Download as PDF, PPTX
Uploaded byRajeswari Muppidi
Health care delivery system in india
The document discusses India's health care system and delivery models at primary level. It begins by defining health care and outlining India's constitutional mandate to improve public health. It then describes the primary health care model comprising multiple tiers from village to district levels. Key functions at village level include village health guides, dais/traditional birth attendants, anganwadi workers, and ASHAs. The roles and training of these frontline workers are explained. The document also outlines the national health policy and goals to achieve 'Health for All' through primary healthcare approach.
More Related Content
Similar to Health care delivery system in india
Health care delivery system in india
- 2. • Health careis an expression of concern for fellow human beings. • It is defined as a “multitude of services rendered to individuals, families of communities by the agents of the health services or professions for the purpose of promoting, maintaining, monitoring or restoring health”. maintaining, monitoring or restoring health”. • Staffing, organizing, administering and financing such services might be done in every imaginable way, but they all have focus on the ultimate, ie the people are being served, diagnosed, helped, cured, educated and rehabilitated by health personnel.
- 3. • For mostof the countries around the world, health care completely or largely is taken by government. • Health care includes “medical care.” • Both are different in their operational aspects and hence, not synonymous. • Medical care is one component under the umbrella of the health care system. • The term medical care refers chiefly to those personal services that are provided directly by physicians or rendered as a result of physician’s instruction.
- 4. A health caredelivery system is the totality of services offered by all health disciplines. Traditionally the primary purpose of a health care system had been to offer care to health care system had been to offer care to ill and injured. For this reason the health care system of the past might be more accurately described as illness care system
- 5. • The challengesthat exist today in many countries is to reach the whole population with adequate health care services and to ensure their utilization. • Rising costs in the maintenance of large hospitals and their failure to meet the total health needs of the community have led many countries to seek alternative models of health care led many countries to seek alternative models of health care delivery with a view to provide health care services that are reasonably inexpensive and have the basic essentials required by rural population.
- 6. HEALTH STATUS ANDPROBLEMS IN INDIA • Health care in India features a universal health care system run by the constituent states and territories of India. • The constitution changes every state with raising of the level of nutrition and the standard of living of its people and the improvement of public health as among its primary duties.
- 7. HEALTH STATUS ANDHEALTH PROBLEMS ! " # # $ % ! " # # ! ! & ## ! ' ! ( ! !(# ) * # # $ % #' # + #*
- 8. HEALTH PROBLEMS OFINDIAARE GROUPED UNDER • ! ! !* , !) # ) " # ! !# " !) # # !! # ! ' " !) # # !! # ! ' # !# # +## (# ! ## ) ## !# ) ( ! # # ) # # *
- 9. • " ## $ % • # " # ) ) ! ! $ ) ! # ) + # ) • & $ # • & $ # • , ! !## ! " ! ! # !+' !## !## # % "# ! % # + - # # # # )# )' # ! ! *
- 10. • Environmental sanitationproblems: • Due to population explosion, urbanization and industrialization leading to the hazards to human health in the air, water and food chain. • Medical care problems: • Uneven distribution of doctors, lack of curative and health care • Uneven distribution of doctors, lack of curative and health care services in rural areas, inequitable distribution of available health care resources etc. • Population problems: • Due to over population unemployment, education, housing, health care and sanitation are the major population problems.
- 11. The data requiredfor analysing the health situation and for defining the health problems comprise the following: 1.Morbidity and mortality statistics. • 2.Demographic conditions of the population. 3.Environmental conditions which have a bearing on health. • 4.Socio-economic factors which have a direct effect on health. 5.Cultural background, attitudes, beliefs, and practices which affect health. • 6.Medical and health services available. • 7.Other services available.
- 12. HEALTH CARE SERVICES Thepurpose of health care services is to improve the health improve the health status of the population.
