LESSIO PLAN -Health-Care-Delivery by sushil poonia.pdf

lession [lan

1. Name of the student : Mr. Sushil Poonia
Subject : Advanced Nursing Practice
Topic : Health Care Delivery System.
Group : 1
st
Year MSc. Nursing
Duration : 50 min
Venue : Govt. College Of Nursing
Date :
Time :
A V Aids : PPT, Poster, Blackboard , handouts
Method of teaching : Lecture Method.

2. GENERAL OBJECTIVES:
 At the end of the class group will get adequate knowledge regarding Health care delivery system.


SPECIFIC OBJECTIVES:
Group will be able to
 To Introduce the Health care delivery system
 To Define the Health care delivery system.
 To Explain the level of health system
 To describe the sectors of Health care delivery system.
.

3. SL.
NO
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TIME SPECIFIC
OBJECTIVE
CONTENTS AV
AIDS
TEACHING
LEARNING
ACTIVITY
EVALUATION

1.















2.











5 min















5 min


























To define
Health care
delivery
system





INTRODUCTION
As it is well known that the over whelming
majority of India’s population live in the rural
area and a segment of the population have been
given in adequate attention so far as health and
medical care facilities are concerned.
In modern time the basis for health care
services organizations and infrastructures have
undergone extensive changes and expansion in
following reasons by a m\number of expert
committees. With the Alma Ata declaration of “
health for all” by 2000 AD primary health care
become the states of India’s are developing
their health care services system

DEFINITION
Health care delivery system concern is to
develop the system which ensures based
comprehensive health care services to people at
large especially those living in e\remote and
backward areas using available resources ( man
power, money, material ) as effectively as
possible.




Chalk
board,
PPT









PPT
Teacher
introduces
the topic














Write Down
the definition
OF TOPIC
Introduces the
topic.















Defines the
Health care
delivery system

4. SL.
NO.
TIME SPECIFIC
OBJECTIVE
CONTENTS AV
AIDS
TEACHING
LEARNING
ACTIVITY
EVALUATION


3.



25
MIN.


To Explain
the level of
health system


The health system in India has 3 main level.
1. Central
2. State
3. Local or peripheral

At the center
The official “ organs” of the health system at the
national level consist of
Ministry of health and family welfare.
The directorate general of health services.The
central council of health and family welfare.

a. Ministry of health and family welfare
The ministry of health and family welfare is
headed by a cabinet minister, a minister of state
and deputy health minister. These are political
appointments currently the union health minister
has the following departments:

Functions:

Union list

1. International health relations and
administration of port quarantine.




PPT


Explain the
levels of
health
systemand
and students
lession
carefully


Explaines the
levels of health
system

5. SL. TIME SPECIFIC
OBJECTIVE
CONTENTS AV
AIDS
TEACHERS
ACTIVITY
EVALUATION
1.





























2. Administration of central institutes such as
all India Institute of hygiene and public
health, Kolkata.
3. Promotion of research through research
centers.
4. Regulation and development of medical,
pharmaceutical, dental and nursing
profession.
5. Establishment and maintenance of drug
standards.
6. Census and collection and publication of
other statistical data.
7. Immigration and emigration.
8. Regulation of labour in the working of
mines and oil fields.
9. Coordination with states and with other
ministries for promotion of health.


concurrent list
are the responsibility of both the union and
state governments.
1. Prevention and extension of
communicable diseases.
2. Prevention of adulteration of food
stuffs.
3. Control of drugs and poisons.







































Lecture cum
discussion.

6. SL
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AIDS
TEACHERS
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4. Vital statistics.
5. Labour welfare.
6. Ports other than major.
7. Economic and social planning.
8. population control and family
planning.

1. The directorate general of health
services.
The director general of health services is the
principle advisor to the union govt. in the
both medical and public health matters he is
assisted by a team of deputies and a large
administrative staff.

Functions:
The general functions are survey, planning,
coordination, programming and appraisal of
the health matters in the country.

International health relations and
quarantine of all major ports in country and
international air port ( Kolkata,
Visakhapatnam, Chennai, Mumbai) are
delivery controlled by the directorate general
of health services.








