EDITORIALS FROM 23rd Sep 2025
EDITORIAL 01
The growing relevance of traditional medicine
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EDITORIAL 02
PHC doctors — a case where the caregivers need care
Issue: Primary Health Centres (PHCs) form the backbone of India’s public health system, envisaged since the Bhore Committee Report (1946).
For millions in rural and tribal India, PHC doctors are not just physicians but also planners, coordinators, and community leaders.
Yet, this critical cadre faces unprecedented clinical, administrative, and emotional burdens, raising concerns about sustainability and the future of Universal Health Coverage (SDG-3.8).
What are the Role of PHC Doctors?
- Population coverage: up ro 30,000 people (20,000 in hilly/tribal areas; 50,000 in urban areas).
- Functions beyond clinical care:
- Disease surveillance and outbreak response.
- Immunisation campaigns & school health programmes (RBSK).
- Health education, gram sabhas, intersectoral meetings.
- Mentoring ASHA, ANM, Anganwadi workers.
- They embody the principles of primary care: equitable access, community participation, intersectoral coordination, and appropriate technology.
What are the concerns?
- On average, 100 outpatients per day, plus antenatal OPD for up ro 100 pregnant women in remote centres lacking BEmONC/CEmONC facilities.
- Expected to cover the entire medical spectrum — from neonatal care to geriatrics, infectious diseases to mental health, emergency trauma to chronic care.
- Must keep pace with national treatment guidelines and rapid updates in medical knowledge.
- Clinical consultations often reduced to “time-pressed encounters”, risking quality of care and empathy.
Administrative Overload and Burnout
- PHCs maintain 100+ paper registers (OPD, MCH, NCDs, drugs, sanitation).
- Parallel digital entry required into IHIP, HMIS, Ayushman Bharat Portal, IDSP, UWIN, PHR.
- Duplication of data → double workload; many doctors work late nights on documentation.
- Burnout:
- Recognised by WHO (ICD-11) as an occupational phenomenon.
- The Lancet calls physician burnout a global public health crisis.
- In LMICs, nearly one-third of primary care physicians report emotional exhaustion (WHO Bulletin meta-analysis).
- Saudi Arabia study: administrative overload a major cause.
- In India, the problem is invisible yet pervasive, even in high-performing states like Tamil Nadu, where NQAS-certified PHCs face the same systemic stressors.
Global Lessons and Rethinking the System
- Global reform initiatives:
- 25 by 5 Campaign (US National Library of Medicine + Columbia University): aims to reduce clinician documentation time by 75% by 2025.
- India’s reforms must include:
- Redesign of PHC systems with empathy and facilitation, not compliance.
- Eliminating redundant registers; streamlining digital platforms.
- Automating non-clinical tasks, delegating admin work to trained staff.
- Continuous capacity-building and protected learning time for PHC doctors.
- Recognition of physician well-being as a public health priority.
What are its benefits for India’s Health System?
- PHCs are the gateway to Universal Health Coverage (UHC).
- Without strong PHCs, SDG-3 (Good Health and Well-being) remains aspirational.
- PHC doctors are the bridge between policy intent and last-mile delivery.
- Investing in their well-being, recognition, and systemic support is not optional — it is foundational to India’s Ayushman Bharat vision.
PHC doctors are the unsung custodians of India’s health system. They ensure that constitutional commitments to equity, inclusivity, and access are translated into reality in the remotest corners.
Yet, their contributions remain under-recognised, and their burdens unacknowledged.
Reimagining PHCs requires human-centric reforms: valuing not only what doctors deliver but also what they endure. If India is to achieve Ayushman Bharat and UHC, it must invest first in those who deliver care at the grassroots — its PHC doctors.
EDITORIAL 03
India US corn trade: Why does India not import corn from the US?
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EDITORIAL 04
Too loud to ignore: Why Indians should care about noise pollution in cities