administrative distribution of health care delivery system and it organization at various levels

1. GOOD
MORNING

3. Introduction
India is a Union of 28 States and 8
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, therefore, has developed its
own system of health care delivery,
independent of the Central Government.

4. CONT……
The Central responsibility consists mainly of
policy making, planning, guiding, assisting,
evaluating, and 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.

5. DEFINITION
According to “J. E. Park”
“It implies the organization, delivery, staffing,
regulation and quality control of health care
services.”

6. I - AT THE CENTRE
The official "organs" of the health system at the
national level consist of :

8. 1. Union Ministry of Health and Family Welfare
Organization

9. Union ministry of family welfare
Secretary
Joint secretary
Deputy
secretary
Administrative
staff
Secretary
Additional
Secretary
Commissioner
joint Secretary

10. FUNCTIONS
The
functions of the Union
Health Ministry are set
out in the seventh
schedule of Article 246
of the Constitution of
India under
 The Union list and
 The Concurrent list.

11. Union list
The functions given in the Union list are:
• International health relations and administration of
port quarantine.
• Administration of central institutes such as the All
India Institute of Hygiene and Public Health, Kolkata;
National Centre for Disease Control, Delhi, etc.
• Promotion of research through research centers and
other bodies
• Regulation and development of medical,
pharmaceutical, dental and nursing professions.

12. Cont …..
• Establishment and maintenance of drug standards
• Census, and collection and publication of other
statistical data
• Immigration and emigration
• Regulation of labour in the working of mines and oil
fields and
• Coordination with States and with other ministries
for promotion of health.

13. Concurrent list
The functions listed under the concurrent list are the
responsibility of both the Union and State governments.
The concurrent list includes:
Prevention of extension of communicable diseases from
one unit to another.
Prevention of adulteration of foodstuffs.
Control of drugs and poisons
Vital statistics
Labor welfare
Ports other than major
Economic and social planning, and
Population control and Family Planning

15. ORGANIZATION: - Directorate General
of Health Services is the principal adviser to the
Union Government in both medical and public
health matters. He is assisted by an additional
Director General of Health Services, a team of
deputies and a large administrative staff. The
Directorate comprises of three main units.
e.g., medical care and hospitals, public health and
general administration the director general of health.

16. FUNCTIONS
• International health relations and quarantine
• Control of drug standards
• Medical store depots
• Post graduate training
• Medical education
• Medical Research
• Central Govt. Health Scheme

17. • National Health Programmes
• Central Health Education Bureau
• Health Intelligence
• National Medical Library:

18. • The center council of health was set up by president
order on 9 august 1952 under article 263 of the
constitution of India for promoting co coordinating
and concerted action between the Centre and the
States in the implementation of all the programmer
and measures pertaining to the health of the nation.

19. FUNCTION
To consider and recommend broad
outlines of policy in regard to matters
concerning health in all it aspects such as
the provision of remedial and preventive
care, environmental hygiene nutrition
health education and the promotion of
facilities for training and research
To make proposals for legislation in
fields of activity relating to medical and
public health matters and to lay down the
pattern of development for the country
as a whole.

20. Cont …
To make recommendations to the Central
Government regarding distribution of
available grants-in-aid.
 To review periodically the work
accomplished in different areas through the
utilization of these grants-in-aid.
 To establish any organization or
organizations invested with appropriate
functions for promoting and maintaining
cooperation between the Central and State
Health administration

21. II - AT THE STATE
LEVEL

22. Cont…
• The Government of India Act, 1935 gave further
autonomy to the States. The health subjects were
divided into three groups: federal concurrent and
state.
• The "state" list which became the responsibility of
the State Included provision of medical care,
preventive health services and pilgrimages within
the State. The position has largely remained the
same, even after the new Constitution of India came
into force in 1950.

24. STATE MINISTRY OF HEALTH
Health secretary
Additional secretary
Deputy secretary
Administrative staff

25. Function
Assisting the ministers in policy making
Formulating, review and modification of broad
policy.
Execution of policies
Coordination with Govt. of India and other
state
Control for smooth and efficient functioning
Budgeting and control over expenditure

26. STATE HEALTH DIRECTORIATE
Functional deputy director Regional
deputy director Additional directors.
FUNCTIONS
 Provide adequate medical care
Medical education and research
National health program implementation
 Provision for health scheme

27. III-AT THE DISTRICT LEVEL
The District
The principal unit of administration in India is the
district under a Collector. There are 707 (veer 2016)
districts in India.
There is no "average" district that is the districts
vary widely in area and population. Within each
district again, there are 6 types of administrative
areas

