Health committees ppt

HEALTH &
FAMILY
WELFARE
PLANNING
COMMITTEES
IN INDIA

OUTLINE
Introduction
Various health and welfare committees
Bhore committee
Mudaliar committee
Chadha committee
Mukherji committee
Jungalwalla committee
Kartar Singh committee

OUTLINE
Shrivastav committee
Rural Health Scheme
Shivaraman Committee
Ramalingaswamy Committee
Bajaj Committee
Krishnan Committee
Health For All

INTRODUCTION
Health planning in India is an integral part of national
socio-economic planning. The guidelines for national
health planning were provided by a number of
Committees dating back to the Bhore Committee in
1946.
These Committees were appointed by the
Government of India from time to time to review the
existing health situation and recommend measures for
further action.

INTRODUCTION
More recently the Alma Ata Declaration on primary
health care and the National Health Policy of the
Government gave a new direction to health planning
in India, making primary health care the central
function and main focus of its national health system.
The goal of national health planning in India was to
attain Health for ALL by the year 2000.

VARIOUS HEALTH
COMMITTEES
BHORE
COMMITTEE
(1946)
MUDALIAR COMMITTEE
(1962)
CHADHA COMMITTEE
(1963)
MUKERJI COMMITTEE
(1965)
MUKERJI COMMITTEE
(1966)

VARIOUS HEALTH
COMMITTEES
JUNGALWALLA
COMMITTEE
(1967)
KARTAR SINGH
COMMITTEE
(1973)
SHRIVASTAV
COMMITTEE
(1975)
RURAL HELTH SCHEME
(1977)
Shivaraman
Committee
(1979)

VARIOUS HEALTH
COMMITTEES
HEALTH FOR ALL by
2000AD- Report of the
working group, 1981
Krishnan
Committee
(1992)
Ramalingaswamy
Committee
(1980)
Bajaj Committee
(1986)

BHORE COMMITTEE (1946)
□ This committee, known as the Health Survey &
Development Committee, was appointed in 1943
with Sir Joseph Bhore as its Chairman.
□ It laid emphasis on integration of curative and
preventive medicine at all levels. Comprehensive
recommendations were made by him for remodelling
of health services in India.

□ The committee observed: “ if the nation’s health is
to be built, the health programme should be
developed on a foundation of preventive health
work and that such activities should proceed side
by side with those concerned with the treatment of
patients”.

Comprehensive
healthcare comprising a
package of:-
• Medical Relief,
• Communicable Disease
Control
• Environmental Sanitation
• Maternal and Child Health
Care
• School Health Services
• Health Education
• Vital Statistics

The report, submitted in 1946, had some important
recommendations like :-
1.) Integration of preventive and curative
services of all administrative levels.
2.) Development of Primary Health Centres in
2 stages:
Short-term measures
Long-term measures

DEVELOPMENT OF PHC IN TWO
STAGES:
Short term measures long term measures
Government should establish
1 primary health centre for
every 40,000 population
staffed by
• 2 doctors,
• 1 nurse,
• 4 public health nurses,
• 4 midwives,
• 4 trained dais,
• 2 sanitary inspectors,
• 2 health assistants
• 1 pharmacist.
Government should setup
the following (termed as ‘3
million plan’)
• 75 bedded primary health
centre for 10,000-20,000
rural population.
• 65 bedded regional
hospital.
• 2,500 bedded hospital at
the district level.

3) Major changes in medical education which includes 3
- month training in preventive and social medicine to
prepare “social physicians”.
The committee’s Report continues to be a
major national document, and has provided
guidelines for national health planning in
India.

MUDALIAR COMMITTEE(1962)
This committee known as the “Health Survey and
Planning Committee”, headed by Dr. A.L.
Mudaliar, was appointed in 1959 to assess the
performance in health sector since the submission of
Bhore Committee report and to make
recommendations for future development and
expansion of health services.
This committee found the conditions in PHCs to be
unsatisfactory and suggested that the PHC, already
established should be strengthened before new ones
are opened.
Strengthening of sub divisional and district hospitals

Medical Care Public Care
Control of
Communicable
Disease
Population
Control
Professional
education and
research
Indigenous
system of
medicine
Drugs and
Medical
supplies
Legislation
Health
Administration
Medical
Research
The Committee
was sub-divided
into different sub-
committees to deal
with different
subjects like:

MUDALIAR COMMITTEE
(1962)
The main recommendations of the Mudaliar Committee
were:
Consolidation of advances made in the first two five
year plans
Strengthening of the district hospitals with specialist
services to serve as central base of regional services
Regional organizations in each state is placed
between the headquarter organization and the district
as Regional Deputy or Assistant Directors to
supervise 2-3 District Medical and Health Officer.

MUDALIAR COMMITTEE
(1962)
Integration of medical and health services as
recommended by Bhore Committee
It was emphasized that a PHC should not be made to
serve to more than 40,000 populations and that the
curative, preventive and promotive services should be
all provided at the PHC.
The Mudaliar Committee also recommended that an
All India Health service should be created to replace
the erstwhile Indian Medical service.

