UNIT- 1 Health care delivary system in india.pptx

unit -1 Health system in India
Organization and administration of health system in India
a) Central level
- Union Ministry
- Directorate General of Health Services
- Central Council of Health
b) State level
- State Health Administration
- State Ministry of Health
- State Health Directorate
c) District level
- Sub Divisions
- Tehsils/ Talukas
- Villages
- Municipalities & Corporation
- Panchayats

INTRODUCTION
• Health has been at the centre of human concern since ancient times.
Civilizations developed and perished due to wars, conflicts and raging
diseases, which left none untouched, save those whose health was taken
care of by an organized system. Ancient civilizations that developed in
Indus valley, Greece, Rome and Mesopotamia had fairly advanced health
systems for their times and the medical practitioners enjoyed a high
status in the society due to their practice.
• Two renowned medical systems developed in India in ancient times;
Ayurveda and Siddha, which were quite similar in concept and practice.
Indian systems sought knowledge by which life could be prolonged and
some of the popular medical treatises of those times were the Charaka
Samhita and the Sushruta Samhita.
• The practice of medicine has come a long way since the time of magic,
religion and supernatural thoughts to a modern science following
evidence-based practice with a range of services extending from
preventive, promotive, curative to rehabilitative offered to the individual
and community.

DEFINITIONS
• Health
Health is defined as," A state of complete, physical, mental and social well-
being and not merely an absence of disease or infirmity." (WHO)
• Health Care
Health care is defined as," multitude of services rendered to individuals,
families or communities by the agents of the health services or professions for
the purpose of promoting , preventing, maintaining, monitoring or restoring
health." (OXFORD DICTIONARY)
• System
A set of interrelated and independent parts designed to achieve a set of
goals.
• HEALTH CARE SYSTEM
 Health care delivery system is a system in which the services related to
health care delivered to the target population.
 Health care delivery system is an integral part of the government,
responsible to central authority and interrelated in its activities with a general
conduct to governmental affairs

Health System
• Health system covers a whole extent of health activities, health
programmes, institutions providing medical care such as hospitals,
clinics and primary health care centres and the policies enunciated
by governments to provide optimal health care for its citizens.
• In general health system defines as "Complex of facilities,
organizations, and trained personnel engaged in providing health
care within a geographical area."
• Health System as described by WHO is the "sum total of all the
organizations, institutions and resources whose primary purpose is
to improve health."
• Health systems should be accessible, efficient, affordable and of a
good quality.
• Health systems usually include the following -
– Development of health policies, plan for their implementation and
development of a system of regulation of health services.
– Define and develop the institutional framework to deliver the health
services within the purview of this system.
– Allocate and mobilize financial and human resources for its functioning.
– Plan, manage and deliver the health services.

Aim Of Health Systems
• Ultimately aim of Health systems is to
improve, maintain and restore the health
status of the community at a cost that an
individual and the community can afford to
spend without substantial change in their
financial status.

Goals of Health care System
• A health system has to provide for much more than
routine delivery of services. It has to protect the health
of its community, treat them with dignity and ensure
that it responds fairly to the expectations of the
population. The WHO has thus identified three overall
goals for the health systems to be -
– Effective in contributing to better health throughout the
entire population.
– Responsive to people's expectations, including safeguarding
patient's dignity, confidentiality and autonomy and being
sensitive to the specific needs and vulnerabilities of all
population groups.
– Fair in how individuals contribute to funding the system so
that everyone has access to the services available and is
protected against potentially impoverishing levels of
spending.

Organization & administration of health system in
India
• Health administration is the science of the organizing and
coordinating government agencies whose purpose is to improve
the physical, mental and social well-being of the people of the
country. It is a part of the public administration.
• India is a Union of 28 States and 7 Union territories. Under the
Constitution of India, the States are largely independent in
matters relating to the delivery of health care to the people.
Each State has developed own system of health care delivery,
independent of the Central Government.
• The Central responsibility of an organization of policy making,
planning, guiding, assisting, evaluating, and coordinating the
work of the State Health Ministries, so that health services cover
every part of the country, In order to achieve the goal to "Health
for All – 2020". Health administration governed in India at 3
levels -
• Central level
• State level
• District level

1.Centre level Health Care Administration
• The official "organs" of the health system at the
national level consist of:
• The Ministry of Health and Family Welfare;
• The Directorate General of Health Services; and
• The Central Council of Health and Family Welfare
A. Union Ministry of Health and Family Welfare
• ORGANIZATION
The Union Ministry of Health and Family Welfare is
headed by a Cabinet Minister, a Minister of State and a
Deputy Health Minister. The Union Ministry has three
departments-
• Departments of health
• Departments of family welfare
• Departments of Indian Systems of Medicine and
Homoeopathy (ISM&H)

FUNCTIONS of the Union Health Ministry
The functions of the Union Health Ministry are set out in the seventh schedule
of Article 246 of the Constitution of India under
• The Union list and
• The Concurrent list
Union list
• The functions given in the Union list are:
– International health relations and administration of port quarantine
– Administration of central institutes such as the All India Institute of Hygiene
and Public Health, Kolkata; National Institute for the Control of
Communicable Diseases, Delhi, etc.
– Promotion of research through research centers and other bodies
– Regulation and development of medical, pharmaceutical, dental and
nursing professions
– Establishment and maintenance of drug standards
– Census, and collection and publication of other statistical data
– Immigration and emigration
– Regulation of labour in the working of mines and oil fields
– Coordination with States and with other ministries for promotion of health.

