The health care delivery system in India has three main levels: central, state, and district. At the central level, the Ministry of Health and Family Welfare is responsible for policymaking, planning, and coordinating health services. States each have their own health care systems overseen by state health directors. Districts are divided into subdivisions, blocks, municipalities, and villages served by primary health centers, community health centers, and hospitals. The system aims to provide comprehensive, accessible, affordable, and community-participatory health care through primary, secondary, and tertiary levels.
Overall in India, we have 35,416 government hospitals which have 13,76,013 beds. But unfortunately merely 2℅ of the doctors serves in rural India, which comprises 68% of our population.
A decentralized system of disease surveillance for timely and effective public health action with a focus on functional integration of surveillance components of various vertical programmes.
The National Health Mission (NHM) encompasses
its two Sub-Missions, the National Rural Health
Mission (NRHM) and the National Urban Health
Mission (NUHM). The main programmatic
components include Health system strengthening
in rural and urban areas, ReproductiveMaternal-Neonatal-Child and Adolescent Health
(RMNCH+A) and Communicable and NonCommunicable Diseases. The NHM envisages
achievement of universal access to equitable,
affordable & quality healthcare services that are
accountable and responsive to people’s needs.
Overall in India, we have 35,416 government hospitals which have 13,76,013 beds. But unfortunately merely 2℅ of the doctors serves in rural India, which comprises 68% of our population.
A decentralized system of disease surveillance for timely and effective public health action with a focus on functional integration of surveillance components of various vertical programmes.
The National Health Mission (NHM) encompasses
its two Sub-Missions, the National Rural Health
Mission (NRHM) and the National Urban Health
Mission (NUHM). The main programmatic
components include Health system strengthening
in rural and urban areas, ReproductiveMaternal-Neonatal-Child and Adolescent Health
(RMNCH+A) and Communicable and NonCommunicable Diseases. The NHM envisages
achievement of universal access to equitable,
affordable & quality healthcare services that are
accountable and responsive to people’s needs.
3. 2nd PBBSc - Comty - Unit - 3 - Organization and administration of health s...thiru murugan
2nd Year PBBSc Nursingcommunity Health Nursing
Organization and administration of health services in India
UNIT III:
Organization and administration of health services in India.
National health policy
Health Care Delivery system in India.
Health team concept
Centre, State, district, urban health services, rural health services
System of medicines
Centrally sponsored health schemes
Role of voluntary health organizations and international health agencies
Role of health personnel in the community
Public health legislation.
Important questions:
Different level of health services in india (Centre, State, district, urban health services, rural health services)
Health team
System of medicines / AYUSH
Role of health personnel in the community
National health policy
voluntary health organizations – WHO, UNICEF, Red cross
Public health legislation.
National health policy:
Definition:
Health policy can be defined as the "decisions, plans, and actions that are undertaken to achieve specific healthcare goals within a society”
National health policy 1983:
National health policy in India was not framed and announced in 1983.
The ministry of health and family welfare evolved a National Health Policy in 1983.
The policy focus on the preventive, promotive, public health and rehabilitation aspects of health care.
To attain the objectives “Health for all by 2000 AD”.
KEY ELEMENTS OF NATIONAL HEALTH POLICY 1983:-
Awareness of health problems
Safe drinking water and sanitation
Rural health infrastructure
Health management of information system
Legislative support to health
Combat wide spread of malnutrition
Research in health care
Different system of medicines
Factors interfering with the progress towards health for all:
Insufficient political commitment
Failure to achieve equality
The low status of women.
Slow socio-economic development.
Lack of human resources.
Inadequacy of health promotion activities.
Weak health information system and no baseline data.
Pollution, lack of water supply and sanitation.
Uncontrolled population
Advanced technology
Natural and man-made disasters
National Health Policy 2002:
The national health policy 1983 revised in 2002 with new objectives and strategies in order meet the health problems and demand of peoples
Objectives:
To achieve an acceptable standard of good health
To upgrading health infrastructure
To improve equitable health service
To give priority for prevention and first line curative
To promote rational use of drugs.
To increase use of Traditional Medicine (AYUSH)
National Health Policy 2002 - Policy prescriptions:
Equity
Delivery of national health programmes
Extending public health services
Education of health care professionals
Need for specialists in 'public health' & 'family medicine
Nursing personnel
Urban health
Mental health
Information Education and Communication
Health research
Role of private sector
Health statistics
Women's health
Medical ethics
Enforcement of quality standard for food &drug
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.
Introduction of Social Pharmacy Role of Pharmacist /Chapter -1
L-1 Social Pharmacy D.Pharm 1st Year based on the new syllabus of d Pharma as per PCI ER 2020.
