The concept of Primary Health Center (PHC) is not new to India. In 1946, the Bhore Committee proposed PHC as a basic health unit to provide integrated curative and preventive healthcare to the rural population as close to the people as possible, with emphasis on healthcare promotion and prevention.
PHC and its sub-centres (SC) have been viewed by Indian health planners as a suitable infrastructure for providing health services to the rural population. To provide comprehensive health care to the rural population, the Central Health Council in its first meeting in January 1953 recommended the establishment of PHCs in community development blocks. These centers were functioning as external health care facilities with little or no involvement of the community. These centers came under increasing criticism because they could not provide adequate health coverage, partly because they did not have adequate staff, equipment or infrastructure.
One PHC for every 30,000 rural people in the plains and one PHC for every 20,000 rural people in hilly, tribal and backward areas was proposed in the 6th Five Year Plan (1983–1988) for better coverage. As of September 2004, a total of 23,109 PHCs had been established across the country.
PHCs are the foundation of rural health services. They act as the first point of contact for sick people in rural areas who report directly or are referred by sub-centres for curative, preventive and promotive health care. It serves as a referral unit for six sub-centres sending patients to community health centers (CHCs, 30-bed hospitals) and higher-ranking public hospitals in sub-district and district hospitals. There are 4-6 patient beds inside.
PHCs are not immune to problems such as unmet expectations because (i) there are no doctors; (ii) ii) Doctors do not reside at the PHC headquarters, even if posted; iii) inadequate physical facilities and infrastructure; iv) medicines in inadequate quantities; v) Lack of public accountability and community participation; vi) Among other things, there are no established guidelines to evaluate the quality of care.
One way to describe the level of quality that healthcare organizations are expected to achieve or strive for is through the use of standards. The primary purpose of these standards is to support the provision of high quality services that are equitable, responsive to client needs, provided equitably, and contribute to improvements in population health and well-being. Continuous quality advancement is primarily driven by standards. Established standards can be used to evaluate the performance of healthcare delivery organizations. The National Rural Health Mission (NRHM) provided an opportunity to health centers in rural areas to set the Indian Public Health Standards (IPHS).
The Bureau of Indian Standards (BIS) has established guidelines for a thirty-bed hospital. Indian public health standards have recently been established for community health centers under the NRHM, as the BIS is currently considered highly resource-intensive. Primary health care facilities, on the other hand, are not required to meet these standards. A set of guidelines called Indian Public Health Standards (IPHS) are being suggested for primary health centers to provide the highest possible level of health care.
PHCs are referred to in different ways depending on the state. There are block-level PHCs (located at block headquarters and serving about 100,000 people with varying numbers of indoor beds) and additional PHCs/new PHCs (serving 20,000-30,000 people, etc.). Since all block-level PHCs will eventually be upgraded to 30-bed community health centers to provide specialized services, there is a need for a six-bed PHC as per the standards outlined in this document to serve a population of 20,000 to 30,000 . Setting standards is a powerful interaction. The IPHS for Primary Health Centers has been developed keeping in mind the available resources, which inter alia includes minimum standards for building personnel, equipment, instruments, medicines and other facilities.
