The document summarizes the key aspects of India's five-year plans from the first plan in 1951 to the twelfth plan. Some of the highlights include: - The first plan focused on irrigation and agriculture to improve the country's economy and address poverty. - Later plans emphasized industry, health infrastructure development, poverty alleviation and increasing employment. - Health budgets and programs expanded over time, with a focus on rural health, communicable diseases, and integrating services. - Key committees like the Bhore committee influenced the development of primary health centers and an emphasis on preventative healthcare.

1. RAMA COLLEGE OF NURSING
PRESENTED BY
ANUJ KUMAR
M.S.C NURSING II YEAR

2. INTRODUCTION
Five years plan is mechanism to bring about uniformity
in policy formulation in program of national importance.

3. FIRST FIVE YEAR PLAN [1951-1956]
The first Indian prime minister Jawaharlal Nehru presented in the
first five year plan to the parliament of India on 8 December 1951.
The first plan sought to get the country’s economy out of the cycle of
poverty. The plan mainly addressed ,the agrarian sector, including
investment in dams and Irrigation.
The total planned budget of 206.8 billion was allocated to seven
broad areas.
1. Irrigation and energy
2. Agriculture and of community development.
3. Transport and communication
4. Industry

4. 5. Social services
6. Land rehabilitation
7. Other sectors and services
THE SPECIFICOBJECTIVES WERE
Provision of water supply & sanitation
Control of malaria
Preventive health care of the rural population
Health services for mother & children
Education & training in health
Self sufficiency in drug & equipment
Family planning & population control

5. SECOND FIVE YEAR PLAN 1956-1961
The second five year plan focused on industry, especially
heavy industry.
Unlike the first plan, which focused mainly on agriculture, domestic
production of industrial products was encouraged in the second
plan, particularly in the development of the public sector.
The specific objectives were
Establishment of institutional facilities to serve as a basis from which
serve could be render to the people both locally & surrounding
territory.
Development of technical man power through appropriate training
Programmes.
Intensifying measures to control widely spread communicable disease.
Encouraging active campaign for environmental hygiene.
Provision of family planning and other supporting services.

6. THIRD FIVE YEAR PLAN[1961-1966]
The third plan stressed on agriculture and improving production
of rice.
Many primary schools were started in rural areas. In an effort to
bring to democracy to the grassroots level, Panchayat elections
were started and the states were given more development
responsibilities.
State electricity boards and state secondary education boards
were formed.
States were made responsible for secondary and higher education.
During this plan period the public sector outlay was Rs. 7500
crore of which Rs.341.8 crore of which were allotted for
health programs.

7. FOURTH FIVE YEAR PLAN [1969-1974]
At this time Indira Gandhi was the prime minister. The Indira Gandhi
government nationalized Green Revolution in India advanced agriculture.
Certain objectives of the Mudaliar committee were the
base for this plan in relation to health.
To provide an effective base for health services in rural areas by strengthen
the PHCs
Strenghtening of sub-division & district hospitals to provide effective
referral services for PHCs
Expansion of medical & nursing education & training of para-medical
personnel to meet the minimum technical man power requirements.
During this period the public sector outlay was Rs. 16,774 crore of which
Rs.1.156 crore were allotted for health programs.

8. FIFTH FIVE YEAR PLAN[1974-1979]
Stress was laid on employement, poverty alleviation, and justice.
The plan also focused on se lf-reliance in agricultural production
and defense.
In 1978 the newly elected Morarji Desai government rejected the plan.
Electricity Supply Act Was enacted in 1975.
The emphasis of the plan was on removing imbalance in respect of medical
facilities & strengthening the health infrastructure in rural areas.
Specify objectives to be pursuedduring the plan were
Increase accessibility of health services to rural areas
Correcting regional imbalances
Further development referral services

9. Integration of health, Family planning & nutrition.
Intensification of the control & eradication of
communication diseases especially malaria & smallpox.
Quantitative improvement in the education & training of
health personnel.
During this plan period the public sector outlay was Rs.
32,750 crore of which Rs.3,277 crores were allotted for
health programs.

