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17 views8 pagesHealth Delivery System
Health care delivery system
Uploaded by
Parul SinghCopyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
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/ 8
AMRING AME) MAAGEMEN
878
TABLE 4
Achievements during the plan periods
> Health Assistan
eats Aasisant Fy
U7. Village Health Guides
Source: (91)
sible, shows the investments in health and Family
re Progiammes during different plan periods.
HEALTH SYSTEM IN INDIA
India
Under gis 2,Uaion of 29 States and 7 Union territories.
ae oe Constitution of India, the States are largely
fo the pent in matters relating tothe delivery of health care
SsiemPapble: Exch State, therefore, has developed its own
maa ge salen jaeevendent of the neal
E int. The Central responsiblity consists mainly 0
Peon akng, planning guiding asamtng costuatng. ah
health sont? Work of the State Health Ministries, so that
ices cover every part ofthe county, and no State
lags behi
ind for want of these services. The health system in
‘Toll plan
Investment
1960.00
4672.00
8576.00
6625.40,
15,778.50
39,322.00
11,650.00
97,500.00
180,000.00
61,518.10
official ther ke
organs” of the health system ot then
ett 0) Ee tHe cs
The puncit of Health ‘and Family Welfare.
y of Health and Family Welf,
th and Family Were i
The Union Min st and a
A re political appoint
headed PY itn Ministe THES Frristry has the folowny
Deputy Healy on Heal =
‘the Unio ent of Health and (2) Dey i
Gepartments: (1) Depart TF Department is headed by a
of Family Welfare. ment of India as its executive head,
Secretary torte COVEN eputy secretaries rae
= int SeeeTaE SS riment of Family Welfare was
‘Ministry of Health and Family
satin ine itso Heal ood Fam
Gee to the Govt. of India in the Minis
Wear, The Seri Welfare i To overal cg of the
of Heath and Fry Welle. He ie seed by on
aon
‘TIONS
2 ONC rons ofthe Union Health Ministry are set out in
The functions tule of Article 246 of the Constitution of
toe sector (a) the Union list and (b) the Concurrent list
(a) Union list: The functions given in the Union lis are
ites such as
vernalional
Cee 2) Administration of central in:
sne-and Public Health, Kolkata
the ALI :
National. Institute for the Control of Communicable
through
Diseases, Delhi, etc. (3) Promot
research centres and other bodies (4) Regulation and
development of medical, pharmaceutical, dental and
nyrsing professions (5) Establishment and maintenance of
drug standards (6) Census, and collection and publication of "ALTH PLANNING AND MANAGEMENT
TABLE 4
Primary Health Centres
Subcentres
Total beds (2002),
9. Medical colleges
6 Annual admissions
in medical colleges
7. Dental colleges
8. Allopathic doctors
9. Nurses
10, ANNs.
AL, Health visitors
12. Health Workers (F)
{in position)
13, Health Workers (M)
{in positon)
14, Block Extension Educator
15, Health Assistant (M)
{in position)
16, Health Assistant (F/LHV
{in position)
17, Village Health Guides
Source: (31)
Table 5 shows the investments in health and Family
Welfare Programmes during different plan periods.
