3. Introduction
Various committees of experts have been
appointed by the government from time
to time to render advice about different
health problems in India.
5. It was set up in 1943, under the
chairmanship of Sir Joseph
Bhore by the british
government of India.
The Government of India
appointed this committee, to
make broad survey of the
existing health conditions
6. Members of the committee
• 1.B Shiva Rao,member,Medical council of
India
• 2.LK Maitra,Member, Medical council of India
• 3.PN Sapru, Member, Medical council of India
• 4.NM Joshi, Member, Medical council of India
• 5.Dr BC Roy, Member, Medical council of
India
• 6.Dr Viswanath, Member, Medical council of
India
• 7.Prof MA Hameed, Member, Medical council
of India
7. • 8.Dr.JB Grant,Director,All India Institute
of Public Health
• 9.Dr Henry Sigerist,Hohn Hopkins
society of Hygiene and Public health
• 10.Dr.Ognev,Soviet union
• 11.Dr.AC Banerjee,Public Health
Specialist
• 12.Dr AH Butt, Public Health Specialist
• 13.Dr.KCKE Raja, Public Health Specialist
• 14.Dr Jungalwalla, Public Health
Specialist
8. PRINCIPLES
• No individual should be denied to secure
adequate medical care
• The health services should provide,all
the consultant, laboratory and
institutions facilities necessary for
proper diagnosis and treatment.
• The health program must from the very
beginning, lay special emphasis on
preventive work.
9. • Medical relief and preventive care to
the vast rural population .
• Health services should be located as
close to the people
• Essential to secure the active
cooperation of the people in the
development of the health program
• Health development must be
entrusted to ministries of Health
10. • The basic training to the doctor should be
designed to equip him for social
duties(protecting and guiding the people)
• Suffering and mortality in the country mainly
the result of an inadequate provision of
certain fundamental factors.
11. • 1. Integration of preventive and curative
services at all administration level
• 2. Development of Primary health
centres in 2 stages.
In short-term measure PHC in
rural area should include population of
40,000 with a secondary health centre to
serve as a supervisory, coordinating and
referral institution.
12. • 2 medical officer
• 4 public health nurses
• one nurse
• 4 midwives
• 4 trained dais
• 2 sanitary inspectors
• 2 health assistants
• one pharmacist
• 15 other class IV
employees
13. • Provision of hospitals and dispensaries in rural areas ,
less than that in urban areas
• Medical service should be free to all without
distinction and that should be through the proper
channel .It should ultimately decided by the
government
14. In long-term program (also called 3 million
plan) -setting up PHC with 75 bedded
hospital, for each 10,000- to 20,000
population and secondary units with 650-
bedded hospitals with 2500 beds
3 months training in preventive and social
medicine to prepare social physicians.
15. SHORT TERM PROGRAMME-DETAILS
Short term programme--details
• Combined preventive and curative health
work by ---a number primary,secondary and
district health units and special health
services for mothers and children,school
children and industrial wookers
• Impersonal health services .
16. • Promotion of the hygienic mode of life
style
• In each village,a health committee
consisting of 5-7 individuals should be
established
• Dental section should be established
in the hospitals at secondary health
services,provision should be made for
‘travelling dental units’ for service in
rural areas.
17. • Provision of housing accommodation for
health staff is essential
• For each 30 bed hospital, there should be 2
motor ambulances and one animal drawn
ambulance
• Travelling dispensaries should be provided to
supplement the health services in sparsely
populated areas
19. • Provision of optimum
diet for all
• 8 ounces of milk per
day should be included in
the average diet, Nursing
and expectant mothers
,children need much
more.
