health care delivery system in india

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Health care delivery system in india Submitted by, Akshay k .dhakade P.B. Bsc 2 nd year student Submitted To, Mr. Gawai sir, Msc in Community health nursing.

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Health :- A state of complete physical , mental , and social well-being and not merely the absence of disease or infirmity System :- this is word From late Latin systēma and Ancient Greek ( sustēma , " organised whole, body") example respiratory system

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Introduction :- Health care delivery system is initially started from central government of India. The scope of health services is varies widely from country to country and influenced by general and ever changing national, state And local health Problem, need attitude as well as available resources. 3

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Health care should be :- Accessible Acceptable Provide scope for community participation Comprehensive Affordable at low cost 4

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5 Resources :- M an power M oney power M aterial power M inutes power

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6 Organization and administration of health services in india at different level. National level State an union territories District health organization and basic specialties hospital/districts Community health sub-districts/ Centers taluka hospital P.H.C Sub centers Village health Guides People in Population

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At central level:- Union ministry of health and family The director general of health services The central council of health and family welfare

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8 Union ministry function International heath relation and administor of port-quarantine Administration of central health institutes such as “all India institute of hygiene” Promotion of research through research centers and other bodies Regulation and development of medical, nursing and other allied health promotion Establishment and maintains of the drug Census and collection and publication of other statistical data Immigration and migration Regulation of labor in the working in mines

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9 Director general of health services General function :- the general function are survey planning, co- ordination, programme and appraisal of all health matters in the country Specific funtion :- international health relation and quarantine control of drug standards medical stores depots post graduation training medical education medical research central govt. health scheme

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10 Central council health function are :- Environmental hygiene, nutrition, education, promotion, research Making the proposal Distribution sources to the state level Promoting and maintain between central and state level

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Panchayti Raj :- it is rural administration It is last phase in the system of the health care structure Three institution of panchayati Raj are following: - Panchayat :-(at village level) Panchayat Samiti :- (at block level) Zilla parishad :- (at district level)

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1) Panchayat :- Gram sabha :- They meet at least twice in a year and elected the member of gram panchayat gram panchat :- it constitude on the popullation of 5,000 to 15,000 15 to 30 panch as members Headed by surpanch It term upto 3 to 5 year nyaya panchat it villages platform to resolves the disputes between villages /local group Mainting peace among people

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2) Panchayat samiti : - It consist of 100 villages Covering 80,000 to 1 lack people It consist of all surphanchs B.D.O. headed 3) Zilla parishad at the district level collector also member of this team but not right of voting Nearest 70 to 80 members Mainly supervising by collector

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14 Primary health care :- Launched in 1977 base on rural health scheme The principle is “placing people health in people hand” 1983 national health policy based on PHc approved by parliament 1)Village level a) village health guide scheme b) training of local dais c) ICDS scheme( Anganwadi worker) 2)Sub centre 3)P.H.C

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15 a)Village level one of the basic tends of primary health care. implement the policy of primary care following scheme are operating:- Village health guides :- a person with an aptitude for social services and it not full time government functionary. This scheme introduced on 2 nd oct 1977 In May 1986 male guide replaced by female health guides They provide the first contact between the individual and the health systems

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16 The guidelines for their selection are :- they should be permanent residents of the local community, preferably women they should be able to read and write having minimum formal education at least 10 th standard Should be accept all section of the community They should be spare at least 2 to 3 hrs every day Training for health guide:- At the PHC Duration 200 hrs for 3 months received stipend Rs. 200/month

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17 Providing knowledge and training Knowledge is emphasize on elementary concepts of maternal and child health and sterilization The training is 30 working days Stipend of Rs.300 2 days training in a week After completion each dais getting kit and certificate Anganwadi worker One anganwadi for 1000 people popullation Under ICDS Local dais:-

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18 Sub-center level:- it is peripheral outpost of the existing health delivery systems in rural area One sub centre ……. Every 3000 population in hilly and tribal …… Each sub-center one male/female ANM Primary health center level it not new to India before in depended also there was PHC In 1946 Bhore community put the concept of P.H.C. One P.H.C. for 30,000/25,000 One P.H.C. for 20,000/15,000 in hilly and tribal

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19 Function of P.H.C . M edical care MCH including family planning Safe water supply and basic sanitation Prevention and control of locally endemic disease collection and reporting of vital statistic Education about health National health programme as relevant Referral services Training of health guides health workers local dais and health assistants Basic laboratory services (tubectomy vasectomy and tracheotomy MTP and minor surgery)

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Staffing pattern of P.H.C Medical officer 1 Pharmacist 1 Nurse mid-wife 1 Health worker 1 Block extension educator 1 Health assistant 1 Health assistant 1 U.D.C. 1 L.D.C. 1 Lab technician 1 Driver 1 Class VI 4

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21 Job description of members of the health team 1)Medical officer, P.H.C . Captain O.P.D. devotes work at morning Supervised the field at afternoon Supervising and leadership of health team Each month one day participating in meeting at P.H.C. He must to planner, promoter, director supervisor, coordinator and evaluator too.

