Health care..:))

HEALTH CARE DELIVERY SYSTEM IN INDIA

Submitted by,Rakshita Asati10th “B”

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

3

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.

Health care should be :-

Accessible

Acceptable

Provide scope for community participation

Comprehensive

Affordable at low cost

4

5

Resources:-

Man power

Money power

Material power

Minutes power

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 inPopulation

At central level:-

Union ministry of health and family

The director general of health services

The central council of health and family welfare

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

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 quarantinecontrol of drug standardsmedical stores depots post graduation training medical education medical research central govt. health scheme

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

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:-

1) Panchayat :-(at village level)

2) Panchayat Samiti:- (at block level)

3) Zilla parishad :- (at district level)

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

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

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

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 2nd oct 1977

In May 1986 male guide replaced by female health guides They provide the first contact between the individual and the health systems

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 10th 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 PHCDuration 200 hrs for 3 months received stipend Rs. 200/month

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:-

18

Sub-center level:- it is peripheral outpost of the existing

health delivery systems in rural areaOne 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 PHCIn 1946 Bhore community put the concept

of P.H.C.One P.H.C. for 30,000/25,000One P.H.C. for 20,000/15,000 in hilly and

tribal

19

Function of P.H.C. Medical 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 relevantReferral servicesTraining of health guides health workers

local dais and health assistants Basic laboratory services

(tubectomy vasectomy and tracheotomy MTP and minor surgery)

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

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.

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

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

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

25

hospital health centers :-Community health centers:-• 31st 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 medicine24 hrs delivery services Cesareans sectionFull range of family planning services,

laparoscopy too. safe abortion New born careTracheotomy, nasal pack National health programme Other

Staffing pattern at CHC:-

1) Existing clinical manpower:-General surgeon Physician DGOPediatrician

2)Proposed clinical manpower:- AnesthetistEye surgeon Public health manager

3)Existing support manpower:-Nurses + midwifes (7+2)Dresser (certified by Red cross)Pharmacist Lab technician radiographer Ophthalmic assistant Ward boySweeper

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

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

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.

30Other 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

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.

32

Other agencies :-Defense medical services:-

it is largest and almost best organization of health care delivery systems in the country

Supported facilities:-1. Ambulance 2. Mobile beds3. Hospital (all)4. 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

33

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

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.

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

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

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

38

Economic trends:- Improved 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)

Thank you for patience