The document summarizes India's health care system, which consists of 5 major sectors: 1) the public health sector including primary health centers, community health centers, and hospitals; 2) private sector hospitals and clinics; 3) indigenous medical systems like Ayurveda and Unani; 4) voluntary health agencies; and 5) national health programs. It then provides details on primary health care delivery through a 3-tier rural health infrastructure of village-level health workers, sub-centers, and primary health centers. The document also outlines health insurance schemes and the roles of hospitals, private providers, and indigenous medical systems in India's health system.

1. HEALTH CARE SYSTEM
SRUTHI JOSEPH
KERALA
DELIVERY OF COMMUNITY HEALTH
SERVICES

2. HEALTH CARE SYSTEM
• The health care is intended to deliver the health care services. In India ,it is represented
by 5 major sectors or agencies which is differ from each other by the health technology
applied and by the source for operation.

3. 1) PUBLIC HEALTH SECTOR
• a) Primary health care;
• Primary health centers
• Sub –centers
• b) Hospitals/ health centers
• Community health centers
• Rural hospitals
• District hospitals
• Specialist hospitals
• Teaching hospitals
• c) Health insurance schemes
• Employee state insurance
• Central gov. health scheme
• d) Other agencies
• Defence services
• Railways

4. 2) PRIVATE SECTOR
• A ) private hospitals , poly clinics, nursing homes, and dispensaries
• B) general practitioners and clinics.

5. 3) INDIGENOUS SYSTEMS OF MEDICINE
• Ayurveda and Siddha
• Unani and Tibbi
• Homeopathy
• Unregistered practitioners

6. • 4) VOLUNTARY HEALTH AGENCIES
• 5) NATIONAL HEALTH PROGRAMME

7. 1) PUBLIC HEALTH SECTOR
A) PRIMARY HEALTH CARE ;-
• Health for all by 2000 AD promoted for health care at the door step. The
rural health infrastructure is based on a 3 tier system of services ,provided at 3
levels.
1) village leve
2) sub-center level
3) primary health centers level

8.  VILLAGE LEVEL :-
Health care must be available & accessible to rural areas and that
everyone should have assess to it . based on this aim, health
organization at village level includes activily functioning bodies,
those includes
o Village health guides :-
 Introduced on 2nd October 1977 with the idea of securing peoples participation in the care
of their own health.
 It is a person who intrested in social and it is not a govt functionary.

9.  Guidelines for there selection are:-
 They should be permanent residence of the local community, preferably women.
 They having minimum formal education at least up to the 6th standerds.
 They should be acceptable to all sections of the community and
 They should able to spare at least 2 to 3 hrs everyday for community health work

10. o B) local dais:-
Under the rural health scheme based on the principles of “planning people's health in peoples hands
(shivashakthi committee,1975) is an extensive program to train all categories of local dais (traditional birth
attenders) (TBA) in the country to improve their knowledge in the elementary concepts of meternal& child health
and sterilization.
o c) Anganwadi worker:-
Under the ICDS (integrated with child develepment services sheme),there is ananganwadi worker
for the population of1000. there services,
Health check up
Immunization
Supplementary nutrition
Health education

11.  SUB-CENTER LEVEL:-
• They are being established on the basis of one sub center for every 5000 population in
general &1 each in every 3000 population in hilly, tribal and backward areas.
• Facilities in sub centers
• IUD insertion
• Simple laboratory investigation like albumin and suger.

12.  PRIMARY HEALTH CENTER LEVEL:-
The national health policy in (1983) proposed recoganization of PHC on the basis of 1 PHC for
every 30,000 rural population in the plains & 1PHC for every 20,000 population on hilly, tribal and
backward areas for more effective coverage.
• FUNCTIONS OF THE PHC
(Alma ata declaration )
• Medical care
• Maternal and child health includinding family planning
• Safe water supply & basic sanitation
• Prevention & control of locally endemic diseases
• Collection & reporting of vital statitics.
• Education about health & nutrition

