This document provides an overview of the health care delivery system in India. It describes the organizational structure at the central, state, district, block, primary health center, and village levels. The key shortcomings are discussed as inverse care, impoverishing care, fragmented care, unsafe care, and misdirected care. Reforms proposed by the WHO are also outlined, including universal coverage, service delivery, public policy, and leadership reforms. The objectives and importance of establishing Indian Public Health Standards are also presented. In conclusion, it acknowledges advances but notes the system remains ineffective and discusses needed reforms and decentralization to improve healthcare quality and delivery.
Understanding the concept of Universal Health Coverage (UHC) and how can we reach it, both globally and also in India. The presentation also includes HLEG report , which is the proposed architecture for India's guide to reach UHC.
Intersectoral coordination and and community participation is a key to success in health sector in India. This is a unique opportunity to play our role for better, healthy and happy society. One can enjoy and achieve the goals of health objectives through these techniques in the field/community setup.
Understanding the concept of Universal Health Coverage (UHC) and how can we reach it, both globally and also in India. The presentation also includes HLEG report , which is the proposed architecture for India's guide to reach UHC.
Intersectoral coordination and and community participation is a key to success in health sector in India. This is a unique opportunity to play our role for better, healthy and happy society. One can enjoy and achieve the goals of health objectives through these techniques in the field/community setup.
A new group of healthcare professionals who are not doctors are called community health officers CHOs . As a part of Comprehensive Primary Health Care, CHOs will be vital in providing an increased range of essential services. They are expected to direct the primary care staff at the Sub Centre, Health and Wellness Center, offer ambulatory care and clinical management to the neighborhood, and act as a crucial coordination link to guarantee the continuum of car. Mr. Saneesh CM | Dr. S. Victor Devasirvadam "Community Health Officer (CHO): An Overview" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-7 | Issue-1 , February 2023, URL: https://www.ijtsrd.com/papers/ijtsrd53840.pdf Paper URL: https://www.ijtsrd.com/medicine/nursing/53840/community-health-officer-cho-an-overview/mr-saneesh-cm
Community health nurses, also known as public health nurses, work to improve the health of a population and reduce disease and disability. This holistic approach to healthcare draws on knowledge of nursing, social sciences, and public health.
A new group of healthcare professionals who are not doctors are called community health officers CHOs . As a part of Comprehensive Primary Health Care, CHOs will be vital in providing an increased range of essential services. They are expected to direct the primary care staff at the Sub Centre, Health and Wellness Center, offer ambulatory care and clinical management to the neighborhood, and act as a crucial coordination link to guarantee the continuum of car. Mr. Saneesh CM | Dr. S. Victor Devasirvadam "Community Health Officer (CHO): An Overview" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-7 | Issue-1 , February 2023, URL: https://www.ijtsrd.com/papers/ijtsrd53840.pdf Paper URL: https://www.ijtsrd.com/medicine/nursing/53840/community-health-officer-cho-an-overview/mr-saneesh-cm
Community health nurses, also known as public health nurses, work to improve the health of a population and reduce disease and disability. This holistic approach to healthcare draws on knowledge of nursing, social sciences, and public health.
Principle, Scope, Nature and Administration of Health Services in Nigeria
(block posting lecture presented to final year medical class of University of Port Harcourt on thursday 31/05/18)
“Sarvé bhavantu sukhinaḥ, sarvé santu nirāmayāḥ, Sarvé bhadrāṇi pashyantu, mā kashchid_duḥkha-bhāg-bhavét”. The meaning of this Sanskrit Sloka is “All should/must be happy, be healthy, see good; may no one have sorrow. Mahatma Gandhi also says, “It is health which is real wealth, and not pieces of gold and silver”. Without robust health nobody can do anything. WHO emphasized on “Health for all” in this 21st Century in Geneva Conference in 1998. Government of India also committed to the goal of ‘Health for All’. WHO defined “health” as "State of complete physical, mental, and social well being, and not merely the absence of disease or infirmity". There are strong linkages between population, health and development. India’s health challenges are not only huge in magnitude due to its large population but they are complex due to its diversity and the chronic poverty and inequality. There are extreme inter-state variations, caused by not only the cultural diversity but because -the states are at different stages of demographic transition, epidemiological transition and socio economic development. Along with the old problems like persistence of communicable diseases and high maternal mortality in some parts, there is an urgent need to address the emerging issues like the threat of non-communicable diseases, HIV (AIDS) and health problems of the growing aged population. Accelerating demographic transition is not only necessary for the population stabilization but it is closely related to health goals. Despite substantial improvements in some health indicators in the past decade, India contributes disproportionately to the global burden of disease, with health indicators that compare unfavorably with other middle-income countries and India's regional neighbours. Large health disparities between states, between rural and urban populations, and across social classes persist. A large proportion of the population is impoverished because of high out-of-pocket health-care expenditures and suffers the adverse consequences of poor quality of health care. The obligation of the Government of India is to ensure the highest possible health status to its population and access to quality health care has been recognized by a number of its key policy documents. This paper attempts to study the over view of health care in India.