- 13. The goals tobe achieved • Mortality and morbidity reduction • Increase in • Decrease in populatio n growth rate • Resources development • Food production • literacy rate • Increase in expectation of life • Health manpower requirements • Improvem ents in nutritional status • Provision of basic sanitation • literacy rate • Reduced levels of poverty, etc.
- 14. The scope ofhealth services varies widely from country to country and influenced by general and ever changing national, state and local health problems, needs and attitudes as well as the available resources to provide these services. A comprehensive list of health services may be found in the Report of the WHO Expert Committee (1961) on "Planning of Public Health Services" .
- 15. ! # %"! +! !(# ) " ) ! # ( )) # " )) " ! (# ) ! ) #' ! # )# # ( # " ) ) #' ) !' ) ! *
- 16. These are theessential ingredients of primary health care which forms an integral part of the country' s health system, of which it is the central function and main agent for delivering health care .
- 17. HEALTH CARE DELIVERY CONSUMERS PROVIDERSSYSTEM PUBLIC SECTOR Medical officer Nurses Pharmacist Lab technician BEE, ANM, HA 1015 million PRIVATE SECTOR INDIGENOUS SYSTEM OF MEDICINE VOLUNTARY HEALTH AGENCIES NATIONAL HEALTH PROGRAMMES
- 18. ) ! # (!' # ) ! !(# ) ) ! ' . ) ! ' ! ! " ! # ( ! ( # ( ! # ( " # ) !# ( !' # # + + # ! !)
- 19. THE MODEL • TheINPUTS are the health status or health problems of the community, they represent the health needs and health demands of the community. • Since resources are always limited to meet the many health needs, priorities have to be set. • This envisages proper planning so that resources are not wasted.
- 20. • '( )') ! * ! ! # + ) #' ! + ( # " $ % + ! !) * • !(# ) ! (# " ) ! # ( ) #' " * • ! !) " # !# " )) ! # + ) #'*
- 21. • The HEALTHCARE SYSTEM is intended to deliver the health care services, in other words, it constitutes the management sector, and involves organizational matters. • The final outcome or the OUTPUT is the changed health status or improved health status of the community which is expressed in terms of lives saved, death averted, diseases expressed in terms of lives saved, death averted, diseases prevented, cases treated, expectation of life prolonged, etc. • Models such as these are being employed for improving health care services.
- 22. The health caresystem is intended to deliver the health care services. It constitutes the management sector and involves organisational matters. It operates in the context of the socioeconomic and political It operates in the context of the socioeconomic and political framework of the country. In it is represented by five major sector or agencies which from each other by the health technology applied and by the source of funds for operation .
- 23. Health care deliverysystem 1. PUBLIC HEALTH SECTOR a) Primary Health Care Primary health centers Sub centers b) Hospitals/Health centers b) Hospitals/Health centers community health centers Rural hospitals District hospital/health center Specialist hospitals Teaching hospitals
- 24. c) Health insurancesschemes Employees state insurance Central Govt. Health scheme d) Other agencies Defence service Railways Railways 2. PRIVATE SECTOR a) Private hospitals, polyclinics, nursing homes, and dispensaries b) General practitioners and clinics
- 25. 3.INDIGENOUS SYSTEMS OFMEDICINE Ayurveda and siddha Unani and tibbi Homeopathy Unregistered practitioners 4. VOLUNTARY HEALTH AGENCIES 4. VOLUNTARY HEALTH AGENCIES 5. NATIONAL HEALTH PROGRAMMES
- 26. PRIMARY HEALTH CAREIN INDIA In 1977, the Government of India launched a Rural Health the Scheme, based on the principle of "placing people' s health in people' s hands". It is a three tier system of health care delivery in rural areas based on the recommendation of the Shrivastav Committee in 1975. Committee in 1975. Close on the heels of these recommendations an International conference at Alma-Ata in 1978, set the goal of an acceptable level of Health for All the people of the world by the year 2000 through primary health care approach.