13. • National health programme like malaria, filarial, leprosy, tb, STD,AIDS etc
• Referral services
• Traing of health guides, health workers, local aids, health assistance
• Basic laboratory services

14. B) HOSPITALS OR HEALTH CENTERS
• 1) community health centers
CHC covers a population of 80,000 to 1.20 lakh with 30 beds and specialists in surgery
medicine,OBG, pediatrics,with X-ray and lab facilities.
New non medical post is called community health officer,( need minimum 7 years of
experience in rural health programme.
Functions of CHC :-
 care of routine and emergency cases in surgery. ( this include I&D, surgery for
hernia , hydrocele, appendicitis etc.)
 care of routine and emergency cases in medicine. ( dengue, cerebral maleria)
 24 hours delivery services including normal and assisted deliveries.
 Essential & emergency obstetric care eg. LSCS

15.  full range family planning serveces including laproscopic services
 Safe abortion services
 Newborn care
 Routine and emergency care of sick children
 All the national health programmes (NHP) deleverd through CHC.

16. • HOSPITALS
Apart from the PHC the present organization of health services of the Gov. sector consist of
rural hospitals , sub divisional ( tehsil/taluka hospitals, district hospitals, specitistics
hospitals,& teaching institution.
Rural hospitals
there are basically attached to Gov.medical colleges.
District hospitals
a hospital differs from a health centers in the following respects:-
The services are preventive ,promotive & curative all integrated

17. C) HEALTH INSURANCE
There is no universal health insurance in India.
 Employee state insurance scheme( ESI)
Introduced by an act of parliament in1948 is a unique piece of social legislation in India.
The act provides for medical care in cash&kind,benefits in the contingency of sickness
meternity, employment injury,and pension for dependents on the death of the worker because
of employment injury.

18.  Central gov. health scheme
Introduced in New Delhi in 1954 to provide comprehensive medical care to central
govt.employees.
Facilites:-
OP care through a network of dispensares.
Supply of necessary drugs
Domiciliary visits
Hospitalization facilities of Govt. as well as consultation
Paediatric services including immunization
Emergency department
Supply of optical and dental aids at responsible rate

19. • Other agencies
• A) defence medical services
• (armed force medical services)
• B) health care of railway employees

20. 2. PRIVATE AGENCIES
• A) privet hospitals, poly clinic ,nursing homes ,and dispensaries.
• B) general practitioners and clinics.
• there has been a rapid expansion in the number of qualified allopathic physicians
from about 50,000 at the time of independence to about 7067 lakhs in 2005& the doctor
patient population ratio for the country as a whole is 1:1428.
• There services are available to those who can pay.

21. 3. INDIGENOUS SYSTEMS OF MEDICINE
• Ayurveda and Siddha
• Unani and Tibbi
• Homeopathy
• Unregistered practitioners
• The practitioners of indigenous systems of medicine provide the bulk of medical care to
the rural peoples.
• The govt.of India has established a national institute of Ayurveda in Jaipur a national
institute of homeopathy in kolkatha.
• A central council of Indian medicine was established in1971 to prescribe minimum
standards of education in Indian medicine.

22. 4) VOLUNTARY HEALTH AGENCIES
• Indian red cross society
• Hindu kusht nivaran sang
• Indian council for child welfare
• Tuberculosis association of india
• Bharat sevak samaj
• Central social welfare bord
• The kasturba memorial fund
• Family planning association of India
• All India womens conference
• The all India blind relief society
• Proffesional bodies
• International agencies

23. 5) NATIONAL HEALTH PROGRAMMES
• Health programmes play a major contributing factor in reducing prevalence and mortality
rate in India.
• Reproductive and child health programme (RCH)
• National vector born disease control programme (NVBDCP)
• Revised national tuberculosis control programme (RNTCP)
• National leprosy eradication programme(NLEP)
• Integrated disease surveillance project( IDSP)

24. • Integrated child development services (ICDS)
• National water supply and sanitation programme
• National cancer control programme
• National programme for diabetics stroke and cardiovascular diseases
• National mental health programme
• National programme for control of blindness(NPCB)
• National iodine deficiency disease disorder control programme