NATIONAL HEALTH POLICY (INDIA) AND HEALTH CARE DELIVERY SYSTEM IN INDIA

2. NATIONAL HEALTH POLICY
AND
HEALTH CARE DELIVERY
SYSTEM
IN
NATIONAL/STATE/LOCAL
LEVEL

3. INTRODUCTION
 THE NATIONAL HEALTH POLICY OF
1983 AND THE NATIONAL HEALTH
POLICY OF 2002 HAVE SERVED WELL IN
GUIDING THE APPROACH FOR THE
HEALTH SECTOR IN THE FIVE-YEAR
PLANS
 TO IMPROVE THE STATUS OF PEOPLE
IN INDIA THE NATIONAL HEALTH
POLICY REVIEWED IN 2017.

4. GOAL OF NATIONAL HEALTH POLICY
 THE ATTAINMENT OF THE
HIGHEST POSSIBLE LEVEL OF HEALTH
AND WELL-BEING FOR ALL AT ALL
AGES, THROUGH A PREVENTIVE AND
PROMOTIVE HEALTH CARE.

5. KEY PRINCIPLES
 PROFESSIONALISM, INTEGRITY AND ETHICS
 AFFORDABILITY
 UNIVERSALITY
 PATIENT CENTERERD AND QUALITY OF CARE
 ACCOUNTABILITY
 INCLUSIVE PARTNERSHIPS
 PLURALISM
 DECENTRALIZATION
 DYNAMISM AND ADAPTIVENESS

6. SPECIFIC QUANTITATIVE GOALS AND
OBJECTIVES
● HEALTH SYSTEM PERFORMANCES
● HEALTH STATUS AND PROGRAM IMPACT
●HEALTH SYSTEM STRENGHTHENING

7. POLICY THRUST
 ENSURING ADEQUATE INVESTMENT
 PREVENTIVE AND PROMOTIVE HEALTH
 ORGANIZATION OF PUBLIC HEALTH
CARE DELIVERY
 PRIMARY CARE SERVICES AND
CONTINUITY OF CARE

8. CONT..
 SECONDARY CARE SERVICES
 REORIENTING PUBLIC HEALTH
HOSPITALS
 CLOSING INFRASTRUCTURE AND
HUMAN RESOURCES OR SKILL GAPS
 URBAN HEALTH CARE

9. NATIONAL HEALTH PROGRAMS
 RMNCH+A Services
 CHILD AND ADOLESCENT HEALTH
 INTTERVENTIONS TO ADDRESS
MALNUTRITION AND MICRO NUTRIENT
DEFICIENCIES
 UNIVERSAL IMMUNIZATION

10. CONT..
COMMUNICABLE DISEASES
PREVENTION
NON COMMUNICABLE DISEASES
PREVENTION
MENTAL HEALTH
POPULATION STABILIZATION

11. OTHER AREAS
 WOMEN’S HEALTH AND GENDER
MAINSTREAMING
 GENDER BASED VIOLENCE
 SUPPOTIVE SUPERVISION
 EMERGENCY CARE AND DISASTER
PREPAEDNESS
 AYUSH

12. SPECIALIST ATTRACTION AND
RETENTION

 MID LEVEL SERVICES PROVIDERS
 NURSING EDUCATION
 ASHA
 PARAMEDICAL SKILLS
 PUBLIC HEALTH MANAGEMENT CADRE
 HUMAN RESOURCES GOVERNANCE AND
LEADERSHIP DEVELOPMENT

13. CONT.
 FINANCING OF HEALTH CARE
 COLLOBORATION WITH NGOs
 VACCINE SAFETY
 MEDICAL TECHNOLOGIES
 PUBLIC PROCUREMENT

14. CONT..
 AVAILABILTY OF DRUG AND MEDICAL
DEVICES
 ALIGHNING OTHER POLICIES FOR MEDICAL
DEVICES
 HEALTH RESEARCH
 REGULATORY FRAMEWORK
*Food safety
*drug regulation
*medical devices regulation

15. HEALTH CARE DELIVERY SYSTEM
 INTRODUCTION
HEALTH CARE DELIVERY
SYSTEM IS INTENDED TO DELIVER THE
HEALTH SERVICES. IT CONSTITUTES THE
MANAGEMENT SECTOR AND INVOLVES
ORGANIZATIONAL MATTERS. HEALTH
SYSTEM HAS 3 MAIN LINKS CENTRAL,
STATE AND LOCAL/PERIPHERAL.

