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1. Health System In India

2. • INTRODUCTION :
• Community is comprised of on individual, families and
groups.
• Several groups of people with different religions, castes,
cultures and customs are living together in community.
• Common rules and regulations will be there in the community.

3. • Community health is the organized form of treatment,
protection or preventive and health related services.
• Community is defined as several group of people living in a
definite geographical area representing various religion,
values, goals, believes, interests and practices.

4. • Community health is defined, in a broader way as community
organized efforts for maintaining, protecting and improving
the health status of the people.
• It involves in motivating individuals and families to change
pattern of behaviours and to take such actions including
seeking of medical care as it would enable them to achieve
optimum health.

5. • Community health nursing has been defined by American
nurses association( 1980).
• “Community health nursing is a synthesis of nursing practice
and public health practice applied in promoting and preserving
and public health practice applied in promoting and preserving
the health of population.”
• The practice is general and comprehensive. It is not limited to
a particular age groups or diagnosis and is continuous, not an
episodic.

6. • The dominant responsibility is to population as a whole
• Nursing is directed to individuals, families or groups
contributes to the health of the total population, health
promotion, health maintenance, health education, coordination
and continuing of care are utilized in a holistic approach to the
measurement of the health care of individuals, families and
groups in a community.

7. Organization and administration of
health system in India.
• India is union of 29 states and 7 union territories.
• Under the constitution, of India the states are largely
independent in matters relating to the delivery of health care to
the people.
• Each state, there fore, has developed its own system of health
care delivery, independent of the central government.

8. The central responsibility consists mainly of policy making,
planning, guiding, assisting, evaluating , co coordinating the
work of the state health ministries.
so that health services cover every part of the country and no
state lags behind for want of these services.
state lags behind for want of these services.

9. CENTRAL,
STATE AND
LOCAL OR PERIPHERAL.

10. 1 – AT THE CENTRAL
THE OFFICIAL “ORGANS” OF THE HEALTH SYSTEM AT THE
NATIONAL LEVEL CONSIST OF:
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11. • The union ministry of
health and family
welfare is headed by a
cabinet minister, a
minister of state and a
deputy health minister.
• These are political
appointments.
ORGANIZATION:

12. At the centre
At the centre
At the centre
At the centre
Union ministry of health and family welfare
1) Organization
Cabinet minister
(minister of state & deputy health minister)
Dept of health Dept of family welfare
Secretary to the Govt.of India Secretary to the Govt.of India
Joint secretaries Additional secretary
Deputy secretary Commissioner
Large administrative staff joint secretary

13. )* * +
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DEPARTMENT OF
HEALTH
DEPARTMENT OF
FAMILY WELFARE

14. • Deals with planning, co-
ordination, programming,
evaluation of medical and
public health matters, including
drug control and prevention of
food adulteration.
THE HEALTH
DEPARTMENT
• Deals with family welfare
matters.

15. / Union List
• Concurrent
List.
The
functions of
union health
ministry
List.
ministry
constitutes
under

16. FUNCTIONS - UNION LIST
1.International
health relations
and
3. Promotion of
research through
research centers
and other bodies.
5.Establishment
& maintenance of
drug standards.
administration of
port quarantine.
2.Administration
of central
institutes.
4. Regulation &
development of
medical,
pharmaceutical,
dental & nursing
professions.
6. Census, and
collection and
publication of
other statistical
data.

17. 7. Immigration &
emigration.
8.
Regulation
of labour in
the working
of mines
and oil
fields
9. Coordination
9. Coordination
with states & with
other ministries
for promotion of
health.

18. CONCURRENT LIST - FUNCTIONS
• Prevention of extension of communicable diseases from one
unit to another.
• Prevention of adulteration of food stuffs
• Control of drugs and poisons
• Vital statistics
• Vital statistics
• Labour welfare
• Ports other than major
• Economic and social planning, and
• Population control and family planning.

19. DIRECTORATE GENERAL OF HEALTH SERVICES
The director of health
services is the principal
ORGANIZATION
services is the principal
adviser to the union
government in both medical
and public health matters.

20. Director general of health services
Additional Director general of health services
) + . + , 0 ) + . 1 +
Team of deputies
large administrative staff

21. THE DIRECTORATE COMPRISES OF
THREE MAIN UNITS
MEDICAL CARE
AND HOSPITALS
PUBLIC HEALTH
GENERAL
ADMINISTRATION

22. DIRECTORATE GENERAL OF HEALTH SERVICES
FUNCTIONS --- GENERAL
Surveys, planning,
coordination, programming
and appraisal of all health
matters in the country.

