The health system in India is organized across three levels - central, state, and district. At the central level, the key organizations are the Ministry of Health and Family Welfare, Directorate General of Health Services, and Central Council of Health and Family Welfare. The Ministry is responsible for health policy, programs, and departments related to health and family welfare. It aims to improve population health, care experience, and social justice. The Directorate General provides technical guidance and oversees health programs and facilities. The Central Council promotes coordination between central and state governments on health issues.

1. HEALTH SYSTEM IN INDIA

2. DEFINITION OF HEALTH SYSTEM
• Health system covers a whole gamut of health activities, health
programmes, institutions providing medical care such as hospitals,
clinics and primary health care centres and the policies enunciated
by governments to provide optimal health care for its citizens.
• A health system as described by WHO is the “sum total of all the
organisations, institutions and resources whose primary purpose is
to improve health.
• It implies the organization, delivery, staffing, regulation and quality
control of health care services.” - J.E.Park

3. GOALS OF HEALTH SYSTEM
• To improve the health status of population.
• To improve the experience of care.
• To reduce the economic burden of illness.
• To improve social justice equity.

4. ORGANIZATION OF HEALTH SYSTEM IN INDIA
CENTRAL LEVEL
STATE LEVEL
DISTRICT LEVEL

5. CENTRAL LEVEL
Union
ministry of
health and
family welfare
(MoFHW)
The
directorate
general of
health
services
The central
council of
health and
family welfare

6. Ministry of Health and Family Welfare
• It is an official organ of health system in India.
• It is responsible for framing the health policy and for all the
programmes that are related to family planning in India.
• Currently it has departments under its control:
1. Department of health.
2. Department of family welfare.
3. Department of health reasearch.

7. Organizational Structure Of MoHFW
Union Minister
Of Health
Health
secretariat
Secretary
Additional
secretary
Joint secretary
Cabinet Ministers
Of State And
Deputy Minister

8. Department of health
The Department of Health deals with health care, including awareness campaigns,
immunization campaigns, preventive medicine, and public health. Bodies under the
administrative control of this department are:
1. National AIDS Control Organisation (NACO)
2. Medical Council of India
3. Dental Council of India
4. Pharmacy Council of India
5. Indian Nursing Council
6. All India Institute of Speech and Hearing (AIISH), Mysore

9. Department of health(continued)
7. All India Institute of Physical Medicine and Rehabilitation (AIIPMR), Mumbai
8. All India Institute of Hygiene and Public Health, Kolkata
9. Hospital Services Consultancy Corporation Limited (HSCC)
10. Food Safety and Standards Authority of India
11. Central Drugs Standard Control Organization
12. National Centre for Disease Control
13. COVID-19 Pandemic

10. Department of health(continued)
• 14 National Health Programmes
– National AIDS Control Programme (AIDS) Department Of Aids Control (National AIDS Control Organisation)
(Details About Aids)
– National Cancer Control Programme (cancer) (since 1985)
– National Filaria Control Programme (filariasis)
– National Iodine Deficiency Disorders Control Programme (iodine deficiency)
– National Leprosy Eradication Programme (leprosy)
– National Mental Health Programme (mental health)
– National Programme for Control of Blindness (blindness)
– National Programme for Prevention and Control of Deafness (deafness)
– National Tobacco Control Programme (tobacco control)
– National Vector Borne Disease Control Programme (NVBDCP) (vector-borne disease)
– Pilot Programme on Prevention and Control of Diabetes, CVD and Stroke (diabetes, cardiovascular
disease, stroke)
– Revised National TB Control Programme (tuberculosis)
– Universal Immunisation Programme

11. Department of Family Welfare
• The Department of Family Welfare (FW) is responsible for aspects
relating to family welfare, especially in reproductive health, maternal
health, pediatrics, information, education and communications;
cooperation with NGOs and international aid groups; and rural health
services. The Department of Family Welfare is responsible for:
• 18 Population Research Centres (PRCs) at six universities and six other
institutions across 17 states
• National Institute of Health and Family Welfare (NIHFW), South Delhi
• International Institute for Population Sciences (IIPS), Mumbai
• Central Drug Research Institute (CDRI), Lucknow
• Indian Council of Medical Research (ICMR), New Delhi: founded in
1911, it is one of the oldest medical research bodies in the world
• National Institute of Virology (NIV), Pune
• Viral Research & Diagnostic Laboratories (VRDL)

12. Department of Health Research (DHR)
• Department of Health Research (DHR) was created as a separate
Department within the Ministry of Health & Family Welfare and
became functional from November 2008 with the appointment of
first Secretary of the Department.
• The aim of the DHR is to bring modern health technologies to the
people through research and innovations related to diagnosis,
treatment methods and vaccines for prevention; to translate them
into products and processes and, in synergy with concerned
organizations, introduce these innovations into public health
system along with administering and monitoring of Indian Council
of Medical Research (ICMR).