16. HEALTH CARE DELIVERY SYSTEM IN
INDIA
HEALTH
DELIVERY
SYSTEM
AT CENTRAL
LEVEL
AT STATE LEVEL
AT
DISTRICT/LOCAL
LEVEL

17. AT CENTRAL LEVEL
OFFICIAL
ORGAN
THE UNION
MINISTRY OF
HEALTH AND
FAMILY
WELFARE
DIRECTORATE
GENERAL OF
HEALTH
SERVISCES
THE
CENTRAL
COUNCIL OF
HEALTH AND
FAMILY
WELFARE

18. I. UNION MINISTRY OF HEALTH AND
FAMILY WELFARE
(1)ORGANIZATION
 THE UNION MINISTRY OF HEALTH
AND FAMILY WELFARE IS HEADED BY A
CABINET MINISTER ,A MINISTER OF STATE
AND HEALTH MINISTER.
 DEPARTMENTS
* DEPARTMENT OF HEALTH
* DEPARTMENT OF FAMILY
WELFARE

19. FUNCTIONS
● UNION LIST
THE FUNCTIONS GIVEN IN THE UNION LIST IS;
→INTERNATIONAL HEALTH
RELATIONS AND ADMINISTRATION OF PORT
QUARANTINE.
→ADMINISTRATION OF CENTRAL
INSTITUTES.
→PROMOTION OF RESEARCH
THROUGH RESEARCH CENTERS AND OTHER
BODIES.
→ESTABLISH AND MAINTENANCE
OF DRUG STANDARDS

20. CONT..
→CENSES AND COLLECTION AND
PUBLICATION OF OTHER STATISTICAL DATA
→ IMMIGRATION AND
EMIGRATION
→REGULATION OF THE LABOUR IN
THE WORKING OF MINES AND OIL PERIODS
→COORDINATION WITH STATES
AND WITH OTHER MINISTRIES FOR PROMOTION
OF GROWTH

21. ●CONCURRENT LIST
→ PREVENTION OF EXTENSION OF
COMMUNICABLE DISEASES FROM ONE TO
ANOTHER
→ PREVENTION OF ADULTERATION
OF FOOD
→ CONTROL OF DRUG AND
POISONS
→VITAL STATISTICS

22. CONT..
→LABOUR WELFARE
→ PORTS OTHER THAN MAJOR
→ECONOMIC AND SOCIAL
PLANNING
→POPULATION CONTROL AND
FAMILY PLANNING

23. 2.DIRECTOR GENERAL OF HEALTH SERVICES
(A)ORGANIZATION
THE DIRECTORATE GENERAL OF
HEALTH SERVICES IS THE PRINCIPAL
ADVICES TO THE UNION GOVERNMENT
IN BOTH MEDICAL AND PUBLIC HEALTH
MATTERS.

24. (B)FUNCTION
THE SPECIFIC FUNCTIONS INCLUDE;
 INTERNATIONAL HEALTH RELATIONS AND
QUARANTINE
 CONTROL OF DRUG STANDARDS
 MEDICAL STORE DEPOTS
 POST GRADUATE TRAINING
 MEDICAL EDUCATION

25. CONT..
 MEDICAL RESEARCH
 CENTRAL GOVERNMENT HEALTH SCHEME
 NATIONAL HEALTH PROGRAMS
 CENTRAL HEALTH EDUCATION BUREAU
 HEALTH INTELLIGENCE
 NATIONAL MEDICAL LIBRARY

26. 3.CENTRAL COUNCIL OF HEALTH AND FAMILY
WELFARE
FUNCTIONS
*TO CONSIDER AND RECOMMEND BROAD
OUTLINESOF POLICY
* TO MAKE PROPOSALS OR LEGISLATION IN
FIELD OF MEDICAL AND PUBLIC HEALTH MATTERS.
*TO MAKE RECOMMENDATIONS TO THE
CENTRAL GOVERNMENT REGARDING THE HEALTH.
* PROMOTING AND MAINTAIN COOPERATION
BETWEEN CENTRAL AND STATE HEALTH
ADMINISTRATION.

27. AT STATE LEVEL
STATE
MANAGEMENT
SECTOR
STATE
MINISTRY OF
HEALTH
HEALTH
SECRATERY
DEPUTY
SECRET
ARY
ADMINISTR
ATIVE
STAFF
DIRECTORATE OF
HEALTH AND
FAMILY WELFARE
SERVISES
FUNCTION
AL DPUTY
DIRECTOR
S
REGIONAL
DEPUTY
DIRECTERS
ASSISTANT
DIRECTORS
STATISTICS
LEPROSY /MCH/
NUTRITION
FAMILY WELFARE/
PHC
IMMUNISATION

28. I. STATE MINISTRY OF HEALTH AND FAMILY
WELFARE
 ORGANIZATION
STATE MINISTRY OF HEALTH AND
FAMILY WELFARE IS HEADED BY CABINET MINISTER
AND DEPUTY MINISTER.
 FUNCTIONS
*THE STATE MINISTRY OF
HEALTH AND FAMILY WELFARE HAS TO SEE
THE POLICIES APPROVED BY LEGISLATURE
ARE FAITHFULLY IMPLEMENTED OR NOT.