Key words: Health Care, National Health Policy, Access, Affordability, Equity, Urban Vs Rural-------------
This is the first part of the lecture in Community Health Nursing. This course provides an overview of the Philippine Health Care Delivery System and the different programs implemented by the Philippine Department of Health to promote and protect the health of the people.
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
How to Give Better Lectures: Some Tips for Doctors
An overview of health care delivery system in
1. B Y - D R . D H A R M E N D R A G A H W A I
( P G S T U D E N T )
M O D E R A T O R -
P R O F . Y . D . B A D G A I Y A N
H E A D O F D E P A R T M E N T
D E P A R T M E N T O F C O M M U N I T Y M E D I C I N E
C I M S , B I L A S P U R ( C G )
An Overview of Health Care
Delivery System in India
2. INTRODUCTION
As is well known , the majority of India’s population
lives in the rural areas
and
• this segment of population have been given
inadequate attention so far as health and medical
care facilities are concerned.
3. The dense rural population with varied ethnic
background , high level of illiteracy, low per capita
income have been a challenge to Central and state
government to improve the quality of people’ lives.
To cope up with various plans, programmes were
developed aiming to improve the level of living and
health of the people.
4. This planned development of about five decades has
resulted in increase in the health infrastructure to
meet the increasing demand on health services at
various level.
At the same time , there has been marked shift in
National Health Policy from hospital based services
to community based services duly backed by strong
referral services.
5. Today , it is clear that health system in India do not
gravitate naturally towards the goal of HEALTH
FOR ALL through primary health care as
articulated in the Declaration of Alma-Ata.
Health systems in India are developing in directions
that contribute little to equity and social justice
and
Fail to get best outcomes for their resources.
6. Three worrisome trends of health care system in
India -
1.Health system that disproportionately focus on narrow
offer of specialized health care.
2.Health system where a command and control approach
focused on short-term results and is fragmenting the
service delivery.
3.Health systems where governance has allowed
unregulated commercialization of health to flourish.
8. Common shortcomings
1.Inverse care.
2.Impowerising care.
3.Fragmented and fragmenting care.
4.Unsafe care.
5.Misdirected care.
9. INVERSE CARE
People with most means - whose needs for health
care are often less - consume the most health care
services.
Whereas those with the least means and greatest
health problems consume the least.
Public spending on health services most
often benefits the rich more than the poor.
10. IMPOVERISHING CARE
Wherever people are lack of social protection and
payment for health care , they are largely out of
pocket at the point of health services.
They can be confronted with catastrophic expenses.
Millions of people fall in to poverty because they
have to pay for health care services.
11. FRAGMENTED AND FRAGMENTING CARE
The excessive specialization of health care providers
and the narrow focus on many disease control
programmes discourage the holistic approach to the
individuals and families.
Health services for the poor and marginalized groups
are highly fragmented and severely under resourced .
12. UNSAFE CARE
• Poor system design that is unable to ensure safety
and hygiene standards leads to high rates of hospital
acquired-infection.
• Medication error and other avoidable adverse
effects are underestimated cause of death and ill
health.
13. MISDIRECTED CARE
Resource allocation clusters around curative services
at great cost and it is neglecting the potential of
primary prevention and health promotion to
prevent up to 70% of disease burden in developing
countries.
Health sector lacks to mitigate the adverse effects on
health from other sectors and
At the same time, unable to make most of what these
sector can contribute to health.
15. Health development is integral to overall
socioeconomic development.
Ministry of Health and Family welfare plays a vital
role in planning and making policies.
16. Under the Constitutions of India, the item like
public health, sanitation, hospitals and dispensaries
fall in the state list.
Health care is the subject of state government and
each state in India has developed its own system of
health care delivery independent of central
government.
The central organization is mainly for policy making
and planning and is mostly consultative and
advisory.
17. At Central Level
The organization at centre comprise of :
1.Union Ministry of Health and Family Welfare.
2.Directorate General of Health Services.
3.Central Council of Health and Family Welfare.
Ministry of Health and Family Welfare is headed by
1. A Cabinet Minister.
2.A Minister of State.
18. Currently it consist of four departments –
1.Department of Health and Family Welfare.
2.Department of AYUSH.
3.Department of Health Research.
4.Department of AIDS control.
19. The Union Ministry –
- formulates national policies on health and gives
advise on health allied matters.
- coordinates health programmes and policies.
-supplies technical information and equipments.
-provides financial and other assistance towards
health measures.
In general it promotes the health and well
being of people.
20. At State Level
The state is ultimate authority responsible
for all the health services operating within its
jurisdiction.
At present there are 28 states and 9 union territories
in India and as many type of health administration.
In all the state it comprises of –
1. State Ministry of Health and Family Welfare.
2.Directorate General of Health Services.
21. The State Ministry of Health and FW is headed by-
1.A Minister of Health and Family Welfare.
2.A Deputy Minister of Health and Family Welfare.
• Health Secretariat is a official organ-
• 1. Health Secretary.(Head)
• 2. Joint Secretaries.(2 or 3)
• 3. Deputy Secretaries and
• 4. Under Secretaries.
