Family and Child Welfare

Family and Child Welfare 3 (3+0)

Lesson 22 : Programmes for Women

Access to Health Services

The broad objectives of the health programmes have been to provide both curative and preventive health services in rural areas through the Primary Health Centres and to train medical and para-medical personnel. The Fifth Plan, while realizing the shortfalls and inadequacy of staff, medical supplies and equipment and trained personnel, envisages an integrated programme of family planning and maternity and Child Health Services. The lowest unit of the Health Services structure is the P.H.C. The Bhore Committee (1946) had recommended that each centre should cater to a population of 40,000, with a 30-bed hospital, two medical officers, four mid-wives, and four trained 'dais' as the 'irreducible minimum.' The Mudaliar Committee (1964), while reiterating these recommendations, suggested the additional provision of three specialists in medicine, surgery, obstetrics, and gynecology and 75 maternity and 50 paediatric beds for each district hospital. When PHCs were established they had to serve a population of 60,000-70,000. From the begining, family planning services were initiated with one medical officer, one extension doctor, one ANM and two family workers to supervise four sub-centres. Each sub-centre was expected to cater to a population of approximately ten thousand.

Emphasizing the need to improve maternity and child welfare services, this committee recommended the provision of domiciliary maternity services. The present pattern of health services puts more emphasis on curative services on which the expenditure is three times more than on preventive services, and most of it is urban ­centered. The impact of these services has not been uniform because factors such as education, employment, and cultural norms are important variables influencing the utilization of these services.