LEVEL OF HEALTHCARE.seminar.hgfyhgvvhhpptx

hguwuqguqwusgqusgqwus

1. LEVEL OF HEALTHCARE ORGANISATION Presented by: Anupam Sisodia 1

2. HEALTH According to WHO, health is defined as “a dynamic state of complete physical, mental and social well-being not merely an absence of disease or infirmity”. HEALTH CARE SERVICES It is defined as “multiple services rendered to individuals, families or communities by the purpose of promoting, maintaining, monitoring or restoring health.” 2

3. L evels of health care organization 3

4. PRIMARY LEVEL OF HEALTH CARE 4

5. SECONDARY LEVEL HEALTH CARE 5

6. TERTIARY LEVEL HEALTH CARE 6

7. HEALTH CARE DELIVERY SYSTEM According to Stanhope (2001), healthcare delivery system refers to the totality of resources that a population or society distributes in the organization and delivery of health population services. It also includes all personal and public services performed by individuals or institutions for the purpose of maintaining or restoring health. 7

8. Philosophy of health care delivery system: 8

9. 9

10.   Principles of health care delivery system: 10

11. Functions of health care delivery system: 11

12. Determinants of Health care system in India 12

13. 1.   Public health sector Primary healthcare Hospitals/health centres Health insurance schemes Other agencies   2.   Private sector Private hospitals, nursing homes and dispensaries General practitioners and clinics 3. Indigenous system of medicine Ayurveda and siddha Unani Homeopathy Unregistered practitioners 4. Voluntary health agencies 5. National health programs 13

14. Primary healthcare system in India According to Alma-Ata, “Primary health care is essential health care made universally accessible to individuals and acceptable to them, through their full participation and at a cost the country and community can afford”. 14

15. Elements of primary health care are: 15

16. Equitable distribution Community participation Intersectoral coordination Appropriate health technology Coverage and accessibility Multisectoral approach Human resource Services by community health workers and traditional health practitioner Referral system Logistic of supply The physical facilities Control and evaluation 16 PRINCIPLES OF PRIMARY HEALTH CARE

17. PRIMARY HEALTHCARE INFRASTRUCTURE Level Population Functionaries Plain Hilly/difficult Village 1000   Health volunteers, Anganwadi workers, Trained workers subcentre 5000 3,000 Multipurpose health workers PHC 30,000 20,000 Health professionals CHC 1,20,000 80,000 Specialists 17

18. Village 18

19. Selection Every village / large habital (1000 population) will have a female community health chosen by and accountable to the panchayat to act as the interface between the community and the public health care system. Qualities or Requirements for ASHA ASHA must be primarily a women resident of the village-married/ widow/ Divorced and preferably in the age group of 25 year. She should be a literate woman with formal education up to 8th class. The Indian MoHFW describes ASHA as: ...health activist(s) in the community who create awareness on health and its social determinants and mobilize the community towards local health planning and increased utilization and accountability of the existing health services. 19

20. 20

21. 21

22. STAFFING OF SUBCENTERS TYPE A TYPE B One ANM (Essential), Two ANMs: (Desirable to split the population between them and one of them provides outreach services and the other is available at the Sub-centre) One Health Worker (Male) (Essential) Two ANM (Essential) One Health Worker (Male): (Essential) One Staff Nurse or ANM (if Staff Nurse not available) (Desirable, if number of deliveries at the Sub-centre is 20 or more in a month) 22

23. Primary health centers (PHC) 23

24. 24

25. 25

26. Community health centre (CHC) 26

27. Staffing pattern of CHC Category No Category No Medical officers 4 Dhobi 1 Nurse midwives 7 Sweepers 3 Dresser 1 Maid 1 Pharmacist 1 Chowkidar 1 Lab technician 1 Aya 1 Radiographers 2 Peon 1 Ward boys 2     27

28. HEALTH INSURANCE 28

29. 29

30. 30

31. 31

32. VOLUNTARY HEALTH AGENCY 32

33. National Rural Health Mission (NRHM) 33

34. 1. RCH-Phase II 2 . Non communicable disease programs - National diabetes control program - National cancer control program 3. Nutritional Program - ICDS - Mid day meal - Balwadi nutrition program - Applied nutrition program Iodine deficiency disorder control program - National nutritional anemia prophylaxis program National program for control of blindness 4. National mental health program 5 . National water supply and sanitation program 6. National family welfare program 7. Communicable disease control program - National vector borne disease control program - National leprosy eradication program - Revised national tuberculosis control program - National AIDS control program 34 All national health programs are being run under NRHM. NRHM includes following health programs:

35. ORGANIZATION OF THE HEALTH CARE DELIVERY SYSTEM AT DIFFERENT LEVELS: 35

36. INDIA HAS 3 MAIN LINKS 36

37. I) AT THE CENTRAL LEVEL: 37

38. 38

39. 39

40. 40

41. 41

42. Was set up by Presidential order on 9th August 1952 under article 263 of the constitution of India. 42

43. 43 Functions: 1) Broad outlines of policy concerning health & its aspects. 2) Proposals for legislation. 3) Recommendations to the central Government. 4) To establish any organization.