HEALTH SYSTEM IN INDIA
India is a Union of 29 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, therefore, has developed its own
system of health care delivery, independent of the Central
Government. The Central responsibility consists mainly of
policy making, planning, guiding, assisting, evaluating, and
Coordinating the work of the State Health Ministries, so that
hhealth services cover every part of the country, and no State
Jags behind for want of these services. The health system in
i
Be
$. Community heath centres
5
6
__—_—_—
a oan in, Cn Se
india has
ripheral
| AT THE CENTRE
vaanat of the health system at the nati
‘he official “OT the Ministry of Health and Famiy
tevel consist Of rrorate General of Health Kervi
Were (2) There el of Health and Family Wel
(3) The Centr
n Ministry of
ealth and Family Welfare
1. Unio
(1) ORGANIZATION
‘The Union Ministr
y of Health and Family Welfare is
in ler of State and
Mirnese are Political appointments,
Ministry has the following
Deputu Health Minister
Currently, the partment of Health and (2) Depart
departments: (1) PSE Health Department is headed by 2
of Family Weltare ment of India as its executive head,
Secretary to tre Cor rafies, deputy secretaries ar 3
aesisted by joint See imily Welfare was
the Department of
adminis ee Set gin the Minit) of Health and Family
created in, 1966 roy 10 the Govt, of India inthe Ministry
Welfare, The oer iy Welfare isin, overall charge of the
Deer Giotiare, He is assisted by an
Additional & Cs id
one domnt Secreiary
(2) FUNCTIONS
“The functions of the Union Health Ministry are set out in
the tventh echedule of Article 246 of the Constitution of
the acer (a) the Union list and (b) the Concurrent list
{o) Union lis: The functions given in the Union list are
* ernational health telations and administration-of port
(1) neat ae en of central inttutes suchas
the All vgiene and Public Health, Kolkata;
National Institute for the Control of Communicable
Diseases, Delhi, etc. (3) Promotion of through
esearch, centres and othér bodies (4) Regulation and
development of medical, pharmaceutical nd
nursing professions (6) Establishment and maintenance of
dug standards (6) Census, and collection and publication of,
5
‘Total plan
Period
be eee? __vestment
Pla (1951-56) 1960.00
11 lan (1956-61) 4672.00
Plan (1961-66) 8576.00
‘Annual Plans (1966-69) 6525.40
IV Plan (1969-74) 15,7880
Plan (1974-79) 39,322.00
1978-80 Outlay 11,650.00,
VIPlan (1980-85) 97,500.00
Vil Pian (1985-90) 180,000.00
‘Annual Plan (1990-91) 61,518.10
‘Annual Plan (1991-92) 72,316.80
| VIL Pian (1992-97) 798,000.00
| 1xPlan (1997-02) 859,200.00
| X Plan (2002-07) 1,484,131.30
[_XPlan (2007-12) 2,156,
Health Family Water supply
See Welfare & sanitation
65.20 ot NA
140.80 220 NA
225.00 24.90 10.70
140.20 70.50 102.70
395.50 284.40 458.90
682.00 497.40 971.00
‘ a a 116,20 429.50
eae 1,010.00 3,922.02
ee 3,256.26 6,522.47
ses 2 784.90 1,876.80
1575.92 Bane 25
gaz sion sm
i 125. s
esd 90,553.00 175,000.00) ae
rer statistical data (7)
4 Regulation of labour in ristation
Blas and (9) Coordinatign’™®, Working and
fetes promotion stp Si
ip) Concurrent ist F
funeti
arent list are the reg ions
Gare governments. The ‘Coelly of bop ted
Under the
Zmultaneous powers of |
both th
, e U
legis! and th ion ay
restcted to the framewor eo Ne Doin esha
OWers have
anaeren i the Cente. The teh elaigg mei
en v be
Cyemnit to another tat Pe couamnicable st ncladen
C ention a es
stuf (3) Se aulteration
Prtshaucweltave (6) Porte satboison am
god sscallannins, and (3) Peete tal As
ion control and rae
ay
Plansins.
2. Directorate General of He
(a) ORGANIZATION : The Diecon @
services the principal adviser to the Un General of Heath
both medical ad public Reatth manee 7 Government!