29. 2.HEALTH SECRETARY
 FUNCTIONS
1. ASSISTING THE MINISTER IN POLICY MAKING, IN
MODIFYING POLICIES FROM TIME TO TIME
2.FORMULATION, REVIEW AND MODIFICATION OF BROAD
POLICY OUTLINE.
3.EXECUTION OF POLICIES, PROGRAMME ETC.
4.COORDINATION WITH GOVT. OF INDIA AND OTHER STATE
GOVERNMENTS.
5, CONTROL FOR SMOOTH AND EFFICIENT FUNCTIONING
OF ADMINISTRATIVE MACHINERY.

30. 3.STATE HEALTH DIRECTORATE AND FAMILY
WELFARE
 ORGANIZATION
THE DIRECTOR OF
HEALTH AND FAMILY WELFARE IS THE
PRINCIPAL ADVISOR TO THE STATE GOVT. ON
ALL MATTERS RELATING TO MEDICINE AND
PUBLIC WEALTH. HE IS ASSISTED BY JOINT
DIRECTOR. REGIONAL JOINT DIRECTORS AND
DEPUTY AND ASSISTANT DIRECTORS OF
MAJOR WING.

31. FUNCTIONS
* To provide adequate medical care through hospitals, dispensaries,
health centers and mobile domiciliary units both in rural and urban areas.
* To make proper arrangement for medical education and research.
* Proper Implementation of National Health Programme
*To make provision for personnel and impersonal health schemes
* Control of food and drug administration
*Collection and dissemination of health information
*Control over ESI scheme
*Enforcement of professional standard

32. AT DISTRICT LEVEL
THE MAJOR UNIT OF
ADMINISTRATION IN INDIA IS THE
DISTRICT. EACH DISTRICT IS DIVIDED
INTO SUB-DIVISION OR TALUKA, UNDER
WHICH ARE SITUATED THE COMMUNITY
DEVELOPMENT BLOCKS.

33. LOCAL SELF GOVERNMENT IN THE RURAL
AREA OF DISTRICT
PANCHAYATH
RAJ
PANCHAYTH
PANCHAYATH
SAMITHI
ZILA
PANCHAYATH
 PANCHAYATHI RAJ

34. AT VILLAGE LEVEL
PANCHAYATH
RAJ
GRAM
SABHA
NYAYA
PANCHAYAT
GRAM
PANCHAYAT

35. AT BLOCK LEVEL
PANCHAYAT RAJ AGENCY AT THE
BLOCK LEVEL IS THE PANCHAYAT SAMITI. THE
BLOCK DEVELOPMENT OFFICER (BDO) IS THE
EX-OFFICE SECRETARY OF THE PANCHAYAT
SAMITI.
FUNCTIONS
THE EXECUTION OF THE COMMUNITY
DEVELOPMENT PROGRAM IN THE BLOCK.

36. LOCAL SELF GOVERNMENT IN THE URBAN
AREAS
 MUNICIPAL BOARDS
THE MUNICIPAL BOARD LOOKS
AFTER SANITATION, DRAINAGE, WATER
SUPPLY, CONSTRUCTION AND MAINTENANCE
OF ROADS, REGISTRATION OF BIRTHS AND
DEATH, EDUCATION, RUNNING OF HOSPITAL
AND DISPENSARIES.

37. CORPORATION
THE CORPORATION IS HEADED BY A MAYOR. IT
MEMBERS ARE COUNCILORS WHO ARE
ELECTED FROM VARIOUS WARDS OF THE CITY.
IT CARRIES THE SIMILAR FUNCTION OR THAT
OF MUNICIPAL BOARD BUT ON A LARGE &
WIDE SCALE.

