The health care delivery system in India operates at the village, sub-centre, primary health centre, and community health centre levels. At the village level, Accredited Social Health Activists (ASHAs), Anganwadi workers, and local dais provide primary medical care and health education. Sub-centres serve populations of 5000-3000 and are staffed by Lady Health Visitors who provide maternal and child health services, family welfare programs, and treatment of common illnesses. Primary health centres serve larger populations of 30,000-20,000 and have beds for patients as well as medical officers and staff. Community health centres serve the largest populations and have 30 beds as well as specialists and facilities for childbirth and minor sur

1. Health Care Delivery System
of India
Dr. Arkadeb Kar

3. At village level
• ASHA
• Anganwadi worker
• Local dais

4. ASHA
•Accredited (Recognized by the community)
•Social (From the community, by the community and for the community)
•Health Activist (Spreading awareness for health concerns promoting change in health
related practices)

5. ASHA
• One for 1000 population
• Woman in the age group of 25 to 45
• Resident of the village
• Education up to class 8
• Having good communication and leadership skills

6. Roles of ASHA
• Health education
• Counselling on MCH care
• Accompany women and children to health facility
• Primary medical care
• Provider of DOTS
• Depot holder for IFA, ORS, OCPs
• Improve sanitation

7. AWW
• One for a population of 400 – 800
Roles –
MCH
Nutrition
Immunisation
Pre-school education

8. Sub-centre
• First contact point between the primary health care system and the
community
• One for every 5000 population
Every 3000 population in hilly, tribal areas
• Manpower
• 1 LHV (HWF)
• 1 HWM
• Services provided
• Maternal and child health,
• Family welfare, nutrition, immunization, diarrhoea control and control of communicable diseases
programmes

9. TYPES OF SUBCENTRE

10. Health worker Female
• Duties –
• Record keeping – antenatal register, postnatal register, U-5 register,
eligible couple register, Birth and death, family planning
• Antenatal, intra natal, postnatal care.
• Family planning services
• Health care
• Immunisation
• Notification

11. Health worker male
Duties
• Control of communicable diseases
Malaria
Leprosy
Tuberculosis
• Environmental sanitation
• Immunisation

12. Primary health centre
• Referral unit for 6 Sub-centres and has 4-6 beds for patients
• One for every 30000 in plains
• One for every 20000 in hills
• Man power 1 medical officer and 12/13 other staffs
TYPES OF PHCs
•Type A PHC : PHC with delivery load of less than 20 deliveries in a month.
•Type B PHC : PHC with delivery load of 20 or more deliveries in a month

14. • Roles
1. Medical care
2. MCH including family planning
3. Prevention and control of locally endemic diseases
4. Safe water supply
5. Collection and reporting of vital statistics
6. Health educations
7. National health programs
8. Training
9. Laboratory services

15. Community health centres
• One for a population of 80000 – 120000
• 30 beds
• Specialities in surgery, medicine, obs & gynae, paediatrics

16. Services provided at CHC
• Care of routine and emergency cases in surgery.
• Care of routine and emergency cases in medicine.
• 24 hour delivery services
• Family planning services including Safe abortion services.
• School health services
• Newborn care.
• Adolscent clinic
• Delivery of all National Health Program services.
• Other services like
– Blood storage services
– Essential laboratory services
– Referral (transport) services