44. II. AT THE STATE LEVEL: 44

45. 45

46. 46

47. 47

48. 48

49. 49

50. III) AT THE DISTRICT LEVEL: 50

51. 51

52. 52

53. 53

54. COMMUNITY LEVEL 54

55. 55

56. NURSE’S ROLE ON HEALTHCARE TEAM 56

57. 57

58. 58

59. 59

60. 60

61. CURRENT RESEARCHES: Kirti Sundar Sahu, Bhavna Bharati conducted a community-based, cross-sectional survey on Out-of-Pocket Health Expenditure and Sources of Financing for Delivery, Postpartum, and Neonatal Health in Urban Slums of Bhubaneswar, Odisha, India. Among a sample of 240 recently delivered women. Only 29.6% of the households incurred OOPE, and the others incurred either nil OOPE or had a net income because of benefits received from Janani Shishu Suraksha Karyakram (JSSK), Janani Suraksha Yojana (JSY), and “Mamata” schemes of the government. The median total OOPE was found to be 2100 INR (100–38,620). . 61

62. Multivariate analysis found parity, place of delivery, type of delivery, and presence of morbidity to be significantly associated with incurring any OOPE. Nearly 15% of the households incurred OOPE exceeding 40% of the reported monthly household income including 9%, whose OOPE was 100% or more of the reported household monthly income. • Conclusion: While mechanisms such as JSSK, JSY, and Mamata had benefitted the vast majority, around half of those who did incur OOPE experienced catastrophic expenditure (CE). Additional insurance facility for cesarean section delivery might reduce the excessive financial burden on households. 62

63. CONCLUSION In conclusion, the healthcare delivery system in India is multifaceted, facing numerous challenges yet brimming with opportunities for improvement. As future advanced nursing practitioners, it is incumbent upon us to advocate for equitable, accessible, and high-quality healthcare for all. By embracing innovation, collaboration, and a patient-centered approach, we can contribute significantly to transforming India's healthcare landscape. 63

64. REFRENCES HC, B.N.K.R. (2015) Textbook of Advanced Nursing Practice . Jaypee Brothers Medical Publisher (P) Ltd., new delhi : jaypee . PARK, K. (2023) Parks Textbook of Preventive and Social Medicine . S.l. : B Home : Ministry of health and family welfare: GOI (no date) Home | Ministry of Health and Family Welfare | GOI . Available at: https://main.mohfw.gov.in/ (Accessed: 29 April 2024). Health Care Delivery System in India (2018) SlideShare . Available at: https://www.slideshare.net/NidhiChauhan17/health-care-delivery-system-in-india-97800433 (Accessed: 29 April 2024). Health Care Delivery Sysytem in India . Available at: https://ucms.ac.in/Lectures-C-2020/Health care delivery sysytem in india-2020.pdf (Accessed: 29 April 2024). Ministry of Health and Family Welfare (2024) Wikipedia . Available at: https://en.wikipedia.org/wiki/Ministry_of_Health_and_Family_Welfare (Accessed: 29 April 2024). Guidelines for Primary Health Centres . Available at: https://nhm.gov.in/images/pdf/guidelines/iphs/iphs-revised-guidlines-2012/primay-health-centres.pdf (Accessed: 29 April 2024 Guidelines for sub-centres - national health mission . Available at: https://nhm.gov.in/images/pdf/guidelines/iphs/iphs-revised-guidlines-2012/sub-centers.pdf (Accessed: 29 April 2024). 64

65. MCQ’S 65

66. 66 Identify the national health program depicted by the symbol: RNTCP NIDDCP NRHM NVBDCP

67. 67 Population covered by a sub-center in hilly areas: 5,000 3,000 10,000 30,000

68. 68 In India, which one of the following is the first referral unit? Subcenter Primary health center Community health center Regional hospital

69. 69 The three tier system of local self government at block level? Panchayat samiti Gram Sabha Nyaya panchayat Zila parishad

70. 70 All are true about Anganwadi workers except? Part time worker Covers population of 5000 Supply nutrition and educate about vaccination Under control ICDS

71. 71 THANKYOU!