UPSC Mains 2018 GS Paper 2 Q7: model answer
Appropriate local community-level healthcare intervention is a prerequisite to achieve ‘Health for All’ in India. Explain.
What the question wants
Explain why suitable community-level health interventions are essential to achieve health for all in India.
How to structure it
Explain: why community-level, what works, what to do.
- Alma-Ata
- Why the community
- Examples
- Measures
How to think it through
The Alma-Ata Declaration of 1978 called for 'Health for All by 2000' through primary health care. In India, the ASHA and Mitanin experiences show that a woman from the village does what a distant doctor cannot.
Model answer
The Alma-Ata Declaration (1978) promised 'Health for All by 2000' through primary health care rooted in communities. India missed the deadline, but its biggest gains since, from polio to institutional births, have come from exactly that route. The doctor matters; the trusted neighbour who brings the patient to the doctor matters more.
Why the community level matters
- Most illness is preventable: diarrhoea, anaemia, TB and hypertension need early detection and simple care.
- Villages are far from hospitals; the first contact must be close.
- Behaviour change in hygiene, nutrition and breastfeeding needs trusted local people.
Examples
- ASHAs (about 10 lakh) raised institutional deliveries and immunisation.
- Chhattisgarh's Mitanins inspired the ASHA model.
- Kerala's local bodies ran Covid control through ward committees.
- Ayushman Arogya Mandirs screen for diabetes, hypertension and cancers.
Measures
- Fair pay for ASHAs.
- Village health and sanitation committees with funds.
- Community-based monitoring.
- Link community care to referral hospitals and ambulances (108 services).
- Use local data to target hotspots of TB, anaemia and malnutrition.
Health for all begins in the village, not in the hospital, and it is built by people the community already trusts.
Draw: An inverted pyramid: community care (widest), PHC, CHC, district hospital (narrowest).
Keywords, cases and data to drop in
Alma-Ata 1978, primary health care, ASHA, Mitanin, VHSNC, community-based monitoring, Ayushman Arogya Mandirs, Kerala ward committees.
Where most answers lose marks
- Writing about hospitals and insurance only.
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Question text as printed in the official UPSC Civil Services (Main) question paper. The model answer is original Battle IAS work; use it to learn structure, not to memorise.
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