23. DIRECTORATE GENERAL OF HEALTH SERVICES
Specific --- functions
1.International
health relations and
3.Medical store
depots.
6.Medical
research
9.Central health
9.Central health
education
bureau.
health relations and
quarantine
2. Control of drug
standards.
depots.
4.Post graduate
training.
5.Medical
education.
7.Central govt.
health scheme
8.National
health
programmes. medical library.
bureau.
10.Health
intelligence.
11.National
medical library.

24. SPECIFIC
1. International health relations and quarantine:
All the major ports in the country (kolkata, Visakhapatnam,
Chennai cochin Mumbai, Kandla) and international air ports
(Mumbai-santa Cruz, Kolkata-Dum Dum, Chennai-
Meenambakkam, Tiruchirapalli, Delhi-Palam) are directly
Meenambakkam, Tiruchirapalli, Delhi-Palam) are directly
controlled by the directorate general of health services.
All the matters relating to the obtaining of assistance from
international agencies and the coordination of their
activities in the country are undertaken by the directorate
general of health services .

25. 2. Control of drug standards:
The drugs control organization is part of the directorate
general of health services, and is headed by the drugs
controller.
Its primary function is to lay down and enforce standards
and control the manufacture and distribution of drugs
and control the manufacture and distribution of drugs
through both central and state government officers.
The drugs act ( 1940 ) vests the central government with
the powers to test the quality of imported drugs.

26. The union government
runs medical store depots
at Mumbai, Chennai,
kolkata, karnal, Gauhati
and Hyderabad.
These depots supply the civil
medical requirements of the
central government and of the
various state governments. These
depots also handle supplies from
foreign agencies.
The medical stores
organization endeavors to
ensure the highest quality,
cheaper bargain and prompt
supplies.

27. 4. POST GRADUATE TRAINING
The directorate general of health services
is responsible for the administration of
is responsible for the administration of
national institutes, which also provide
post graduate training to different
categories of health personnel.

28. SOME OF THESE INSTITUTES ARE :-
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29. !"#
• The central directorate is directly in charge of the
following medical colleges in India: The lady herding,
The maul Ana Azad and The medical colleges at
Pondicherry, and GOA.
• There are many medical colleges in the country which
are guided and supported by the centre.

30. $ % & % '
• Medical research in the country in organized largely
through the Indian council of medical research, founded
in 1911 in New Delhi.
• The council plays a significant role in aiding, promoting
and co coordinating scientific research on human
diseases, their causation, prevention and cure.

31. • The research work is done through the councils several
permanent research institutes, research units, field
surveys and a large number of ad-hoc research enquiries
financed by the council.
• Tuberculosis Chemotherapy Center at Chennai, Virus
Research Centre at Poona, National institute of Nutrition
at Hyderabad and Blood group references centre at
Mumbai

32. 7. Central government Health Scheme
8. National Health Programmes:
• the various national health programmes for the
eradication of malaria and for the control of
Tuberculosis, Filarial, Leprosy, AIDS and other
communicable diseases involve expenditure of cores
of rupees

33. 9. CENTRAL HEALTH EDUCATION BUREAU
An outstanding activity of this
bureau is the preparation of
education material for creating
Health Awareness among the
people.
people.
The bureau offers training
courses in health education to
different categories of health
workers.

34. () *
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35. 11. NATIONAL MEDICAL LIBRARY
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36. CENTRAL COUNCIL OF HEALTH
Organization
Chairman – The union health minister
Members – State health ministers

37. • CENTRAL COUNCIL OF HEALTH
• It promotes coordinated and concerted action between
centre and the state in implementation of all the
programmes and measures pertaining to the health of the
nation.
• The union health minister is the chairman and the state
health ministers are the members.

38. FUNCTIONS
Toconsider and
recommend broad
outlines of policy in
remedial & preventive
care, envt hygiene,
nutrition, HE, trg &
research.
To make
recommendations to
central govt. on
grants- in-aid and
review utilization
periodically.
Tomake proposals for
legislation in medical
& public health
matters for
development of the
country.
To establish organization
for maintaining
cooperation between
central and state health
administrations

39. AT THE STATE LEVEL
AT THE STATE LEVEL
• In all the states, the management sector comprises the state
ministry of health and directorate of health.
• Its the responsibility of the state in provision of medical care,
preventive health services and pilgrimage within the state.
• For a long time, two departments, medical and public health,
were functioning in the states; the heads of these departments
were known as surgeon general and inspector general of
Civil Hospitals and Director of public health respectively.

40. • The public health engineering organizations in most states
its part of the public works department of the state
government.
• It has been recommended by experts in the public health
• It has been recommended by experts in the public health
that the public health engineering organization in every
state should be part of the state health department, and that
the Chief Engineer of public health should have the status
of an additional Director of Health service.