- 27. As a Signatoryto the Alma-Ata Declaration, The Government of India is committed to achieving the goal of Health for Al! through primary health care approach Which Of seeks to provide universal comprehensive -health care at cost which is provide universal comprehensive -health care at cost which is affordable. Keeping in view the WHO goal of "Health for All" by 2000 AD, the Government of India evolved a National Health Policy based on primary health care approach.
- 28. It was approvedby Parliament in 1983. The National Health Policy has laid down a plan of action for reorienting and shaping the existing rural Health infrastructure with specific goals to be achieved by 1985, 1990 and 1995 within the framework of the Sixth (1980- 85) and Seventh (1985- 90) Five Year Plans and the new 20 point Programme. 90) Five Year Plans and the new 20 point Programme. Steps are already under way to implement the National Health Policy objectives towards achieving Health for All by the year 2000.
- 29. / 0 One ofthe basic tenants of primary health care is universal coverage and equitable distribution of health services, that is health care must penetrate into the farthest reaches of rural area, and that everyone should have access to it.
- 30. village level thefollowing schemes are in operations: 1 # + + # 2 1 ! # # + ) # 3 1 ! # # + ) # 3 1 ) 4 1 ) 5
- 31. / /6 0 Villagehealth guide is a person with an aptitude for social service and is not a full time government functionary. The village health guides scheme was introduced on 2nd The village health guides scheme was introduced on 2nd October 1977with idea of securing peoples participation in the care of their own health. The scheme was launched in all states except some states like kerala,Karnataka,Tamilnadu,etc..which have alternative systems of providing health services at the village level.
- 32. / # # ! 7 ! !# ) ) #' " ! % !# (# + # # " ! 304 ! ( !' ' ! ) # # # ! ) # 8 ! )) " ) # ) #' ! ( !' ' ! ) #' % !$*
- 33. After selection ,the health guides undergo a short training in primary health centre, sub centre or any other suitable place for the duration of 200 hours, spread over a period of 3 months. During the training period they receive a stipend of Rs. 200 per month. . ) # ! # # + ' ! ) # ( % !$# + . ) # ! # # + ' ! ) # ( % !$# + $# # # )# " +# + ! ! ## ' # )# *
- 34. FUNCTIONS OF VILLAGEHEALTH GUIDE Treatment Of Simple Ailments Mother Activities In First Aid Mother And Child Health Family Planning Sanitation. Health Education
- 35. *. Most deliveries inrural areas are still handled by untrained dais who are often the only people immediately available to women during perinatal period. period. An extensive programme has been undertaken under the rural health scheme to train all categories of local dais in the country to improve their knowledge in the elementary concepts of maternal and child health and sterilization besides obstetric skills
- 36. The training isfor 30 working days. Each Dai is paid a stipend of Rs 300 during her training period. The training is given at the PHC, Sub-centre or MCH centre for 2 days in a week, and on the remaining 4 days they will be accompany the health worker ( female) to the village preferably in the dais own area. During her training each dai is required to conduct at least 2 deliveries under the guidance and supervision of the deliveries under the guidance and supervision of the HW( F),ANM OR HA(F). After successful completion of training, each dai is provided with a delivery kit and a certificate. She is entitled to receive an amount of rs.10 per delivery provided the case is registered with sub-centre/PHC.
- 37. * / 77 . 9 anganliterallymeansacourtyard. Under the ICDS scheme there is an anganwadi worker for a population of 1000. There are about 100 such workers in each ICDS project There are about 100 such workers in each ICDS project The anganwadi worker is selected from the community she is expected to serve. She undergoes training in various aspects of health, nutrition, and child development for 4 months. She is a part time worker and is paid an honorarium of Rs 200- 250 per month for the services rendered.