Saal Diecor General y pate es ange nN
deputies and a large administrative sat ie 8 team of
comprises of three main units, e.g he Ditectorate
hospitals. public health Ladin tical cara and
; tuinistration,
(b) FUNCTIONS: The GENERAL fox
gaz, corns. Hoag ne as
Feat matters The county, The SPECIE PSEA of al
0) Jotrnational health felaions sae, MeO ae
raldt-ports in the country (Kolkaie namtne: Al the
Genel, Cochin, Mumba Hendley inekhapatnan,
ports (Mumbai-Santa Cruz, Kolkata-Du Tyee
contolled by the Directorate General of Hey eee
matters relating to the obtaining of am aoevces All
Intemational agencies “and the coordination oy
acts in the county are undertaken by the Dice
General of Health Services. (2) Control of Se
The Drugs Control Organization" part of Rese
General of Health Services, and is headed ty erat
Controller. lis primary function isto lay down ond eras
sendards and control the manufacture and demon
drugs through both Central and State Government ge
The Drugs Act (1940) vests the Central Government wifes
sewers fo test the quality of imported drugs (3) Media
Bee denote The Union Gas ae
depots at Mumbai, Chennai, Kolkata, Karnal, Cauwohed
and Hyderabad. These depots supply the civil medical
requirements of the Central Government and of the various
Siate Governments. These depots also handle supplies from
foreign agencies, The Medical Stores Organization
endeavours to ensure the highest quality, cheaper bargain
and prompt supplies. (4) Post graduate. taining: The
Directorate General of Health Services is responsible for the
Bérinsation of national inte, which also rule
ext-graduate training to different categories of heal
Personnel. Some of these insltues are. the Al Todi
institute of Hygiene and Public Health at Kolkata, All India
Insite of Mental Heath at Banglore, Cllege of Nusing
at Delhi, National Tubereuloss Institute al Bangalore,
National’ nstitute of Communicable Diseases, at Deli
Ganial Research Insitute at Rasa Naina nse of
Health and Family. Welfare at Del, etc (5) Medical
dcalion: The Cenral Directorate is dieelly in chara o
the folowing medical colleges in India: the Lady Harding,
the Maulana Azad and the medical colleges at Pu
2 from,
Human diseases, omenatg
.
se, The research ‘causation,
sal mn i
Weld surveys and a lar number:
teseatch
we Council.
Ir cubetculons Chemotherapy Gente e
h Cente at Poona, Mational Institute
Blood Group Reference
Zhe funds of the Council are wholly
buclget of the Union Ministry of Heath,
Health Scheme: 6) National Health
ath programmes for
for the control of
Seases invol Sea AIDS and éther ate
rammavolve expenditure of crores of rupees, Heal
Rerpammes of this kind can hardly succeed wathout the
Plays Ne Central Government. The Central Directora
coordinayeY important part in planning, guiding and
ctyating all the national health programmes in the
Cult ycetal Health Education Bureau An
Cuistanding activity of this Bureau is the preparation of
peosition material for creating health awareness among the
People. ‘The Bureau offers training courses in health
(ication to different categories of health workers.
{10} Health Intelligence: The Central Bureau of Health
Inteligence was established in 1961 to centralise collection,
compilation, analysis, evaluation and dissemination of all
information on health statistics for the nation as a whole. It
Gisseminates epidemic intelligence to States and
Intemational bodies. The Bureau. has an Epidemiological
Unit, a Health Economics Unit, a National Morbidity Survey
Unit and a Manpower Cell. (11) National Medical Library:
‘The Central Medical Library of the Ditectorate General
Health Services was declared the National Medical Library
in 1966. The aim is to help in the advancement of medical,
health and related sciences by collection, dissemination and
exchange of information,
3. Central Council of Health
A large number of health subjects fallin the Concurrent
list which calls for continuous consultation, mutual
Understanding and cooperation between the Cente and the
States. 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 pramating-ceordinatéd and
concerted action between the Centre and the States in the
implementation of _all_the programmes ae
Minister isthe-Chaisman and the State Health Mibisters are
foetal
FUNCTIONS : The functions of the Central Counell of
[againciea ehprejenerste cieiesrror otra ou
Hips iy recare ome en (encanta
erga aati evita ee ee
are, environmental Hygiene nuttion, heat eaueation
£ promotion of Tecities Tor Waning aTetWese
and thd” promotion of Tacilities for tainlmg-ant- research,
(2}-Fo-make proposals for legislation jvity
rglating to medical and pubtie-healti-matiers and 79 lay
wn the pattem of development for the country as a whole,
(8) To make recommendations To the Central fnment
Plane eal HEALTH PLANNING.
‘AND MANAGEMENT
regarding dlstibution of available grants-in-aid for health
Durposes to the States and to review periodically the work
accomplished in different areas through the utilisation of
these grants-in-aid. (4) To establish any organisation oF
crannisations invested wth appropsiatefunctions_for
_-Ryomotingand_maintainina cooperation between—the
Central and State Health administratio
~ AT THE STATE LEVEL.
