community health nursing

2. Health care system
M.Amala seeli
M.sc nursing,p.g.dhs

3. Healthcare
central
state
Local

4. At central level

5. Ministry of Health and
Family Welfare
It is the apex body to make health policies and plans
Headed by union ministry of health and family
Implementation of all health programmes in national
scale

7. Functions of MoHFW
Union list
International health relations and administration of port quarintine
Administration of Central Institutes and 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

8. 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

9. Directorate General
of
Health Services

10. 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

11. Administration of certain medical colleges in India
Conducting medical research through Indian Council of
Medical Research ( ICMR )
Central Government Health Schemes.
Implementation of national health programmes
Preparation of health education material for creating
health awareness through Health Education Bureau
Collection, compilation, analysis, evaluation and
dissemination of information
National Medical Library

12. Central Council of health

13. Functions
To consider and recommend broad outlines of policy related
to matters concerning health like
environment hygiene, nutrition and health education.
To make proposals for legislation relating to medical and
public health matters.
To make recommendations to the CentralGovernment
regarding distribution of grants-inaid.

14. AT STATE LEVEL
The management sector
comprises the State Ministry of
Health and a Directorate
Health of State.

16. Rural health services through minimum needs programme
Medical development programme, MCH, family welfare and
immunization programme
NMIP(malaria)& NFCP(filaria), NTCP, Prevention and
control of communicable diseases like diarrhoeal diseases,JE
Laboratory services and vaccine production units
Health education and training programme, curative
services etc

17. Chief Medical Officer is overall responsible for the
administration of medical/ health services in the
entire district.
The district level structure of health services is a
linkage system between the state and
peripheral level structure

18. Medical Superintendent /Zonal Medical Officer
specialists of Gynaecology, Child Health
Medicine ,Surgery Public Health ,Medicine
Surgery Public Health and family planning
Lab technician ,X-ray technician, Extension
Education officers, Health Staff, Nursing Staff
and Hospital Staff

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

20. Urban health
administration
M.AMALA SEELI
M.SC NURSING,P.G.DHS

21. Main units of urban administration are
municipality
Municipal
boards
Town area
committees

22. Municipal corporation
Top level urban local government
Population over 2 lakh
Headed by mayor .It has council, councilors elected
from different wards and their term is five years
At the administration level CEO look after to it and he is
called as commissioner
Health officer is responsible for the health and sanitation
of the city and disposal of waste

23. Municipalityboards
It is were the population of the city is 1L to 2L population
It has three components
chairman
Municipal commissioner
Executive officer

24. It is headed by chairman who is elected by board
members
Board members from different wards
Its term for 3-5 years
Sanitary inspectors are responsible for cleaning of the
city

25. Role of municipal board
Waste
disposal
Water
supply
sanitation
Death and
birth
registration
Construction of
roads
Street
lights

26. Town area committees
Town are between village and city
They are administrated under district collector
Town areas are found in MP, UP, WB, J&K, TN ,Gujatat
Population is 5k to10k
Responsible for sanitation

27. Rural administration
Panchayat Raj -
The panchayat raj is a 3-tier structure of rural local
self-government in India linking the village to the
district.It includes
Ø Panchayat (at the village level)
Ø Panchayat Samiti( at the block level)
Ø Zila Parishad(at the district level

28. Panchayat (at the village level):
The Panchayat Raj at the village level consists of
Ø The Gram Sabha
Ø The Gram Panchayat
The Gram Sabha:
It is the assembly of all the adults of the village, which
meets at least twice a year. The gram sabha considers
proposals for taxation, and elect members of TheGram
Panchayat.

29. The Gram Panchayat
It is the executive organ of the gram sabha and an agency
for planning and development at the village level. The
population covered varies from 5000 to 15000 or more. The
members of panchayat hold offices for a period of 3to4 years.
Every panchayat has an elected president(Sarpanch or
Sabhapati or Mukhia), a vice president and panchayat
secretary. It covers the civic administration including
sanitation and public health and work for the social
andeconomic development of the village

30. Panchayat Samiti (at the block level):
• The block consists of about 100 villages and a population
of about 80,000 to 1,20,000. The panchayat samiti consists
of Sarpanch, MLAs, MPs residing in block area,
representative of women, SC, ST and cooperative societies.
The primary function of
The Panchayat Samiti is the execute the community
development programme in the block. The Block
development Officer and his staff give technical assistance
and guidance in development work.

31. Zila Parishad (at the district level):
• The Zila Parishad is the agency of rural local self
government at the district level . The members of Zila
parishad include all heads of panchayat samiti in the
district,MPs, MLAs, representative of SC, ST and women
and 2 persons of experience in administration, public
life or rural development. Its functions and powers vary
from state to state.

32. LACK OF A POSITIVE,DYNAMIC AND MULTIDIMENSIONAL CONCEPT
OF HEALTH
PROBLEMS OF INEQUALITY
SOCIO-ECONOMIC, CULTURAL AND RELIGIOUS PROBLEMS
POLITICAL WILL
EMERGENCE OF PRIVATE HEALTH CARE

33. POLICY ISSUES IN HEALTH CARE REFORMS
A)PUBLIC –PRIVATE CO-OPERATION
o Disease specific approach
o General utilization approach
o Primary VS tertiary care approach
o Preventive VS curative approach
B)DECENTRALISATION