Unit I Health System in India

Health System in India, Organization and Administration of health Services in India

1. Heath system in India Community Health Nursing-II Unit-I ( III GNM) Mrs.Nagamani.T Associate Professor QHC School of Nursing

2.   Unit Learning objective   Contents   Hr Teaching learning Activities Assessment methods I Explain the health system in Heath system in India Organization and administration of health system in India at Central level Union Ministry Directorate General of Health Services Central Council of Health State level State Health Administration State Ministry of Health State Health Directorate District level Sub Divisions Tehsils/ Talukas Villages Municipalities & Corporation Panchayats 10 Lecture cum discussion Short answer   India     Objective type       Organizational         chart of various Essay type       levels         Visit to Municipality         Office, Panchayat office, Health         block office, CHC  

3. India has a vast health care system, but there remain many differences in quality between rural and urban areas as well as between public and private health care. India's Ministry of Health was established with independence from Britain in 1947. The government has made health a priority in its series of five-year plans, each of which determines state spending priorities for the coming five years.  Introduction

4. 5,000 year old ancient civilization 325 languages spoken – 1,652 dialects 18 official languages 3.28 million sq. kilometers - Area 7,516 kilometers - Coastline >1 Billion population. Worlds largest democracy.

5. Worlds 4th largest economy. Largest English speaking nation in the world. 3 rd largest standing army force 2 nd lar g est poo l o f sc i enti s ts and engineers in the World.

6. India is a union of 29 states and 7 union territories. States are largely independent in matters relating to the delivery of health care to the people. Each state has developed its own system of health care delivery, independent of the Central Government. The Central Government’s responsibility consists mainly of policy making , planning , guiding, assisting, evaluating and coordinating the work of the State Health Ministries.

7. States are largely independent in matters relating to the delivery of health care to the people. Each state has developed its own system of health care delivery, independent of the Central Government. The Central Government responsibility consists mainly of policy making , planning , guiding, assisting, evaluating and coordinating the work of the State Health Ministries.

8. President of India Shri Pranab Mukherjee

9. Vice President of India Muhammed Hamid Ansari

10. Prime Minister of India shri Narendra Modi

11. At the Center The official “organs” of the health system at the national level consist of Ministry of Health and Family Welfare UNIOUN MINISTER OF HEALTH Shree Jagat Prasad Nadda The Directorate General of Health Services The Central Council of Health and Family Welfare

12. Health System in India has 3 links

13. At the central level The official “organs” of health system at national level are

14. Ministry of Health and Family Welfare

15. Organization Structure

16. Functions of MoHFW Union list International health relations and administration of port quarintine Administration of Central Institutes Promotion of research Regulation and development of medical, pharmaceutical, dental and nursing professions Establishment and maintenance of drug standards Census and collection and publication of other statistical data Coordination with states

17. co n t…. Concurrent List: Prevention of Communicable disease Prevention of food adulteration Control of drug and poison Vital statistics Labour welfare Economic and social planning Poulation control and family planning

18. Directorate General of Health Services

19. Organization chart

20. Functions of Directorate General of Health services General functions Surveys Planning Coordination Programming and appraisal of all health matters Specific function International health relations and quarantine of all major ports in country and international airport. Control of drug standards Maintain medical store depots Administration of post graduate training programmes

21. Cont… Council of Administration of certain medical colleges in India Conducting medical research through Indian Medical Research ( ICMR ) Central Government Health Schemes. Implementation of national health programmes Prep a rat i on o f he a lth ed u c a ti o n mat e ri a l for creating he a lth awareness through Health Education Bureau Col l e c ti o n, c o mpilat i on, an a lys i s, evaluat i on and dissemination of information National Medical Library

22. Central Council of health

23. Organization chart

24. Functi o ns To consider and recommend broad outlines of policy related to matters concerning health like environment hygiene, nutrition and health education . To recommend guidelines in all aspects of health i.e. preventive, promotive , curative & rehabilitative. To make proposals for legislation relating to medical and public health matters. To make recommendations to the Central Government regarding distribution of grants-in- aid.

25. State Level

26. Functions: 1. Study and evaluation of health problems, planning and implementing measures against health problems. 2. Supervision of Primary Health Centres and its staff through District Health Officer. 3.Responsible for prevention of any outbreak of communicable diseases 4. Collection, tabulation and publication of vital statistics.

27. 5.Promotion of all health programmes , including National Health Programmes . 6. Training of In Service personnel. 7. Recruitment of Health Personnel for rural health services. 8.Co ordination of health services with other Ministeries of State and voluntary agencies .

28. At District level There are 593 ( year 2001 census) districts in India. Within each district, there are 6 types of administrative areas. Sub –division Tehsils ( Talukas ) Community Development Blocks Municipalities and Corporations Villages and Panchayats

29. Disrtict Level Districts Tehsils /Talukas (200-600 villages) Community Development Blocks (approx 100 Villages & 80,000 - 1.2 Lac Pop) Municipalities & Corporations Municipal Board (10,000- 2 Lac Pop) Corporations (> 2 lac pop) Town Area Committee (5,000-10,000 Pop) Panchayats V ill a ges

30. Finally there are village panchayats, which are institutes of rural local self government. The Urban Area Town area committees - in area with population ranging between 5,000- 12,000 Municipal Boards- in area with population between 10,000-2 lakhs Corporations- with population above 2 lakhs

31. The town area provide sanitary services. The municipal boards are headed by chairman or president, elected by the members. The term of a municipal board ranges between 3-5 years, & functions are Construction & maintenance of roads Sanitation & drainage Street lighting & water supply Maintenance of hospitals & dispensaries Education & registration of births & deaths etc.

