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Health Systems in India and Five Year Plans

Health Systems in India and Five Year Plans. Dr. Pracheth R. Outline. Introduction At the Centre At the State level District level Five Year Plans. Objectives. To enlist each component under the three levels of health system in India

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Health Systems in India and Five Year Plans

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  1. Health Systems in India and Five Year Plans Dr. Pracheth R.

  2. Outline • Introduction • At the Centre • At the State level • District level • Five Year Plans

  3. Objectives • To enlist each component under the three levels of health system in India • To enumerate the functions of Ministry of Health and Family Welfare • To enlist the functions of Directorate General of Health Services in India • To explain Panchayati Raj Institutions in detail • To enumerate the salient features of the 12th Five Year Plan.

  4. Introduction • Union: 28 States, 7 UT • States: independent: health care • Each State: system • Centre: planning, guiding, evaluating • Three main links

  5. CENTRAL • Ministry of Health and Family Welfare • Directorate General of Health Services (DGHS) • Central Council of Health and Family Welfare

  6. MINISTRY OF HEALTH AND FAMILY WELFARE • Cabinet Minister, Minister of State, Deputy Health Minister • Departments: Health, Family Welfare • Secretary to GOI, Joint Secretaries

  7. Functions: Union List • International health relations • Central Institutes • Promote research • Regulation of professions • Establish, maintain drug standards • Census • Regulate labour • Coordinates : States

  8. Concurrent list • Responsibility of Union, State Governments • Centre and States: equal powers • Prevent extensions : communicable diseases • Prevent adulteration: food • Control: drugs, poisons • Vital statistics • Family planning

  9. DGHS • Adviser: Government- health matters • Additional Director • Large staff • Three main units: • Medical care, hospitals • Public health • General administration

  10. Functions General: Survey, planning, coordination, assess health problems Specific: • International Health relations, quarantine • Control drug standards • Medical Store depots • Postgraduate training

  11. Specific Functions • Medical Education: Lady Hardinge, Maulana Azad, Puducherry, Goa • Medical Research: ICMR: aids, promotes, coordinates Cancer Research Centre: Chennai National Institute : Virology National Institute: Nutrition Funds: Union Budget.

  12. Specific Functions • National Health Programmes • Central Health Education Bureau: Prepares material: awareness Training courses: health education • Central Bureau of Health Intelligence: Collect, analyze: health statistics Aim: advancement medical sciences.

  13. Central Council of Health • Set up to promote coordination: Centre and States • Union Health Minister: Chairman, State Health Ministers: members

  14. Functions • Consider, recommend broad outlines: policy: regarding health • Make proposals: legislations: health • Make recommendations: Centre: distribute: grants • Establish organizations: coordination-State and Centre.

  15. STATE • In 1919: States: autonomy • Government of India, 1935: further • State list: • Provide medical care • Preventive health services • Pilgrimages

  16. State Health Administration • State Ministry of Health: • Minister of Health and Family Welfare • Health Secretariat: official organ, Secretary: Senior IAS Officer.

  17. State Health Directorate • Long time: medical, public health separate • Bhore Committee: medical + public health-integrated. • Director of Health and Family Welfare: adviser to State Government: health related • Director of Medical Education.

  18. State Health Directorate • Director of Health and Family Welfare: deputy directors: • Two types: regional, functional • Regional: inspect all branches : public health: area • Functional: specialists- MCH, nutrition.

  19. DISTRICT • Main unit of administration under a Collector • There are 6 administrative areas: • Sub-divisions • Talukas • Community Development Blocks • Municipalities, Corporations • Villages • Panchayats.

  20. District level • A Taluk: 200-600 villages • Rural areas: divided into blocks • Block: 100 villages: 80,000 to 1,20,000 population • In charge: Block Development Officer • Village Panchayats: rural local self-government

  21. Urban areas of districts • Town area committees: 5,000-10,000 • Municipal Boards: 10,000 to 2 lakhs • Corporations: above 2 lakhs • Town area: like Panchayat- sanitary services • Municipal Boards: construct, maintain roads, sanitation, street lights, water supply, register births, deaths • Corporations: Mayor- activities similar to municipalities- wider range.

  22. District Health Organization • District Health Officer • Deputies: • RCH Officer • District Project Management Officer • Surveillance Officer • District Medical Officer

  23. Panchayati Raj • Three tier rural local self-government in India • Panchayat: village level • PanchayatSamiti: block level • ZillaParishad: district level • Agencies of public welfare • Strengthen democracy- better people participation.

  24. At village level • Gram Sabha: • Assembly: all adults in village • Meet twice a year • Proposals : taxation, discuss annual programme, elects members of Gram Panchayat.

