HEALTH PLANNING IN INDIA• Started in 1938• Bhore committee,1943• Sir Joseph bhore• To survey the then existing position regarding the health condition and health organisations• To make future recommendations• Submitted report in 1946
The committee observed that….• “If the nation’s health is to be built ,the health programme should be developed on a foundation of preventive health work and that such activities should proceed side by side with those concerned with the treatment of patients”
Guiding principles adopted…• No individual should be denied to secure adequate medical care because of inability to pay• Facilities for proper diagnosis and treatment.• Health programme must lay special emphasis on preventive work.• As much medical relief and preventive health care should be provided to the vast rural population
Continued…• Health services should be located close to the people to ensure maximum benefit to the community.• Doctor should be a social physician protecting the people.• Medical services should be free to all,without distinction.
Observations made by the committee….• Health status of the country as indicated by various indicators was poor.• Mortality rates were very high.• Life expectancy at birth was about 27yrs.• Incidence of communicable diseases was very high.• Many of the health problems were preventable.
Continued…• Committee stated that health and development are interdependent.• Improvement in sector other than health will also lead to improvement in health like water supply ,sanitation improvement ,nutrition ,elimination of unemployment.
Important Recommendations..• Integration of preventive and curative services at all administrative levels.• Minimum required ratio 567 hospital beds,62 doctors,151 nurses per 1,00,000 population.• The committee visualised the development of PHC in 2 stages:
Continued…1.A short term measure Each PHC-40,000 POP,2 MOs,4 PHN,1 nurse,2 midwives,4 trained dais, 2 sanitory inspectors,2 health assistants 1 pharmacist and 15 other class Iv employees.2.A long term programme (3 million plan) consist of health care system in 3 tiers
PRIMARY UNIT• 10000-20000 pop,75 hosp beds,6 MOs,6 PHN,2 sanitory inspectors,2 health assistants and 6 midwives.• 25-med ,10-sur ,10-obs&gyn, 20-infect ds, 6-malaria & 4-TB.• Highly dense province - 20,000/PU• Highly dispersed province - 10,000/PU
SECONDARY UNIT• 60 primary units under a secondary unit• 650 hosp bed,140 doc,180 nurses, 178 other staffs,15 hosp social workers,50 ward attendants and 25 compounders.• 150-med , 200-sur ,100-obs&gyn , 20-inf ds, 10-malaria ,120-TB , 50-ped.• First level referral hospital.
DISTRICT HOSPITAL• 2500 beds,269 doc,625 nurses,50 hosp social workers and 723 other workers.• 300-med, 350-sur,300-obs, 54-TB, 250-ped, 300-lep,40-inf ds,20-malaria,400-mental illness.• Nutrition ,health education , professional/UG/PG education ,population problem.• 2 grades in nursing profession.
Continued…• Village health committee, medical research.• Special attention to diseases like malaria ,TB ,small pox ,leprosy ,plague ,cholera , veneral ds , filariasis ,mental illness.• Special programmes for health of mothers and children, environmental hygiene and occupational health for industrial workers.
SIGNIFICANCE & IMPORTANCE OF BC REPORT• Imp landmark in public health in india.• Initiated the concept of integrated development & comprehensive health care.• Idea of primary health care.• The three tier pattern of health care services.