Definition of social pharmacy
Social pharmacy as a discipline
Objectives of social pharmacy
Social pharmacy research
Social pharmacy education
Scope of social pharmacy in improving health
Role of pharmacist in public health
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
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
Follow us on: Pinterest
Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
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
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.
- 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
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.
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
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.
2. Introduction
Health is…..
……..a state of complete Physical, Mental
and Social well being and not merely an
absence of disease or infirmity….
…..which allows a person to
live a socio-economically productive life.
Illness is…..
…a state in which a person’ s physical,
emotional, intellectual, social or spiritual
functioning is diminished or impaired.
3. Cont….
Health care is...
…….multitude of services rendered to
individuals or communities by the agents
of health services or professional for the
purpose of
Promoting
Restoring and
Maintaining health
Embraces all the goods and services
designed for “prevention, promotion and
rehabilitation interventions” includes
Medical Care
4. Health Care provider
A person or organization that provides services
and/or health care personnel….
….to deliver proper health care in a systematic
way to any individual in need of health care
services.
Could be a government…or…
….the health care industry,
….a health care equipment company,
….an institution such as a hospital or laboratory.
Health care professionals may include physicians,
dentists, and other support staff.
5. Cont….
Health services
Permanent countrywide system of
estabilished institutions with the objective of…
….coping with the various health needs and
demands of population…
…thereby provide health care to individuals and
community with preventive and curative activities
….utilizing health care workers
6. Cont…
System
Includes… concepts ( e.g health and diseases)
Ideas(e.g equity)
Objects(e.g hospitals, health centres)
Persons (health care workers viz. physician,
nurses)
Together these forms a system interacting
with each other, supporting and controlling
each other
8. 1. Structure of health system
Aspects of the design of health services that influences the
way in which they are delivered Includes….
Number and type of personnel and staff
Way of these personnel organized to work
Nature and extend of facility and equipment
Range of services offered
System of management and amenities
Financing
Enumeration and determination of the eligible population for
these services
Governance and decision making
9. Cont…
2. Process of health care delivery
Consists of two parts
Behavior of professionals
Recognition of the problem i.e diagnosis
Diagnostic procedure
Recommendation of treatment or management
Appropiate follow up
Participation of people
Utilization of services
Understanding the recommendations
Satisfaction with the services
Participation in decision making
10. Cont…
3. Outcomes of health care
Aspects of health that results from interventions provided by the
health system
4. Flow of patients in health care system
Varies from country to country
India harbors a multistage (three tier) system, where majority of
health care is delivered by community health care worker
Indian system is more cost effective if health workers are skilled
and effectively supervised
Such system could one of the reason to reduced cost of health
care in developing countries
11. Levels of health care
Primary Health care
Provided at the community level
Secondary health care
Provided at PHC, CHC, DH etc.
Tertiary health care
Provided at hospitals
Tertiary health
care
12. Alma-Ata international conference
In 1977, World Health Assembly decided to launch a
movement called “Health for all by 2000”
Fundamental principle of this concept was equity, an equal
health status for all the people in all countries
This is to be ensured by equitable distribution of health
resources
In 1978, the note of “Health for all” was reaffirmed and
marked as the major social goal for every country.
It was stated in the declaration that the best way to achieve
HFA is by providing primary health care……
……… especially to vast size of
underserved rural and urban poor
14. Alma-Ata Declarations
A main social target of governments, international
organizations and the whole world community in the coming
decades should be the attainment by all peoples of the world
by the year 2000 of a level of health that will permit them to
lead a socially and economically productive life. - “HEALTH
FOR ALL BY 2000”
Primary health care is the key to attaining this target as part of
development in the spirit of social justice.
Primary health care is essential health care based on
practical, scientifically sound and socially acceptable methods
and technology, made universally accessible to individuals
and families in the community through their full participation
and at a cost that the community and country can afford.
15. Alma-Ata Declaration
It forms an integral part of the country's health
system, and of the overall social and economic
development of the community.
It is the first level of contact of individuals, the
family and community with the national health
system.
All governments should formulate national policies,
strategies and plans of action to launch and sustain
primary health care as part of a comprehensive
national health system and in coordination with
other sectors.
16. Primary health care
Primary Health Care as defined by the World Health
Organization (WHO) in 1978 is…
Essential health care; based on
practical,
scientifically sound, and
socially acceptable method and technology….
…….made universally accessible to individuals
and families of the community through their full
participation….
……at a cost that community and country can
afford to maintain every stage of their development in
the spirit of self determination.