- 38. SERVICES RENDERED BY ANGANWADIWORKER health education nonformal pre school education health check up immunization supplement ary nutrition, education education !! !(#) *
- 39. * 0: . ; :- ASHAmust be the resident of village a women preferably in the age group of 25- 45 years with formal education upto eighth class having communication skills and leadership qualities. communication skills and leadership qualities. Adequate representation from the disadvantaged population group should be ensured to serve such groups better. the general norm of selection will be one ASHA for 1000 population.
- 40. . . .< 0 ASHA will take steps to create awareness and provide nutrition, basic sanitation and hygiene practices, healthy living and She will counsel women on birth preparedness provide information to the community on determinants of health healthy living and working conditions, information on existing health services and the need for timely utilization of health and family welfare services preparedness importance of safe delivery, breastfeeding and complementary feeding.etc..
- 41. ASHA will mobilizecommunity and facilitate them in accessing health and health related services available., at the anganwai/subcenter/primary health centres •immunization •antenatal check-up 2 3 3 •Postnatal check up •supplementary nutrition 4 5 •sanitation •other services provided by the government = 8
- 42. She will arrangeescort/accompany pregnant women and children requiring treatment/admission to the nearest pre identified health facility ie primary health center/community health center/first referral unit. ASHA will provide primary medical care for minor ailments such as Diarrhoea, fevers, and first aid for minor injuries. She will be a provider of directly observed treatment short course (DOTS)under revised National Tuberculosis Control programme. She will also act as depot holder for essential provisions being made available to every habitation like oral rehydration therapy.iron folic acid tablet,oral pills,condoms etc.
- 43. . / .7 / 7 :- On health day the women ,adolescent girls and children from village will be mobilized for orientation on health related issues such as importance of nutritious food. personal hygiene, care during pregnancy, importance of antenatal check up and institutional delivery, home remedies, for minor ailment and importance of immunization Anganwadi and ANM’s will act as resource persons for training of ASHA Anganwadi workers will inform ANM to participate and guide organizing the health days at anganwadi center Anganwadi worker will update the list of eligible couple and also the children less than one year of age in the village with the help of ASHA.
- 44. . / .7 ANM will guide ASHA in performing following activities. Anganwadi and ANM’s will act as resource person for training ASHA She will hold weekly/fortnightly meeting with ASHA and discuss activities undertaken during week/fortnight She will guide her in case ASHA had encountered any She will guide her in case ASHA had encountered any problem during the performance of her activity. ANM will guide ASHA in motivating pregnant women for taking full course of IFA tablets and TT injections etc.. •ANM will participate and guide in organizing health days at anganwadi center. ANM’s will orient ASHA on the dose schedule and side effects of oral pill •ANM will participate and guide in organizing health days at anganwadi center. % # ) + ! #+ ! + )' " ! ) # ' # # ' " #)# !' # + # + ! ! ! *
- 45. 6 It is theperipheral outpost of the existing health care delivery system in rural areas . They are being established on the basis of one sub center for every 5000 population in general and one for every 3000 population in hilly, tribal and backward areas . As of march 2015 , 153,655 sub-centres were established in the country.
- 46. • A sub– centre provides interface with the community at the grass –root level, providing all the primary health care services. • One LHV and one health assistant ( male ) located at PHC are entrusted with the task of supervision of six sub –centre' s.
- 47. !(#) ! (#") ! ! ) # < # ' # + ) ! ) # # + ) ) ! # ) 7 ! & # ' # !# + ! # # #
- 48. <# (# # #' ! #( !(#) ! # ! # ! # # + > ) # ' ! # # + > ) # ' ( ! 0 ! # !(#) + % # % !$ ! (# + # # ) #
- 49. 1 !( #) " ' " ! # )! # ) # !! > ' !' ( ! ' "! $ # 1 7 $ ' " # # ! ! # !( # ) 1 7 $ ' " # # ! ! 1 #) " # ! +! 1 ?) #) " # ! +! # ! +!
