The document outlines India's healthcare delivery system from the central, state, and district levels. At the central level, the Ministry of Health and Family Welfare oversees health policies and programs. States have their own health directorates to provide medical care and implement national health programs. Primary healthcare is delivered through a network of subcenters, primary health centers (PHCs), and community health centers (CHCs) at the village and block levels. PHCs and CHCs are staffed by doctors, nurses, and other personnel to provide maternal and child health services, family planning, treatment and implementation of health programs.

1. By –
Shakti Singh (M.Sc. Nursing)
Sr. Nursing Educator
SMVDNSH JK
Mob. 97827-55166
HealthCare Delivery
System In India

2. Definition…
 “ It implies the organization, delivery, staffing, regulation and quality control of
health care services.”
- J.E.Park

3. Objectives…
 To improve the health status of population
 To improve the experience of care
 To reduce the economic burden of illness
 To improve social justice equity

4. Characteristic…
 Orientation toward health
 Population perspective
 Intensive use of information
 Focus on consumer
 Knowledge of treatment outcome
 Constrained resources
 Coordination of resources
 Reconsideration of human values
 Expectations of accountability
 Growing interdependence

5. Organization of Health Services…
CENTRAL LEVEL
STATE LEVEL
DISTRICT LEVEL

6. Central Level…
Ministry of Health and Family
Welfare
Central Council of Health
Director of Health Services

7. Union Ministry Of Health and Family
Welfare
Department of Health
Secretary
Joint
Secretory
Deputy
Secretory
Administrative Staff
Department of Family Welfare
Secretary
Additional
Secretary
Commissioner
Joint
Secretary

8. Functions…
 Functions are divided in two forms according to the responsibility of concerning
authority:
 Union list
 Concurrent list

9. Union List…
 International health relation and administration of port quarantine.
 Administration of central institutes.
 Promotion of research through research centers.
 Regulation and development of medical, pharmaceutical, dental and nursing
professionals.
 Establishment and maintenance of drug standards.
 Census collection and publication of other statistical data.
 Regulation of labour in the working fields.
 Coordination with states and other ministries.
 Immigration and Emigration.

10. Concurrent List…
 Prevention of extension of communicable diseases.
 Prevention of food adulteration.
 Control of drugs and poisons.
 Vital statistics.
 Labor welfare.
 Economic and social planning.
 Population control and family planning.

11. Central Council of Health…
 It was setup by a Presidential order on 9th August 1952, under article 263 of the
Indian Constitution.
Chairman – The Union
Health Minister
Members – The State Health
Minister

12. Functions…
Consider and recommend broad
outline of the policy
Make proposal of legislation in
field of medical and public health
Recommendation regarding
distribution of available aid for
health purposes
Establish organization to maintain
cooperation between central and
state health department
Functions

13. Director General of Health Services…
DGHS
Deputy DGHS
Medical Care
Nursing Advisor
Deputy Nursing
Advisor
Deputy DGHS
(Public Health)
Deputy DGHS
(General
Administration)

14. Functions…
General
• Survey
• Planning
• Coordination
• Programming
• Appraisal of all health matters
Specific
• International health relation
• Control of drug standard
• Medical store depots
• Post graduate training
• Medical Education
• Central Govt. health scheme
• National health programmes
• Central health education bureau
• Health intelligence
• National medical library

15. State Level…
State Ministry
of Health
State Health
Directorate

16. State Ministry of Health…
Health Secretary
Additional Secretary
Deputy Secretary
Administrative Staff

17. Function…
 Assisting the ministers in policy making.
 Formulating, review and modification of broad policy.
 Execution of policies.
 Coordination with Govt. of India and other state.
 Control for smooth and efficient functioning.
 Budgeting and control over expenditure.

18. State Health Directorate…
State Health
Directorate…
Functional
Director
State Health
Directorate…
Regional
Director
Additional
Director

19. Functions…
 Provide adequate medical care.
 Medical education and research.
 National health program implementation.
 Provision for health scheme.
 Food and drug administration control.
 Collection of health information.
 Control over ESI scheme.
 Enforcement of professional standards.

20. District Level…
Subdivision
Tehsil
Community Development Blocks
Municipality Corporation
Villages
Panchayti Raj

21. Urban Area Districts…
Corporations
Municipal Boards
Town Area Committee

22. Functions of Municipal Boards…
Construction and maintenance of roads
Sanitation and drainage
Street lighting
Public health
Maintenance of hospitals and dispensaries
Education and registration of births and deaths

23. Panchayti Raj…
Panchayti Raj
Panchayat
Gram Sabha
Gram
Panchayat
Panchayat
Samiti
Zila Parishad

24. Primary Health Care in India…
Village
Level
Sub Center
Primary
Health
Center
Community
Health
Center

25. Village Level…
• Started in 1977.
• Now replaced by ASHA.(Accredited Social Health
Activist)
Village Health Guide
• Started under rural health scheme.
• Training of local dias for 30 days.
• Now not preferred.
Training of Local Dias
• Advent with NRHM (per 1000 population)
• Imp link between community and health services.
ASHA
• Under ICDS.
• For every 400-800 population.
AWW

26. Sub Center Level…
 It is the peripheral outpost of the existing health care delivery system in rural areas.
They are being established on the basis of one sub center for every 5000
population in general and one for every 30000 population in hilly. Tribal and
backward areas.
 Currently a sub center is staffed by one female health worker known as
 Auxiliary nurse midwife – 01.
 Male health worker – 01.
 Health assistant known as lady health visitor – 01.