17. Cont…
Definition
Primary health care is essential health
care made universally accessible to
individuals and acceptable to them
through their full participation and at a cost
the community and country can afford
18. What is there in Primary Health
Care..?????
Primary Health Care includes:
– Primary Care (physicians, midwives & nurses);
– Health promotion, illness prevention;
– Health maintenance & home support;
– Community rehabilitation;
– Pre-hospital emergency medical services… and…
– Coordination and referral to other areas of health care.
19. Cont.…
It is the first level of contact with the health system to promote
health, prevent illness, care for common illnesses, and
manage ongoing health problems.
Primary Health Care involves concerted effort to provide
rural population of developing countries with least bare
minimum of health services.
Some services are also provided community and hospitals
Primary Health Care is different in each community depending
upon:
– Needs of the residents;
– Availability of health care providers;
– The communities geographic location; &
– Proximity to other health care services in the area.
20. Elements of primary health care
1. Education about prevailing health conditions and methods
to prevent and control them
2. Promotion of food supply and proper nutrition
3. Adequate water supply and basic sanitation
4. Maternal and child health care with family planning
5. Immunization against major infectious diseases
6. Prevention and control of locally endemic diseases
7. Appropriate treatment of common diseases and injuries
8. Provision of essential drugs
21. Principles of primary health care
Equitable distribution
Community participation
Intersectoral coordination
Appropriate technology
22. Health Care Delivery System in India
India is a union of 28 states and 7 union territories.
States are largely independent in matters relating to
the delivery of health care to the people.
Each state has developed its own system of health
care delivery, independent of the Central
Government.
The Central Government’s responsibility consists
mainly of policy making , planning , guiding,
assisting, evaluating and coordinating the work of
the State Health Ministries.
23. Health System in India
The health system in India has 3 main links
24. At the central level
The official “organs” of health system at
national level are
27. Functions of MoHFW
Union list
International health relations and administration of port
quarintine
Administration of Central Institutes
Promotion of research
Regulation and development of medical, pharmaceutical, dental
and nursing professions
Establishment and maintenance of drug standards
Census and collection and publication of other statistical data
Coordination with states
28. cont….
Concurrent List:
Prevention of Communicable disease
Prevention of food adulteration
Control of drug and poison
Vital statistics
Labour welfare
Economic and social planning
Poulation control and family planning
31. Functions of Directorate General of Health
services
General functions
Surveys
Planning
Coordination
Programming and appraisal of all health matters
Specific function
International health relations and quarantine of all major
ports in country and international airport.
Control of drug standards
Maintain medical store depots
Administration of post graduate training programmes
32. Cont…
Administration of certain medical colleges in India
Conducting medical research through Indian Council of
Medical Research ( ICMR )
Central Government Health Schemes.
Implementation of national health programmes
Preparation of health education material for creating health
awareness through Health Education Bureau
Collection, compilation, analysis, evaluation and
dissemination of information
National Medical Library
35. Functions
To consider and recommend broad outlines of
policy related to matters concerning health like
environment hygiene, nutrition and health
education.
To make proposals for legislation relating to
medical and public health matters.
To make recommendations to the Central
Government regarding distribution of grants-in-
aid.
38. Functions of state health Director
(1) Studies in depth the health problem and needs in the state and
plans scheme to Solve them
(2) Providing curative &preventive services
(3) Provision for control of milk and food sanitation
(4) Prevention of any outbreak of communicable diseases
(5) Promotion of health education
(6) Promotion of health programmes such as school health, family
planning, Occupational health
(7) Supervision of PHC
(8) Establishing training courses for health personnel
(9) Co-ordination of all health services with other minister of state
such as minister of education, central health minister &voluntary
agency .
39. At District level
There are 593 ( year 2001 census) districts in
India. Within each district, there are 6 types of
administrative areas.
1. Sub –division
2. Tehsils ( Talukas )
3. Community Development Blocks
4. Municipalities and Corporations
5. Villages and
6. Panchayats
40. Disrtict Level
Districts
Tehsils /Talukas (200-600
villages)
Community Development Blocks
(approx 100 Villages & 80,000 -
1.2 Lac Pop)
Municipalities & Corporations
Municipal Board
(10,000- 2 Lac Pop)
Corporations (> 2 lac
pop)
Town Area Committee
(5,000-10,000 Pop)
Panchayats
Villages
41. Most district in India are divided into two or more subdivision, each
incharge of an Assistant Collector or Sub Collector
Each division is again divided into taluks, incharge of a Thasildhar. A taluk
usually comprises between 200 to 600 villages
The community development block comprises approximately 100
villages and about 80000 to 1,20,000 population, in charge of a Block
Development Officer.