- 50. 1 ! #) ' ( # " #) !" 1 ) ! (# ( # ) # + "#! 1 ! # # # !# + 7 7 (# + # # !# # ) # # # !# # ) # 1 . ! ) # !(#) 1 # + !# # ' ) "! # ) # * 1 !( ' 1 (# #
- 51. !# !' )! ( • ) ) !# !' ) ! # % # * • " ! ) # # 2@58 + ( ) ) !# !' ) ! " #) # ! (# ) #" # +! ) ! #( ! ( #( ) ! ! ! # % # # ! ( #( ! #( ) ) ! *
- 52. • ) !) )# # #! # + # A !' 2@=4 ! ) " # !# !' ) ! B # ) # ' ( " )$ ! (# ) ! #( ) ! ! ! # * ! (# ) ! #( ) ! ! ! # * • " ! !# !' ) ! B " # # ) # )! ! C3= !# + #! #( ' ! =5D5 "' # #( ' ! : 2@C=0 2@DE;
- 53. • ) !# ? ) ! ) # 2@CD # + + ! "' 3EEE ! # % # ' & # ' % ! ) !# !' ) ! ! ) * • # : 2@D4; ! ! !+ #F # !# !' ) ! B " # ! ( !' 4E EEE ! ! # # # ! ( !' 3E EEE ! ! # # # ! ( !' 3E EEE # # # ' !#" " )$% ! ! ! ! ) #( ) ( ! + * • !) 3E2= 3= 4ED !# !' ) ! B ( " " # # ) !'*
- 54. <6 . .< * • ) ( ! D # !# !' ) ! # # ) ! # #) ) ! # ) # + # ' # + % ! ' " #) # # ! ( # ) ! ) ' #) # ) # ! ! # + (# # #) ) # " # ! +! ! ( ! !(#) #) " ! !' # * ! # #+ + # % !$ ! ) # #
- 55. . 6 These wereestablished by upgrading the primary health centers,each community health center should cover a population of 8000 to 1 lakh with 30 beds and specialists in surgery ,medicine,obstetrics,paediatrics etc.the community health officer is selected from amongst the supervisory category of staff at phc and district level with minimum of 7 yrs experience in rural health programmes.
- 56. • 6 <. •6 <. . 6 0
- 57. 24 hrs delivery services includingnormal This includes incision and drainage and also surgery for Hernia,Hydro Every CHC has to provide following services which including normal and assisted devices. Hernia,Hydro coele,Appendi citis,Haemorr hoids,fi stulas etc. services which are known as assured services.
- 58. Essential and emergency Safe abortion services,new born care,routine emergency Careof routine and emergenc y cases in medicine emergency obstetric care including surgical interventions like caesarian,and other medical interventions. care,routine emergency care of sick children
- 59. Rural Hospitals:-it IsNow Proposed To Upgrade The Rural Dispensaries To Phc’s. District hospitals:-There are proposals to convert the district proposals to convert the district hospitals to District health center Health insurance:-There is no universal health insurance in india.Health insurance I snow available to industrial workers and their families only.
- 60.
- 61. • ! !!# !' ) ! ! !+ #F # !(#) + ( ! ) ! ) # ! ! # " #(# # > # > $ # # !#) # )# # # ) # + # # # * # !#) # )# # # ) # + # # # *
- 62. 6 • ! ##( ! # ! ) # # # * • # ! ) # ! # # # !# % !$ ! #! # # * • ) ! + ( ! ' ! ) ( ! "' # ! ) ! " ! G) ! + ( * ) *H
- 63. Employees State InsuranceScheme • The ESI scheme, introduced by an act of parliament in 1948, is a unique piece of social legislation in India. • It was introduced for the first time in India the principle of contribution by employer and employee. • The act provides for medical care in cash and kind, benefits in • The act provides for medical care in cash and kind, benefits in the contingency of sickness, maternity, employment injury, and pension for dependents on the death of worker because of employment injury. • The act covers employees drawing wages not exceeding rs. 7500 per month.