13. Department of Health Research (DHR) [continued]
• Promotion and co-ordination of basic, applied and clinical research including clinical trials and operational
research in areas related to medical, health, biomedical and medical profession and education through
development of infrastructure, manpower and skills in cutting edge areas and management of related information
thereto.
• Promote and provide guidance on research governance issues, including ethical issues in medical and health
research.
• Inter-sectoral coordination and promotion of public- private – partnership in medical, biomedical and health
research related areas.
• Advanced training in research areas concerning medicine and health, including grant of fellowships for such
training in India and abroad.
• International co-operation in medical and health research, including work related to international conference in
related areas in India and abroad.
• Technical support for dealing with epidemics and natural calamities.
• Investigation of outbreaks due to new and exotic agents and development of tools for prevention.
• Matters relating to scientific societies and associations, charitable and religious endowments in medicine and
health research areas.
• Coordination between organization and institutes under the Central and State Governments in areas related to the
subjects entrusted to the Department and for the promotion of special studies in medicine and health.
• Administering and monitoring of Indian Council of Medical Research (ICMR).

14. Functions of MoHFW
• Union list :
• 1) International health relations and administration of port
quarantine
• 2) Administration of Central Institutes
• 3) Promotion of research through research centers
• 4) Regulation and development of medical, pharmaceutical, dental
and nursing professions
• 5) Establishment and maintenance of drug standards
• 6) Census and collection and publication of other statistical data
• 7) Coordination with states
• 8) Immigration and emigration
• 9) Regulations of labour in the working of mines & oil fields

15. Functions of MoHFW (continued)
• Concurrent List:
• 1) Prevention of Communicable disease
• 2) Prevention of food adulteration
• 3) Control of drug and poison
• 4) Vital statistics
• 5) Labour welfare
• 6) Economic and social planning
• 7) Population control and family planning.

16. Directorate General of Health Services
• The Directorate General of Health Services (Dte.GHS) is a repository of technical
knowledge concerning Public Health, Medical Education and Health Care.
• It is an attached organisation of the Ministry of Health & Family Welfare.
• The Dte.GHS is headed by Director General of Health Services (DGHS), an officer
of Central Health Services, who renders technical advice on all medical and
public health matters to Ministry of Health and Family Welfare.
• The Directorate co-ordinates with the Health Directorates of all States/UTs for
implementation of various National Health Programmes through its Regional
Offices of Health and Family Welfare.
• The Dte.GHS oversees the functioning of Central Government Hospitals and their
management.
• It also addresses health concerns of the people through its Subordinate
Offices/Institutes spread all over the country.

17. Organisational structure
Director General Of Health
Services
Additional Director General
Of Health Services
Deputy Director General Of
Health Services
Administrative staff

18. Functions of DGHS
• General functions:
• 1) Surveys
• 2) Planning
• 3) Coordination
• 4) Programming and appraisal of all health matters.

19. Functions of dghs (continued)
• Specific functions:
1. International health relations and quarantine of all major ports in country and international
airport.
2. Control of drug standards.
3. Maintain medical store depots.
4. Administration of post graduate training programme
5. National health programme.
6. Administration of certain medical colleges in India.
7. Conducting medical research through Indian Council of Medical Research ( ICMR )
8. Central Government Health Schemes.
9. Implementation of national health programmes.
10. Preparation of health education material for creating health awareness through Central
Health Education Bureau[ CHBI ]
11. Central bureau of health intelligence[CBHI] to Collection, compilation, analysis, evaluation
and dissemination of information
12. National Medical Library

20. Central Council of health(CCH)
• It was set up on August,1952 by the presidential order to
promote coordinated concerted action between centre and
state for the implementation of all the national health
programmes.

21. Organisational structure of CCH
Union Health Minister (Chairman)
State Health Minister(Member)

22. Function of CCH
• To consider and recommend broad outlines of health policies.
• To make proposal for legislation on matters related to public
health.
• To make recommendations to the central Government grand -in –
aid for the health purpose and review of utilisation of these grant
in aid.
• To establish organisations invested with appropriate functions for
promoting and maintaining cooperation between centre and state
health administration.

23. Health system at state level
• States are largely independent in matters related to the
delivery of health care to their people.
• Each state has developed its own system of health care
machinery independent of the central government.

24. Health system at state level
Health System Of
State Level
State Ministry Of
Health
State Health
Directorate

25. Organisational structure state ministry of health
Health Minister Of State
Secretariat
•Deputy Secretary
•Administrative staff

26. Functions of state ministry of health
• Prevention of extension of communicable diseases.
• Prevention of food adulteration.
• Labour welfare.
• Economic and social planning.
• Population control and family planning.

27. Oragnisational structure of state health directorate
Director of health services
Ex-officio secretary
Additional director
Joint director
Deputy director
Assistant director

28. Functions of state health directorate
• To study the health problems to identify the health needs of
people.
• To provide curative and preventive services.
• To make provision for control of milk and food sanitation.
• To take all the remedial action at the time of outbreak of
communicable diseases.
• To establish and maintain central laboratories for preparation of
vaccines.
• To promote health awareness among people.