10. The Sixth Plan
Also marked the beginning of economic liberlizartion. Price controls
were eliminated and ration shops were closed. This led to an increase
in food prices and an increase in the cost of living.
Family Planning was also expanded in order to prevent
overpopulation.
In contrast to china`s srtict and binding one child policy. India did
not rely on the threat of force. More prosperous areas of India adopted
family planning more rapidly than less prosperous areas, which
continued to have a high birth rate.

11. SEVENTH FIVE YEAR PLAN[1985-1989]
The main objectives of the 7th five year plans were to establish
growth in the areas of increasing economic productivity,
production of food grains ,and generating emloyement
opportunities.
The thrust areas to the 7th Five year plan have been enlisted below
*Social Justice
*Using modern technology
*Removal of oppression of the weak
*Agricultural Development
*Anti-poverty programs

12. The objectives were
Eliminate poverty & illiteracy by 2000
Achieve near full employment secure satisfaction of the
basic needs of food, cloth, shelter and provide health
for all.
To provide an effective base for health services in rural
areas by strengthening the PHCs
Universal immunization program
During this plan period the public sector outlay was
Rs.1,80,000 crores of which Rs.3,392 crores were allotted
for health programs

13. PERIOD BETWEEN 1989-
91
P.V.Narisimha Rao was the twelth Prime Minister of the Republic of
India and head of congress Party .1989-91 was a period of political
instability in India and hence no five year plan was implemented.
Between 1990 and 1992,There were only Annual Plans
EIGHT FIVE YEAR PLAN[1992-1997]
India became a member of the World Trade Organization on 1st
january 1995. This plan can be termed as Rao and Manmohan mode
of economic development. The major objectives included.
Population growth
Poverty reduction

14. Employment generation
Strengthening the infrastructure,
Institutional building, tourism management
Human Resource development
Involvement of Panchayat Raj,
Nagarpalikas,
N.G.O’s
Decentralization and people’s participation
The PHC,s were strengthened staff vacancies,By supplying
essential equipment & drugs.
AIDS control program was initiated during this plan.

15. NINTH FIVE YEAR PLAN[1997-2002]
In ninth five year plan India runs through the period from 1997-2002 with the
main aim of attaining objectives like speedy industrialization, human
development, full-scale employment, poverty reduction and self-reliance on
domestic resources.
Backgroundof NineFive Year Plan India:-
Nine five year plan was formulated amidst the backdrop of India’s Golden
jublie of independence.
The main objectives of the nine five year plan india are
*to prirorities agricultural sector and emphasize on the rural development
*to generate adequate employment opportunities and promote poverty
reduction
*to stabilize the prices in order to accelerate the growth rates of the
economy

16. *to ensure food and nutritional security
*to provide for the basic infrastructural facilities, like
education for all, safe drinking water, primary health care,
transport, energy.
CONTNIUES…..
During this plan, vertical health programs were integrated horizontally
with general health services.
The reproductive & child health program was improved under following
guidelines
Decentralize RCH to the level of PHC’s.
Base planning for RCH services on assessment of the local needs.
Meet the needs of contraceptives.
Involve the general practitioners & industries in family welfare
work.

17. TENTH FIVE YEAR PLAN[2002-2007]
Reduction of poverty ratio by 5 % points by 2007;
* Providing gainful and high quality employment at least to the
addition to the labor force.
All children in India in school by 2003; all children to complete 5
years of schooling by 2007
*Reduction in gender gaps in literacy and wage rates by at least
50% by 2007.
This plan has laid down the following targets
*Bring down the decadal growth rate by 16.2 % in the decade from
2001- 2011

18. To achieve the above, the government planned to do the
following.
* Restructure existing health infrastructure
* Upgrade the skills of health personnel
* Improve logistic supplies
* Carry out the research on nutritional deficiency
CONTNIUES…..
*Improve the quality of reproductive & child health
*Promote rational drug use

19. ELEVENTH PLAN[2007-2012]
1.Income & Poverty:
* Create 70 million new work opportunities.
* Reduce educated unemployment to below 5%
* Raise real wage rate of unskilled workers by 20 percent.
2.Education
* Reduce dropout rates of children from elementary school from 52.2% in
2003-2004 to 20% by 2011-2012
* Develop minimum standards of educational attainment in elementary
school, and by regular testing monitor effectiveness of education to
ensure
quality
* Increase literacy rate for persons of age 7 years or above to 85%