20. Health education
• Health education must promote
health and health
consciousness
• Instruction of school children
on hygiene should begin at the
earliest possible stage
• Responsibility of health
education rest on health
departments of Governments
21. • There should be 1 or 2
physical training colleges
in each province
• National Physical
Education programme
should include
games,sports,and folk
dances
22. Health services for
mothers and children
• Measures directed to
reduce the sickness and
mortality among
mothers and children
must have priority
23. The functions of the school health services
should be
• Preventive and curative health
measures,including,detection and
treatments and creation and maintenance
of hygienic environment in and around the
school
• Improvement of the nutritional state of the
child
24. • Occupational health
Occupational health
• Special measures
should be taken to
counteract the
adverse effects
associated with the
occupation
26. Professional education
• At the end of the first 10 years the
production of doctors should be4000-4500
per year
• New medical colleges with suitable teachers
• All India institutes should provide teachers
with high quality,selected persons should be
send abroad for training
27. Undergraduate education
• There should be a reorganization in teaching
• Establishment of Preventive and Social Medicine in
every college and inclusion of internship
• Stressing the importance of research
• Expansion of facilities in existing colleges
• Conversion of medical schools into colleges and the
establishment of new colleges
28. • Post graduate education
• Post graduate education should be
devised to provide training for
consultants and specialists
• A special organization called the central
committee should be established for
laying down standards in respect of
post graduate training in particular
subjects
• There should be refresher course for
general practitioner
29. Dental education
• Provision should be made in
medical and dental colleges
for training dental
surgeons,dental hygienists
and dental mechanics
• Legislation for compulsory
registration of dentists
• Prohibition of practice by
unregistered dentists
31. Medical research
• A statutory central research
organization should be
constituted
• Provision of laboratory
services in all provinces
• Development of research in
various subjects like
malaria and nutrition
32. Drugs and medical requisites
• Drugs and other
medical requisites
requirement of the
country should be
examined by a small
committee
• Drug act of 1940
should be brought into
operation throughout
the country
34. Stipends to medical and nursing students
• In medical profession,Who are willing to
enter into public service after
completing the course,should be given
annual stipend of Rs.1000
• Provision of stipends of Rs.60 per
month for pupil nurses
35. Nurse midwives and dais
• Number of nurses available in
the country was 7,000 but
short term progranne itself
requires 80,000
• The committee suggested
that,by 1971the number of
trained nurses available in the
country should be raised to
740000
36. Establishment of
preliminary training
school
There should be two
grades in the nursing
profession,junior grade
and senior grade
Establishment of nursing
colleges
37. Male nurses
• Male nurses and male staffs should be
trained and employed in male wards and
male OPD
Public health nurses
• Committee has suggested specific proposals
with regard to training of public health
nurses,they are fully qualified nurses with
training in midwifery
• Their educational programme should stress
throughout preventive point of view
38. Midwives
• Number of midwives available for midwifery duties
in the country is 5000.100000,midwives are
required to provide 1 midwife for every 100 births
• Existing training schools required considerable
improvement
• Suggested certain fundamental requirements
necessary for a training centre for midwives and
made detailed recommendation for the training
courses
39. Dais
• Committee advocated the training of
dais, until an adequate number of midwives
will become available
40. Health Survey and
Planning Committee
(1962)
The Government of India in
the Ministry of Health set up
this Committee in 1959
Dr A
Lakshminarayanaswami
Mudaliar : Chairman of the
committee
41. Terms of references
• To review the developments
• Evaluation in medical relief and public
Health.
• Review the first and second five year
plans
• Formulation of recommendations
42. Six sub-committees
• Professional Education and Research,
• Medical Relief
• Public Health including Environmental Hygiene
• Communicable Diseases
• Population problem and Family planning
• Drugs and Medical stores.
43. Recommendations
• Strengthening of efforts and
achievements made in the first two 5
year plans in the field of health.
• Equipping district hospitals with
specialist services.
• Need for regionalization of health
services.
• Each primary health center: 40,000
people & have all compliment staff
recommended by the committee
44. • The quality of care provided by the primary
health center needs improvement.
• In planning hospital one bed for every 1000
population should be taken for each district.
-Taluk hospitals will provide 600-800 beds
-PHCs will provide 10 beds each
• Integration of medical and health services
should be achieved as already suggested by the
Bhore Committee
45. • Greatest attention should be
given to the health of the children
• The LHV and midwife posted in
health centers is responsible for
health education,personal
hygiene and nutrition.
