On this day we visited a primary health center.  We were given a lesson in the public health system in India that was so intense I felt my hand starting to cramp from writing so much and so fast.  I loved learning about their system, despite the hand cramping, because I am very interested in working in public health when I graduate.  India's public health system compared to the US system is very different but also follows some similar methodology. The woman speaking to us was a nurse studying for public health masters at this facility. She explained the key points of public health.  First off, the key services included access to care, preventative services, treatment services, health promotion/ education, and rehab services. She then gave us a definition of universal health care and the 3 A's of care which included the following:

" Full participation at a cost the community can afford to maintain every stage of self determination and self reliance (aka the community can maintain health services without health worker assistance). "

3 A's: availability, access ( location and time) and affordability

As her education continued, I started to see differences between our systems.  The first difference (and biggest) is that these public health workers are faced with the challenge of maintaining the health of a massive amount of people with very limited resources.  It is amazing how much can be done with very little. This specific center cared for about 30,000 people in the urban communities and about 20,000 people in rural communities.  Rural community care has a unique concept known as ASHA's ( which stands for Accredited Social Health Activist) .  The ASHA is a local resident of the community and is trained with basic first aide skills.  There is one ASHA for every 1,000 people.  The ASHA is responsible for reporting these 1,000 people's health issues and acts as a voice for the health concerns for their specific community.  This idea is wonderful I think, because it really pinpoints community issues and allows the care given to be as effective and efficient as possible.

A summary of Public Health in India:

 ELEMENTS of Public Health

Education (Health)

Locally endemic disease (present and often diseases)

E Immunizations (curve ball here as this item doesn't start with E)

Maternal/ child care

Essential drug supplement

Nutrition (Anganwavi- functions similar to a daycare)

Treatments (minor aliments)

Safe water and sanitation

Principles of Public Health (Kerala, India)

1. Equal/ equitable care and distribution

2. Intersectional coordination (multiple sectors working in union)

3. Community participation

4. Universal accessibility

Day Block Concept: Health workers (grassroots workers) are assigned an area they are supposed to cover within 20 days and assess all elements of the community including pregnant women, working toilets, super ill people, presence of TB/leprosy/HIV, etc.  Each house in the community will get two visits from these workers in 40 days.