20. 3.Health
*Reduce infant mortality rate to 28 and material mortality ratio to 1 per 1000
live births
* Reduce Total Fertility Rate to 2.1
* Provide clean drinking water for all 2009 and ensure that there are no slip
backs
* Reduce malnutrition among children of age group 0-3 to half its present level
4.Women and Children
*Raise the sex ratio for age group 0-6 to 935 by 2011-12 and to 950 by 2016-
2017
*Ensure that at least 33 percent of the direct and indirect beneficiaries of all
government schemes are woman and girl children
*Ensure that all children enjoy a safe childhood,without any compulsion to
work

21. 5.Infrastructure:
*Ensure electricity connection to all villages and BPL household by 2009 and
round-the-clock power.
*Ensure all-weather road connection to all habitation with population 1000 and
above (500 in hilly and tribal areas)by 2009,and ensure coverage of all significan
habitation by 2015
*Connect every village by telephones by November 2007and provide
broadband connectivity to all villages by 2012
*Provide homestead sites to all by 2012 and step up the pace of house
construction for rural poor to cover all the poor by 2016-17
6.Environment:
*Increase forest and tree
*Treat all urban waste water by 2011-2012 to clean river waters.
*Increase energy efficiency by 20 percentage points by 2016-17

22. TWELVETH FIVE YEAR
A. Access and expansion:
*Rashtriya ucch shiksha abhiyan (RUSA)as a mission mode national program fo
enhancing access to achieve 25% GER
*Establishment of 400 college Cluster Universities
* Establishment of 800 Constituent colleges in 40 central universities
* Increasing intake in 2000 colleges by evening college system & including
them under section-12 B of UGC Act.
*Increasing intake in universities teaching departments through evening
program.
*Establishments of 20 women universities

23. *Support to autonomous colleges
*Starter grant to establish State Higher Education Council in all states
*Construction of hostel/Guest house
CONTNIUES…..
B-Equityand Inclusion:
*Transport/Rent allowance for rural girl students more than 10 km from
institution
*Higher Education Stipend for girls Students.
*Scholarships for Muslim and OBC students for graduate/PG students
*Research Fellowship for Muslims & OBC students
*Post Doc Fellowships for SC/ST Muslim &OBC Students

24. C. Quality and Excellence
I- Establishment of one pace-setting college in each district with 100% financial
support from the UGC
ii. Widening the scope of existing area study centers and establishing additional
centers in specified knowledge domains to create global expertise.
iii-Promotion of indigenous languages and book policy
iv-Inclusion of scholarship to Non-NET qualified candidates for M.phil and Ph.d
D. Research Projects :
*Establishment of 10 university housed networking centres for
Research
& Consultancy
*Stregthening of social sciences and humanities teaching and
research activities

25. E. ICT Integration:
*Digital Repository in Universities & college Libraries
*Internet Connectivity and NKN(National Knowledge network)portals to
universities and colleges
* E-content development
F. Governance & efficiencyimprovement:
(i)Restructuring of UGC and its Governance with e-governance as end to end
solution
(ii)e-governance of Higher Education IN Universities & Colleges
(iii)Training for academics Administrators of Universities, Colleges, UGC
Officers
CONTNIUES…..

26. FIRST FIVE
YEAR PLAN
SECOND FIVE
YEAR PLAN
THIRD FIVE
YEAR PLAN
2256 CRORES
4800 CRORES
7500 CRORES
Irrigation projects were started during that
period, Mettur dam , Hirakund dam and
Bhakra dam, Soil conservation was given
importance
Five steel mills ,Durgapur, Rourkela, and
Jamshedpur. Coal production was
increased, Railway lines were added in the
North East
The construction of dams continued,
Punjab begun producing an abudance of
wheat. Panchayat elections
were started and the states were given
more development responsibilities
FIVE YEAR PLAN ALLOCATED
BUDGET ACHIEVEMENT

27. FOURTH FIVE
YEAR PLAN
FIVETH FIVE
YEAR PLAN
SIXTH FIVE
YEAR PLAN
16,774 CRORES
37,250 CRORES
1,58,710 CRORES
The Government Nationalized 14 major
Indian Banks. Green Revolution in India
advanced agriculture
Electricity Supply Act was enacted in
1975. Importance of labor intensive,
foreign exchange to the Indian economy
The Indian National Highway system was
introduced for the first time and many
roads were widened to accommodate the
increasing traffic.

