๐ Organisation and administrationย of health system in india
India is a democratic country which is made up of 28 states and eight union territories which are further divided into districts and talukas. Thus, providing health care in India is very challenging because India has different areas which include inaccessible forests as well as mountains and desert areas and many areas in terms of population are also there, so it is a challenge to provide health care to everyone. But since India is a welfare state, the government ensures that every citizen gets basic health services because all these have to work as per the constitutional provisions of India.
๐ Health services organization at different levels
โก๏ธIn India, the line of authority of the organization for health services i.e. the responsible structure of the administration starts from the national level and goes all the way down to the block level. Due to this organization, health services can be provided to the smallest rural areas. This organization is divided into four stages.
Central level
State level
District level
Block level
๐ write Principles of organization and administration
๐1. The main responsibilities are of one person but different responsibilities are given for each activity, for example, CHC- MO
๐2. When any work is to be done, it should be done in coordination with the main authority.
๐3. When any disease prevention work is to be done or treatment is to be given, each authority should be coordinated.
๐4. Administration should be based on financial budget with great success.
๐5. If any planning is to be done, its frame work should be carefully prepared and its points should be prepared (micro plan).
๐6. Provide necessary education to the staff for the program that is being implemented or running. So that the program becomes effective and progressive. For example pulse polio, IMNCI and IMMUNIZATION.
๐7. It is necessary to know the opinion of the people in every health activity so that people can be given proper health education and information and people’s cooperation can be obtained in health activities.
๐8. Planning of every program should be done on scientific basis.
๐9. Effective evaluation of the program that is running and knowing the progress.
๐10. Provide favorable conditions for every member of the health team for the staff.
๐ Central Level:-
Uninion Minister of Health and Family Welfare –Shree Mansukh Bhai Mandaviya
DGHS – Director General of Health Services
CDCO – Central Drugs Control Organisation
HR – Health Research
WHO โ World Health Organization
SEARO โ South East Asia Regional Office
๐ Responsibility of central health organization or Responsibility of health ministry
Policy making
Planning
Guidance
Co-ordination
Evaluation
๐1. To make international health regulation and collect information related to it.
๐2. To administer central health institutions including,
A. All India Institute of Medical Science which is in Delhi (AIIMS).
B. Post graduation Institute of Medical Science which is in Chandigarh.
C. Indian Institute of Hygiene and Public Health which is in Calcutta.
All these are properly managed by the Ministry of Health.
๐3. To provide necessary opportunities to advance research, to start research centers and to help them.
๐4. For education, such as medical education, nursing education, pharmacological branch, etc. To make efforts to update knowledge.
๐5. Drugs control, including maintaining the quality of drugs. Regulating it to prevent its misuse and keeping the price of drugs affordable to the people.
๐6. Collecting population census and vital statistics and publishing necessary information.
๐7. Helping to go abroad for educational purposes and providing necessary scholarship for that.
๐8. Preparing regulations related to labor.
๐9. Planning for implementing health skills and making necessary amendments in it.
๐10. Taking intensive steps to prevent communicable diseases.
๐11. Prevention of food adulteration.
๐12. Control of poisonous drugs
๐13. Sanitary control of food
๐14. Helping in public health activities.
๐15. Working with the Central Health Bureau which is in Delhi for health education.
๐16.To collect and publish information on vital statistics.
๐ Function of D.G.H.S (Director of general health services)
D.G.H.S (Director of general health services)-
Lieutenant Governor
Shri Vinai Kumar Saxena
โ ๏ธThere are three other units under D.G.H.S.,
Medical care and hospital ๐ฅ
Public health
General administrative unit
For the above services, a commissioner was appointed for rural health service and mobile hospital in 1973.
FUNCTION OF DIRECTORATE GENERAL OF HEALTH SERVICES (D.G.H.S) The functions of D.G.H.S are as follows,
๐1. General function
๐2. Specific function
๐ 1. General function
a. Survey
b. Planning
c. Co-ordination
d. Programme
e. Health matters
It works to give approval to each work.
๐ 2. Specific function
a. International health relations and quarantine (to check and isolate passengers coming from diseased areas)
b. Drugs control and standards of drugs
c. Medical store depot
d. Medical education (for colleges)
c. Medical research
d. Health scheme
e. National health programme
f. Central health education bureau (เคฌเฅเคฏเฅเคฐเฅ)
g. Health statistics
h. National Medical library
โก๏ธ 1.International health relations and quarantine:- Works for health related activities. Preventive and promotive)
โก๏ธ2. Drugs control and standard of drugs:- Maintains quality and standard and works on distribution control. It is responsible for checking the quality of imported drugs as per the Drugs Act of 1940.