27. Functions…
 Maternal and Child Health.
 Family planning.
 Immunization.
 Nutritional Services.
 Control over communication diseases.
 Records of vital statistics.

28. Primary Health Center and It’s Functions…
 Concept of PHC was given by BHORE COMMITTEE.
 01 PHC for every 30,000 population in plain area and for 20,000 in hilly area.
Functions…
 Medical care
 MCH and family planning
 Safe water supply and basic sanitation
 Prevention and control of diseases
 Collection and reporting of vital statistics
 Education about health
 National health program involvement
 Training of health workers

29. Staffing of PHCs…
Staff
Type-A Type-B
Essential Desirable Essential Desirable
Medical Officers-MBBS 1 1 1*
Medical Officers-AYUSH 1* 1*
Accountant cum Data Entry Operator 1 1
Pharmacist 1 1
Pharmacist AYUSH 1 1
Nurse Midwife (Staff-Nurse) 3 1 4 1
Health worker (Female) 1* 1*
Health Assistant (Male) 1 1
Health Assistant (Female)/Lady Health Visitor 1 1
Health Educator 1 1
Laboratory Technician 1 1
Cold Chain & Vaccine Logistic Assistant 1 1
Multi-Skilled Group D Worker 2 2
Sanitary worker cum wathcman 1 1 1
Total
13 5 14 7
18 21
Source: IPHS 2012

30. Community Health Center…
 The block is unit of rural planning and development and comprises about 80,000 to
1.2 lakh population.
 One community Health Center is being established in each block.
 The officer in-charge of CHC is known as Superintendent CHC or Block Medical
Officer.
 Normally one CHC should have – 30 bed hospital

31. Staffing of CHS’s…
Block Public Health Unit
PERSONNEL ESSENTIALDESIRABLE QUALIFICATIONS REMARKS
Block Medical
Officer/Medical
Superintendent
1
Senior most
specialist/GDMO
preferably with
experienced in Public
Health/Trained in
Professional
Development Course
(PDC)
Will be responsible for coordination of
NHPs, management of ASHA's Training
and other responsibilities under NRHS
apart from overall
administration/Management of CHC etc.
He will be responsible for quality &
protocols of service delivery being
delivered in CHC.
Public Health
Specialist
1
MD (PSM/MD/CHA)
MD Community
Medicine or Post
Graduation Degree with
MBA/CPH/MPH
Public Health Nurse
(PHN)#
1 1

32. Staffing of CHS’s…
Speciality Services
General Surgeon 1 MS/DNB, (General Surgery)
Physician 1 MS/DNB, (General Medicine)
Obstetrician and
Gynaecology
1 DGO/MD/DNB
Paediatrician 1 DCH/MD(Paedtiarics)/DNB
Anaesthetist 1
MD
(Anaethesia)/DNB/DA/LSAS
trained MO
Esseintial for utilization of the
surgical scpciality. They may be on
contractual appointment or hiring of
the services from private sector on
per case basis.
General Duty Officers
Dental Surgeon 1 BDS
General Duty Medical
Officers
2 MBBS
Medical Officer - AYUSH 1 Graduate in AYUSH

33. Staffing of CHS’s…
Nurses and Paramedical
Staff Nurse 10
Pharmacist 1 1
Pharmacist - AYUSH 1
Others Supportive Staff
Lab Technician 2
Radiographer 1
Dietician 1
Opthalmic Assitant 1
Dental Assitant 1
Cold Chain and Vaccine
Logistic Assitant
1
OT Technician 1
Multi
Rehabilitation/Community
based Rehabilitation
worker
1 1
Counsellor 1

34. Staffing of CHS’s…
Administrative Staff
Registration Clerk 2
Statistical Assistant/Data
entry operator
2
Account Assistant 1
Administrative Assistant 1
Group D Staff
Dresser (Certified by red
cross/Johns Ambulance)
1
Ward boy/Nursing orderly 5
Driver 1 3
Total 46 52

35. Functions…
 Care of routine and emergency.
 24 hours delivery services.
 Essential and emergency obstetric care.
 Full range of family planning services.
 Safe abortion services.
 New born care.
 Routine and emergency care of sick children.
 Foreign body removal, tracheostomy etc.
 Implementation of national health programmes.

36. Always welcome yours
suggestions…
Regards!!!
Team Education
SMVDNSH JK
+91-97827-55166
educationdailyreports@gm
mail.com