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. 2020 Dec 31;9(12):5872–5880. doi: 10.4103/jfmpc.jfmpc_1574_20

Box 1.

Approach to health service delivery in select countries[21,22,23,24]

Brazil: Community-based healthcare network, Family Health Clinics. PHC services delivered through a network of 38,000 family healthcare team, 275,00 Community health workers, which covers two third of the population. Family health team comprises of one doctor, one nurse, 1-2 ANM and 4- 6 community health workers for every 1,000 households or 4,000 to 5,000 people.
China: Primary healthcare services delivered through 37,000 township health centres and 639,000 village health clinics. There are multiple types of doctors with full training to village doctors who are authorised to prescribe limited number of medicines and can serve in village only. Traditional Chinese medicine care is widely provided along with allopathic medical care.
The Cost Rica: Delivers primary health services through EBAIS clinics health networks across the country. The entire country is divided into Health Areas and Each health area has five and fifteen EBAIS teams, each covering approx. 6,000 population. These doctors and nurses provide, technical assistant medical data clerk and pharmacist.
Cuba: Considered to have one of the most effective primary healthcare systems. Primary care delivered through community-based polyclinics & family doctor-and-nurse offices. Each polyclinic serves 30,000 to 60,000 people, supplemented by neighbourhood-based doctors and nurses office, one for every 1,000-2,000 people. The doctor or nurse offices ensure care closer to the communities.
India: There is an extensive network of primary healthcare system in rural India, which has nearly 2/3 of total population. There is one urban PHC proposed for every 50,000 population; For a population of nearly 370 million, there are only 5,600 UPHC in early 2020. There were nearly 26,000 Primary healthcare centres in rural India, which is five times more than urban setting; though rural population is just double of urban population. There is a health sub-centre staffed by multi-purpose workers and auxiliary nurse midwife in rural area for every 3,000 to 5,000 population. The Govt of India has announced a new program by the name of health and wellness centres to upgrade the existing government primary healthcare facilities.
Kazakhstan: Primary healthcare services are delivered at the level of Uchstok -locality if around 4,000 people, through Feldsher accousherski punkt or Feldsher-midwife post. Each of the posts has provision of 2-3 physicians. There is an increasing focus in the country on preventive health services and inclusion of general physician in health services.
Sweden: Primary Care Clinics mostly run by the county councils. Each clinic has a team of 4-6 General Practitioners; Nurses; Physiotherapists, occupational therapists, psychologists, and Social welfare counsellors. Average population catered by each clinic is 4,000-6,000.
Thailand: Primary healthcare services through district health system with typical district’s catchment population of around 50,000 served by a district hospital and 10-15 subdistrict health centres, each with 3-5 paramedical staff. Primary Care Units: For every 10,000-15,000 registered beneficiaries. Contracted (district) hospitals to set up one primary care units for every 10,000-15,000; the “contracting unit for primary care” or CUP.
United Kingdom: The Primary care run by General Physicians (GPs) forms the bedrock of National Health services (NHS). Primary medical care provided by general practitioners (GPs), free (or with small co-payment). GPs work in group of 4-6 and people get registered with them. People have to be mandatorily seen by GPs or Primary care system, before they can access secondary level of facilities. On average, one GP and related services are available for every 2,000 to 3,000 people.
Venezuela: Primary healthcare services are delivered through: popular medical dispensaries, consultation points (in family homes), dental clinics and optical centres, for every 5,000- 7,000 population. The number of popular medical dispensaries has increased from 5,360 in 1998 to total 13,731 in 2012.
Vietnam: Primary healthcare is delivered through 11,400 commune health centres, each serving an average of 5,000 people, located in an area. The district health centres (CHC) serves as first point of referral. Each of Commune Health centres operates three days per week and employ full time traditional medicine specialist, a village health worker, one population/family planning officer, one pharmacist and one midwife. Benchmark is minimum of five staff per CHC with maximum ten depending upon population density and coverage area.