The document discusses several health committees constituted in India to review and improve the country's health system. Key points: 1) The Bhore Committee (1943) found high communicable disease rates, low life expectancy, and recommended a three-tier primary-secondary-tertiary healthcare system. 2) The Mudaliar Committee (1959) observed inadequate basic health facilities and staff shortages. It recommended strengthening primary health centers. 3) The Mukerji Committee (1966) reviewed family planning programs and recommended strengthening education efforts and designating a state health directorate for family planning.

1. Health Committees in India
Presented by:-
Iqra Zeenat
B.Sc (SKIMS) , DNA,M.Sc
Community Health Nursing
SKIMS SRINAGAR

2. Unit II
HEALTH
COMMITTEES
BY:
MR. J.C. FRANK M.Sc
(N)
ASSISTANT
PROFESSOR

3. Sir JosephWilliam
Bhore

4. Bhore Committee
- Constituted by pre independent GOI
- Under Sir Joseph William Bhore,
Indian Civil Servant
- Formed in 1943
- “Health Planning and Development
Committee”

5. Terms of Reference
• A survey of existing conditions and
organisation
• Secondly suggestions for future
development
• Consider short term objectives which
might reasonably be expected to be
reached within a period of four to five
years

6. Bhore Committee Report
• Submitted in 1946
• Runs into 4 volumes
• Volume I A survey of the State of the
Public Health and the existing health organisation
• Volume II Recommendations
• Volume III Appendices
• Volume IV Summary

7. Observations
• CDR : 22.4/1000
• IMR : 162/1000 live births
• MMR : 20/1000 live births
• Life expectancy at birth : 27
years.

8. Observations
● Incidence of communicable disease also
was very high.
● Diseases like chicken pox, cholera etc
occurred in epidemics.
● Many of the health problems were
preventable
● Investment made in preventing these
problems would give high returns in the
forms of increased productivity and
development.

9. Recommendations
Short term plan:
- To be implemented within 5-10 years.
- Each primary health centre in the rural
area to cater to a population of 40,000
- Secondary health centre to serve as a supervisory,
coordinating and referral institution
- For each PHC 2 medical officers, 4 public
health nurses, one nurse, 4 midwives, 4 trained
dais and 15 class IV employees

10. Recommendations
Long term plan (3 million plan):
Health care system in three tires.
• First tier: primary health units with 75 bedded hospital for
each 10,000 – 20,000 population with staff of 6 medical officers,
6 public health nurses, 2 sanitary inspectors, 2 health assistants
and other supportive staff.
• Second tier: 650 bedded Regional Health Unit (RHU) to serve as
a referral centre for 30 – 40 PHUs.
• Third tier: district hospitals with 2,500 beds to serve the needs
of about 3 million.

11. Recommendations
• 3 months training in preventive and social
medicine to prepare ‘SOCIAL PHYSICIANS’
• Special emphasis on preventive work
(Integration of curative and preventive services)
• Village Health Committee consisting of 5 to 7
individuals for procuring the active participation
of the people in the local health programme.
• Inter-sectoral Coordination

12. Sir A Lakshmanaswamy
Mudaliar

13. Mudaliar Committee
• Constituted in 1959
• By GOI
• Under Dr. A Lakshmanswamy Mudaliar,
Vice Chancellor, Madras University
• “Health Survey and Planning Committee”

14. Terms of Reference
1. The assessment (or evaluation) in the field of
medical relief and public health since the
submission of the Health Survey and
Development Committee's Report (the Bhore
Committee)
2. Review of the First and Second Five-Year Plan
Health projects and
3. Formulation of recommendations for the
future plan of health development in the country.

15. Observations
• Basic health facilities had not reached at least
half the nation
• Gross mal distribution of hospitals and beds in
favour of urban areas.
• Quality of services provided by PHCs were
grossly inadequate with poor functioning,
lack of referral system, and gross under
staffing due to insufficient resources

16. Recommendations
• Consolidation of 1st
two 5 yr plans
• Strengthening DH to serveas central base
for specialist services
• PHC - 40,000 population
• 1 BHW per 10,000 population
• Improve secondary services
• Integration of Medical and Health services

17. Chadha Committee
• A committee of health administrators and
malariologists reviewed the National
Malaria Eradication programme.
• Constituted in 1963
• By GOI
• Under Dr. MS. Chadha,DirectorGeneral
of Health Services

18. Dr. MS Chadda
Former Director General Health Services
GOI

19. Terms of Reference
1. The committee should go into the details of the
requirement related to the primary health
centers, their planning, the necessary priority
required according to the needs of the
maintenance phase of the Malaria Eradication
progrmme.
2. The committee should also consider the Staffing
pattern required for the malaria eradication
programme.

20. Recommendations
• One basic health worker per 10,000
population
• Basic health workers should visit house to
house once in a month to implement malaria
vigilance activities.
• BHW to serve as MPHW for family planning
and vital statistics and malaria vigilance.

21. Mukerji Commitee
• Following the Central Family
Planning Council meet at Madras
• Constituted in 1965
• Headed by Shri Mukerji, Secretary,
Ministry of Health and Family Planning

22. Terms of Reference
• In 1965, the ICMR Director pronounced that
Lippes Loop was safe.
• So, IUCD was introduced into the family
planning programme and reorganisation of
the FP programme was needed.
• CBR was 41 per thousand and was aimed at
reducing to 25 per thousand in a period of 10
years.