โก๏ธ3. Medical care depot:- Medical stores and depots run by the union government such as those located in Kolkata, Hyderabad and Madras. It provides medical equipment to the state government and provides high quality drugs.
โก๏ธ4. Post graduation training:- It is responsible for working for post graduation in various national training in India, all these institutions work under B.G.H.S. Through it, they train different categories of health persons.
โก๏ธ5. Medical education for colleges
in which,
All India Institute of Medical Science of New Delhi
Post Graduate Institute of Medical Education Chandigarh and Delhi
National Institute of Nutrition in Hyderabad
All Indian Institute of Hygiene and Public Health at Kolkata
National T.B Institute of Bangalore
Central research institute of Kasauli
โก๏ธ6. Medical research
A large number of research centers have been organized in our country by the Indian Council of Research. such as,
Cancer Research Center Kolkata.
Virus Research Center Pune.
National Research Center Hyderabad.
tuberculosis and chemotherapy at Chennai.
National Institute of Medical Health in Neuroscience at Bangalore.
Rajkumari Amrut Kaura(R.A.K) College of Nursing New Delhi.
National Institute of Communicable Diseases at New Delhi.
National Institute of Health and Family Welfare New Delhi.
Statistical Research Centre.
The above National Institute and Nutritional Center maintains all these institutions.
โก๏ธ7. Health scheme:- Central government provides medical relief to its employees and their families (for example, heart disease, kidney disease or other major problems)
โก๏ธ8. National health programme:- In which the director plays a major role in planning and co-ordination.
โก๏ธ9. Central health education bureau:- Provides training for health education to different categories of health workers. Prepares literature to create awareness about health among the people.
โก๏ธ10. Health statistics:- Centralizes collection, analysis and evaluation to obtain health statistics.
โก๏ธ11. National health library:- Performs the work of medical health collection and publication and sends information.
๐ write shot notes Central council of health in india (Central Council of Health in India)
๐Central Council of Health was established on 9 August 1952 by the order of the resident. The Union Health Ministry and the State Health Ministry are responsible for promoting health measures and planning to improve the health program, which are as follows,
A. Policy making
B. Legislation
C. Recommendation
๐ For continuous consultation on the tasks to be done in the concurrent (immediate) list and for maintaining co-operation between the central and state for understanding, the Central Council of Health has been established. It carries out the work of implementation and evaluation of the tasks in all the programs. The Health Minister is its chairman.
The State Health Minister is its member.
Function of Central Council of Health โจ๏ธ
๐1. Increases the facility of all activities related to health aspects such as preventive environmental hygiene, nutritional health education, training and research. Considering and approving such matters, it prepares policies.
๐2. To develop medical and public health related patterns for the development of the country. To prepare its proposal and legislation.
๐3. If the central government gives grants to the state government, it should make recommendations for it, and conduct periodical evaluation of whether all the state grants are being used properly.
๐4. Establish an institute that works by maintaining co-operation between the state health administration and the central administration.
๐ Health organization at State level (Tell the health organization at the state level)
Gujarat State Health Minister-Shri Rishikesh Bhai Patel
In India, all matters related to health are handled by the state government. The administration pattern of all the states in India is similar to the central level, in which the work is done by the State Ministry of Health and the State Health Director
.
๐ State Ministry of Health
The State Minister of Health in the state is the head of the Health and Family Welfare Department and the Health Secretary and the Commission of Health and various directors work under him. He has his own political vision and according to that, the Health Secretary and a large number of administrative staff work accordingly.
๐ State Health Director
This is a technical wing of the State Level Health and Family Welfare Department, in which the Director of Health and Family Welfare is its head, under which the work of Public Health and Health and Family Welfare Services as well as Family Planning Services etc. comes to help him. There is also a Deputy Director and in a state like Gujarat, there is also a Regional Deputy Director whose main job is to provide family planning services and health education.
๐ Regional Deputy Director (Regional Deputy Director)
Assistant R.D.D (regional deputy director) who is a different departmental head who has to supervise and manage the operations of the hospital and other agencies in his area. There are a total of six RDDs in the state of Gujarat which are as follows,
6 Ahmedabad
๐ Functions of state health department
Medical care – It works to provide adequate medical care and preventive care in rural and urban areas.
National health programme – Actions have to be taken to implement the National Health Programme.
Communicable Disease control – Works for the control of Communicable Diseases, including planning, implementation and evolution.