PPT








TEACHER
EXPLAIN
THE TOPIC


.







Explains the
directorate
general of health
services.

7. SL. TIME SPECIFIC
OBJECTIVE
CONTENTS AV
AIDS
TEACHERS
ACTIVITY
EVALUATION
1.



and is headed by the drugs controller. Its
primary function is to lay down and enforce
standards and control the manufacture and
distribution of drugs through both central and
state government officers.
2. Maintain medical store depots : these
depots supply the civil medical requirements
of the central governments. These depots also
handle supplies from foreign agencies. Eg.
Mumbai, Chennai, Kolkata .
3 Administration of post graduate
training programmes : The Directorate
general of health services is responsible for
administration of national institutes, which
also provide post graduate training to
different categories of health personnel. Eg.
All India institute of mental health At
Bangalore.
4.Administration certain medical colleges
in
India : There are many medical colleges in the
country which are guided and supported by
the center. Eg. The Maulana Azad and the
medical colleges at Pondicherry.
5.Conducting Medical Research: Through
Indian Council of Medical Research (ICMR)
founded in 1911 in New Delhi. The council

8. SL. TIME SPECIFIC
OBJECTIVE
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AIDS
TEACHERS
ACTIVITY
EVALUATION












































































plays a significant role in aiding, promoting
and coordinating scientific research on human
disease their causation, prevention and cure.
The research work is done through the
council’s several permanent research
institutes, research units, field survey and a
large number of ad-hoc research enquiries
financed by the council. It maintains cancer
research centre tuberculosis chemotherapy
centre at Chennai. The funds of the budget of
the union ministry of health.
6. Central Government Health Scheme
7. Implementation of National health
programmes: The various national health
programmes for the eradication of malaria
and for the control of Tuberculosis,
Filarial , leprosy and other communicable
diseases. involve expenditure of crores of
rupees. The central directorate play a very
important part in planning, guiding and
coordinating all the national health
programmes in the Country.
8. Preparation of health education
material
for creating health awareness through Central
health education Bureau : The bureau offers
training courses in the health education to
different categories of health workers.

9. SL. TIME SPECIFIC
OBJECTIVE
CONTENTS AV
AIDS
TEACHERS
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EVALUATION




































































9. Collection, compilation, analysis,
evaluation and dissemination of information
through the central Bureau of the Health
intelligence.
10. National medical library : The aim is to
help in the advancement of medical, health and
related sciences by collection, dissemination and
exchange of information

1. 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 for
promoting coordinated and concerted action
between the centre and the states in the
implementation of all the programmes and
measures pertaining to the health of the nation.
The union health minister is the chairman and the
state health ministers are the members.

Functions:
1. To consider and recommend board
outlines of policy in regards to matters
concerning health in all its aspects such as the
provision of remedial and preventive care,










PPT










Describe the
CCH and
students
understand it


















Explains central
council of health.

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OBJECTIVE
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environmental hygiene, nutrition, health
education and the promotion of facilities for
training and research.
2. 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.
3. To make recommendations to the
central government regarding distribution of
available grants – in – aid for health purposes to
the states and to review periodically the work
accomplished in different areas through the
utilization of these grants- in – aid.
4. To establish any organization or
organizations invested with appropriate function
for promoting and maintaining co-operation
between the central and state health
administration.
II. At the state level
1. State ministry of health
2. state health directorate
The health subjects are divided in to three groups
: Federal, concurrent and state.
The state list is the responsibility of the state
including provision of medical care preventive
health services and pilgrimage with in the state.
At present there are 28 states in India each state
having its own health administration.

11. SL. TIME SPECIFIC
OBJECTIVE
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1. State ministry of health
The state ministry of health headed by a minister
of health and family welfare and
a deputy minister of health and family welfare.
The health secretariat is the official organ of the
state ministry of health and is headed by a
secretary who is assisted by deputy secretaries,
under secretaries and a large administrative staff.
The secretary is a senior officer of the Indian
administrative service.
Function:
1. Formulation review and
modification of board policy outlines.
2. Execution of policies programmes etc
3. Coordination with govt. of India
and other state governments.
4. Control for smooth and efficient
functioning of administrative machinery.

