Health care delivery - Revisiting the concept of area wide planning with application to Guntur District of Andhra Pradesh

Abstract

For many marginalised families, availability of healthcare is uncertain leading to catastrophic costs. To meet the need in an orderly and efficient manner without duplication, Areawide / Regional planning was envisioned by health planners in the 1950s. This paper aims to revisit the above concept in healthcare with application to the existing system of Guntur district. A search was made for available health facilities and bed strength in the public sector of the district. An effort is made to apply the arewide planning concept to the district in strategic locations. The recent pandemic has shown the need for preparedness across the district in terms of bed strength, equipment and personnel. The urban population of the district is 33.8% (1.5 beds/1000 ) and the rural population is 66.19% (0.5/1000). Areawide planning envisages Mandal, Division and District level hospitals. The PHCs at the mandal level can be upgraded to have Maternal and Child health units and ICUs with the necessary specialists and equipment in place. The division level hospital must have all primary specialities with consultative support to the lower facilities. The District level hospital must have all the super specialities and provide referral services.Regionalisation also looks at creating one special care unit like burns, mental health, cancer etc at each strategically located hospital. Areawide planning will improve efficiency and economy in health care delivery. Gaps in healthcare and wastage due to overlapping can be avoided.