Promotion of health – Performs various activities for the promotion of health, including RCH (Reproductive and child health) immunization programme and school health programme.
Food adultration – Maintains the standard of food adultration and maintains the standard of drugs.
Health and vital statistics – Collects necessary information in accordance with health and vital statistics.
Reporting – Special reports are made on certain diseases that require adequate attention.
Health services – Provide health services everywhere, including providing health services in jails.
Facility – Provides facilities for providing education in medical, dental and nursing branches, pharmacy and sanitation etc. branches.
Research- It gives importance to research and encourages it and provides facilities related to it.
Indigenous system of medicine (Swadeshi) – In which it encourages the development of branches like Homeopathy, Ayurvedic, Allopathic etc.
Laboratory – Maintains a laboratory for the production and distribution of vaccines and toxoids which is in Baroda.
Storage of hospital drugs material and distribution.
Co-ordination – Maintains coordination for the development of health services through local organizations and supervision of its workers.
Sets and maintains standards of different universities, councils, education branches, research centers and different practices. Maintains health problems in which necessary action is taken to identify, study and reduce morbidity and mortality of diseases.
Regional Investigation Laboratory maintains and makes efforts to remain active.
๐Health organization at District Level (District Level Health Organization):-
Like the State level, at the district level, health services are headed by CDHO (Chief District Health Officer) while for medical care, CDMO is the head. CDHO is responsible for the supervision of all PHCs and block levels in the district, besides being involved in the supervision of health related to the municipality. Every district has a block health which is at the taluka level.
๐ Functions CDHO (Chief District Health Officer)
Preventive care
Curative care
Promotive care
According to these three issues, they perform different functions.
A. Direct supervision of PHC
B. Supervision of subcenter
C. Supervision and planning of whether the people of the community get adequate health services or not.
D. To see whether the National Health Program which is running up to the community level is reaching the people or not.
E. Runs the training program.
F. Takes responsibility for posting, transfer or leave of health staff.
G . Delivers family welfare services to the people
๐ Organization of block level
๐There are 100 villages under a block, it includes a population of 80,000 to 2,00,000 (2 lakhs) which does all the work related to health. PHC and sub-centers are under it.
๐In the health organization of the block level, they organize health programs in the area associated with them. Each service provides statistical information and provides it to the district.
๐ Block level
BDO (Block development officer)
โฌ๏ธ
BEO (block extension officer)
โฌ๏ธ
FHS (female health supervisor)
โฌ๏ธ
BICO (Block information and communication officer)
โฌ๏ธ
Clerk
โฌ๏ธ
Peon
๐ Municipal Corporation
It is formed when the population of a city exceeds two lakhs.
It has a head mayor, who leads it.
It has a council.
Councilors are elected from different wards of the city.
There are different committees of councilors in the corporation.
Its tenure is 5 years.
At the administrative level, the executive agency includes the CEO i.e. Chief Executive Officer, who is also called commissioner, secretary, engineer and health officer.
โ ๏ธFunctions
The functions of a municipal corporation are similar to those of a municipal board.
But it is on a larger scale. Which includes the following.
health and sanitation of city
construction and maintenance of roads
Safe drainage system
street lighting
Safe water supply
maintenance of hospitals and dispensaries
Education
registration of birth and death
๐ Local level
๐ Municipality
Municipality or municipality whose population is more than 10,000 and up to two lakhs. The municipality or corporation is responsible for providing services in urban areas.
๐ Function of Municipality
1.extra disposal and sanitation
2.Maternity services in which services are provided by FHW, which has a full-time or part-time medical officer.
Provides family planning services.
Control of stray dogs and disposal of dead animals.
Collecting statistical information such as Birth, death, marriage etc..
Immunization
Water supply
Control of food and food sanitation.
Organization of city dispensary and indoor.
The Municipal board has a head or president who is selected by the committee members of each board.
๐ Town
๐Town is an area between a city and a village. It is neither a village nor a city.
๐Town area committee comes under the administration of the district collector. Which is found in states like MP, UP, West Bengal, Kerala, Assam, Jammu and Kashmir, Himachal Pradesh etc.
๐They are like Panchayats. Town area committee covers a population of 5,000 to 10,000 and is responsible for maintaining sanitation in that area.