2. State health directorate
Two separate major departments, medical and
public health are functioning in the state
1. The Directorate of health services
or the director of medical and health services.
2. The Directorate of health and family
welfare.
3. Directorate of medical education









.

12. SL. TIME SPECIFIC
OBJECTIVE
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for the management of medical colleges and
hospitals. The directorate of public health
services
I. At the district level
The principle unit\t of administration in India is
the district under a collector. There are 593 ( year
2001) district in India. With in each district there
are 6 types of administrative areas.
1. Sub division
2. Tehsil (taluka)
3. Community development blocks.
4. Municipalities and corporations.
5. Villages.
6. Panchayats.
Most District in India are divided in to two or
more Subdivision, each incharge of an assistant
collector of sub collector.
Each division is again divided in to taluka
incharge of the a Thasildar. A taluka usually
comprises between 200 to 600 villages.
The community development block comprises
approximately 100 villages and about 80,000 to
1,20,000 population in charge of a block
development officer.
Finally there are the villages Panchayats, which

13. SL. TIME SPECIFIC
OBJECTIVE
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are institutions of rural local self government.
The urban areas of the district are organized in to
Town area committees ( in areas with population
ranging between 5,000 to 10,000)
Municipal boards (in areas with population
ranging between 10,00 to 2,00,000)Corporations
( with population above 2,00,000)
The town area committees are like
Panchayats.They provided sanitary services.
The municipal boards are headed by chairmen/
president, elected by members.
PANCHAYAT RAJ
The panchayat raj is a 3- tier structure of rural
local self government in India, linking the village
to the District
1. Panchayat – at the village level
2. Panchayat samiti – at the block level
3. Zilla parishad- at the District level
The panchayat raj institutions are accepted as
agencies of public welfare.
All development programmes are channeled
through these bodies.
The panchayat raj institutions strengthen
democracy at its root, and ensure more effective
and better participation of the people in the
government.




































Teachers ask the
questions and
students answer
the questions

14. SL. TIME SPECIFIC
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AIDS
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Panchayat - at the village level
The panchayat raj at the village level consist of
The gram sabha, The gram panchayat,
The nayaya panchayat
Gram sabha : It is the assembly of the all the
adults of the village, which meets at least twice
a year the gram sabha considers proposals for
taxation discusses the annual programmes and
elects members of the gram panchayat.
Gram panchayat :
It is the executive organ of the gram sabha and
an agency for planning and development at
the village level. The power and functions of the
panchayat secretary are vary wide-they cover the
entire field of public health and of social and
economic development of the village.
Nayaya panchayat : nayaya panchayat is
comprised of 5 members from the panchayat. It
tries to solve the dispute between two
parties/groups/individuals over certain matter
on mutual consent. Thus saves the trouble of
going to formal judicial system.
Panchayat samiti– at the block level
The panchayat samiti consist of all sarpanchas
(heads) of the village Panchayats in the block;

15. SL. TIME SPECIFIC
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MLAs, MPs residing in the block area;
representatives’ of women, scheduled tribes and
cooperative societies. The block development
officer (BDO) is the ex – officio secretary of the
panchayat samiti.
The prime function of the panchayat samiti is the
execution of the community development
programme in the block. The block development
officer and his panchayat engaged in
development work.
Zilla parishad - at the District level
The Zilla parishad / Zilla panchayat is the agency
of rural level local – self- government at the
district level.
The members of the Zilla parishad include all
heads of the panchayat samitis in the district;
MPs, MLAs of the district; representatives of
scheduled castes, schedule tribes and women;
and 2 person of experience in administration,
public life or rural development.
The Zilla parishad is primarily supervisory and
coordinating body. Its functions and powers vary
from state to state.

16. SL. TIM
E
SPECIFIC
OBJECTIVES
CONTENTS AV AIDS TEACHERS
ACTIVITY
EVALUATION
1.
4.
15
min
To Describe the
sectors of
Health care
delivery system.



