Health Care Delivery System
In India
•Union of 29 states
and 9 union
territories
•Population is more
than 1.3 Billion
•Rural population
65%
•Diversified culture
•Developing country
National Level
State Level
District Level
CCH
DGHS
MOHFW
Village/ Local
Sub-District
Taluka
Municipality
CD Block
Panchayat
Village
PanchayatSamiti
ZilaParishadPanchayat
01-NATIONAL LEVEL
The official organs of the health system at the
national level consist of:
1.The ministry of health and family welfare
2.The Directorate general of health services
3.The central council of health.
Functions
•Surveys
•Planning
•Co-ordination
•Programming
•Appraisal of all health matters in the country
02-STATE LEVEL
1.State ministry of health
2.State health directorate
Functions
•Prevention of ofcommunicable and NCDs
•Prevention of adulteration of food stuffs
•Controls of drugs and poisons
•Vital statistics
•Labour welfare
•Ports other than major
•Economic and social planning
•Population control and family planning
03-DISTRICT LEVEL
AdministrationinIndiaisthedistrictunderthe
Collector(720districtsin2019).Withineachdistrict
againthereare6typesofadministrativeareas:
1.Sub-Divisions
2.Talukasor Tehsils
3.Community Development Blocks (Rural)
4.Municipalities and Corporations (Urban)
5.Villages
6.Panchayats
( District Collector, Dy.DC, MP, MLA, BDO, Parsad,
Sarpanch, Ward member etc)
Function at district level
1.construction and maintenance of roads
2.sanitation and drainage
3.street lighting
4.water supply
5.maintenance of hospitals and dispensaries
6.education
7.registration of births and deaths.
4. LOCAL LEVEL/Village
1.Panchayat( at the village level)
2.Panchayatsamiti(at block level)
3.Zilaparishad(at district level)
At the village level :The PanchayatiRaj at the
village level consists:
•Gram sabha
•Gram panchayat
•Nyayapanchayat
HEALTH CARE MODEL IN INDIA
HEALTH
CARE
SERVICES
INPUT
HEALTH
CARE
SYSTEM/
Organization
OUTPUTS
HEALTH
STATUS &
Health Problems
RESOURCES
CURATIVE
PREVENTIVE
PROMOTIVE
Rehabilitative
PUBLIC
PRIVATE
VOLUNTARY
INDEGENOUS
NGOs
CANGES
IN
HEALTH
STATUS
HEALTH STATUS
AND
HEALTH PROBLEMS
IN INDIA
Major HEALTH PROBLEMS IN INDIA
1.COMMUNICABLE DISEASES:
1.Malaria
2.Tuberculosis
3.Diarrheal diseases
4.Leprosy
5.Filaria
6.HIV Aids
7.ARI
8.Others
Kala-azar, meningitis, viral hepatitis, Japanese
encephalitis, enteric fever, guinea worm diseases.
3. ENVIRONMENTAL SANITATION:
a)Lack of safe water in many areas of the
country
b)Use of primitive methods for excreta
disposal/open Defecation
c)Pollution
4. MEDICAL CARE PROBLEMS:
1.Unequal distribution of health resources
between rural and urban areas
2.Lack of penetration of health services within
the social periphery.
3.Lack of financial resources to treat persons in
large hospitals
4.No proper facilities to people
5. POPULATION PROBLEMS:
a) employment
b) education
c) housing
d) health care
e) sanitation
f) environment
Kolkata,India
Organizational framework of Health Care Systems
PUBLIC SectorPrivate Sector AYUSH NGOs & Health
Agencies
A. Primary Health
Care
a. Primary health
centers
b. Sub centers
a. Private
hospitals,
polyclinics, nursing
homes
b. General
practitioners’
clinics
c. Dispensaries
a. Ayurveda
b. Siddha
c. Unani
d. Tibbi
e. Homeopathy
f. Yoga
g. Unqualified and
unregistered
practitioners.
a. SEVA Bharati
Rural
b. Bhansali
Trust
c. ARCH Mangrol
( Action Research in
Community Health
& Development)
B. Hospitals
a. CHC /Taluka
Hospitals
b. District hospitals
c. Teaching hospitals
d. Specialist hospitals
C. Other agencies
a. ESIC Hospitals
b. Railway hospitals
c. Defense hospitals
Primary Health Care
•The Alma (1978) –Ata conference called for
proclaimed primary health care as way to
achieving health for all.
•Health For All (HFA)
DEFINITION:
Primaryhealthcareistheessential
healthcare made universally
accessible toindividualsand
acceptabletothem,throughtheirfull
participationandatacostthe
community and thecountrycan
afford.
PURPOSES
1.Increase in lifeexpectation.
2.Improvement in nutritionalstatus.
3.Provision of basicsanitation.
4.Development of manpower andother
resources.
8-Essential Components of primary
healthcare.
1.Education concerning prevailing health
problems and the methods of preventing and
controlling.
2.Promotion of food supply and proper
nutrition.
3.Adequate safe water supply and basic
sanitation.
4.Maternal and child health care, including
family planning.
5.Immunization against major infection
disease.
6.Privation and control of locally endemic
diseases.
7.Appropriate treatment of common disease
and injuries.
8.Provisional treatment of community.
5 –As of Primary Health Care
Accessible
Affordable
Primary healthcare
Acceptable
Appropriate
Adaptable
ATTRIBUTES OF PRIMARYHEALTH
CARE
•Essential healthcare
•Universallyaccessible
•Acceptable
•Communitybased
•First point ofcontact
•Affordability
Principles
1.Equitabledistribution
2.Manpower development
3.Community participation
4.Inter-sectoralcoordination
5.Appropriatetechnology
Tier of health care in India
The health care services in India are organized at three levels,
each level supported by the higher level, to which the patient is
referred.
Tertiary
State Hospital
Medical Colleges
Secondary
DH / CHC / TalukaHospital
Primary
PHC / Sub Centre
Staffing of Primary health care in
India –in rural areas
1. Village level
•Atvillageleveltherearehealthfunctionarieschosen
bythelocalcommunitythemselves.
1.Villagehealthguide,
2.LocalDai,
3.ASHAand
4.Anganwadiworker.
3. Primary health centre (PHC)
The concept of a PHC was given by Bhore
committee.
•Currently there is 1 PHC per 30,000 population
in plain areas & 20,000 in tribal, hilly and
backward areas.
•It has a staff of 15 including a doctor.
•6 Beds
4. Community health centre (CHC)
Established at block level
Catering to a population of 80,000 to 120,000.
first referral units (FRU) from PHCs.
Total staffing strength is 25.
30 IPD beds.