  25. At village level • Gram Panchayat: • Executive organ : Gram Sabha • Agency: planning, development- village • Strength: 15-30 • Population: 5-15,000 • Elected President • Vice President, Secretray • Functions: sanitation, public health, social and economic development - village

  26. At block level • Panchayati Raj Agency at Block level: PanchayatSamiti/JanapadaPanchayat • Function: execute community development programme-block • All heads of Village Panchayats, MLAs, MPs in that block area, representatives: women, scheduled castes/tribes • BDO: in-charge, guidance: Village Panchayats

  27. At District level ZillaParishad/ ZillaPanchayat • All heads of PanchayatSamitis in District, MPs, MLAs, women, SC /STs • Two persons: experienced-administration • Collector of District: non-voting member • Membership of ZP: 40-70. • Supervising, coordinating body • Functions, powers: vary from State to State • Some states: administrative functions

  28. Five Year Plans • Conceived to re-build rural India • Lay foundations: industrial progress, balanced development • Recognized health • Objectives : • Control/eradicate: major communicable diseases • Strengthen basic health services: PHC • Population control • Develop health manpower.

  29. Twelfth Five Year Plan (2012-2017) • Universal Health Coverage • Outcome indicators: • Reduce IMR to 25 • Reduce MMR to 100 • Reduce TFR to 2.1 • Control undernutrition : <5 years • Prevent anaemia (15-49 years): 28% • Prevent, reduce NCDs

  30. Focus areas • Access to services • Special services to vulnerable, disadvantaged • Train professionals • Increase public expenditure: health • Access to medicines • Drug regulation • Regulation medical practice

  31. NitiAayog • National Institution for Transforming India • Replace Planning Commission

  32. National Health Policy-2002 • MOHFW: National Health Policy: 1983- Health For All 2000 • Revised: 2002 • Acceptable standard of good health • Equitable access • Rational use of drugs

  33. Goals • 2005: • Eradicate polio • Eliminate leprosy • Increase state sector health spending: 5.5% to 7% of budget

  34. Goals • 2007: • Achieve zero growth of HIV/AIDS • 2010: • Eliminate Kala Azar • Reduce mortality by 50%: TB, malaria • Reduce blindness: 0.5% • Reduce IMR, MMR • 2015: Eliminate lymphatic filariasis

  35. NATIONAL HEALTH MISSION • Universal access to equitable, affordable & quality health care • Health System Strengthening in rural and urban areas • Reproductive-Maternal- Neonatal-Child and Adolescent Health (RMNCH+A) • Communicable and Non-Communicable Diseases.

  36. NATIONAL RURAL HEALTH MISSION • Launched in 2005 • Vulnerable population • Empowered Action Group States • Integration of all programmes • Decentralization • National Mission, State Mission, District Mission

  37. NATIONAL URBAN HEALTH MISSION • Urban population increase, slums • Improve health status of urban poor • Urban Primary Health Centre (UPHC) • Community Participation • Urban Social Health Activist (USHA) • MahilaArogyaSamiti (MAS)

  38. Voluntary Health Agencies • Voluntarism ?? • Voluntary Organizations, Non-Governmental Organizations • Administered : autonomous board • Meetings, funds • With or without paid workers • Conduct programmes • Further health, provide health services • Motor trucks-railways

  39. Functions • Supplementing work of Government • Pioneering • Education • Demonstration

  40. Continued…. • Demonstration • Guarding the work of Government • Advancing Health Legislation

  41. Indian Red Cross Society • Henry Dunant: Italy-1859 • Indian: 1920 • Over 400 branches • Programmes: health promotion, disease prevention

  42. Indian Red Cross Society • Relief work • Milk and food supplies: • Hospitals, schools , dispensaries • Milk powder, medicines • Armed forces: • Care of sick, wounded • Red Cross Home- Bangalore

  43. Indian Red Cross Society • Maternal and Child Welfare Services: • Financial aid, technical assistance: centres-MCH • Family Planning: Clinics • Blood Bank and First Aid: • St. Johns Ambulance Association • Training: first aid, home nursing

  44. Hind KushtNivaranSangh • Established: 1950, New Delhi • Earlier: BELRA • Financial assistance: leprosy homes, clinics • Health education • Training of medical workers • Research: field investigations • Journal: Leprosy in India

  45. Indian Council for Child Welfare • Established: 1952 • Services for India’s children • Opportunities, facilities-enable : develop • State and District Councils all over India

  46. Tuberculosis Association of India • Formed in 1939 • TB Seal Campaign every year- • Raise funds • Train doctors, health workers • Health education • New Delhi, TB Centre • Sanatorium, Kasauli • Sanatorium, Dharmapur

  47. Family Planning Association of India • Formed: 1949, Mumbai • Pioneers: family planning • Run Family Planning Clinics- aid from Government • Training: doctors, health workers • Answer enquiries

  48. Central Social Welfare Board • Survey needs for voluntary organizations • Financial aid to deserving organizations • Initiated: Family and Child Welfare Services: rural areas

  49. Other important VHA • Bharat SewakSamaj: • Achieve health: people’s actions • Improve sanitation in villages • Kasturba Memorial Fund: • Improving women-Gram Sevikas • All-India Blind Relief Society: • Coordinate institutions working for blind • Organize eye relief organizations • Professional Bodies: IMA, AIDA

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