Advanced Nursing Practice

 As it is well known that the over whelming majority of

India’s population live in the rural area and a segment
of the population have been given in adequate attention
so far as health and medical care facilities are
concerned.

 With the Alma Ata declaration of “ health for all” by

2000 AD primary health care become the states of
India’s are developing their health care services system
 Health care delivery system concern is to develop the
system which ensures based comprehensive health care
services to people at large especially those living in
e\remote and backward areas using available resources
( man power, money, material ) as effectively as
possible.
 1.Central
 2. State
 3. Local or peripheral
 At the center
 The official “ organs” of the health system at the
national level consist of Ministry of health and family
welfare.
 The directorate general of health services.
 The central council of health and family welfare.
 a. Ministry of health and family welfare-
The ministry of health and family welfare is headed by a
cabinet minister, a minister of state and deputy health
minister. These are political appointments currently the
union health minister has the following departments:
Functions:-
Union list-
 1. International health relations and administration of
port quarantine
 2.Promotion of research through research centers.

 3. Regulation and development of medical,

pharmaceutical, dental and nursing profession.

 4. Establishment and maintenance of drug standards.

 5. Census and collection and publication of other

statistical data.
are the responsibility of both the union and state governments.
 1. Prevention and extension of communicable diseases.

 2. Prevention of adulteration of food stuffs.

 3. Control of drugs and poisons4. Vital statistics.

 5. Labour welfare.

 6. Ports other than major.

 7. Economic and social planning.

 The director general of health
services is the principle advisor to
the union govt. in the both medical
and public health matters he is
assisted by a team of deputies and a
large administrative staff.
Functions:-
 The general functions are survey, planning,
coordination, programming and appraisal of the health
matters in the country.
 International health relations and
 quarantine of all major ports in country and
international air port ( Kolkata, Visakhapatnam,
Chennai, Mumbai) are delivery controlled by the
directorate general of health services.
 2. Maintain medical store depots

 3 Administration of post graduate

 4.Administration certain medical colleges in

 5.Conducting Medical Research

 Central Government Health Scheme

 7. Implementation of National health

 The central council of health was set up by a
presidential order on 9 August 1952 under article 263
of the constitution of India for promoting coordinated
and concerted action between the centre and the states
in the implementation of all the programmes and
measures pertaining to the health of the nation. The
union health minister is the chairman and the state
health ministers are the members.
 1. To consider and recommend board outlines of policy in
regards to matters concerning health in all its aspects such
as the provision of remedial and preventive care,
environmental hygiene, nutrition, health education and
the promotion of facilities for training and research.

 2. To make proposals for legislation in fields of activity

relating to medical and public health matters and to lay
down the pattern of development for the country as a
whole.
 1. State ministry of health
 2. state health directorate

 The health subjects are divided in to three groups : Federal,

concurrent and state.
 The state list is the responsibility of the state including
provision of medical care preventive health services and
pilgrimage with in the state.
 At present there are 28 states in India each state having its
own health administration.
 1. Formulation review and modification of board
policy outlines.
 2. Execution of policies programmes etc
 3. Coordination with govt. of India and other state
governments.
 4. Control for smooth and efficient functioning of
administrative machinery.
 1. The Directorate of health services or the
director of medical and health services.
 2. The Directorate of health and family welfare.
 3. Directorate of medical educationfor the
management of medical colleges and hospitals.
 The directorate of public health services
 The principle unit\t of administration in India is the
district under a collector. There are 593 ( year 2001)
district in India. With in each district there are 6 types
of administrative areas.
 1. Sub division
 2. Tehsil (taluka)
 3. Community development blocks.
 4. Municipalities and corporations.
 5. Villages.
 6. Panchayats.

 The panchayat raj is a 3- tier structure of rural local self
government in India, linking the village to the District
 1. Panchayat – at the village level
 2. Panchayat samiti – at the block level
 3. Zilla parishad- at the District level

 The panchayat raj at the village level
 The gram sabha, The gram panchayat,
 The nayaya panchayat
The panchayat samiti consist of all sarpanchas (heads) of
the village Panchayats in the block; MLAs, MPs residing
in the block area; representatives’ of women, scheduled
tribes and cooperative societies. The block development
officer (BDO) is the ex – officio secretary of the
panchayat samiti.
 The prime function of the panchayat samiti is the
execution of the community development programme
in the block. The block development officer and his
panchayat engaged in development work.
 The Zilla parishad / Zilla panchayat is the agency of
rural level local – self- government at the district level.
 The members of the Zilla parishad include all heads of
the panchayat samitis in the district; MPs, MLAs of the
district; representatives of scheduled castes, schedule
tribes and women; and 2 person of experience in
administration, public life or rural development.
 The Zilla parishad is primarily supervisory and
coordinating body. Its functions and powers vary from
state to state.
 In India it is represented by five major sectors or
agencies which differ from each other by health
technology applied and by the source of fund available.
These are:
 1) Public Health Sector
 2) Private Sector
 3) Indigenous system of Medicine
 4) Voluntary Health Agencies
 5) National Health Program’s
 i. Primary Health Care
 I.Village Level One of the basic tenets of this is
universal coverage and equitable distribution of health
resources.
a)Village Health Guides
 B). Training of Local Dais
 C) ICDS scheme (Anganwadi Workers)

 . 1 subcentre‐5000 population in general but in hilly,
tribal and backward areas 1 ‐3000 population.
 •Two functionaries at this level ‐Health worker male
and health worker female (multipurpose worker).6‐8
month in service training and orientation by PHCs
medical officer. Form a link between health guide and
PHC & responsible for all health services and programs
in that area work under the supervision of health
assistant
 Community health centres.
 Rural health centres.
 District hospitals/health centre.
 Specialist hospitals.
 Teaching hospitals.
 iii.Health Insurance Schemes -
 Employees State Insurance.
 Central Govt. Health Scheme.
 iv.Other Agencies -
 Defence services.& Railways

 2) Private Sector
 A. Private hospitals, polyclinics, nursing homes and
dispensaries.
 B. General practitioners and clinics.

 3) Indigenous system of Medicine

 Ayurveda ,Sidda ,Unani ,Homeopathy

 Naturopathy, Yoga, Unregistered practioner.
 4) Voluntary Health Agencies
 1.Indian Red Cross Society
 2.Hind Kusht nivaran sangh
 3.Indian council for child welfare
 4.Tuberculosis association of India
 5.Bharat sevak samaj
 6.Central social welfare board
 7.The kasturba memorial fund

1.Anti‐malaria program
 2.National filaria control program
 3.Kala‐azar control program
 4.Japanese encephalitis control
 5.Dengue control
 6.National Leprosy‐eradication program
 7.National tuberculosis program
 8.National AIDS control program
 9.National program for control of blindness
 10.Iodine deficiency program
Summery-
 In todays class we discussed about health care delivery
system, meaning and definition, determinant and
component of health care delivery system, levels of
health care delivery system and sectors of health care
delivery system etc.
Conclusion-
 After the end of this lesson plan the group will be able
to understand regarding health care delivery system, its
determinant and component, levels and various sectors
of health care delivery system etc.
 B.T.Basavanthappa’s “community health nursing”,
Jaypee brothers, 2nd edition, pp752-753
 Stanhope Lancaster, “ Community health nursing”
Mosby publications, 18th edition, pp 791-792
 Park .K, “ Preventive and social medicine”, Bhanot
publishers, 18th edition, pp325-326.

 http://en.wikipedia.org/wiki/ emergency management

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