28. SEVENTH
FIVE YEAR
PLAN
EIGHT FIVE
YEAR PLAN
1,80,000 CRORES
India strove to bring about a self-
sustained economy in the country with
valuable contributions from voluntary
agencies and the general populace. Care
was taken to establish a harmony in all
the sectors that are contained in an
economy.
Productive of food increased to 176.22
million from 51 million. Energy was given
priority with 26.6%. India became a
member of the WORLD TRADE
ORGANIZATION on January 1995.
An average annual growth rate of 6.7%
against the target 5.6% was achieved

29. NINTH FIVE
YEAR PLAN
TENTH FIVE
YEAR PLAN
ELEVENTH
FIVE YEAR
PLAN
15,25,639
CRORES
36,44,718
CRORES
A combined effort of public, private and all levels of
Goverment
Service sectors shows fast growth rate, Ensured the
growth of Indian economy.
Population growth has decreased by 2%. Literacy rate
has increased from 52% to 65% in 2001
Increase in national income resulted in increase of per
capita income, Growth of agricultural sector. India
become net exporter. Infrastructure development

30. TWELVETH
FIVE YEAR
PLAN
Health care condition are improving. India is
now self dependent on deomestinc demands.
GDP Growth rate is 8%

31. VARIOUS COMMITTES REPORTS ON HEALTH
1.BHORE COMMITTEE
The health survey and development committee, generally referred and popularly
known as the Bhore committee. Although this committee was set up by the British
colonial authorities was greatly influenced by the aspiration of the national
movement. It was appointed by British Government of India in October 1943 under
the chairmanship of Sir Joseph Bhore.
The Government of India appointed this committee in 1943 to make broad survey
of then existing health conditions and health organizations in the country and to
make recommendations for further development.

32. The Guiding principle adopted by the committee proposal for further
health development in the country were:
No individual should be denied to secure adequate medical care
because of inability to pray for it.
The health program must from the very beginning, lay special emphasis
on preventive work.
It is essential to secure the active cooperation of the people in the
development of the health program to stimulate health consciousness
through health education.
Health development must be entrusted to ministries of health who
enjoy the confidence of the people and are able to secure their
cooperation.

33. RECOMMENDATION
Bhore committee presented its report in 4 volumes in 1946 in which the committee
observed if the nation’s health is to be built, the health programs should be developed on a
foundation of preventive health work that such activities should be proceed side by side
with those concerned with the treatment of patients. Some of the main recommendation
are as follows:
1. Integration of preventive and curative services at all administration level,
2. Development of Primary Health Centre in 2 stages. In short-term measure PHC in rural
area should cater to a populations of 40,000 with a secondary health center to serve as a
supervisory, coordinating and referral institution. For each PHC two medical officers, 4
public health nurses, one nurse,4 midwives.4 trained dais, 2 sanitary inspectors. 2 health
assistants, one pharmacist and 15 other class IV employees.

34. 3.Major changes in medical education which includes 3 months training in
preventive and social medicine to prepare social medicine to prepare to prepare
social physicians
The Short-Term Program
Personal and impersonal health services should be provided. A province-wide organization
for the combined preventive and curative health work will be provided by the
establishment of a number of primary , secondary and district health units and special
health service for mothers and children, school children and industrial workers, Which will
deal also with more important diseases prevalent such as malaria, tuberculosis, Venereal
disease, leprosy and mental diseases.
In each village , a health Committee consisting of 5-7 individuals should be established for
procuring the active participation of the people In the local health programs.
The bed-population ratio should be raised from 0.24 per 1000 to 1.03 at the end of years.