38. HEALTH CARE SERVICES
 PRIMARY HEALTH SECTOR
 PRIVATE SECTOR
 INDIGENIOUS SYSTEM OF MEDICINE
 VOLUNTARY HEALTH AGENCIES
 NATINAL HEALTH PROGRAMS

39. ▀PRIMARY HEALTH SECTOR
 VILLAGE HEALTH GUIDE SYSTEM
 TRAINING OF LOCAL DAIs
 ICDS PROGRAM
 ANGANWADI WORKERS

40. RURAL HEALTH CARE SYSTEM
PRIMARY LEVEL
COMMUNITY HEALTH CENTER
(CHC)
PRIMARY HEALTH CENTER
(PHC)
SUBCENTER

41. SUB CENTER LEVEL
 FUNCTIONS
*MOTHER AND CHILD HEALTH CARE
*FAMILY PLANNING AND
IMMUNIZATION
*IT IS PROPOSED TO EXTEND THE
FACILITIES AT ALL SUB- CENTERS FOR IUD
INSERTION, AND SIMPLE LABORATORY
INVESTIGATION
* THE WORK AT SUB-CENTERS IS
SUPERVISED BY MALE AND FEMALE HEALTH
ASSISTANTS.

42. PRIMARY HEALTH CENTER
 FUNCTIONS
1. MEDICAL CARE
2. MCH INCLUDING FAMILY
PLANNING
3. SAFE WATER SUPPLY
AND BASIC SANITATION
4. PREVENTION AND
CONTROL OF LOCALLY ENDEMIC DISEASES.
5. COLLECTION AND
REPORTING OF VITAL STATISTICS.

43. CONT..
6. EDUCATION ABOUT HEALTH
7. NATIONAL HEALTH
PROGRAMS-AS RELEVANT
8. REFERRAL SERVICES
9. TRAINING OF HEALTH GUIDES,
HEALTH WORKERS LOCAL DAIS AND HEALTH
ASSISTANTS.
10. BASIC LABORATORY
SERVICES.

44. STAFFING PATTERN OF PHC
MEDICAL OFFICER: 1
PHARMACIST: 1
NURSE MID-WIFE: 1
HEALTH WORKER (FEMALE)/ANM: 1
BLOCK EXTENSION EDUCATOR: 1
HEALTH ASSISTANT (MALE): 1
HEALTH ASSISTANT (FEMALE): 1
U.D.C (UPPER DIVISION CLERK): 1
L.D.C (LOWER DIVISION CLERK): 1
LAB. TECHNICIAN:
DRIVER: 1
CLASS IV: 4
TOTAL : 15

45. COMMUNITY HEALTH CENTER
 FUNCTIONS;
1. CARE OF ROUTINE AND
EMERGENCY CASES IN MEDICINE AND
SURGERY.
2. 24 HOUR DELIVERY SERVICES,
3. ESSENTIAL AND EMERGENCY
OBSTETRIC CARE
4. FULL RANGE OF FAMILY PLANNING
SERVICES

46. CONT..
5. SAFE ABORTION SERVICES.
6. NEW BORN CARE AND CARE OF SICK CHILDREN
7. OTHER MANAGEMENT INCLUDING NASAL PACKING,
TRACHEOSTOMY, FOREIGN BODY REMOVAL ETC.
8. ALL THE NATIONAL HEALTH PROGRAMS (NHP)
SHOULD BE DELIVERED THROUGH THE CHCS.
9. OTHER:-
A) BLOOD STORAGE FACILITY
B) ESSENTIAL LABORATORY SERVICES
C) REFERRAL SERVICES

47. STAFFING PATTERN OF CHC
EXISTING CLINICAL MANPOWER
1. GENERAL SURGEON (1)
2. PHYSICIAN (1)
3. OBSTETRICIAN/ GYNECOLOGIST (1)
4. PEDIATRICIAN (1)
PROPOSED CLINICAL MAN POWER:
1. ANESTHETIST -1
2. EYE SURGEON -1
3. PUBLIC HEALTH PROGRAMME
MANAGER -1
4. DESIGNATED AS BLOCK SURVEILLANCE
OFFICER -1

48. CONT
 EXISTING SUPPORT MANPOWER
 NURSE- MID WIFE -7+2
 DRESSER- 1
 PHARMACIST/ COMPOUNDER- 1
 LAB TECHNICIAN -1
 RADIOGRAPHER -1
 OPHTHALMIC ASSISTANT -1
 WARD BOY/ NURSING ORDERLY- 2
 SWEEPERS -3
 CHOWNKIDAR -2
 OPD ATTENDANT- 2
 DATA ENTRY OPERATOR- 5
 OT ATTENDANT -2
 REGISTRATION CLERK-3

49. HOSPITAL
 RURAL HOSPITALS
 SUB DIVISIONAL HOSPITALS
 DISTRICT HOSPITALS
 SPECIALIST HOSPITAL
 TEACHING HOSPITAL

50. CONCLUSION
 THE PRIMARY AIM OF THE
NATIONAL HEALTH POLICY, 2017, IS TO
INFORM, CLARIFY, STRENGTHEN AND
PRIORITIES E IN SHAPING HEALTH SYSTEMS
IN ITS ENTIRE DIMENSION.