- 64. FACILITIES UNDER THEESI SCHEME 1 # ) ! 1 ' ) !' ! + 2 3 4 1 # #F # )# # # 4 5 1 " -0! ' # ( #+ # 1 #)# # !'(# # = 8
- 65. FUNCTION ESI SCHEME medicalcare benefits in the contingency of sickness Maternity employment injury pension for dependents on the death of worker because of employment injury
- 66. Central Govt HealthScheme • The central government health scheme for the central government employees was first introduced in new Delhi in 1954 to provide comprehensive medical care to central Govt.Empolyees. • The scheme is based on the principle of cooperation effort by the employee and the employer, to the mutual advantage of both*
- 67. The facilities underthe scheme # #F # )# # # + ( ! % !#( # #F # )# # # + ( ! % !#( # ! ) + #F ! ! . # ) ! ! + % !$ # !# ' ) !' ! + " ! !' -0! ' # ( #+ # # !#) !(#) # ) # + # #F # ' #) # ! " ! !(#) !(#) !+ )' ! !+ )' ! < # ' % ! !(#) # ! ) + #F ! ! #)# # !' (# # )# # ) #
- 68. • The scopeof the scheme has been gradually extended over the years to cover cities outside Delhi as well as other sectors of population such as the employees of the autonomous organizations, retired central govt. servants, widows receiving family pension, members of parliament, ex-governors and retired judges. • Now the scheme covers all the states.
- 69. • The employeesstate insurance scheme and the central government health scheme cover two large groups of wage – earners in the country, • They are well organized health insurance schemes, and are • They are well organized health insurance schemes, and are providing reasonable medical care plus some essential preventive and promotive health services. • Health insurance is a logical step towards nationalization of health services.
- 70. Other agencies • DEFENCEMEDICAL SERVICES; • Defence services have their own organization for medical care to defence personnel under the banner “ armed forces medical services.” • The services provided are integrated and comprehensive embracing preventive, promotive, and curative services.
- 71. Health care ofrail way emplo' • The railways provide comprehensive health care services through the agency of railway hospitals, health units and clinics. • Environmental sanitation is taken care by health inspectors in big stations. big stations. • A chief health inspector supervises the divisions work. • Health check-up of employees is provided at the time of entry into service, and there after at yearly intervals. • There are lady medical officers, health visitors and midwives who look after MCH and school health services. • Specialists services are also available at the divisional hospitals.
- 72. Private agencies • Ina mixed economy such as India’s private practice of medicine provides a large share of the health services available • There has been a rapid expansion in the number of qualified allopathic physician from about 50,000 at the time of allopathic physician from about 50,000 at the time of independence to about 3.94 lakhs in 1992 and the doctor- population ratio for the country as a whole is 1: 2100. • The general practitioners constitute 70 per cent of the medical profession.
- 73. • Most ofthem tend to congregate in urban areas. • They provide mainly curative services. • Their services are available to those who can pay. • The private sector of health care services is not organized. • The private sector of health care services is not organized. • Some statutory bodies like the medical council of India and Indian medical association regulate some of the functions and activities of the large body of private registered medical practitioners*
- 74.
- 75. • The PradhanMantri Surakshit Matritva Abhiyan has been launched by the Ministry of Health & Family Welfare (MoHFW), Government of India. • The program aims to provide assured, comprehensive and quality antenatal care, free of cost, universally to all pregnant women on the 9th of every month. • Hon’ble Prime Minister highlighted the aim and purpose of introduction of the Pradhan Mantri Surakshit Matritva Abhiyan in the 31st July 2016 episode of Mann Ki Baat.
- 76. • PMSMA guaranteesa minimum package of antenatal care services to women in their 2nd / 3rd trimesters of pregnancy at designated government health facilities • The programme follows a systematic approach for engagement with private sector which includes motivating private practitioners to volunteer for the campaign developing strategies for generating awareness and appealing to the private sector to participate in the Abhiyan at government health facilities.