29. Functions of state health directorate(continued)
• To collect tabulate and publish vital statistic.
• To promote all the health programmes.
• To recruit health personnel for the rural health services.
• Supervision of PHC and staff.
• Planning and carrying out surveys of health related matters.
• Establishing training courses.
• To coordinate all health services with other states.

30. HEALTH SYSTEM AT DISTRICT LEVEL

31. Health system at district level
Administrative areas in a district:
1. Sub divisions
2. Tehsils (Taluka)
3. Community Development Blocks
4. Municipalities and corporations
5. Panchayats and
6. Villages

32. Administrative set up
District
/zila
• Ultimate unit for administration of all purpose.
• .Varies widely in area and populations.
• District magistrate/Collecter is the chief executive and administrative officer.
Subdivi
sion
• Each district is divided into two or more subdivisions.
• Sub divisional officer (SDO) /sub collector is incharge of each subdivisions.
Tehsil
/Taluk
• Each division is again divided into tahsils /taluk
• Incharge-tahsildar/talukdar.
• Comprises-of 200-600 village.
Block
• In 19 52 with the launching of community development program in India ,rural areas of the
districts organized into blocks /community development block.
• Ultimate unit of rural planning and development.
• Comprises approximately 100 villages and about 80,000 to 1,20,000 populations.
Self
govern
ment
• Rural local self government (panchayati raj system)
• Urban local self government

33. Local self government at the town area
1. Town area committees-
• Population between 5000-10000.
• Like Panchayat and provide sanitary service in the area.
2. Municipal board-
• Population between 10000-200000
• Member elects its chairman/president.
• Term 3-5 years.
• Looks after sanitation, drainage, water supply, construction and
maintenance of road, registration of birth and death,education,
running hospital and dispensary.

34. Local self government at the town area
3. Corporation :
• Population more than 200000.
• Headed by mayor elected by councillors.
• It has executive agency headed by the commissioner.
• Also has secretarial staff headed by secretary , health officers,
engineers etc.
• Functions like municipal board on larger population.

35. Panchayati raj system
• It is a 3 tier structure of rural local self-government.
• It links village to the district.
• Involves people at various levels.
• It also implies application of democratic principles at the grass
root level.
• 3 tier institutions at three different levels are described:
1. At the village level-panchayat
2. At the block level-panchayat samiti
3. At the district level-zilla parishad

36. At village
level
At the block
level
At the
district level
Zila
Parishad
Panchayat
Samiti
Gram
sabha
Gram
panchayat
Nyay
panchayat

37. At Village level
Gram
sabha
• Assembly of all adults of the village.
• Meets twice in a year.
• Function-discusses developmental issues, elects members of Panchayat.
Gram
pancha
yat
• Executive organ of gram sabha .
• Agency for Planning and development at the village level.
• Consist of 15-30 members who hold office for 3-4 years.
• Covers population of 5000-20000.
• Each panchayat has an elected president called Sarpanch/mukhiya/sabhapati/...........,vice-
president and a panchayat secretary.
• Panchayat secretary has wide range of powers and functions including maintainence of
sanitation and public health.
Nyaya
panchay
at
• Comprises 5 members from the Panchayat.
• Solves the dispute between two parties/groups/individuals over certain matters on mutual
consent.

38. At the block level
• Panchayati Raj institution at the block level is known as Panchayat Samiti.
• It includes following members:
 Sarpanch all gram panchayat of block.
 MLSs and MPS residing in the area.
 Represntative of women,scheduled castees,scheduled tribes
 And cooperative societies.
• Block Development Officer(BDO) is the ex-officio secretary of the
panchayat samiti.
• Prime function-execution of community development program.
• BDO and his staff give technical assistance and guidance to the village
panchayats engaged in development work.

39. At the district level
• Zilla parishad /Zilla Panchayat is the agency of rural local self
government at the district level.
• It is primarily supervisory and coordinating body.
• Members:
All heads of the Panchayat samitis in the district.
MPs and MLAs of the district.
Representative of women, scheduled castes, scheduled tribes
2 persons of experience in administration ,public life or rural
development.

40. Health organization
VILLAGE LEVEL (1000)
SUB CENTER LEVEL (3000-5000)
SECTOR LEVEL (20000-30000)
BLOCK LEVEL (80000-1,20,000)
DISTRICT LEVEL (10-15 MILLION)
DISTRICT LEVEL (10-15 MILLION)
Chief medical
officer of
health(CMOH)
Deputy Chief
Medical Officer
Of Health I (Dy
CMOH I)
BLOCK
MEDICAL
OFFICER OF
HEALTH
MEDICAL
OFFICER
Deputy Chief
Medical Officer
Of Health I I(Dy
CMOH II)
Deputy Chief
Medical Officer
Of Health III
(Dy CMOH III)
District Public
health nursing
officer
Block Public
Health Nurse
Health
Supervisor(HS)
Health
Assistant
(Female/Male)
ASHA
District
maternal and
child health
officer
District
Leprosy
Officer(DLO)
Zila
tuberculosis
officer(ZLO)