Historically, the fest milestone in State health
administration was the year 1919, when the States (then
known as provinces) obtained ‘autonomy, under the
Montague-Chelmsford reforms, from the | Central
Government, in matters of public health. By 1921-22, all the
States had created some form of public health organization.
‘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. The State is the ultimate authority responsible for all,
the health services operating within its jurisdiction.
State health administration
At present there are 29 States in India, with each state
hhaving its own health administration, In all the States, the
management sector comprises the State Ministry of Health
{and a Directorate of Health A (fee at
ao
1. State Ministry of Health }V" o)’
The State Ministry of Health fs Neaded b)'» Minister of
Health and Family Welfare and a Dapuity-Minister of Health
and Family Welfare, In some States, the Health Minister is
also in charge of other portfolios. The Health Secrctaiat is
theofficial roan of the Sate Minty of Heath and is
headed by a Secretary whois assisted by Reputy Secretates,
Under Secretaries and large adminisratve=stal The
Secretary is a senior officer of the Indian Administrative
Service. The Bhore Committee (1946) recommended that
the Direcior of Health Services should also be Secretary to
the Stale Government to facilitate administration, but this
recommendation has not been implemented.
2, State Health Directorate
Fora long time, iyo separate departments, medical and
te health, were functioning inthe States; The Heads of
these-Tepatiments were known as Surgean-Genevat-and
Inspector General of Cul Hospitals and Director of Public
Health respectively. The Bhore Committee (1946)
recommended that the medical and public health
organizations should be integrated at all levels and
therefore, should have a single administrative officer for the
curative and preventive departments of health, West Bengal
led the process of integrating health services at the State
level by creating a post of the Director of Health Services in
August 1947; the process was completed by Maharashtra in
May 1970.
The Director of Health Services (known in some States as
Director of Medical and Health Services) is the chief
technical adviser to the State Government on all matters
relating to medicine and public health. He is also responsible
for the organization and direction of all health activities,
With the advent of family planning as an important
ion of Director of Health Services
ramme, ation tates and is now known es
Pie%been changed IP #77" “Family Welfare. A recent
Director 2 gome States is the appointment ofa Direct
jevelopment In 707, “in wiew of the increasing number of
euelopray Education 18 Vee Or eal that there ig ch
medical _colleg Semoval of medical education from,
justification femeunder the Director of Health
general he vice’ ces and training institutions should
Services. The healt eco) whole designed to an end ~ the
develop inte Pe nealth of the people :
prcieeten {Health and Family Welfare is assisted by a
‘The Director of Fir uties and assistants, The Deputy and,
uae us at Health may be of 0 {8 teainal
Assistant Ditectons oC pe ional Directors inspect all the
and funcional. The Fe2eth within their Jurisdiction,
branches of pul ecalty. The Functional Directors are
Necapete of i Perec ane of publ heh
usually specials i 14 health, family planning, nutztion,
such as mother and hid Tr Caucation ete. The Puble — *
tuberculosis Tag Organization in most States is Part of the
Health Enaines'i"4 “ment of the State Government, It has,
Public Works Departhy experts in the public health that the
beet cory engineering organization in every State should
public healt eGfate Lealth Department, and that the Chief
tre itonal Director of Health Services
the desianat
fl - AT THE DISTRICT LEVEL
he District
se rrinspal unit of administration in India isthe diset.
ee Pc peton There are 614 (year 2007) districts in
dade clcino saverage” district, that is the distlls vary
ge Thee en and population. Within each distet again,
there are 6 types of administrative areas
Sub-iisons
Tahsils (Talukas).
Community Development Blocks*~
Munidpales and Corporations
Villages
Panchayats, /
Most districts in India are divided into two or more sub:
divisions, each in charge of an Assistant Collector or sib:
Collector. Each division is again divided into tabsils (taluks),
in charge-of a Tabsildar. A tahsil usually comprises between
200 to 600 villages. Since the launching of the Community
Development Programme in India in 1952, the rural areas of
the district have been organized into Blocks, known as
Community development blocks, the area of which may or
may not coincide with a tahsil, The block is a uni obautal
a ponina and