Concurrent list
The functions listed under the concurrent list are
the responsibility of both the Union and State
governments. The concurrent list includes:
– Prevention of communicable diseases
– Prevention of adulteration of foodstuffs
– Control of drugs and poisons
– Vital statistics
– Labour welfare
– Ports other than major
– Economic and social planning
– Population control and Family Planning

• Functions of Department of Medical & Public Health
The functions of the Department of Medical &
Public Health are –
– Health Policy preparation
– National Health Programs conduction
– Drug Control
– Diseases control
– Communicable/Non-communicable
– Supplies & Disposal Maintenance
– CME (continuing medical education) & Trainings
– Medical Education & Research
– Vital statistics & Health intelligence
– International support

• Functions of Department of Family Welfare
The functions of the Department of Family
Welfare are :
– Policy preparation & Planning
– Information collection & Evaluation
– Contraceptive-Research /Supply
– Seeking International support for Family Welfare
– EPI/UIP/CSSM/RCH/ARI/ORT-Trainings & area
development
– Maternal and Child Health Services.
– IEC - Information, Education and Communication.
– Rural Health Services
– Paraprofessional training
– NGO support
– Development of Sub-center

• Functions of Department of IMS & H
The functions of the Department are –
– Upgrade the educational standards in the Indian
Systems of Medicines and Homoeopathy colleges in
the country;
– Strengthen existing research institutions and ensure a
time-bound research programme on identified
diseases for which these systems have an effective
treatment;
– Draw up schemes for promotion, cultivation and
regeneration of medicinal plants used in these
systems;
– Development of Indian Systems of Medicine and
Homoeopathy drugs

B.The Directorate General of Health Services

functions
The general functions are surveys, planning,
coordination, programming and appraisal of all
health matters in the country.
The specific functions are -
• International health relations and
quarantine:
• Control of drug standards:

• Medical store depots:
• Post graduate training:
• Medical education:
• Medical Research:

C.Central Council of 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.
ORGANIZATION
The Union Health Minister is the Chairman
and the State Health Ministers are the
members.

FUNCTIONS
The functions of the Central Council of Health
are:
– To consider and recommend broad outlines of policy
in regard to matters concerning health in all its
aspects.
– To make recommendations to the Central
Government regarding distribution of available
grants-in-aid for health purposes.
– To establish any organization to promoting and
maintaining cooperation between the Central and
State Health administrations

2.State level Health Care Administration
• Organizational structure at the state level is on
the similar pattern as that as that as the
central level.
• At present there are 28 States in India, with
each state having its own health
administration

Functions
• Implementation of national health programmes and
evaluating their achievements.
• Promoting providing and supervising all types of health
services in the state such as primary health services
• Collection of vital statistics.
• Encouraging reproductive and child health
• Improvement of nutrition programme and Controlling
food adulteration and also sanitation in milk.
• Medical and nursing education, training of nurses, female
health workers and other health workers.
• Controlling rural and urban health services through district
medical officer.
• Providing feedback to the state health ministry regarding
health.

3.District level Health Care
Administration
District there are 6 types of
administrative areas - Sub-divisions, Tehsils
(Talukas), Community Development Blocks,
Municipalities and Corporations (urban area),
Panchayats (Villages)
• District is Peripheral most Planning unit

• Middle level management
organization
• The principal unit of administration in
India is the district under a Collector.
• It is a link between the State/ regional
structure on one side and the
peripheral level structures such as
PHC/ Sub-Centre on the other side

• Chief Medical and Health Officer (CM & HO)
Chief Medical and Health Officer - CM & HO is
a Director of health and family welfare service at the
district in rural area and are overall in-charge of the
health and family welfare programmes in the rural
area. CM&HO is assisted by Dy. CMO, RCH officer and
programme officers. Dy. CMO and RCH officer are
assisted by Block CMOs.
• Principle Medical Officer (PMO)
Principle Medical Officer – PMO is a Director of
health and family welfare service at the district in
urban area and is overall in-charge of the health and
family welfare programmes in urban area.