HEALTH CARE DELIVERY SYSTEM IN
INDIA; SECTORS
In India it is represented by five major sectors or
agencies which differ from each other by health
technology applied and by the source of fund
available. These are:
1) Public Health Sector
2) Private Sector
3) Indigenous system of Medicine
4) Voluntary Health Agencies
5) National Health Program’s

1)Public Health Sector
i. Primary Health Care
I.Village Level
One of the basic tenets of this is universal cove
rage and equitable distribution of health res
ources.
Village Health Guides
A village health guide is a person with an aptitude
for
Social service and is not a fulltime government
functionary.
The health guide are now mostly women.
They serve as links between the community and
the Governmental infrastructure.
They provide the first contact between the
individual and health system.
PPT

Describe the
sector and
students
understand its
Describes the
sectors of health
care delivery
system.

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Guidelines: Be permanent resident of the
local community Have minimum formal
education (VI class) Spare at least 2‐
3 hours/day for community health work
After selection ,they undergo training in nea
rest PHC for 3 months .1 for each village per 10
00 rural population
 Duties
Treatment of simple medical problem and first
aid,
Mother and child health care including family plan
ning, Health education and Sanitation
b. Training of Local Dais
Traditional birth attendants‐
concepts of maternal and child health and steriliza
tion, besides obsteric skills. The training is for 30
working days. She is paid a stipend of Rs. 300 duri
ng her training period. Training is given at the PH
C, subcenter or MCH center for 2 days in a week,
and on the remaining four days of the week they ac
company the health worker.They are expected to pl
ay vital role in propagating small family normsem
phasis is given on asepsis so that home deliveries a
re conducted
under safe hygiene to reduce maternal and child m
ortality.
c. ICDS scheme (Anganwadi Workers)

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Under the ICDS (Integrated Child Development
Services) scheme, there is an Anganwadi for a
population of 1000.there is about 100 such
workers in each ICDS Project Training in
various aspects of health, nutrition, and child
development for 4 months.
b .Sub center level
1 subcentre‐
5000 population in general but in hilly, tribal
and backward areas 1 ‐3000 population.
•Two functionaries at this level ‐
Health worker male and health worker femal
e (multipurpose worker).6‐
8 month in service training and orientation by
PHCs medical officer.
Form a link between health guide and PHC &
responsible for all
health services and programs in that area
work under the supervision of health assistant
ii,Hospital/Health Centres
Community health centres.
Rural health centres.
District hospitals/health centre.
Specialist hospitals.
Teaching hospitals.

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iii.Health Insurance Schemes
Employees State Insurance.
Central Govt. Health Scheme.
iv.Other Agencies
Defence services.& Railways.
2) Private Sector
A. Private hospitals, polyclinics,
nursing homes and dispensaries.
B. General practitioners and clinics.

3) Indigenous system of Medicine
Ayurveda ,Sidda ,Unani ,Homeopathy
Naturopathy, Yoga, Unregistered practioner.
4) Voluntary Health Agencies
1.Indian Red Cross Society
2.Hind Kusht nivaran sangh
3.Indian council for child welfare
4.Tuberculosis association of India
5.Bharat sevak samaj
6.Central social welfare board
7.The kasturba memorial fund
8.The All‐India blind relief society
9.Professional bodies
10.International agencies

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2

















5) National Health Program’s
1.Anti‐malaria program
2.National filaria control program
3.Kala‐azar control program
4.Japanese encephalitis control
5.Dengue control
6.National Leprosy‐eradication program
7.National tuberculosis program
8.National AIDS control program
9.National program for control of blindness
10.Iodine deficiency program
11.Universal immunization program
12.Reproductive and child health program
13.National caner control program

21. Summery
In todays class we discussed about health care delivery system, meaning and definition, determinant and component of health
care delivery system, levels of health care delivery system and sectors of health care delivery system etc.

Conclusion
After the end of this lesson plan the group will be able to understand regarding health care delivery system, its determinant
and component, levels and various sectors of health care delivery system etc.
BIBLIOGRAPHY:
 B.T.Basavanthappa’s “community health nursing”, Jaypee brothers, 2
nd
edition, pp752-753
 Stanhope Lancaster, “ Community health nursing” Mosby publications, 18
th
edition, pp 791-792
 Park .K, “ Preventive and social medicine”, Bhanot publishers, 18
th
edition, pp325-326.

 http://en.wikipedia.org/wiki/ emergency management in children