35. Village communications should be developed in order to enable health organizations to provide
efficient service.
CONTINUES…
The Long-term Program
The smallest administrative unit should be the primary unit serving an area with a population of
about 10,000 t 20,000. About 15 to 25 primary units will together constitute a secondary unit. At
the primary ,secondary and district health units there will be a health center as the focal point
for radiating different types of health activity.
The objectives to be kept in view after the first 1o years should be as follows:
i- Raising of hospitals accommodation to 2 beds per 1000 of population
ii- Creation of 18 new medical colleges in addition to the 43 to be established during the first 10
years

36. iii- Establishing of 100 training centers for nurses
iv- Nursing training of 500 hospitals social workers
NUTRITION:
Improved nutrition plays a vital role in preventing, sickness and promoting positive health.
Food planning should have, as per its objective , the provision of an optimum diet for all.
Eight ounces of milk per day should be included in the average Indian diet . Expectant and
nursing mothers and children upto 14 years will need much more.
HEATH EDUCATION
Health education must promote health consciousness and there are best achieved when
health practices become part of an individual’s daily life.

37. PHSYICAL EDUCATION
There should be one or two physical training colleges on each province. The
National Physical Education Program should include indigenous games, Sports
and folk dances.
PROFESSIONAL EDUCATION:
At the end of the first 10 years the production of doctors should ba at the
annual rate of 4000-4500. To man the new medical colleges with suitable
teachers, All India Institute should provide a steady stream of teachers of a high
quality.
POPULATION PROBLEM:
Limitation of families through self control may not be feasible. Therefore, birth
control through positive means is the only method which is likely to be effective.

38. NURSES,MIDWIVES AND DIAS:
The number of nurses available in the country is probably about 7000 while
our short-term program will itself require about 80,000 nurses. Without
considerable increase in their number it is possible to proceed with the
development of hospitals and other institutional facilities and with the
organization of the Public Health Nursing Services for curative and preventive
work in the homes of the people.
The committees has suggested that by.1971 the
number of trained nurses available in the country should be raised to
740,000.

39. HEALTH SURVEY AND PLANNING COMMITTEE[1962]
As a result of launching several nationals health programs mostly of vertical
nature around late 50’s and early 60’s actually end of second 5-years plan
,1956-61,a fresh outlook at the health needs and resources was called for to
provide guidelines for national health planning in the context of 5 years plans.
The Government of India in the Ministry of health set
up a committee in 1959 to undertake the review of the developments that have
taken place since the publication of the Report of the Health Survey and
Development committee (Bhore committee) in 1946 with a view to formulate
further Health programs for the country in the third and subsequent 5 years
plan periods.
Dr. A lakshminarayanswami Mudaliar , Vice Chancellor,
Madras University, Was appointed Chairman of the Committee was divided into
six sub-committee.

40. RECOMMENDATION:
The Mudliar Committee found the quality of services provided by the
Primary Health Centers, Inadequate, and advised strengthening of the
existing primary health centers before starting new PHC’s.
The main recommendations of Mudaliar Committee were:
* Consolidation of advanced efforts and achievements made in the first
two 5 years plans in the field of health
*Equipping district hospitals with specialist services.
* Need for regionalisation of health services i.e. setting up of regional
structures between the state and district head quarters
* Each Primary health Center should serve not more than 40,000 people
* The quality of care provided by the primary health center needs
improvement
*Constitute of an all Indian Health Services on the pattern of Indian

41. MATERNAL AND CHILD HEALTH :
Greatest attention should rationally be given to the care of the health of the
children. There is no agency to ensure that a systematic follow-up of
antenatal, Midwifery, Postnatal, infant and child welfare services take place.
Every effort should be made to develop and expand the network of maternity
health centers so that within a period of 10 years one midwife is in position
for 5,000 to 6,000 population in rural areas, supported by a public health
nurse and an auxiliary health workers
“The primary health centers and maternity and child health centers in rural
areas should take a greater part in the programs of immunization of children
and in the notification and checking of births and deaths.