CHADHA COMMITTEE (1963)
This committee was appointed under the
chairmanship of Dr. M.S. Chadha, the then Director
General of Health Services, in 1963, to advise about
the necessary arrangements for the maintenance
phase of National Malaria Eradication Programme.
The committee suggested that the vigilance activity in
the NMEP should be carried out by primary health
centres at block level

CHADHA COMMITTEE (1963)
The committee also recommended that vigilance
operations through monthly home visits should be
implemented through basic health workers.
One basic health worker per 10,000 populations, also
function as “multipurpose workers” and would
perform, in addition to malaria work, the duties of
family planning and vital statistics data collection
under supervision of family planning health
assistants.
The Family Planning Health Assistants were to
supervise 3 to 4 of these basic health workers.

MUKERJI COMMITTEE
(1965) & (1966)

MUKERJI COMMITTEE (1965)
The recommendations of the Chadha Committee,
when implemented, were found to be impracticable
because the basic health workers, with their multiple
functions could do justice neither to malaria work nor
to family planning work.
The Mukherjee committee headed by then Secretary
of Health Shri Mukerji, was appointed in 1965, to
review the performance in the area of family
planning. The committee recommended separate staff
for the family planning programme

After committee recommendation, the family
planning assistants were to undertake family planning
duties only. The basic health workers were to be
utilized for purposes other than family planning.
The committee also recommended delinking the
malaria activities from family planning so that the
latter would receive undivided attention of its staff.

Multiple activities of the mass programmes like
family planning, small pox, leprosy, trachoma,
NMEP (maintenance phase), etc. was making it
difficult for the states to undertake these effectively
because of shortage of funds.
A committee of state health secretaries, headed by the
Union Health Secretary, Shri Mukherjee, was set up
to look into this problem.
The committee worked out the details of the BASIC
HEALTH SERVICES which should be provided at
the Block level, and some consequential
strengthening required at higher levels of

Make family planning a
vertical program.
Fix targets for
contraceptives
distribution and for
sterilizations. Provide
incentives to the
acceptors of contraceptives
/sterilization.

JUNGALWALLA COMMITTEE
(1967)
This committee, known as the “Committee on
Integration of Health Services” was set up in 1964
under the chairmanship of Dr. N. Jungalwalla, the
then Director of National Institute of Health
Administration and Education, New Delhi (currently
NIHFW).
It was asked to look into various problems related to
integration of health services, abolition of private
practice by doctors in government services, and the
service conditions of Doctors.

(1967)
The committee defined “integrated health services”
as:-
(a.) A service with a unified approach for all
problems instead of a segmented approach for
different problems.
(b.) Medical care and public health programmes
should be put under charge of a single administrator
at all levels of hierarchy with due priority for each
programme obtaining at a point of time.

(1967)
Following steps were recommended for the integration
at all levels of health organization in the country-
Unified Cadre
Common Seniority
Recognition of extra qualifications
Equal pay for equal work
Special pay for special work
Abolition of private practice by government doctors
Improvement in their service conditions
The committee stated that “integration should be a
process of logical evaluation rather than
revolution.”

It is called “Committee on
multipurpose worker
under health and F.P.”.
In the year 1972, the
government of India
constituted a committee under
the chairmanship of Kartar
Singh, Additional Secretary,
Ministry of Health and Family
Planning, to study the structure
for integrated services at the
peripheral and supervisory
levels, and the feasibility of
having multipurpose workers
in the field.
This committee
report is a
milestone in the
history of public
health nursing
service
administration.

KARTAR SINGH COMMITTEE
(1973)
References of the committee are as follows:
The structure for integrated services at the peripheral
and supervisory levels
The feasibility of having multipurpose, bipurpose
workers in the field
The training requirements for such workers
Utilization of mobile service unit which is set-up
under Family Welfare Programme

(1973)
Recommendations are as follows:-
The present Auxillary Nurse Midwives to be replaced by
newly designated “Female Health Workers”
Multipurpose workers to be first introduced in areas where
Malaria is in maintenance phase and small pox has been
controlled and later to areas where malaria passes into
maintenance phase or small pox controlled.
1 PHC cover 50,000 population.

(1973)
Every PHC divided in 16 sub- centres, each covering 3,000-
3,500 population, depending upon topography and means of
communication
1 Male Health Worker (MHW) and Female Health Worker
(FHW) to be staffed at each sub-centre
3 to 4 MHW and FHW are supervised by 1 Male and Female
Health Supervisor respectively.

(1973)
The present- day lady health visitors to be designated as
female health supervisors
The doctor in charge of a PHC should have the overall
charge of the supervisors and health workers in his area.

SHRIVASTAV COMMITTEE
(1975)
Also known as
“Group on
Medical
Education and
Support
Manpower”
Headed by Dr J B
Shrivastav, the then
, Director General of
Health Services.

(1975)
This committee was set up to determine steps needed to-
(a.) Reorient medical education in accordance with
national needs & priorities
(b.) to suggest steps for improving the existing medical
educational processes as to provide due to emphasis on
the problems particularly relevant to national
requirements
(c.) to make any other suggestions to realise the above
objectives and matters incidental thereto.