47. • There should be three grades of nurses
,the basic nurses(with 4 years
training)the auxillary nurse wife(2 years
Of training )and the nurse with a degree
qualification
• The qualification of nursing candidates
GNM- matriculation or
equivalent
Degree - higher secondary or
Pre university examination
48. • Age of admission can be 16 years of age in
states where there are difficulties in
recruiting candidates at the age of 17
• Medium of instruction-
Preferably be English for the GNM
courses
Degree courses --only in English
49. • Nurse pupils should not overburdened
with the routine duties in the hospital
• District hospitals with a bed strength of
75-100 should be utilized to train more
nurses
• Student nurses should be provide,free
accommodation,,free supply of
uniforms,laundry arrangements,free
books,free medical services and
medical check ups
50. • The recommendations of the committee
set up by the central council of health
• There should be a nursing advisory
committee in each school for advising on
admission and welfare of the trainees
• Each nursing school have its own
separate budget
51. • One auxillary nurse midwives for 5000
population by the end of 15
years,sufficient number of midwives
are trained to replace dais
• Male nurses should be trained for
certain types of work
• There should be higher training for the
general sick nurse,public health
nurse,paediatric health nurse,mental
diseases nurse,theatre sister,nursing
administrator
52. • Chadha Conmmittee
(1963)
• The Government of India appointed a
committee under the chairmanship of Dr MS
Chadha
• Study the arrangements necessary for the
maintenance phase of the NMEP.
• The Committee known as "special committee
on the preparation of entry of the NMEP into
maintenance phase."
53. RECOMMENDATIONS
• "Vigilance" operations in respect of the
NMEP should be the responsibility of the
general health services
• “ Vigilance operations by basic health
workers
• Existing malaria surveillance worker (MSW)
may be changed into auxiliary health
workers/basic health workers
-- Supervision by One sanitary
inspector/health inspector for 20-
25000population
54. • Creation of the post of laboratory
technicians at the PHC and a post of a
FPFW and FPHA
• Basic health workers envisaged as
"multipurpose" workers to look after
additional duties
55. • A committee was appointed by
the Government of India during
1965 to review the strategy of
family planning.
• Chairman - Shri
Mukherjee
• Recommended separate staff for
the family
planning programme
56. RECOMMENDATIONS
• Creation of post of LHV
• There should be one FPFW for every two
subcenters
• Part-time workers for motivating population for
acceptance of IUD
57. • Block and district levels, education
leaders be appointed for intensifying
motivational campaign and be paid
honorarium of Rs. 600/- per annum.
• Government doctors may be provided
incentives which should also be
available to part-time private medical
practitioners in terms of honorarium of
Rs. 100
58. Jungalwalla Committee (1967
• A committee was appointed, " under
the chairmanship of Dr N Jungalwalla.
• Committee is known as "Committee
on integration of health services’’
• To integrate the health services and
elimination of private practice by
government doctors
59. Integrated approach
• A service with an unified approach for all
problems instead of a segmented approach
for different problems, medical care of the
sick and conventional public health programs
functioning under a single administrator and
operating in unified manner at all levels of
hierarchy with due priority for each program
60. Recommendations
• Unified care
• Common seniority
• Recognition of extra qualifications
• Equal pay for equal work
• Special pay for specialized work
• Abolition of private practice by government
doctors
• Improvement in their service conditions
61. Kartar Singh Committee(1974)
• Government of India constituted a
committee in 1972 known as "The committee
on multipurpose workers under health and
Family Planning"
• Chairmanship of Sri Kartar Singh--Additional
Secretary, Ministry of Health Family planning
of the Union Government
62. The terms of reference of the committee were
• Structure for integrated services at the
peripheral and supervisory levels,
• The feasibility of having multipurpose /
bipurpose workers and the training
requirement of such workers
• The utilization of mobile service units
set-up under family planning program
63. Recommendations
• ANMs should be replaced by the "Family
Health Workers"
• Basic Health workers (BHW), Malaria
Surveillance worker
(MSW), Vaccinators, Health Education
Assistant of Trachoma (HEAT) and FPHAs to
be replaced by "Male Health workers .
64. • There should be one PHC for a populationof
50000.
---Each PHC should be divided into 16
subcenters each having a population of about
3000 to 3500 depending .
--Each subcenters should be staffed by by team
of one male and one female health worker
65. • LHV should be replaced by the newly
designated "Female Health Supervisor"
Creation of such additional posts (to
supervise the female health workers)
clubbing of the posts of Health
Inspectors, Sub- Inspectors, Malaria
Surveillance
Inspectors, Vaccinators, Supervisors
together to make them into; "Male
Health Supervisors"
66. • -- A male health supervisor to supervise
the work of 3 to 4 male health workers
and a female health supervisor to
supervise the work of 4 female health
workers. eg. The doctor in charge of a
primary health centre should have the
overall charge.