42. MANPOWER REQUIREMENTS
The basic infrastructure of health services consisting of subcenters, PHC’s district health
organizations etc. have remained the same over the years, the structure on man-power
training these complex undergoing a change from time to time.
The recommendations related to nursing sectors are as follows:
1 .There should be three grades of nurses, viz, the Basic Nurses ( with 4 years training), the
auxiliary Nurse wife (2 years training) and the nurse with a degree qualification
2. Candidates admitted to the general course should have the minimum qualification of “
matriculation or equivalent ; and the candidates for the degree course should have passed
the higher secondary or preuniversity examination
3. To train more nurses a large number of hospitals in the country could be utilized for
nursing schools. District headquarters hospitals with a bed strength of 75-100 should also be
utilized for this purpose.

43. 4. Each nursing school should have its own separate budget
4. The recommendation of the committee set up by the Central Council of Health (Shetty
Committee)in regard to pay scales and ratio of nurses to hospital beds, etc. are enclosed
5. The continuance of the training of dais in certain states as a temporary measure is
recommended, till such time a sufficient number of midwives are trained to replace them
6. Male Nurses should be trained only for certain types of work, e.g. mental hospitals, VD
clinics and rehabilitation centers
7- There should be higher training for the General Sick Nurse, Public Health Nurse,
Pediatric Nurse, Mental Health Nurse, Theatre sister , Sister Tutor and Nursing
Administrator
CONTINUE…..

44. It would perhaps be safe target to aim at, the Committee had felt, To have one doctor for every
3,000-5,000 population at the end of fourth plan period. If this target could be reached in the
rural areas and if doctors were not unduly concentrated in the urban areas, medical relief
would have been brought as near as possible to all sectors of the population.
CHADHA COMMITTEEE (1963)
In the Last 50,s and early 60s the Government of India was, Therefore seized with the
problem of integrating the maintenance phase of the malaria eradication program with
the general health services in the country consisting of sub-centers, Primary health
centers, and district level organizations. The Government of India appointed a committee
under the chairmanship of Dr MS Chadha, the then Director General of Health Services
to study the arrangements necessary for the maintenance phase of the NMEP

45. The committee recommended that the “vigilance” operations in respects of the NMEP should
be the responsibility of general health services, i.e. primary health center at the block level.
The committee recommended that then existing malaria surveillance worker (MSW)may be
changed into auxiliary health workers , one per 10,000 population supported and supervised
by sanitary inspectors/Health inspectors at the rate of one per 20-25,000 Population for which
an individual post of health inspector was to be created in the end of blocks
It recommended creation of the post of laboratory technicians at the PHC and a post of a
family planning field workers (FPFW) and family planning health assistant (FPHA) at the rate of
one per 30,000 population to take care of the emerging problems and therefore intensifying
family planning measures.
CONTINUES……

46. It recommended that the services of the extension educator should be utilized
for all the national health programs.
It also recommended that the basic health workers envisaged as “
multipurpose” workers to look after additional duties of collection of vital
statistics and family planning in addition to malaria vigilance.

47. MUKHERJEE COMMITTEE (1965)
During the implementation of the Chadha committee’s recommendations by some of the
states, it was realized that basic health workers (BHW) could not function effectively as
multipurpose workers, and as a result the malaria vigilance operations had suffered and also
the work of the family planning program could not be carried out satisfactorily. In 1965, This
matter brought to the central council and discussed at the meetings.
A committee was appointed by the government of India during 1965 to review the strategy
of family planning, under the chairmanship of Shri Mukherjee, the then secretary of health
to the Union Government.
The committee recommended separate staff for the family planning program. The family
planning assistants (FPA) were to undertake family planning duties only. The BHW’s were to
be utilized for the purpose of other than family planning.

48. The committee also recommended to delink the malaria activities from family
planning so that the latter would receive undivided attention of itself staff, the
recommendation accepted by the Government of India.
JUNGALWALIA COMMITTEE (1967)
The Central Council of Health at its meeting held at Srinagar in 1964, taking notice of
the importance and urgency of integration of health services and elimination of private
practices by government doctors, appointed a committee known as the “committee on
integration of health services” under the chairmanship of Dr. N jungalwalla, Director
NIHAE, New Delhi, to examine the various problem including those of service
conditions and submit a report to the central government in the light of these
consideration. The report was submitted in 1967.The committee defined “integrated
health services” as:

