Health care delivery, Health status, Health Problem, Model of Health care system, Communicable health Problem, Non- communicable health problem, Environmental sanitation problems ,Medical care problems ,Population problems. community Medicine, PSM

1. HEALTH CARE DELIVERY
Dr. Anil Kumar
Assistant Professor
Community medicine Department
RMHCRC

2. • The challenge that exists today in many countries is to reach the
whole population with adequate health care services and to ensure
their utilization.
• The "large hospital" which was chosen hitherto for the delivery of
health services has failed in the sense that it serves only a small part
of the population, that too, living within a small radius of the building
and the services rendered are mostly curative in nature.
• Rising costs in the maintenance of these large hospitals and their
failure to meet the total health needs of the community.

3. • That’s why many countries to seek 'alternative'
models of health care delivery with a view to provide
health care services that are reasonably inexpensive,
and have the basic essentials required by population.

4. • The services provided should be comprehensive and community-
based.
• The resources must be distributed according to the needs of the
community.
• The HEALTH CARE SYSTEM is intended to deliver the health care
services

5. The final outcome or the OUTPUT is the changed health
status or improved health status of the community
which is expressed in terms of
•lives saved,
•deaths averted,
•diseases prevented,
•cases treated,
•expectation of life prolonged, etc

6. HEALTH STATUS AND HEALTH PROBLEMS
• This is also known as Community Diagnosis.
• The data required for analyzing the health situation and for defining
the health problems comprise the following :
1. Morbidity and mortality statistics.
2. Demographic conditions of the population.
3. Environmental conditions which have a bearing on health.
4. Socio-economic factors which have a direct effect on health.

7. 5. Cultural background, attitudes, beliefs, and practices which affect
health.
6. Medical and health service available.
7. Other services available.
HEALTH STATUS AND HEALTH PROBLEMS Cont…

9. Mortality profile

10. Demographic profile

11. Health problems
The HEALTH PROBLEMS of India may be conveniently grouped under
the following heads :
1. Communicable disease problems
2. Non-communicable disease problems
3. Nutritional problems
4. Environmental sanitation problems
5. Medical care problems
6. Population problems.

12. Communicable disease problems:
• Malaria :
Malaria continues to be a major health problem in India.
Although total malaria cases has declined compared to previous years,
the proportion of P. falciparum has increased.
Malaria cases have increased in North-East states, Madhya Pradesh,
Chhattisgarh, Jharkhand, Orissa, Andhra Pradesh, Maharashtra etc.
During 2013 there were 0.8 million cases of malaria (which included
0.44 million cases of Pf malaria) and 379 deaths.

13. Tuberculosis:
• Every year about 2.6 million persons develop tuberculosis, of which
about 0.62 million are new smear positive highly infectious cases
and about 0.24 million people die of TB every year.
• The emergence of HIV-TB coinfection and multidrug resistant TB has
increased the severity and magnitude of the disease.

14. Diarrhoeal diseases
ARI
Leprosy
Filaria
AIDS
Others

15. Non-communicable diseases (NCDs)
• India is experiencing a rapid epidemiological transition with a large
and rising burden of chronic diseases, which were estimated to
account for 53 per cent of all deaths and 44 per cent of
Disability Adjusted Life Years lost in 2005.
NCDs, especially diabetes mellitus, CVDs, cancer, stroke, and chronic
lung diseases have emerged as major public health problems due
to an ageing population and environmentally-driven changes in
behaviour.

16. Nutritional problems
• Protein-energy malnutrition
• Nutritional anaemia :
• Low birth weight :
• nutritional blindness
• Iodine deficiency disorders :

17. Environmental sanitation
• The most difficult problem to tackle in this country is perhaps the
environmental sanitation problem, which is multifaceted and
multifactorial.
• The twin problems of environmental sanitation are lack of safe
water in many areas of the country and primitive methods of
excreta disposal.

18. Medical care problems
• India has a national health policy. It does not have a national health
service. The financial resources are considered inadequate to furnish
the costs of running such a service.
• The existing hospital-based, disease-oriented health care model has
provided health benefits mainly to the urban elite. Approximately 80
per cent of health facilities are concentrated in urban areas.
• Even in urban areas, there is an uneven distribution of doctors.
• The rural areas where nearly 72 per cent of the population live, do
not enjoy the benefits of the modern curative and preventive health
services.

19. Population problem
• The population problem is one of the biggest problems facing the
country, with its unavoidable consequences on all aspects of
development, especially employment, education, housing, health
care, sanitation and environment.

20. Thank You