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![II. Mortality profile
• Death rate has steadily declined from 21 (1961) to
7.5 (2004)
• The life expectancy:65.3 years (2001-02)
[Developed countries between 76-80 years]
• IMR: 58 (2004)
[54 global average and 5 in developed
countries]
• Wide variation in death rate between rural and
urban areas and between states](https://image.slidesharecdn.com/healthcaredeliverysystem-bpt-sanjay-241208225726-d815dd39/75/Health-care-delivery-system-bpt-sanjay-pptx-18-2048.jpg)
Health care delivery system-bpt- sanjay.pptx
- 1. Health care deliverysystem
- 2. 2 Health care “Health care”includes a multitude of “services rendered to individuals, families or communities by the agents of the health services or professions, for the purpose of promoting, maintaining, monitoring or restoring health”
- 3. 3 What is ahealth system? - It is the sum total of all the organizations, institutions & resources whose primary purpose is to improve health. - A health system needs staff, funds, information, supplies, transport, communications & overall guidance & direction.
- 4. 4 Levels of healthcare • Health services are usually organized at three levels: • (i) Primary care level • (ii) Secondary (intermediate) care level • (iii) Tertiary care level • Each level supported by a higher level to which the patient is referred • These levels represent different types of care involving varying degrees of complexity
- 5. 5 (i) Primary carelevel • First level of contact of individuals, family & community with the health system where “essential” health care (primary health care) is provided. • This level of care is closest to the people • At this level: -majority of prevailing health problems can be satisfactorily dealt with -health care will be most effective within the context of area’s needs & limitation .
- 6. 6 Primary care level(cont) Primary health centres & subcentres through multipurpose health workers, village health guides and trained dais provide primary health care
- 7. 7 (ii) Secondary carelevel • The next higher level of care where more complex problems are dealt with • Essentially comprises curative services • Generally provided in district hospitals and community health centres • Serves as the first referral level in the health system
- 8. 8 (iii) Tertiary carelevel • Offers super- specialist care • Supports & complements the actions carried out at the primary level • Provides planning and managerial skills & teaching for specialized staff • Medical College Hospitals, All India Institutes, Regional Hospitals, Specialized Hospitals & other apex institutions provide this care
- 9. 9 Referral system • Afundamental & necessary function of health care system • Referral must be a two way exchange of information & returning patients to those who referred them for follow-up care • Ensures continuity of care & inspire confidence of the consumer in the system
- 10.
- 11. Health care delivery •The principal objective of a health system is to improve people's health and the chief function the system needs to perform is to deliver health services • Service provision refers to the way inputs (such as money, staff, equipment and drugs) are combined to allow the delivery of a series of health interventions
- 12. Health care delivery •Improving and scaling up service delivery depends on -having key resources -how those resources are organized and managed • Lack of managerial capacity at all levels of the health system is a binding constraint to scaling up services and achieving the Millennium Development Goals
- 13. • Health servicesinclude (i) personal health services - preventive, diagnostic, therapeutic or rehabilitative (ii) non-personal services - mass health education, legislation and the provision of basic sanitation facilities
- 15. Community diagnosis “identification andquantification of problems in a community in terms of morbidity and mortality rates and ratios, and detection of their correlates for purpose of defining those at risk or those in need of health care”
- 16. Community diagnosis An assessmentof the health status and health problems is the first requisite for any planned effort to develop health care services. The health status of the population (HSP) is reflected in health indicators in a community over a specific time period
- 17. I. Demographic profile Theimportant characteristics of the demographic profile of India are: (a) a large population base (b) high fertility (c) low or declining mortality (d) “young” population (about 35.35% of the population) is below the age of 15 years. (e) the proportion of illiterate population is close to 34.62%. (f) dependency ratio of 62 per 100
- 18. II. Mortality profile •Death rate has steadily declined from 21 (1961) to 7.5 (2004) • The life expectancy:65.3 years (2001-02) [Developed countries between 76-80 years] • IMR: 58 (2004) [54 global average and 5 in developed countries] • Wide variation in death rate between rural and urban areas and between states
- 19. Health problems • Communicabledisease problems • Nutritional problems • Environmental sanitation problems • Medical care problems • Population problems
- 20. Resources An assessment ofthe available resources, their proper allocation and efficient utilization are important considerations for providing efficient health care services. The basic resources for providing health care are: • (I) Health Manpower • (ii) Money and Material • (iii) Time
- 21. Suggested norms forhealth personnel Category of personnel Norms suggested Doctors 1 per 3500 population Nurses 1 per 5000 population Health worker (female and male) 1 per 5000 population (plain area) 3000 (tribal and hilly area) Trained dai 1 for each village Health assistant (female and male) 1 per 30,000 population (plain area) 20,000 (tribal and hilly area) Health assistant (female and male) supervises 6 health workers (male and female) Pharmacists 1 per 10,000 population
- 22. Money and material •To achieve health for all, WHO has set as a goal the expenditure of 5 percent of each country’s GNP on health care • India is spending about 3 percent of GNP on health and family welfare development
- 23. Time • Administrative delaysin sanctioning health projects imply loss of time • Promotion of better utilization of the time resource by different personnel is very important to meet the health needs of the community
- 24. Health care systems 1.PUBLIC HEALTH SECTOR 2. PRIVATE SECTOR 3. INDIGENOUS SYSTEMS OF MEDICINE 4. VOLUNTARY HEALTH AGENCIES 5. NATIONAL HEALTH PROGRAMMES
- 25. 1. PUBLIC HEALTHSECTOR (a) Primary Health Care Primary health centres Subcentres (b) Hospitals/Health centres Community health centres Rural hospitals District hospital/health centre Specialist hospitals Teaching hospitals (c) Health Insurance Schemes Employees State Insurance Central Govt. Health Scheme (d) Other Agencies Defence services Railways
- 26. 2. PRIVATE SECTOR (a)Private hospitals, polyclinics, Nursing homes and dispensaries (b) General practitioners and clinics
- 27. 3. INDIGENOUS SYSTEMSOF MEDICINE • Ayurveda and Siddha • Unani and Tibbi • Homeopathy • Unregistered practitioners
- 28. 4. VOLUNTARY HEALTHAGENCIES
- 29.