๐ Rural area/Rural Administration (เคฐเฅเคฐเคฒ เคเคฐเคฟเคฏเคพ / เคฐเฅเคฐเคฒ เค เคกเคฟเคฎเคฟเคจเฅเคธเฅเคเฅเคฐเคพเคท Village level
A. Gram Sabha B. Gram Panchayat
C. Justice Panchayat
Community development block or Taluka Panchayat
District Council or District Panchayat
๐ Village level
A. Gram Sabha
A unit of the Panchayat system in which a meeting of all the adult people of the village is held. It is called Gram Sabha, which meets twice a year. Gram Sabha is also held when the superior officer orders for special work.
B. Gram Panchayat
The Gram Sabha is the executive organ of the Gram Sabha, and it has 15 to 30 members. The Aldult of the Gram Sabha selects the members of the Panchayat. The head of the Gram Panchayat is called Sarpanch or Mukhi. The term of the members of the Gram Panchayat is five years, the day in the year in which the election of the Up Sarpanch is held is considered the first day of the members.
Function of gram panchayat
Sanitation
Street light
Control of disease
Adult literacy
Youth club
Statistical birth and death registration The secretary of the panchayat helps the panchayat in various activities.
C. Justice Panchayat
It is the judicial organ of the gram sabha. Which tries to dispose of civil cases and minor criminal cases. And also imposes fines up to one hundred rupees when necessary
๐ Taluka Panchayat (community block)
A block consists of 100 villages or a population of 80,000. Which is administered by a panchayat committee. This committee consists of the sarpanchs of 100 villages. In addition to this, the block has MLA Members of (legislative assembly) who take part in the block area.
In addition to the representative of MLA Schedule cast, schedule trip, there is a (block development officer) in the block, who is the (official secretary) of the panchayat committee.
๐Function
Supervises the Panchayat Samiti and helps in development work.
Works as an agent of the State Government.
๐ District level / District Council
The district level is the local self-governing unit. The members of this committee are the heads of all the committees of the district, which also include MLAs. The Collector is a non-voting member in the District Council.
Function
The District Council acts as a supervisory and co-ordination body. The functions of this committee vary from state to state.
In Gujarat, many financial functions of PHC and Council are done by D.H.O.
Education
Construction
Community development programme
From 2 October 1952, the community development programme was started in India as part of the National 5 year plan and this scheme became very popular.
โ ๏ธObjective
The main objective of this scheme is to improve and help the lives of 80,000 people of rural areas.
To reduce poverty, ignorance and disease of the people. ๐Function
The planning and implementation of the health programme is the responsibility of the authority.
Development of agriculture
Improvement of communication
Education
Improvement of health
Rural sanitation
Improvement of housing arts, crafts, cottage, industries
Animal husbandry (related to animal husbandry)
Co-operative marketing
Special programme for women and children and baalvadi
Administration or setting pattern of community health
BDO( Block development officer )
Extension officer who is trained by the government handles the work of each block.
Social education organizer(S.E.O) Male and female
Village level worker – 10
Public health worker- 1
Mukhya Sevika – 1
๐How many women are also involved in this who work with the village leader and solve problems with the help of the extensor officer, organize meetings to know and fulfill the needs of the people, in this too every PHC is involved. Three servants work under the block.
๐ People’s health as well as agricultural, industrial or education etc. are also included in this work. This community development programme is for the people, by the people, for the people. Under this project, 300 villages, an area of โโ150 to 200 miles and a population of about 60 to 10000 are covered.
๐At present, there are more than 50,000 blocks in our country. Our late Pandit Jawaharlal Nehru used to say, “These centers of human activities are like a lamp that spreads light in the surrounding darkness.”
๐ Structure of Nursing services at central level
Nursing Advisor at central level is a responsible person of the government.
Function of central level nursing servicesโจ๏ธ
๐1. Prepares policy for nursing.
๐2. Discusses and plans issues related to nursing and sends it to the government.
๐3. Maintains the standard of nursing services and prepares a policy for the hours of nursing duty.
๐4. Prepares job description.
๐5. Evaluates nursing services.
๐6. Upgrades nursing education, including organizing short term courses. Organizes refresher courses and plans how to use the help provided by WHO and UNICEF.
Organization at state level
At the state level, the assistant director of nursing is responsible for the nursing profession of the entire state.
Function
Decides a policy for maintaining the standard of nursing services.
Supervises.
Performs necessary work for posting and transfer of nursing staff.
Resolves health problems of nursing.
Nursing services at district level
Very few states have the post of district nursing supervisor.
๐ Function
District Health Services DPHNO supervises the health workers and health assistants of PHC and subcenters. 2. Provides necessary guidance.
Conducts evaluation.
Organizes refresher courses for workers.
Organizes seminars and camps for workers whenever necessary so that their knowledge can be upgraded.