23. Terms of Reference
To review what additions and
changes are necessary as a result of
the greatly altered situation due to
the IUCD having come in the forefront
of the programme, in the staffing
pattern, financial provisions, etc.

24. Recommendations
• Strengthening of education and publicity efforts and
involvement of other organisations
• Strong executive agency in Health Directorate of each state
government to exclusively deal with family planning
• Approved the existing Urban Family Welfare centre
• At Rural Family Planning Centre
- BHW to be utilised as MPW for general services
- FPHA to undertake only FP work without having to supervise
BHW D
• Delink malaria and FP activity

25. Mukerji Committee,1966
• Following 13th Meeting of the Central
Council of Health held at Bangalore in June,
1966 - state finding it difficult to take burden of
maintenance phase of malaria and other prog.
like small pox, leprosy, FP, trachoma
• Formed in 1966
• By GOI
• Headed by Shri B. Mukerji, Union Health
Secretary

26. Terms of Reference
• To review the staffing pattern of the primary
health centre complex and to recommend the
minimum staff of various categories required at
different levels within the district so as to provide an
integrated health service capable of fully catering to
the needs of the vigilance services in the maintenance
phase of National Malaria Eradication Programme,
smallpox eradication, tuberculosis, leprosy and
trachoma control, etc.

27. Recommendations
• Basic Health Services to be provided at block level
• Strengthening required at higher level
• Any attempt to give the basic health worker more
work under the family planning programme
would either endanger malaria vigilance work or
would need a larger number of basic health
workers per block than what the Committee has
recommended.

29. Jungalwalla Committee
• Central Council of Health, 1964
Srinagar
• Dr. N. Jungalwalla, Addl. Director
General of Health Services
• “Committee on Integration of Health
Services”
• Submitted report un 1967

30. Terms of Reference
• To study the problems of the health
services
• Service conditions
• Elimination of Private practice

31. Recommendation
The main steps recommended towards integration
were:
• Unified cadre
• Common seniority
• Recognition of extra qualifications
• Equal pay for equal work
• Special pay for specialized work
• No private practice, and good service conditions
• Left states to work out their own strategy.

32. Kartar Singh Committee
• Growing demand for increase of
staff under each programme.
• Need to reduce population/area
covered by each worker.

33. Kartar Singh Committee
• Meeting of the Central Family Planning
Council 1972
• By GOI
• In 1972
• “The committee on Multipurpose workers
under Health and Family Planning”
• Kartar Singh, Addl. Sec., MOHFP
• Report in 1973

34. Terms of Reference
• Structure for integrated services
the peripherals and supervisory levels
• Feasibility of MPW
• Their training requirements
• Utilisation of mobile services for
integration

35. Recommendations
• Multipurpose workers - feasible and desirable
• Redesignation
- ANMs replaced by FHWs
- BHW, Malaria surveillance workers, vaccinators,
FPHAs replaced by MHWs
- LHV designated as FH supervisor
• To be first introduced in malaria maintenancephase
areas and small pox controlled areas
• Clearly spelt out the job functions of HWs and Supervisors

36. Recommendations
• 1 PHC – 50,000 population
• 1 PHC –16 SHC (2000 – 3500)
• 1 SHC – 1 MHW n 1 FHW
• 1 male supervisor – 4 MHWs
• 1 female supervisor – 4 FHWs
• Doctor incharge of all supervisors
• To be impemented in 5th
5yr plan

37. Shrivastav Committee
GOI observed that
• Urban orientation of medical education in India, which relies heavily on
curative methods and sophisticated diagnostic aids
• The failure of the programmes of training in the fields of nutrition, family
welfare planning,
and maternal and child because of their development in isolation from
medical education,
• The deprivation of the rural communities of doctors
• The need to re-orient undergraduate medical education with emphasis on
community rather than on hospital care
• The importance of integrating teaching of various aspects of family planning
with medical education

38. Shrivastav Committee
• MOHFP,GOI
• In 1974
• “ Group on Medical Education
and Support Manpower”
• Submitted report in 1975

39. Terms of Reference
• To devise a suitable curriculum for training a
cadre of Health Assistants
• To suggest steps for improving the existing
medical educational processes as to provide
due emphasis on the problems particularly
relevant to national requirements
• To make any other suggestions to realise the
above objectives and matters incidental
thereto

40. Recommendations
(1) Organization of the basic health services (including nutrition,
health education and family planning) within the community
itself and training the personnel needed for the purposes;
- Creation of Village Health Guide (VHG) or community health
volunteers from the community itself like teachers, postmasters,
gram sevikas who can provide comprehensive health services as
paraprofessionals.
- Primary health care be provided within the community itself
through specially trained workers so that the health of the
people is placed in the hands of people themselves

41. Recommendations
(2) Organization of an economic and
efficient programme of health services
to bridge the community with the first
level referral Centre, viz., the PHC
- Creation of MPW and Health Assistants
(HA) in between the VHG and MO in PHC

42. Recommendations
(3) The creation of a National Referral
Services Complex by the
development of proper linkages
between the PHC and higher level
referral and service centres.
(4) Establishment of ‘The Medical and
Health Education Commission’

43. Rural health Scheme
“Rural Health Scheme” was launched by the government in
1977-78. The major steps initiated were :
a) Involvement of medical colleges in health care of selected
with the objective of reorienting medical education
according to rural population called Re Orientation of
Medical education (ROME). It led to teaching and training of
undergraduate students and Interns at PHCs.
b) Training of Village Health Guides and utilising their
services in the general health service system.