According to the Bhore Committee (1946) and subsequent Indian health policy, which level of health facility is responsible for providing basic curative care, maternal and child health services, and disease surveillance at the grassroots level?

Explanation

## Primary Health Centre (PHC): The Cornerstone of India's Rural Health System **Key Point:** The Primary Health Centre (PHC) is the **first contact point between the community and a qualified medical officer**, responsible for providing basic curative care, maternal and child health (MCH) services, and disease surveillance at the grassroots level. ### Three-Tier Health System in India | Level | Facility | Population Served | Key Functions | |-------|----------|-------------------|---------------| | **Tertiary** | District Hospital / Medical College | 10 lakh+ | Specialized care, referral, training | | **Secondary** | Community Health Centre (CHC) | 80,000–1,20,000 | Referral, specialist care, emergency services | | **Primary** | **PHC** | **20,000–30,000 (plains); 3,000–5,000 (hilly/tribal)** | **Basic curative, preventive, MCH, immunization, disease surveillance** | | **Sub-peripheral** | Sub-centre (SC) | 1,000–3,000 | ANM-led outreach, antenatal care, immunization support | **High-Yield:** The PHC is staffed by: - 1 Medical Officer (MBBS) — the key differentiator from the Sub-centre - Health Assistants, ANMs, Pharmacist, Lab Technician - Provides **OPD curative care, MCH services, family planning, immunization, and disease surveillance** **Clinical Pearl:** The Bhore Committee (1943) laid the conceptual foundation for a comprehensive primary health care network in India. The PHC as an institution was formally established following the recommendations of the Health Survey and Development Committee. The PHC serves as the **nodal unit** integrating preventive, promotive, and curative services — making it the true "grassroots" facility with a qualified doctor. The Sub-centre, by contrast, is staffed only by paramedical personnel (ANM/Male Health Worker) and does NOT have a doctor. **Why Sub-centre (B) is incorrect:** The Sub-centre is a peripheral outpost staffed by an ANM; it does NOT independently provide "basic curative care" in the full sense — it refers cases requiring a doctor to the PHC. The stem's combination of curative care + MCH + disease surveillance under a single facility with medical oversight points to the PHC. **Mnemonic:** **SC → PHC → CHC → DH** — ascending complexity, population coverage, and level of medical expertise. ### PHC Core Responsibilities (as per Indian Health Policy) 1. Outpatient curative care (OPD) by a Medical Officer 2. Maternal and child health services including antenatal, intranatal, and postnatal care 3. Family planning services 4. Immunization and vaccination programs 5. Disease surveillance and outbreak reporting to district authorities 6. Health education and sanitation promotion 7. Referral linkage to CHC/District Hospital *(Reference: Park's Textbook of Preventive and Social Medicine, 27th ed.; National Health Mission guidelines)*