- 78. RATIONALE FOR THEPROGRAM • Data indicates that Maternal Mortality Ratio (MMR) in India was very high in the year 1990 with 556 women dying during child birth per hundred thousand live births as compared to the global MMR of 385/lakh live births. • As per RGI- SRS (2011-13), MMR of India has now declined • As per RGI- SRS (2011-13), MMR of India has now declined to 167/lakh live births against a global MMR of 216/lakh live births (2015). India has registered an overall decline in MMR of 70% between 1990 and 2015 in comparison to a global decline of 44%.
- 79. • While Indiahas made considerable progress in the reduction of maternal and infant mortality, every year approximately 44000 women still die due to pregnancy-related causes and approximately 6.6 lakh infants die within the first 28 days of life. • Many of these deaths are preventable and many lives can be • Many of these deaths are preventable and many lives can be saved if quality care is provided to pregnant women during their antenatal period and high risk factors such as severe anemia, pregnancy-induced hypertension etc are detected on time and managed well.
- 80. GOAL & OBJECTIVESOF PMSMA • Goal of the PMSMA • Pradhan Mantri Surakshit Matritva Abhiyan envisages to improve the quality and coverage of Antenatal Care (ANC) including diagnostics and counselling services as part of the Reproductive Maternal Neonatal Child and Adolescent Health Reproductive Maternal Neonatal Child and Adolescent Health (RMNCH+A) Strategy
- 81. OBJECTIVES OF THEPROGRAM ! ( & # ' ) ! !# + 0 (# # * # # ) !# + ! (# # % # + !(#) ! !# ) # + #) " # + #) !(#) )! # + ! #) " ) # #) ) # # ! !# + ' -# # + ) # #) ) # # ) # ! + )' # ) ' ! # / # # " )* ! !# ) # + !(#) ! ! ) # !(#) ! ! # # !(#) ! # ' ! + % % ( # 0 (# #
- 82. # #) ## 0 # # + #+ !# $ ! + )# " " !#)> #) # !' -# # + ) # #) ) # # * ! !# "#! # + ) #) # )# # ! ' # + # )# ) ) ) #) # ! # ! ) ! + % )# ' # # # % # ' !# $ ) ! ! ) !"# ) # # * ! ' # + # & ! !# + % % # !# # * ) ! ' ! + )# ! + )# - ! )# #F ) !
- 83. KEY FEATURES OFPMSMA 1 ( !' ! + % # 1 ( !' ! + % # # # - # "' ' #)# ! !# ' # ( #+ ) !# + ! !# ' % I ! ) ) ! # ! ) # # " ! ! # ! ) !'* # " ! # ! # ! ) !'* 1 . / )# # > ! 1 . / )# # > # +# > ' #)# % # ! ! !#( ) ! ) ! ! + ( ! ) !* ) )$0 !(#)
- 84. # # )$+ ) ! # # )$ + ) ! !(#) :# ) # + # ( #+ # ! + ; % " ! (# " #)# !# @ ' ( !' # # # " #) )# # # : > > !" )# # # );# " !" ! ! ! # # # ! # )# # '> ! ) * 6 # + !# )# # + % # % 6 # + !# )# # + % # % ' # # (# + # # )$ + # ( #+ # :# ) # + ! !# + 3 !# ! ! + )'; #)# ) < ! + )'; #)# ) < ) )# ) % " ! (# ! + % # + ) # #) 7 # !+ % ! ) ! + % )# ! % " ! ) % % ( ! +# ! ! : > # ; % ( ! +# ! " ( # !(#) : ! ; % #+ # $ ! + % *
- 85. . / )## > # +# > ' #)# ! !#( ) ! % " ) ! + ! (# ( !' !(#) " #) )# # # % ! + ( ! ) ! ! ) # # ! ! ( # " ! # & * ! + % % " +#( ! # ! ) # ! ! " $ * ! + % % " +#( ! # ! ) # ! ! " $ * . )!# #) ) " #' # # # #) # % #+ !# $ ! + )# *
- 86. #)$ ! ##) # + ) # # !# $ ) ! ! + % % " ) ! ! ) (# # /! #)$ !0 ! #)$ ! ? ! ! % % # !# $ ) ! ) ! % % # #+ !# $ ! + )'
- 87. # ! ! "# #)# ( " ( )# # + + J + < !@K ) # ( ! % ! ( " (# ) "! # #(# ) # ( + + !#( > ( !' ) !* ) # ( )$ % + ( !' ) !#" # ! # # !#) )! # *