Finally, there are the village panchayats, which are institutions of rural
local self-government.
The urban areas of the district are organized into
Town Area Committees (in areas with population ranging between 5,000
to 10,000
Municipal Boards (in areas with population rangingbetween 10,000 and
2,00,000)
Corporations (with population above 2,00,000)
The Town Area Committees are like panchayats.They provide sanitary
services.
The Municipal Boards are headed by Chairmen /President, elected by
members.
42. The functions of Municipal Board:
Construction and maintenance of roads
Sanitation and drainage
Street lighting
Water supply
Maintenance of hospitals and dispensaries
Education and
Registration of births and deaths etc
The Corporations are headed by Mayors, elected by
councillors, who are elected from different wards of
the city. The executive agency includes the
commissioner, the secretary, the engineer and the
health officer.The activities are similar to those of
municipalities, on a much wider scale.
43. Panchayat Raj
The panchayat raj is a 3-tier structure of rural
local self-government in India linking the
village to the district. It includes
Panchayat (at the village level)
Panchayat Samiti( at the block level)
Zila Parishad(at the district level)
44. Panchayat (at the village level)
The Panchayat Raj at the village level consists of
• The Gram Sabha
• The Gram Panchayat
45. The Gram Sabha
• It is the assembly of all the adults of the
village, which meets at least twice a year.The
gram sabha considers proposals for
taxation,and elect members of The Gram
Panchayat.
46. The Gram Panchayat
• It is the executive organ of the gram sabha and an
agency for planning and development at the village
level. The population covered varies from 5000 to
15000 or more.The members of panchayat hold offices
for a period of 3to4 years. Every panchayat has an
elected president (Sarpanch or Sabhapati or Mukhia), a
vice president and panchayat secretary. It covers the
civic administration including sanitation and public
health and work for the social and economic
development of the village
• (
47. Panchayat Samiti (at the block level)
• The block consists of about 100 villages and a
population of about 80,000 to 1,20,000.
• The panchayat samiti consists of Sarpanch, MLAs, MPs
residing in block area, representative of women, SC, ST
and cooperative socities.
• The primary function of The Panchayat Samiti is the
execute the community development programme in
the block.
• The Block development Officer and his staff give
technical assistance and guidance in development
work.
48. Zila Parishad (at the district level)
• The Zila Parishad is the agency of rural local
self governmen at the district level . The
members of Zila parishad include all heads of
panchayat samiti in the district,MPs, MLAs,
representative of SC, ST and women and 2
persons of experience in administration,public
life or rural development. Its functions and
powers vary from state to state.
49. Health Services
Out patient services -Patients who don’t require hospitalization
can receive health care in a clinic. An out patient setting is
designed to be convenient and easily accessible to the patient.
Clinics – Clinics involve a department in a hospital where patients
not requiring hospitalization, receive medical care.
Institutions – Hospitals – Hospital have been the major agency
of health care system.
In broad sense the health services should be
a. Comprehensive
b. Accessible
c. Acceptable
d. Provide scope of community participation and….
e. Available at an affordable cost by country and commuity
50. Health care systems
Intended to delivery healthcare services and represented by five
major sectors different from each other by health technology
1. Public health sector
a. Primary health care
Primary health centres
Sub centres
b. Hospitals/Health centres
Community health centres
Rural hospitals
District hospitals/health centres
Specialist hospitals
Teaching hospitals
c. Health insurance schemes
Employees State Insurance
Central Govt. Health Schemes
d. Other agencies
Defense services
Railways
51. Cont…
2. Private sector
a. Private hospitals, polyclinic, nursing homes and
dispensaries
b. General practitioners and clinics
3. Indigenous system of medicine
a. Ayurveda and Siddha
b. Unani and Tibbi
c. Homeopathy
d. Unregistered practitioners
4. Voluntary health agencies
5. National health programmes
53. Introduction
In 1977, GoI launched Rural Health Scheme based on the
principle of “placing people’s health in people’s hand”
Subsequently in the international conference of Alma-
Ata(1978)the goal of “Health for all” by 2000 through
primary health care approach was set.
Keeping in view WHO “Health for all” by 2000 GoI
formulated National health policy 2002
54. Cont….
More recently GoI formulated NRHM and Indian Public Health
Standards (IPHS) in this regards
In order to provide quality care in the public health agencies of
health care delivery IPHS are being prescribed.
