Health care delivery system in India
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The document summarizes India's health care system from the central, state, and district levels. At the central level, the Union Ministry of Health and Family Welfare is responsible for policymaking, planning, and coordinating health services nationwide. States have their own health ministries and directorates to administer health programs independently. Districts are the primary administrative units, with Chief Medical Officers overseeing preventive, curative, and public health services for rural and urban populations through primary health centers, municipalities, and village panchayats.
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Health care delivery system in India
- 1. GOOD MORNING
- 3. Introduction India is a Union of 28 States and 8 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, therefore, has developed its own system of health care delivery, independent of the Central Government.
- 4. CONT…… The Central responsibility consists mainly 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, and no State lags behind for want of these services.
- 5. DEFINITION According to “J. E. Park” “It implies the organization, delivery, staffing, regulation and quality control of health care services.”
- 6. I - AT THE CENTRE The official "organs" of the health system at the national level consist of :
- 8. 1. Union Ministry of Health and Family Welfare Organization
- 9. Union ministry of family welfare Secretary Joint secretary Deputy secretary Administrative staff Secretary Additional Secretary Commissioner joint Secretary
- 10. FUNCTIONS 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.
- 11. 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 Centre for Disease Control, Delhi, etc. • Promotion of research through research centers and other bodies • Regulation and development of medical, pharmaceutical, dental and nursing professions.
- 12. Cont ….. • 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 and • Coordination with States and with other ministries for promotion of health.
- 13. 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 extension of communicable diseases from one unit to another. Prevention of adulteration of foodstuffs. Control of drugs and poisons Vital statistics Labor welfare Ports other than major Economic and social planning, and Population control and Family Planning
- 15. ORGANIZATION: - Directorate General of Health Services is the principal adviser to the Union Government in both medical and public health matters. He is assisted by an additional Director General of Health Services, a team of deputies and a large administrative staff. The Directorate comprises of three main units. e.g., medical care and hospitals, public health and general administration the director general of health.
- 16. FUNCTIONS • International health relations and quarantine • Control of drug standards • Medical store depots • Post graduate training • Medical education • Medical Research • Central Govt. Health Scheme
- 17. • National Health Programmes • Central Health Education Bureau • Health Intelligence • National Medical Library:
- 18. • The center council of health was set up by president order on 9 august 1952 under article 263 of the constitution of India for promoting co coordinating and concerted action between the Centre and the States in the implementation of all the programmer and measures pertaining to the health of the nation.
- 19. FUNCTION To consider and recommend broad outlines of policy in regard to matters concerning health in all it aspects such as the provision of remedial and preventive care, environmental hygiene nutrition health education and the promotion of facilities for training and research 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.
- 20. Cont … To make recommendations to the Central Government regarding distribution of available grants-in-aid. To review periodically the work accomplished in different areas through the utilization of these grants-in-aid. To establish any organization or organizations invested with appropriate functions for promoting and maintaining cooperation between the Central and State Health administration
- 21. II - AT THE STATE LEVEL
- 22. Cont… • The Government of India Act, 1935 gave further autonomy to the States. The health subjects were divided into three groups: federal concurrent and state. • The "state" list which became the responsibility of the State Included provision of medical care, preventive health services and pilgrimages within the State. The position has largely remained the same, even after the new Constitution of India came into force in 1950.