(1975)
It recommended immediate action for:-
1. Creation of bonds of paraprofessional and semi-
professional health workers from within the
community itself.
2. Establishment of 3 cadres of health workers
namely– multipurpose health workers and health
assistants between the community level workers and
doctors at PHC.
3. Development of a “Referral Services Complex”

(1975)
4. Establishment of a Medical and Health Education
Commission for planning and implementing the
reforms needed in health and medical education on
the lines of University Grants Commission.
Acceptance of the recommendations of the
Shrivastava Committee in 1977 led to the
launching of the Rural Health Service.

RURAL HELTH SCHEME
(1977)
The basic recommendations of the Committee were
accepted by the Govt. in 1977, which led to the
launching of the Rural Health Scheme.
The Programme of training of community health
workers was initiated during 1977-78.

RURAL HELTH SCHEME (1977)
Steps were also initiated-
(a) For involvement of medical colleges in the total
health care of selected PHCs with the objective of
reorienting medical education to the needs of rural
people.
(b) Reorienting training of multipurpose workers
engaged in the control of various communicable
disease programmes into uni-purpose workers. This
"Plan of Action" was adopted by the Joint Meeting of
the Central Council of Health and Central Family
Planning Council held in New Delhi in April 1976.

Shivaraman Committee (1979)
A Committee on Basic Rural Doctors was framed under
the guidance of Shri Shivaraman, the then Member of
Planning Commission. The committee recommended
establishment of countrywide cadre of basic rural
doctors consisting of trained paraprofessionals to extend
comprehensive health care delivery to rural community.

Ramalingaswamy Committee
(1980)
This committee under the chairmanship of Dr V
Ramalingaswamy, the then DGHS, recommended:
•Involvement of community for health planning and
health program implementation
•30 bedded hospital for every 1 lakh population
•Integration of health services at all levels
•Redefined the role of doctor in the community
•Recommended that PHC and District Health Centers
should be under the control of three tier Panchayat Raj
System.

Bajaj Committee (1986)
An expert committee for ‘health manpower planning,
production and management’ is constituted under the
Chairmanship of Dr JS Bajaj, the then Member of
Planning Commission, to tackle the problem of health
manpower planning, production and management.
"Important recommendations of the Bajaj committee
are:
•Recommended for Formulation of National Health
Manpower planning based on realistic survey.
•Educational Commission for health sciences should
be developed on the lines of UGC.

Bajaj Committee (1986)
• Recommended for National and Medical education
policies in which teachers are trained in health
education science technology.
• Uniform standard of medical and health
science education by establishing universities
of health sciences in all states.
• Establishment of health manpower cells both
at state and central levels.
• Vocational courses in paramedical sciences to
get more health manpower.

Krishnan Committee (1992)
The committee under the chairmanship of Dr Krishnan
reviewed the achievements and progress of previous
health committee reports and also made comments on
shortfalls. The committee addresses the problems of
urban health and devised the health post-scheme for
urban slum areas.

Krishnan Committee (1992)
"The committee had recommended :-
one voluntary health worker (VHW) per 2,000 population.
 Its report specifically outlines which services have to be
provided by the health post.
 These services have been divided into outreach,
preventive, family planning, curative, support (referral)
services and reporting and recordkeeping.
 Outreach services include population education,
motivation for family planning, and health education.
In the present context, a very few outreach services are
being provided to urban slums.

HEALTH FOR ALL by 2000AD-
Report of the working group,
1981
A working group on Health was constituted by the
Planning Commission in 1980 with the Secretary,
Ministry of Health and Family Welfare, as its
Chairman, to outline with that perspective, the
specific programmes for the sixth Five Year Plan.
The Working Group, besides identifying and setting
out the broad approach to health planning during the
sixth
Five Year Plan, has also evolved fairly specific
indices and targets to be achieved in the country by

CONCLUSION
These committees are appointed from time to
time to look in to the issues of the health care
administration.
Recommendations made by these committees
were very helpful to make an excellent change
in our health care delivery system.

SUMMARY
 Introduction
 Various health and welfare committees
Bhore committee
Mudaliar committee
Chadha committee
Mukherji committee
Jungalwalla
committee
Kartar Singh
committee
Shrivastav committee
Rural Health Scheme
Shivaraman
Committee
Ramalingaswamy
Committee
Bajaj Committee
Krishnan Committee
Health For All

ASSIGNMENT
Ques. Enlist all the health committees
and their objectives.

REFERENCES
□ K. Park, Park’s Textbook of Preventive and Social Medicine, 23rd
Edition, Health Planning and Management(873-875)
□ K.K.Gulani , Community Health Nursing (Principles & Practices),
2nd Edition, Health Care Administration in India(627-628)
□ Ghosh J.M., Community Health Nursing, Planning Committees in
India(Chapter-18)
□ Health Planning in India. Last updated on 4/28/2011.
http://business.mapsofindia.com/india-planning/health.html.
□ Health for All. World Health Organization Belarus,
http://undp.by/en/who/healthforall/

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