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22 2) Health care female: - Registration:- Pregnant women Married women Number of home visits Care at home:- Care of pregnant women Advice about nutrition and food hygiene Distributes iron & folic acid tab Immunization Finding gynecological problem Family planning

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23 Supervises deliveries First Aid in emergency Notify disease Record and reports of birth\death Test urine albumin Distribute conventional contraceptive Care at clinic arrange help to M.O. Conduct MCH Family planning clinic at sub centre Care in the community Participant in mahila mandal meeting Helping to other staff other :- maintain cleanliness of centre Attend staff meeting at P.H.C. List the dais of same area Co- ordinating

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24 Health worker male :- Record keeping Malaria (identification, O.P.D. investigation, records, control of spreading,education,followup) Communicable disease Leprosy Tuberculosis Environmental sanitation Expanded programme on immunization Family planning

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25 hospital health centers :- Community health centers: - 31 st march 2003 established by upgrading the primary centers Covering 80,000 to 1.2 lack population 30 beds Specialist surgery C.H.C has provided following services :- Care routine and emergencies cases in surgery Care of routine and emergencies in medicine 24 hrs delivery services Cesareans section Full range of family planning services, laparoscopy too. safe abortion New born care Tracheotomy, nasal pack National health programme Other

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Staffing pattern at CHC:- 1) Existing clinical manpower:- General surgeon Physician DGO Pediatrician 2)Proposed clinical manpower:- Anesthetist Eye surgeon Public health manager 3)Existing support manpower:- Nurses + midwifes (7+2) Dresser (certified by Red cross) Pharmacist Lab technician radiographer Ophthalmic assistant Ward boy Sweeper

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O.P.D attendent Statistical assistant (date entry,operator ) O.T. attendant registration clerk one ANM and one PHN for family welfare appointed under ASHA

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28 Rural hospital :- It’s convert the sub division hospital into sub division health center . Covering 5 lacks population In this covering P.H.C., sub centre, at tehsil/sub division/ taluka . P.H.C. patient are shifted for infusion level District hospital it’s convert the district hospital into district health centre hospital differs from health centre in the following respect mostly curative services No catchment area Mix team work

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29 Specialist hospital :- The specialist hospital include:- trauma centers Rehabilitation hospital Seniors (geriatric) care Psychiatric hospital Cardiac Oncology etc. Hospital may in a single or number of building on one campus It may expensive or not expensive too. Teaching hospital:- providing clinical education and training to future Provide medical education to the doctor, nsg, health profession In additional providing patient care.

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30 Other agencies health insurance scheme: employee state insurance This act introduce in 1948 The principle of contribution by the employer and employee Provide kind and benefits in the contingency of sickness Maternity care, employment injuries , pension on death on field of work. The act coves employees drawing wages not exceeding Rs. 10,000/month central Govt. health scheme :- Introduced in Delhi in 1954 to provides Provide comprehensive medical care to central govt. employees The facilities under scheme include:- O.P.D. care Supply of necessary drugs Laboratory and x.ray investigation Domiciliary visits hospitalization facilities as well as in private hospital

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31 Specialist consultation Pediatric services including immunization Antenatal, natal and postnatal services Emergency treatment Supply of optical and dental aids at reasonable rate Family welfare services.

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32 Other agencies :- Defense medical services:- it is largest and almost best organization of health care delivery systems in the country Supported facilities:- Ambulance Mobile beds Hospital (all) Staff ( doctors,nsg,co -workers) Health care of railway employee:- Through out railway hospital care are provide MCH School health services Specialist unique hospital Primary care Health check-up

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33 Medical officer are working in sub-division centre The economical sources are providing by railway department for future care at the low cost.

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Private agencies:- In a mixed economy such as India's private practice of medicine a large share of health services available The general practitioner constitute 70% of the medical profession The component of private agencies are poly Nsg home, general practitioner Indigenous systems :- the practitioner of indigenous systems of medicine are ayurveda.sidha,homoepathy 90% of ayurvedic physician serve the rural area The govt. of India is studying best utilized for more effective or total health coverage.

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Voluntary health agencies:- Definition:- An organization that is administrated by an autonomous board which holds meeting collects funds for it supported chief from private sources and expanded money. Function :- Supplementing the work of govt agencies Pioneering Education Demonstration Guarding work of govt. agencies Advancing health legislation

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Health programme in India:- Since india become free several measure have been undertaken by the national govt. Central govt. for control eradication of communicable disease, improved environmental sanitation etc. India given permission to the foreigner countries to implement them organization in india

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Factor influencing :- Demographic trends:- Population explosion Declining mortality for both sex Increasing old age and midline age people Prevalent of non- communicable disease Higher morbidity rates Eliminating communicable disease social trends:- changing of life styles Appreciation of quality of life Changing families composition and living pattern Rising household incomes

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38 Economic trends:- I mproved in std of living Training facilities Allotment of social welfare funds to other job opportunities Self employment scheme Increasing nurses in hospital and non hospital setting Impaired family planning political trends :- policy changes Supports (economic, attitude)

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Thank you for patience