- 24. STATE MINISTRY OF HEALTH Health secretary Additional secretary Deputy secretary Administrative staff
- 25. Function Assisting the ministers in policy making Formulating, review and modification of broad policy. Execution of policies Coordination with Govt. of India and other state Control for smooth and efficient functioning Budgeting and control over expenditure
- 26. STATE HEALTH DIRECTORIATE Functional deputy director Regional deputy director Additional directors. FUNCTIONS Provide adequate medical care Medical education and research National health program implementation Provision for health scheme
- 27. III-AT THE DISTRICT LEVEL The District The principal unit of administration in India is the district under a Collector. There are 707 (veer 2016) districts in India. There is no "average" district that is the districts vary widely in area and population. Within each district again, there are 6 types of administrative areas
- 28. Cont … Sub-divisions Tahsils (Talukas) Community Development Blocks Municipalities and Corporations Villages Panchayats
- 29. • Most districts in India are divided into two or more sub divisions, each in charge of an Assistant Collector or sub Collector. • Each division is again divided into Tahsils (taluks), in charge of a Tahsildar. A Tahsil usually comprises between 200 to 600 villages. • Since the launching of the Community Development Programme in India in 1952, the rural area of the district have been organized into Block is a unit of Blocks known as Community development blocks, the area of which may not coincide with a Tehsil. • The block is a un planning and development, and comprises approximately 100 villages and about 80,000 to 1.20,000 population charge of a Block Development Officer Finally there village panchayats, which are institutions of rural loc government
- 30. • 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 and 10,000) • 2. Municipal Boards - (in areas with population ranging between 10,000 and 2 lakhs). • 3. Corporations - (with population above 2 lakhs). The Town area committees are like panchayats. They provide sanitary services. The Municipal Boards are headed by a Chairman/President, elected usually by the members The term of a Municipal Board ranges between 3-5 years
- 31. The functions of a municipal board are construction and maintenance of roads, sanitation and drainage, street lighting, water supply, maintenance of hospitals and dispensaries, education, registration of births and deaths etc. Corporations are headed by Mayors. The councilors an 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 those of the municipalities, but on a much wider scale.
- 32. Health organization The Bhore Committee (1946) recommended integrate preventive and curative services at all levels and the city up of a unified health authority in each district. Subsequent expert committees, appointed by the Government of in have also recommended the same, Since "health" is a set subject, there is no uniform "model" of a district he organization in India, each State developed its own part to suit its policy and convenience
- 33. • Under the Multi-Purpose Workers Scheme, • it has been district level by having a Chief Medical Officer with three Deputy CMOs (existing Civil Surgeon District Health Officers and District Family Welfare Officers) with each of the Dy. • CMOs being in charge of one-third of the district for all the Health. Family Welfare and MCH programmes.
- 34. • The recent Working Group on Health for All by 2000 AD appointed by the Planning Commission recommended that the District Hospitals should be converted into District Health Centers, each centre monitoring all preventive primitive and curative services of one million populations. • It has been recommended that the district set- up should be reorganized on the basis of the number of primary health centers it comprises.
- 36. PANCHAYATI RAJ • The Panchayati Raj is a 3-tier structure of rural local self government in India, linking the village to the district. The three institutions are: • Panchayat - at the village level; • Panchayat Samiti - at the block level; and • Zilla Parishad - at the district level.
- 37. Cont…. • The Panchayati Raj institutions are accepted as agencies of public welfare welfare. All development programmes are channelled through these bodies. The Panchayati Raj effective and better participation of the people in the institutions strengthen democracy at its root, and ensure more effective and better participation of the people in the government.
- 38. At the Village level The Panchayati Raj at the village level consists of The Gram Sabha The Gram Panchayat The Nyaya Panchayat
- 39. At the Block level The block consists of about 100 villages and a population of about 80,000 to 1,20.000. The Panchayati Raj agency at the block level is the Panchayat Samiti / Janpad Panchayat. The Panchayat Samiti consists of all Sarpanchas (heads) of the village panchayats in the Block: MLAs, MPs residing in the block area; representatives of women, scheduled castes, scheduled tribes and cooperative societies. The Block Development Officer (BDO) is the ex-officio secretary of the Panchayat Samiti
- 40. FUNCTION Execution of the community development programme in the block, The funds provided by the government for stage I and stage in development are channeled through the panchayat samiti. The block development officer and his staff give technical assistance and guidance to the village panchayats engaged in development work.
- 41. HEALTH CARE DELIVERY 1. Public health sector A) Primary health care Primary health centers Sub center B) Hospital/ health center Community health center Rural hospitals District hospital Specialist hospitals Teaching hospitals
- 42. CONT….. C) Health insurance schemes Employee state insurance D) Other agencies Defense services Railway
- 43. 2. Private Sector Private hospitals , polyclinics, nursing homes, and dispensaries General practitioners and clinics 3. Indigenous System of Medicine Ayurveda and siddha Unani and tibbi Homeopathy Unregistered practitioner
- 44. 4. Voluntary health agencies 5. National health programme
- 45. THANK YOU