Functions of District Health System
• Liaison between Field units & Headquarter
–Field reports
–Inspections
–Meetings
• Implementation of Policy & Programs
• District level planning & Action Plans
• Rationale use of Finance & Resources
• Communication Management
• Control & Monitoring

At the District Level
• There are 640 (year 2011)(2020 year-739)districts
in India. Within each district, there are 6 types of
administrative areas.
• 1. Sub-division
• 2. Tehsils (Talukas)
• 3. Community Development Blocks
• 4. Municipalities and Corporations
• 5. Villages
• 6. Panchayats

• Most district in India are divided into two or more
subdivision, each incharge of an Assistant
Collector or Sub Collector.
• Each division is again divided into taluks, incharge
of a Thasildhar.
• A taluk usually comprises between 200 to 600
villages.
• The community development block comprises
approximately 100 villages and about 80000 to
1,20,000 population, in charge of a Block
Development Officer.
• Finally, there are the village panchayats which are
institutions of rural local self-government.

• The urban areas of the district are organized into
the following institutions of local self-government:
1. Town Area Committees (in areas with
population ranging between 5,000 to 10,000)
2. Municipal Boards (in areas with population
ranging between 10,000 and 2,00,000)
3. Corporations (with population above 2,00,000)
• The Town Area Committees are like panchayats.
They provide sanitary services. The Municipal
Boards are headed by Chairman / President,
elected by members.

functions of Municipal Board & Corporations
1. Construction and maintenance of roads
2. Sanitation and drainage
3. Street lighting
4. Water supply
5. Maintenance of hospitals and dispensaries
6. Education and
7. Registration of births and deaths etc.

• The Corporations are headed by Mayors,
elected by councilors, who are elected from
different wards of the city.
• The executive agency includes the
commissioner, the secretary, the engineer and
the health officer.
• The activities are similar to those of
municipalities on a much wider scale

Panchayat Raj
The Panchayat Raj is a 3-tier structure of rural
local self-government in India linking the village
to the district .The three institutions are:
1) Panchayat (at the village level)
2) Panchayat Samiti (at the block level)
3) Zila Parishad (at the district level)

What is a Panchayat ?
Panchayat is the name of the local government
system in India. Panchayat means a group of
"Five Persons". In simple words, a Panchayat is a
council of elders representing a village. The
Panchayat system covers the village level (Gram
Panchayat), clusters of villages (block Panchayat)
and the district level (District Panchayat).

Village Level Panchayat
• It is a local body working for the welfare of the village.
• Panchayati Raj is a system of governance in which Gram
Panchayat are the basic units of administration.
• The number of members usually ranges from 7 to 31;
occasionally, groups are larger, but they never have fewer
than seven members.
• The council leader is named Sarpanch in Hindi, and each
of the five members is a Gram Panchayat Sadasya or
Panch.
• In such a system, each villager can voice his opinion in the
governance of his village.
• Decisions are taken without long legal procedure.

The panchayat raj consist at the village
level
• The gram Sabha
• The gram panchayats
• The nyaya panchayats

• Gram Sabha is a meeting of all people who live in area
covered by Panchayat.
• This could be in one village or few village.
• Gram Sabha meeting started by Panchayat president.
• Panchayat president is also called Sarpanch.
• And members of Panchayat presenting plans on making
and repairing of roads which connect village to mains
highway.
• Members of Panchayat is also called Panch.
• Panchayat member discuss to improve the village
problems like shortage of waters ,roads, environment.
Every village Panchayat is divided in wards.
• Each ward elects their representative who is known as
Ward member.

2.Gram panchayats
•The Sarpanch, Members and
Gram Sevaks represent the voice
and opinion of the village people
on behalf of the Gram Panchayat
to the Taluka and Zila level by
attending the meetings or sending
the official records.
•The Panchayat and Rural
Development Minister of the State
controls all the functions of the
Gram Panchayat Department of
the State.

Benefits and Importance of the Gram
Panchayat
• Reduces poverty by addressing needs at a
grass root level.
• use of local resources.
• People are directly involved in their local
government.

Nyaya Panchayats are considered as a
unit of the Panchayati Raj System of
India. They function at the village or
district level to deliver justice .

Block Level Panchayat
• The block-level institution is called the Panchayat
Samiti.
• Panchayat samiti is a local government body at the
tehsil or Taluka level in India.
• It works for the villages of the Tehsil or Taluka.
• The Panchayat Samiti is the link between the Gram
Panchayat and the district administration.
• The samiti is elected for 5 years and is headed by
the chairman and the deputy chairman.

At the district level
• District Level Panchayat At district level,
panchayati raj system is called as "Zila Parishad".
• It looks after the administration of the rural area
of the district and its office is located at the
district headquarters.
• It is headed by the "District Collector" or the
"District Magistrate" or the "Deputy
Commissioner".
• The Chairman of all the Panchayat Simitis form
the members of Zila Parishad.
• It is the link between the State Government and
the Panchayat Samiti.

The major functions of a district level panchayat is
to provide essential services like-
• supply of improved seeds
• running schools, PHC's and hospitals,
• construction of bridges and roads etc.

UNIT- 1 Health care delivary system in india.pptx

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UNIT- 1 Health care delivary system in india.pptx