32. Corporations are headed by Mayors , elected from different wards of the city. The executive agency includes the Commissioner , the Secretary, the Engineer & the Health Officer. The activities are same as municipalities but on a much wider scale.

33. Panchayati Raj It is a 3 tier structure of rural local self government in India, linking the village to the district. The 3 institutions are; Panchayat- at the village level Panchayat Samiti- at the block level Zila Parishad- at the district level The Panchayati Raj institutions are accepted as agencies of public welfare. All development programmes are channelled through them.

34. They strengthen democracy at its root, & ensure more effective & better participation of the people in the government. 1. At the village level It consists of The Gram Sabha The Gram Panchayat The Nyaya Panchayat Gram Sabha- The assembly of all the adults of the village, which meets at least twice a year. It considers proposals for taxation, discuss the annual programme & elects members of it self.

35. Gram Panchayat An agency for planning & development at the village level. Its strength varies from 15 to 30, & population covered varies widely from 5,000-15,000 or more. The members hold office for a period of 3 to 4 years. Every panchayat has an elected President (Sarpanch /Sabhapati /Mukhiya), a vice President & a Panchayat Secretary.

36. The functions- They cover the entire field of civic administration including sanitation & public health social & economic development of the village maintenance of roads, wells, schools, burning and burial grounds, sanitation, public health, libraries, reading rooms, community centre etc. The Panchayat also keeps records of births and deaths. It makes necessary provisions for the promotion of agriculture and animal husbandry, cottage industries , co-operative societies etc.

37. It seeks to ensure a minimum standard of cultivation for raising agricultural production . In addition, the Panchayat also acts as the agent of the Panchayat Samiti in executing schemes of development at the village level .

38. Nyaya Panchayat The minor disputes among residents of village are also settled by the Village Nyaya Panchayat .

39. 2 . Panchayat Samiti The Panchayat Samiti is the second on join tier of the Panchayati Raj At the Block level It consists of about 100 villages & a population of about 80,000 to 1,20,000. The Panchayati Raj agency at the block level is the Panchayat Samiti /Janpada Panchayat . The Panchayat Samiti generally consists of- ( 1) about twenty members elected by and from the Panches of all the Panchayats falling in the block area; (2) two women members and one member each from the Scheduled Castes and Scheduled Tribes to be co- opted, provided they do not get adequate representation otherwise;

40. It consists of all Sarpanchas of the village panchayats in the Block; MLAs, MPs residing in the block area; representatives of women, scheduled castes, scheduled tribes & cooperative societies. The Block Development Officer is the ex-offici al secretary of it, & his staff give assistant to the village panchayats engaged in development programmes. Function- Execution of the community development programme in the block

41. The President of the Panchayat Samiti is the Pradhan , who is elected by all members of the Panchayat Samiti . Besides the Pradhan , the Up- pradhan is also elected. The Pradhan convenes and presides over the Panchayat Samiti meetings. He guides the Panchayats in making plans and carrying out production programmes .

42. The principal function of the Panchayat Samiti is to co­ordinate the activities of the various Panchayats within its jurisdiction. The Panchayat Samiti supervises the work of the Panchayats and scrutinises their budgets. It also reserves the right to suggest measures for improving the functioning of the Panchayats . The Samiti is charged with the responsibility of preparing and implementing plans for the development of agriculture, animal to SU (husbandry, fisheries, small scale and cottage industries, rural health tropic etc. Functions:

43. 3. Zilla Parishad : At the District level The Zilla Parishad is the agency of rural local self govt. at the district level. The members are all heads of the Panchayat Samities in the district; MPs, MLAs of the district, representatives of scheduled castes, scheduled tribes & women , & 2 persons of experience in administration, rural development. The collector is a non voting member, the members varying from 40-70.

44. The Chairman of the Zilla Parishad is elected from among its members. There is a Chief Executive Officer in the Zilla Parishad . He is deputed to the Zilla Parishad by the State Government. There are subject matter specialists or officers at the district level in all the states for various development programmes .

45. The zilla parishad is primarily supervisory & coordinating body. The District Health Officer ( CDHO) & the District Family Planning & MCH Officers (RCHO ) are under the control of the zilla panchayat .

46. The Zilla Parishad , for the most part, performs co- ordinating and supervisory functions. It coordinates the activities of the Panchayat Samitis falling within its jurisdiction. In certain states the Zilla Parishad also approves the budgets of the Panchayat Samitis . The Zilla Parishad also renders necessary advice to the Government with regard to the implementation of the various development schemes. It is also responsible for the maintenance of primary and secondary schools, hospitals, dispensaries, minor irrigation works etc. It also promotes local industries and art. Functions:

47. Thank you