28. Cont …
Sub-divisions
Tahsils (Talukas)
Community Development Blocks
Municipalities and Corporations
Villages
Panchayats

29. • Most districts in India are divided into two or more sub divisions,
each in charge of an Assistant Collector or sub Collector.
• Each division is again divided into Tahsils (taluks), in charge of
a Tahsildar. A Tahsil usually comprises between 200 to 600
villages.
• Since the launching of the Community Development Programme
in India in 1952, the rural area of the district have been organized
into Block is a unit of Blocks known as Community development
blocks, the area of which may not coincide with a Tehsil.
• The block is a un planning and development, and comprises
approximately 100 villages and about 80,000 to 1.20,000
population charge of a Block Development Officer Finally there
village panchayats, which are institutions of rural loc government

30. • The urban areas of the district are organized into
the following institutions of local self-
government:
• 1. Town area committees - (in areas with
population ranging between 5,000 and 10,000)
• 2. Municipal Boards - (in areas with population
ranging between 10,000 and 2 lakhs).
• 3. Corporations - (with population above 2 lakhs).
The Town area committees are like panchayats.
They provide sanitary services.
The Municipal Boards are headed by a
Chairman/President, elected usually by the
members The term of a Municipal Board ranges
between 3-5 years

31. The functions of a municipal board are
 construction and maintenance of roads, sanitation and
drainage,
 street lighting,
 water supply,
 maintenance of hospitals and dispensaries,
 education,
 registration of births and deaths etc.
Corporations are headed by Mayors. The
councilors an elected from different wards of the city.
The executive agency includes the Commissioner, the
Secretary, the Engineer and the Health Officer. The
activities are similar those of the municipalities, but on
a much wider scale.

32. Health organization
The Bhore Committee (1946)
recommended integrate preventive and
curative services at all levels and the city up of
a unified health authority in each district.
Subsequent expert committees, appointed by
the Government of in have also recommended
the same, Since "health" is a set subject, there
is no uniform "model" of a district he
organization in India, each State developed its
own part to suit its policy and convenience

33. • Under the Multi-Purpose Workers Scheme,
• it has been district level by having a Chief
Medical Officer with three Deputy CMOs
(existing Civil Surgeon District Health
Officers and District Family Welfare Officers)
with each of the Dy.
• CMOs being in charge of one-third of the
district for all the Health. Family Welfare and
MCH programmes.

34. • The recent Working Group on Health for All
by 2000 AD appointed by the Planning
Commission recommended that the District
Hospitals should be converted into District
Health Centers, each centre monitoring all
preventive primitive and curative services of
one million populations.
• It has been recommended that the district set-
up should be reorganized on the basis of the
number of primary health centers it comprises.

36. PANCHAYATI RAJ
• The Panchayati Raj is a 3-tier structure of rural
local self government in India, linking the
village to the district. The three institutions
are:
• Panchayat - at the village level;
• Panchayat Samiti - at the block level; and
• Zilla Parishad - at the district level.

37. Cont….
• The Panchayati Raj institutions are accepted as
agencies of public welfare welfare. All
development programmes are channelled
through these bodies. The Panchayati Raj
effective and better participation of the people
in the institutions strengthen democracy at its
root, and ensure more effective and better
participation of the people in the government.

38. At the Village level
The Panchayati Raj at the village level consists
of
The Gram Sabha
 The Gram Panchayat
 The Nyaya Panchayat

39. At the Block level
The block consists of about 100 villages
and a population of about 80,000 to 1,20.000.
The Panchayati Raj agency at the block level
is the Panchayat Samiti / Janpad 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 cooperative societies.
The Block Development Officer (BDO) is
the ex-officio secretary of the Panchayat Samiti

40. FUNCTION
Execution of the community development
programme in the block,
The funds provided by the government for
stage I and stage in 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.

41. HEALTH CARE DELIVERY
1. Public health sector
A) Primary health care
Primary health centers
Sub center
B) Hospital/ health center
Community health center
Rural hospitals
District hospital
Specialist hospitals
Teaching hospitals

42. CONT…..
C) Health insurance schemes
Employee state insurance
D) Other agencies
Defense services
Railway

43. 2. Private Sector
Private hospitals , polyclinics, nursing homes,
and dispensaries
General practitioners and clinics
3. Indigenous System of Medicine
Ayurveda and siddha
Unani and tibbi
Homeopathy
Unregistered practitioner

44. 4. Voluntary
health agencies
5. National
health programme

45. THANK
YOU