67. --- The program for having MPWs first to
be introduced in areas where malaria is in
maintenance phase and small pox has
been controlled and later to other areas
as malaria passes into maintenance phase
or small pox controlled.
68. Shrivastav Committee
(1975)
The Govt. of India in the Ministry of
Health and Family Planning November
1974 set-up a "Group on Medical
Education and Support Manpower"
under the chairmanship of Dr JB
Shrivastav.
69. TERMS OF REFERENCES
• To devise a curriculum for training of
health assistants
• To suggest suitable ways and means for
implementation of recommendations by
the earlier committees (Medical Education
Committee (1968)
• To make any other suggestions
70. Recommendations
• Steps to create bands of paraprofessionals or
semi professional health workers from the
community itself to provide simple,
protective, preventive and curative services
• Between the community and the primary
health center, there should be two cadres,
health workers and health assistants.
71. • Health workers should be trained and to give
simple, specified remedies for day-to-day
illness.
• Health assistants should be trained and
equipped to give simple specified remedies
for simple illnesses according to their level of
technical competence.
72. • The primary health center should be
provided with an additional doctor and
nurse to look after MCH services
• The primary health center , taluk
hospital, district hospital, regional
institution or medical college hospitals
should develop direct links with the
community around them, as well as with
one another
73. Mehta Committee
• The "Medical Education Review Committee"
was headed by Shri Mehta, known as Mehta
Committee1983.
• Part I of the report deals with medical
education in all its aspects
• Part-Il of the report specifically deals with the
lack of availability of health manpower data
in India,
74. Recommendations
• Training and development of auxillary personnel
• Training and development of paraprofessional
personnel
• Basic and induction training in public health
management
• Continuing education in health and public health
• Undergraduate medical education
• Post graduate medical education
76. Shetty committee (1954)
Report of the nursing committees to review
the conditions of the nursing
profession(Shetty committee 1954)
Government of India constituted a
committee on may 19th,1954 under the
chairman ship of Mr.Shetty and
Ms.Adranvala as the member secretary
77. Recommendations
• Appointment of superintendent of nursing
services in each state
• Combining the nursing services with the public
health
• One midwife to 100 births in rural area in
towns and cities,one midwife to 150 births
78. • One public health nurse or Health visitor to
10000 of population
• Recruitment of necessary staffs for
supervision and teaching in the existing
training centers
• Creation of posts of nursing staffs in
institution and public health aspect
79. • Improvement in condition of
training of nurses
• Married women,unless widowed
and separated from husbands not
be admitted for training
• Minimum requirements for
admission to training schools to be
in accordance with the regulations
of INC
80. • Medium if instruction should be decided
by each state
• Setting up of a system of counseling of
students,by an experienced sister
• Students required to be resident during
training
81. • Selection of nursing personnel by qualified
nurses
• Provision of adequate quarters for nurses
• Improvement in working condition by an
increase in staff .provision of supplies
necessary to carry out good nursing.
• Proper provision for a periodical physical
examination and the treatment during illness.
• Provision of pension or PF
82. • Establishment of refresher courses for all
categories of the nursing staff
• Provide part time work for married woman
who have household responsibilities
• Exchange of nurses between different states
to be encouraged
83. • Recruitment of men as student nurses be
in proportion with the job opportunities
• Reduction in the period of training from 2
years to 18 months
• Setting up of a training division at the
Ministry of Health and family welfare for
looking after training requirements for
Health and family planning
84. Report of Expert committee on
HealthManpowerplanning,Produc
tion and Management ,Ministry of
health andFW,,Govt of India,New
Delhi(Bajaj committee,1986)
85. Bajaj committee(1986-1987)
• The Ministry of Health and Family welfare,
Government of India set-up a committee on
Health Manpower, Planning, Production and
Management in 1986
• Chairmanship : Prof. JS Bajaj , Professor of
Medicine, AIIMS, and New Delhi.