- 88. Significance • As Indiastrives to achieve the Sustainable Development Goals (SDGs), reducing MMR and IMR becomes important. As a pregnant woman can develop life-threatening complications with little or no advance warning, this initiative is a significant step towards reducing maternal mortality in India. India. • Quality and coverage of health facilities would get improved. • The initiative could avoid many preventable deaths if every pregnant woman is routinely examined and appropriately followed up. •
- 89. Indigenous systems ofmedicine • The practitioners of indigenous systems of medicine( ayurveda, siddha, homoeopathy,etc) provide the bulk of medical care to the rural people. • Ayurvedic physicians alone are estimated to be about 3.37 • Ayurvedic physicians alone are estimated to be about 3.37 lakhs. • In recent years there has been considerable state patronage to foster these systems of medicine. • Many ayurvedic dispensaries are state –run. • the govt. of India is utilizing indigenous systems of medicine for more effective or total coverage.
- 90. Voluntary health agencies •The voluntary health agencies occupy an important place in community health programmes. • A voluntary health agency may be defined as an organization that is administered by an autonomous board which holds meetings, collects funds for its support chiefly from private meetings, collects funds for its support chiefly from private sources and extends money, whether with or without paid workers, in conducting a programme directed primarily to furthering the public health by providing health services or health education, or by advancing research or legislation for health, or by combination of these activities
- 91. • The voluntaryhealth agencies have been compared to motor trucks which can penetrate the by-ways, and the official agencies to railway trunk lines which must run on tracks established by law.
- 92. FUNCTIONS • By lendingpersonnel, or contributing funds for special equipment, supplies or services. Supplementing the work of government agencies " # !+ ! " ! * 1 - ! % ' # + % # + * 1 !) # ! # !# +* 7 ! )) " ! ! # + ( ! + )# ) # $ ( ! ! , ) ! " # !+ ! " ! * Pioneering
- 93. 1 1 ! ## # ) ! ) # # # # * 1 + ( ! + )# ) ) % # ! " # # "' ( !' ! ! * Education 1 1 ' # + ! # ( !' + )# ( ( ) ) " #) * 1 ! # " ! !# "' )$ ! # ( ! " $ % ! # # * % #) " ) # # # (#! # # * Demonstration
- 94. • By settinga good example the voluntary health agencies can always guide and critise the work of government agencies. Guarding The Work Of Government Agencies community. • The voluntary agencies can mobilize public opinion and advance legislation on health matters for the benefit of the whole community. Advancing Health Legislation
- 95. Voluntary Health AgenciesIn India # $ #( ! + # ! )! # ) )# ! ) # % ! " !) # )# # # #
- 96. ! ( $, ! )# % ! " ! $ !" !# < # ' # + )# # # # # # % ) ! )
- 97. # # "# ! # )# ' ! # " # # ! # + )#
- 98. ! # "# # # #) # )# # # # #) )# # ! # ! )# # # # # )# #
- 99. International agencies )$ ! <! # : ! #( ! !#) ! # ( !'% ! ;
- 100. HEALTH PROGRAMS ININDIA . . < . . . . > . . < . 6 6 . . . < . 6 . 6 .
- 101. . / 1 7. 9 1 6 < 7 . 6 < 1 1 6 .