49. 1.A service with an unified approach for all problems instead of a segmented approach for
different problems
2.The medical care of sick and conventional public health programs functioning under a single
administrator and operating in unified manner at all levels of hierarchy with due priority for each
programs obtaining a point of time.
The committee recommended integration from the highest from the highest to the lowest level
in the services, organization and personnel. The main steps recommended towards integration
were:
a-Unified care
b-Common senority
c-Recognition of extra qualificatios
d-special pay for specialized work
e-No private practice
f-Good service conditions

50. The committee while giving sufficient indication for action to be taken was careful neither
to spell-out steps and programs nor to indicate an uniform integrated set up but left the
matter to the states to work out the set-up based on the work experience of West
Bengal,Punjab and Defence force. The committee stated that “integration should be a
process of logical evolution rather than revolution.
KARTAR SINGH COMMITTEE 1974
As a result of launching of several national health programs, there occurred tremendous
variations in the categories of manpower requirement, which posed problems in terms of
providing integrated services. This feasibility of integrating various categories of health
manpower to the grass root level to provide integrated services having become available,
The government of India constituted in 1972 known as “ the committee on multipurpose
workers under Family Planning” under the chairmanship of Shri Kartar Singh, Additional
Secretary, Union Government.

51. The terms of reference of the committee were to study and make recommendation on:
1.The structure for integrated services at the peripheral and super visionary levels
2. The feasibility of having multipurpose/ bi-purpose workers in the field,
3. The training requirement of such workers,
4. The utilization of mobile service units set up under family planning programs for integrated
medical, Public health and family planning services operating from Tehsil/ Taluq level.
The committee observed that national Programs in the field of health and family planning and
nutrition had been running almost independently of each other by staff recruited under each
program.it had also yielded sum results notably in malaria, and smallpox.
The committee recommended that the concept of change of uni-purpose to multipurpose
workers was both feasible and desirable.

52. The committee submitted its report in September 1973. Its main
recommendations were :
A.That the present day ANMs to be replaced by the newly designated “Family
Health Workers” and the present day Basic Health Workers (BHW) , Malaria
Surveillance worker (MSW), Vaccinators, health education assistant of
trachoma to be replaced by “Male Health Workers”
B.For proper coverage, there should be primary health center for a population
of 50,000.
C. Each sub-center to be staffed by team of one male- one female heath
worker.
D. The doctor inchrage of a primary health center should have the overall
charge of all the supervisiors and health workers in his are.
This MPW scheme was accepted by Government and after studying its feasibility
was launched on a nation-wide scale in fourth-5 five years plan and are being
implemented in a phased manner during the fifth-5 year plan.

53. SHRIVISTAV COMMITTEE (1975)
The issue of developing alternative strategy for the delivery of health serviceand
rationalization
Of the health manpower both in terms of number of personnel as well as categorie
of personnel had been engaging the attention of the govt. of India from time to tim
The Govt. of India in the ministry of health and family planning had in November
1974 set-up- a “Group on medical Education and Support Manpower” under the
chairmanship of Dr. JB Shrivastav, then the DGHS was established to focus on
the issue.
The terms of reference of this committee were as follows:
1. To devise a suitable curriculum for training a cadre of health assistant coversa
with basic medical aid preventive and nutritional service, Family welfare, materni
and child welfare activities so that they can serve as link between the qualified
medical practitioners and the multipurpose workers, thus forming an effective tea
to deliver health care, family welfare and nutritional services to the people.

54. 2. Keeping in view the recommendation made by the earlier committees on
Medical Education, specially the medical education conference(1970)
3. To make any other suggestion realize the above objectives and matters
incidental there to.
RECOMMENDATIONS
*After carefully examining various reports and papers relevant to the
subject including the recommendations of as many as 12 conference
and committees, held earlier, Shrivastav Group, Made following major
recommendation:
1. A nationwide network of efficient and effective services suitable for
our conditions, Limitation and potentialities should be evolved
2. Steps should be taken to create bands of para-professionals for or
semiprofessional health workers from the community itself to provide
simple, protective, preventive and curative services which are needed
by the community.

55. 3. Between the community and the primary health center, there should be
two cadr, health workers and health assistants.
4. The primary health center should be provided with an additional doctor
and nurse to look after the maternal and child health services.
CONTINUES….