known as sub-health centers, serve as the initial point of contact between the primary healthcare system and the community. These centers are strategically located to ensure accessibility to healthcare services for the population. They offer a range of primary healthcare services including antenatal, natal, and postnatal care, immunization, family planning counseling, and treatments for common ailments. Sub-Centers play a crucial role in community health by conducting needs assessments and implementing various national health and family welfare programs.

Healthcare System Overview

Primary Health Centers (PHC)

• The primary health center is a key part of the three-tier health system, situated above the sub-center. It serves as a fundamental healthcare unit offering both curative and preventive health services, particularly focusing on preventive healthcare measures.
• These centers are strategically located in rural areas and are complemented by sub-centers to ensure efficient healthcare coverage. The aim is to have one primary health center for every 30,000 individuals in plain regions and one for every 20,000 in hilly and tribal areas.
• Primary health centers play a crucial role as the primary point of contact for rural health services, usually being the initial stop for medical attention from a qualified doctor in the public sector.
• With 4-6 indoor beds for patients, each primary health center acts as a referral unit for 6 sub-centers, offering both curative and preventive healthcare services.
• In cases where the services at the primary health center are insufficient, patients are further referred to community health centers or higher-level public hospitals for advanced care.

Community Health Centers (CHC)

• Community Health Centers serve as First Referral Units (FRUs) and represent the secondary level of healthcare provision in the system.
• They are intended to offer referral healthcare services for patients coming from primary health centers and for those requiring specialized care who directly approach the center.
• Each Community Health Center oversees four primary health centers, catering to around 120,000 individuals in plain areas and 80,000 in tribal and hilly regions.
• These centers are 30-bedded hospitals providing specialized care in various fields such as surgery, pediatrics, curative medicine, obstetrics, and gynecology.

District Hospitals and Higher Referral Care Units

• District hospitals serve as the primary healthcare facility in a district, offering a range of curative, preventive, and promotive healthcare services to the local population.
• These hospitals play a crucial role in implementing health policies and managing health services within a specified geographic area.

Janani Suraksha Yojana Scheme and Sukhibhava Scheme

• Janani Suraksha Yojana (JSY) and Sukhibhava Scheme are initiatives supported by both the Central and State Governments.
• Launched on November 1, 2005, these schemes aim to provide financial assistance to healthcare facilities like Teaching Hospitals, District Headquarters Hospitals, and others.

Rajiv Aarogyasri Community Health Insurance Scheme

• Aarogyasri is a Community Health Insurance Scheme introduced in Andhra Pradesh in April 2007.
• It offers financial protection to families below the poverty line, covering expenses of up to Rs. 2 lakhs annually for hospitalization and surgeries.
• The scheme includes over 330 medical procedures and operates through selected insurance companies to enhance access to quality healthcare for BPL families.
• Its goal is to ensure that identified diseases requiring hospitalization, surgeries, and therapies are treated effectively through a network of healthcare providers.

Rural Emergency Health Transportation Scheme

• Research conducted in various countries, including India, has consistently highlighted the significant challenge posed by inadequate transportation options in rural regions. This lack of reliable transport infrastructure significantly hampers the access of rural populations, especially women, infants, and children, to essential healthcare services.
• A key focus lies on enhancing the utilization of institutional delivery services and decreasing maternal and infant mortality rates. This can be effectively achieved through the establishment of a dedicated rural ambulance service. Such a service should prioritize the swift transportation of pregnant women to healthcare facilities for safe deliveries and provide urgent assistance to infants and children affected by preventable and treatable conditions.
• Proposed is the implementation of a comprehensive Rural Emergency Health Transportation Scheme, commonly known as the Rural Ambulance Scheme, in all districts of the state, barring those that are already well-developed. The scheme aims to address the pressing healthcare needs of rural communities by ensuring timely and efficient transportation for medical emergencies.