22. Director General of Health Services is chief
technical advisor to the state government in all
matter of medical and public health.
DGHS is assisted by 2-3 Joint Directors.
Joint Directors may be-
1. Regional.
2. Functional.
23. The Regional Directors are at Divisional level and
area classified according to geographical
distribution.
The Functional Directors are in particular branch
of public health such as –
Maternal and Child health
Family Planning
Nutrition
Health Education.
24. To coordinate the health and family welfare activities
between State government and Central government
there are 17 Regional Health Offices.
For the large state there is one regional office while
2-3 smaller state have been linked with one regional
office.
25. At District Level
The District level structure of health services is a
linkage between state structure on one side and
peripheral structure such as CHC , PHC and sub-
center on other side.
The district officer of overall control designated as
CMHO.
26. CMHO are assisted by deputies , programme officers
and State Civil Medical Officers of different
specialities.
They are responsible for implementing health and
family welfare programmes according to policies lay
down at higher level.
27. At Block Level
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 k/as Superintendent
CHC or Block Medical Officer.
Normally one CHC should have –
- 30 bed hospital .
- Specialist doctors in Pediatrics, Obstetrics, Medicine
and Surgery .
- Four Medical Officer.
28. At Primary Health Center
The delivery of Primary Health Care is principal
objective of rural health care system.
One PHC covers about 20000 – 30000 population.
PHC is manned by Medical Officer and paramedical
staff.
The Primary Health Center is expected to provide
“essential health care” including MCH and
family planning.
MCH services are provided through PHC clinic, sub-
center and out reach sessions.
29. At Sub-center level
Sub-centers are peripheral outpost of health care
delivery system.
Each sub center covers 3000-5000 population and
manned by one MPW male and one MPW female.
MPW female is crucial to provide MCH services.
30. At Village level
1.ASHA.
2.AWW.
3.Village Health Guide.
4. Trained dais.
32. The annual report of World Health Organization’s
(WHO) 2008 focused on “the place of primary
healthcare (PHC) in health systems”.
The report arguing that, in three decades since the
Declaration of Alma-Ata (WHO 1978) on primary
healthcare, only little has changed.
Member countries had largely implemented
'selective' primary care focused on provision of
medical care and services and treatment of specific
conditions.
33. FOUR SETS OF PHC REFORMS
The WHO report (2008) laid out a four-point
framework for Primary Health Care policy.
1.Universal Coverage Reforms.
2.Service Delivery Reforms.
3.Public Policy Reforms.
4.Leadership Reforms.
34. 1.Universal Coverage Reforms
Universal coverage reforms is to improve health
equity, end exclusion and promote social justice.
Primary care should be accessible to all and ideally,
be free at the point of services.
35. 2.Service Delivery Reforms
Service delivery reforms designed to re-organize
services around primary care.
In this sense, the WHO argued that PHC should be
the ‘hub’ from which patients are guided through the
health care system.
PHC should be delivered by multi-professional
teams that provide comprehensive care, co-ordinate
hospital and other specialized patient services, build
partnerships with patients, and promote disease
prevention.
36. 3.Public Policy Reforms.
The WHO advocated for public policy reforms that
integrate public health initiatives into primary care
delivery and
work to promote health in the policies of other
sectors that influence community behaviour and
outcomes.
'intersectoral collaboration'.
37. 4.Leadership Reforms.
The Leadership Reforms replace disproportionate
reliance on command and control on one hand.
The inclusive , participatory , negotiation based
leadership is required by the complexity of health
system.
39. The health system in India has expanded
considerably over the last few decades.
But , due to non availability of man power, problems
of access and lack of community involvement, the
quality of health services is not up to the mark.
Hence, standards are being introduced in order to
improve the quality of health care at public health
level.
40. The Bureau of Indian Standards has already
prescribed standards for health care facilities,
but , at present these are not achievable as they are
very resource – intensive.
41. IPHS are the set of standards envisaged to improve
the quality of health care delivery in the country.
IPHS defining personnel , equipment and
management standards.
It decentralized administration by a hospital
management committee and provision of adequate
funds and powers to enable these committees to
reach desired levels.
42. Objectives of IPHS
1.To provide optimal support and comprehensive
primary health care to the community.
2.To achieve and maintain an acceptable standards
of quality care.
3.To make the services more responsible and
sensitive to the need of community.
43. NRHM aims at strengthening hospital care for rural
areas.
So, as the first step, requirement for Minimum
Functional Grade for CHCs, PHCs and Sub-center
are being prescribed.
45. There have been significant advances in the
healthcare system in India over last few decades.
Despite these recent strides the health system
remains ineffective in providing basic minimum
care as promised in the Indian Constitution.
46. The fiscal constrains on the government make it
obligatory for the private healthcare providers to
take over part of the responsibilities.
New ways for establishing, strengthening and
sustaining the public-private co-operation are
essential for rejuvenating the system.
47. At the same time decentralization exercises can
make the health system more efficient and improve
the quality of healthcare delivery.
All these changes will need to be based on a strong
political will and should be accompanied by
economic and social reforms.