86. Recommendation
• To formulate a National policy on education
in Health services
• To prepare curriculum for school teachers
• To utilize the services of Indian system Of
Medicine
• Continuing education programme for the
health personnel
88. CATEGORIES BASIS OF CALCULATION MANPOWWER
REQUIREMENT
(2001)
Nursing Supdts 1:200 beds 4955
Dy nursing Supdts 1:300 beds 3003
Departmental nursing 7:1000+1 Addl:1000 beds 7928
Ward nursing supervisors 8:2000 51532
Staff nurse for wards 1:3(1:9 for each shift) 429432
For OPD,Blood bank,X
ray,Diabetic clinics
1:100 opt 64415
For ICU (8 beds ICU) 1:8(1:3 for each shiftshift) 51530
For specialized deptts
and clinics,OT,Labour
room
8:200 51530
89. Manpower requirements for
community nursing services by 2000
Infrastructure requirement
Community Health centers 7436
Primary Health services 26439
*30000 population for plain area
*20000 population for difficult area
Sub centers 163941
*5000 population for plain area
*3000population for difficult area
91. Total manpower requirement in
nursing services
Nurse midwives - 664623
Sub centers ANM/FH worker 323882
Health supervisor 107960
Community Health centers Nurse midwives 26439
Primary Health Center PH Nurse 26439
Public Health Nurse supervisor 7436
District Public health nursing officer 900
92. • Sarojini Varadapan committee report
(1989)
A high power committee on Nursing and
Nursing profession was set up by the Govt of
India in july,1987 under the chairman ship of
Smt Sarojini varadapan, Smt Rajkumari
Sood,nursing advisor to Govt of india as the
member secretary
93. RECOMMENDATIONS
• Working conditions of nursing personnel
• Employment
• Job description.
• Working hours
• working facilities
• Pay and allowances
• Special allowance for nursing personnel, ie; uniform
allowance, washing, mess allowance etc should be
uniform
• Promotional opportunities
Promotion is based on merit cum seniority.
Promotion to the senior most administrative teaching
posts is made only by open selection.
94. • Career development
• higher studies after 5 years of regular
service.
• 8. Accommodation
• allotment of accommodation near to
work place.
• 9. Transport
During odd hours, calamities etc
arrangements for transport must be
made
95. • 10. Special incentives
• in terms of awards, special increment
for meritorious work for nurses working
in each state/district/PHC to be worked
out.
• 11. Occupational hazards
Medical facilities should provided by the
central govt. it should be free to all the
nursing personnel.
• 12. Other welfare services
• Hospitals should provide welfare
services
96. There should be 2 levels of nursing personnel
* Professional nurse (degree level) :12 yrs
of schooling with science( 4 yrs –duration)
* Auxiliary nurse (vocational nurse) :10 yrs
of schooling
( 2 yrs-duration)
• All school of nursing attached to medical
college hospitals
97. • All ANM schools and school of nursing
attached to district hospitals be affiliated
with senior secondary boards.
• Post certificate BSc Nursing degree to be
continued
• Master in nursing programme to be increased
and strengthened.
98. • Doctoral programmes
• Central assistance be provided for all levels of
nursing education institutions in terms of
budget
• Each school should have separate budget .
The principal of the school be the drawing
and the disbursing officer.
99. • Selection of students completely based on
merit. Aptitude test is introduced for
selection of candidates.
• All schools to have adequate budget for
libraries and teaching equipments.
• School Of Nursing ::As per the requirements
of INC.
100. • Adequate accommodations are
provided to students
• Students should learn under
supervision in the wards.
Tutors/clinical instructors must go
to the ward with students..
• Community nursing experience
should be as per INC requirements.
Necessary transport
101. • INC requirements for staffing the schools are
followed by all schools
• Speciality courses at post-graduate: at certain
special centres of excellence eg; AIIMS.
• Institutes like National Institute of Health and
Family welfare, RAK College of Nursing and
several others may develop courses on
nursing administration for senior nursing
• Provision for higher training abroad
102. Continuing education
• Definite policies of deputing 5-10% of staff
for higher studies are made by each state.
Provision for training reserve is made in
each institution.
• Deputation for higher study is made
compulsory after 5 yrs.
103. CONCLUSION
These committees are appointed from time to
time to look into 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
104. • Basavanthappa BT.Nursing AdministrationJayppee
publication.New Delhi:171-198
• Park K.Park’s Text book of Preventive and Social
Medicine..Bhanot publication. 19th edition.
Jabalpur:726
• Swarnakar K.Community Health Nursing.N.R
Brothers.2nd edu.Indore.535
• Lucita M.Nursing:Practice and public Health
Administration,current concepts and
trends.Elsevier publications.2nd edition:369-374
• www.nrhm-mis.nic.in
• www.nihfw.org
• www.nursingplanet.com
