2. Planning is for tomorrow
Purpose of planning :
• To match limited resources with many problems.
• To eliminate wasteful expenditure.
• To develop best course of action to accomplish
an objective.
Planning includes 3 steps:
1. Plan formulation
2. Execution
3. evaluation
3. • Health planning: It is the process of defining
community health problems, identifying unmet
needs, surveying the resources to meet them,
establishing priority goals that are feasible and
projecting administrative action to accomplish the
purpose of proposed programme.
• Resources : manpower, money, material, time,
skills
• Objective :It is planned end point of all activities
and is concerned with the problem itself.
4. • Target : is discreet activity. It is degree of
achievement .Ex. No. of blood films, no. of
vasectomies.
• Goal : ultimate desired state towards which
objectives and resources are directed.
Goal is described in terms of
• What is to be attained
• Extent to which it is to be obtained
• Population involved
• Geographical area
• Length of time required for attaining the goal
5. • Plan: is a blue print for taking action.
It has 5 elements
1. Objective
2. Policy : guiding principles stated as an
expectation.
3. Programme: sequence of activities
4. Schedule : is time sequence for work to be done.
5. budget
7. • Planning cycle
1. Analysis of health situation
2. Establishment of objectives and goals
3. Assessment of resources
4. Fixing priorities – meet unmet needs
5. Write up formulated plan – each stage is defined,
costed ,time needed to implement is specified ,working
guidance for all staff and built in system of evaluation.
6. Programming and implementation –
selection,training,and supervision of manpower.
7. Monitoring
8. Evaluation
8. Tools for planning
Situation Analysis
– Epidemiological analysis (time, place & person)
– Stakeholders analysis
– SWOT analysis
– Problem Tree Analysis- Fish Bone Analysis
– Bottle neck analysis
– Critical Path Analysis
Objectives, Target setting and indicators
Gantt Chart preparation
Budgeting
9. Until 1983 India adopted a formal or official
National Health Policy. Before that health
activities were formulated through 5 year plan
and Committees.
10. Health Planning In India
Health planning in India is an integral part of national
socioeconomic planning .the guidelines for national health
planning were provided by various committees appointed by
Government of India .
Bhore committee ,1946
• Integration of preventive and curative services at all
administrative level.
• Development of primary health centers in rural area.
• Major change in medical education- 3 months training in PSM
to make social physicians
11. Mudaliar committee also called as Health Survey and Planning
Committee, 1962
• Strengthening of PHC (for 40,000 population) , sub divisional and
district hospitals .
• To improve the quality of health services.
• Constitution of All India Health Service on the pattern of Indian
administrative services.
Chadah committee ,1963: to study the arrangements for
maintenance phase of National Malaria Eradication Programme.
• Vigilance operations in National Malaria Eradication Programme
should be the responsibility of PHC.
• Basic health workers OR Multipurpose health workers for 10000
population has to carry out monthly home visits.
• The family planning health assistants were to supervise 3 or 4
basic health workers .
12. MUKERJI COMMITTEE,1965
• Separate staff for family planning programme
• To delink the malaria activities from family planning
MUKERJI COMMITTEE,1966
• Worked out details of Basic health services at the block level
JUNGALWALLA COMMITTEE,1967
• Integrated health services
• Unified cadre ,common seniority ,recognition of extra qualification ,equal pay for
equal work, no private practice .
KARTAR SINGH COMMITTEE,1973
• Multipurpose health workers for all the programmes.
• One PHC to cover 50,000 population.
• Each sub centre for 3000-3500 population and staffed by one male and female
health worker
• Health supervisors to supervise 3-4 health workers.
13. SHRIVASTAV COMMITTEE,1975
• Creation of bands of paraprofessional and
semiprofessional health workers (Community
participation)
• referral services
RURAL HEALTH SCHEME,1977
• Involving medical colleges for ROME SCHEME
The National Health Plan ,1983
• One PHC for 30,000 population in rural plains and for
20,000 population in hilly ,tribal and backward areas
15. Health Care in India
India has 1700 patients per doctor
Wide urban-rural gap in the availability of
medical services: Inequity
Poor facilities even in large Government
institutions compared to corporate hospitals
16. National Rural Health Mission
2005-2012
To provide effective health care to rural population throughout
country with special focus on states with weak infrastructure.
To raise public spending on health from 0.9% of GDP to 2-3% of
GDP.
Provision of Accredited Social Female Health Activist (ASHA) in
each village.
To undertake architectural correction of health system.
Decentralization of programmes.
To improve access to rural people .
To revitalize local health traditions (AYUSH)
17. Goals
• Reduction of IMR to 30 per 1000 live births.
• Reduction of MMR to 100 per 100,000 live births by
2012.
• Reduction of total fertility to 2.1.
• Universal access to public health services.
• Prevention and control of communicable and non
communicable diseases.
• Access to integrated comprehensive PHC.
• Population stabilization ,gender and demographic
balance.
• Revitalize local health traditions.
• Promotion of healthy life style.
18. PLAN OF ACTION
Component (A) : ASHA
• Every village will have ASHA chosen by and
accountable to village panchayat to act as the
interface between the community and the public
health system.
• She will be trained honorary volunteer receiving
performance based compensation.
• She will be given training for 23 days, on the job
training would continue for 1 year.
• She will prepare and implement village health plan
along with AWW,ANM and other functionaries under
the leadership of village panchayat.
• She is given drug kit for common ailments.
19. Component (B) :strengthening of subcentre
• Each subcentre will have fund Rs. 10000 per annum.
This is deposited in joint bank account of ANM and
sarpanch.
• Supply of essential drugs.
• Posting additional health workers and upgrading
existing subcentres.
Component (C) :strengthening of PHCs
• Provision of 24 hour services
• Adequate supply of essential quality drugs and
equipments like auto disable syringes.
• Provision of second doctor in case of additional
outlays.
20. Component (D): strengthening of CHCs
• 30 -40 beds in It and making it 24 hours first referral unit with
posting of anesthetist.
• To upgrade quality of services.
Component (E) :District Health Plan
Component (F) :Total Sanitation Campaign
Component (G) :Strengthening disease control programmes
• Strengthening of disease surveillance system
• Provision of mobile medical unit at district level.
Component (H) : Public –private partnership for public health
goals
21. • Component (I) : New health finance mechanism
• Component (J) : Reorienting medical education
to support rural health issues