44. ) 0
The principal unit of administration in India is the district under
a collector.
There are 707 (year 2016) districts in India.
There is no “ average” district that is districts vary widely in area
and population.

45. Within each district there are 6
types of administrative areas
Sub –
divisions
Tehsils (Talukas)
Villages
Municipalities
and
Corporations
Panchayats
Villages
Community
Development
Blocks

46. Most districts in India are divided into two or more sub
divisions, each in charge of an assistant Collector or sub
collector.
TEHSILS / (TALUKAS),
Each division is again divided in to tehsils (talukas), in
Each division is again divided in to tehsils (talukas), in
charge of a Tehsildar .
A tehsil usually comprises between 200 to 600 villages.

47. • VILLAGES : The rural areas of the district have been
organized into blocks, known as community development
blocks.
• It comprises approximately 100 villages and about 80,000 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.

48. The urban areas of the district are organized into the following
institutions of local self-government
• The municipal Boards are headed by a chairman/President,
elected usually by the members.
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Municipal
Boards-(in areas
with population
ranging between
10,000 and 2
lakhs)
Corporations-
with population
above 2 lakhs

49. The functions of a municipal board are:
Construc
tion and
mainten
ance of
roads,
sanitation
and drainage street
lighting
roads,
water supply maintenance of
hospitals and
dispensaries
education
registration of
births and
deaths, et

50. Thecorporationisheaded by mayors,electedbycouncilors,whoareelected
fromdifferentwardsofthecities.
The executive agency includes the Commissioner, the
secretary, the Engineer and the Health officer.
The activities are similar to those of the municipalities,
The activities are similar to those of the municipalities,
but on a much wider scale.

51. ) >
The Panchayati Raj is a 3-tier structure of rural
local self government in India, linking the village to the
district.
district.

52. THE THREE INSTITUTIONS ARE
Panchayat-at the
village level
Panchayat Samiti-
Panchayat Samiti-
at the blocklevel
Zila Parishad- at
the district

53. AT THE VILLAGE LEVEL
The panchayat raj at the village level
consists of:
1. The Gram Sabah
1. The Gram Sabah
2. The Gram Panchayat ;
and
3. The Nyaya Panchayat.

54. • It is the assembly of all the adults of
the village , who meets at least twice
GRAM
SABAH a year.
• The gram Sabah considers proposals
for taxation, discusses the annual
programme and elects members of
the gram panchayat.
SABAH

55. • Gram panchayat:
• It is the executive organ of the gram sabha, and an
agency for planning and development at the village
level.
• Its strength varies from 15 to 30, and the population
covered also varies widely from 5,000 to 15,000 or
more.
• The members of panchayat hold office for a period of 3
to 4 years.
to 4 years.
• Every panchayat has an elected president ( sarpanch or
sabhapati or mukhiya)
• A vice president and a panchayat secretary.
• The powers and functions of the panchayat secretary are
very wide – they cover the entire field of civic
administration, including sanitation and public health,
and of social and economic development of the village.

56. The block is a unit of rural
planning and development, and
AT THE BLOCK LEVEL
comprises approximately 100
villages and about 80,000 to
1,20,000 population.

57. • The panchayat raj agency at the block level is
panchayat samiti/ janpada panchayat.
• The panchayat samiti consists of all sarpanchas (
heads) of the village panchayats in the block.
• MLAs, MPs, residing in the block area ,
representatives of women ,scheduled castes,
scheduled tribes and co operatives societies.

58. • The block development officer ( BDO) is the ex-officio
secretary of the panchayat samiti.
• The prime function of the panchayat samiti is execution of the
community development programme in the block, the funds
provided by the government for stage 1 and stage 2
development are channeled through the panchayat samiti.
development are channeled through the panchayat samiti.
• The block development officer and his staff give technical
assistance and guidance to the village panchayats engaged in
development work.

59. AT THE DISTRICT LEVEL
• The zilla parishad /zilla panchayat is the agency of rural local
self – government at the district level.
• The members of the zilla parishad include all heads of panchayat
samitis in the district, MPs, MLAs of the district .
• Representatives of schedule caste and tribes, and women and 2
persons of experience in administration , public life, or rural
development.
• The collector of the district is a non – voting member. Thus the
membership of zilla parisad is fairly large varying from 40 to 70.

60. • The Zilla Parisahad is primarily supervisory and coordinating
body.
• Its functions and powers vary from state to state.
• In some states, Zilla Parishads are vested with administrative
functions.
• In Gujarat, the district health officer and district family
planning and MCH officers are under control of the Zilla
Parishad.