These standards provides basic promotive, preventive and
curative primary health care to the community and……
…….achieve and maintain an acceptable quality of care
These standards would help monitor and improve functioning
of the health care delivery system
55. Rural Health care system in India
Primary Health Centre (PHC)
A Referral unit for 4-6 Subcentres; 4-6 bedded manned with a
Medical Officer in-charge and 14 subordinate paramedical staff
no. of PHCs with specialized Health Services
Community Health Centre (CHC)
A 30 bedded Hospital/ Referral unit for 4 no. of PHCs with
specialized Health Services
Sub Centre (SC)
Most peripheral contact point of community with Primary Health
Care system; manned with one MPW(M) and MPW(F)
56. Rural Health care system in India
The health care infrastructure in rural areas has
been developed as a three tier system and is
based on the above population norms.
Health Facility
Population Norms
Plain Area
Hilly/Tribal/Difficult
Area
Sub-Centre 5000 3000
Primary Health Centre 30,000 20,000
Community Health Centre 1,20,000 80,000
57. Sub Center
The most peripheral and first contact point between the primary
health care system and the community.
The Ministry of Health & Family Welfare is providing 100%
Central assistance
They are established on the basis of
One SC for every 5,000 pop in general and…
One SC for every 3,000 pop in hilly, tribal and backward areas
Each Sub-Centre is manned by one Male and one female Health
Worker.
One Lady Health Worker (LHV) is entrusted with the task of
supervision of six Sub-Centers.
58. Cont….
Sub Centre are assigned tasks relating to
interpersonal communication
…..in order to bring about behavioral
change and provide services in relation to….
Maternal and child health,
Family welfare,
Nutrition,
Immunization,
Diarrhea control and
Control of communicable diseases programmes.
The sub centre are provided with basic drugs
for minor ailments.
59.
60. Primary Health Center
PHC is the first contact point between village
community and the Medical Officer.
The PHCs were envisaged to provide an
integrated curative and preventive health care to
the rural population with emphasis on preventive
and promotive aspects of health care.
The PHCs are established and maintained by the
State Governments.
At present, a PHC is manned by a Medical Officer
supported by 14 paramedical and other staff.
61. Cont….
It acts as a referral unit for 6 SubCentres.
It has 4 - 6 beds for patients.
The activities of PHC involve curative, preventive,
primitive and Family Welfare Services.
National Health Plan (1983) proposed
reorganization of PHCs on the basis of….
One PHC for every…..30,000 pop in Rural areas
One PHC for every…..50,000 pop in Urban areas
63. Functions of PHCs
Medical care
Health programmes
MCH care and family planning
Health education and training
Referral services
Safe water supply and basic sanitation
Prevention and control of locally endemic diseases
Collection and reporting of vital events
Basic laboratory services
65. Community Health Center (CHC)
These were established by upgrading the primary health centers
CHCs are being established and maintained by the State Government.
centers,each community health center should cover a population of
8000 to 1.2 lakh
It is manned by four medical specialists i.e. Surgeon,
Physician, Gynecologist and Pediatrician and….
……supported by paramedical and other staff.
It has 30 in-door beds with one OT, X-ray, Labour Room and Laboratory
facilities.
It serves as a referral centre for 4 PHCs and also provides facilities for
obstetric care and specialist consultations.
66. Functions of CHCs
Care of Routine and Emergency Cases in Surgery
Dressings, I&D, and surgery for Hernia, Hydrocele,
Appendicitis etc.
Emergencies like Intestinal Obstruction, Haemorrhage, etc.
Other management including nasal packing, tracheostomy,
foreign body removal etc.
Fracture reduction and putting splints/plaster cast.
Conducting daily OPD.
Care of Routine and Emergency Cases in Medicine
Daily OPD
Handling all the emergency and routine cases
67. Cont…
Maternal Health
Minimum 4 ANC check ups including Registration &
associated services
1st visit: Within 12 weeks—preferably as soon as
pregnancy
2nd visit: Between 14 and 26 weeks
3rd visit: Between 28 and 34 weeks
4th visit: Between 36 weeks and term
24 hr delivery services including normal and assisted
delivery and cesarean section
Managing labour using Partograph.
Minimum 48 hours of stay after delivery, 3-7 days stay
post delivery for managing Complications
68. Cont….
Newborn Care and Child Health
Essential Newborn Care and Resuscitation
Counseling on Infant and young child feeding
Routine and emergency care of sick children
Full Immunization of infants and children against VPDs
Management of Malnutrition cases.
Family Planning
Counseling, provision of Contraceptives, NSV,
Laparoscopic Sterilization Services and their follow up.
Safe Abortion Services
69. Cont….
All National Health Programmes delivered through
CHCs
School health services
Others
Blood storage facility
Essential laboratory services
Referral (transport) services
Maternal Death review (MDR)