🧠 High-Yield Topic for Nursing Competitive Exams – NORCET, AIIMS, NHM, RRB, ESIC, NCLEX
The Health System in India refers to the organized structure of institutions, people, and resources designed to deliver healthcare services to meet the health needs of the population.
🛠️ Responsible for:
🧑⚕️ Key Departments:
🛠️ Responsible for:
🧑⚕️ Led by: State Health Ministry
📌 Main Implementation Unit
🛠️ Services Provided:
🧑⚕️ In charge: Chief Medical Officer (CMO)
| 🏥 Facility | 🧍♀️ Covers Population |
|---|---|
| Sub-Centre (SC) | 5,000 (plain), 3,000 (hilly) |
| Primary Health Centre (PHC) | 30,000 (plain), 20,000 (hilly) |
| Community Health Centre (CHC) | 1.2 lakh |
| District Hospital | Full district |
🏙️ Includes:
Implemented under schemes like NUHM (National Urban Health Mission)
| 👤 Personnel | 🧠 Role |
|---|---|
| ANM / MPHW(F) | Maternal-child health, immunization, family planning |
| ASHA | Community mobilization, counseling |
| Health Assistant | Supervises ANMs and health workers |
| Medical Officer (PHC) | Supervises PHC services |
| CMO / DHO | Manages district-level health services |
| Nursing Officers | Provide inpatient care & assist in programs |
| 🏨 Level | 🧠 Description |
|---|---|
| Primary | Basic outpatient care, MCH, immunization – at SC, PHC |
| Secondary | Specialist services – at CHC, Sub-District Hospital |
| Tertiary | Advanced & super-specialty care – Medical Colleges, AIIMS |
✔️ Involves NGOs, private hospitals, trust-run institutions
✔️ Improves access to diagnostic, surgical, and emergency care
✔️ Used in schemes like Janani Suraksha Yojana, Free Dialysis Program
✅ Q1. What is the population coverage of one Sub-Centre?
🅰️ 5,000 in plains and 3,000 in hilly areas
✅ Q2. Who manages health services at the district level?
🅰️ Chief Medical Officer (CMO)
✅ Q3. Which is the tertiary care level in India?
🅰️ Medical colleges, AIIMS, super-specialty hospitals
✅ Q4. What is the urban health scheme in India called?
🅰️ NUHM – National Urban Health Mission
✅ Q5. What is the role of an ASHA worker?
🅰️ Community mobilization and health education
🧠 Important for Nursing Competitive Exams – NORCET, AIIMS, NHM, RRB, ESIC
Central health agencies are organizations working under the Ministry of Health & Family Welfare (MoHFW), Government of India, to manage, implement, and monitor health programs, medical research, policy, and regulation at the national level.
🔹 Apex body for health governance in India
🔹 Divided into two major departments:
| 🧪 Department | 📘 Focus Area |
|---|---|
| Health and Family Welfare | Public health, hospitals, health programs |
| Health Research | Medical research, research institutions |
🔹 Apex medical research body in India
🔹 Works under Dept. of Health Research
🔹 HQ: New Delhi
✅ Key roles:
🔹 HQ: New Delhi
🔹 Formerly known as NICD
🔹 Focus: Epidemiology, outbreak investigation, disease surveillance
✅ Functions:
🔹 Provides comprehensive healthcare to:
✅ Services:
🔹 HQ: New Delhi
🔹 Ensures food safety & public health
🔹 Regulates manufacturing, storage, distribution, sale & import of food
✅ Role:
🔹 Launched in 1992
🔹 Nodal agency for controlling HIV/AIDS epidemic
🔹 Implements NACP (National AIDS Control Programme)
✅ Services:
🔹 National regulatory authority for drugs & medical devices
🔹 Headed by the Drug Controller General of India (DCGI)
✅ Role:
🔹 Implementing body for Ayushman Bharat – PMJAY
🔹 Provides cashless health insurance up to ₹5 lakh/year
🔹 Coordinates with public & private hospitals across India
🔹 Premier tertiary care institution & research university
🔹 Located in New Delhi and across various states
🔹 Provides specialized clinical services, teaching & training
✅ Q1. What is the apex body for biomedical research in India?
🅰️ Indian Council of Medical Research (ICMR)
✅ Q2. Which organization manages food safety in India?
🅰️ FSSAI
✅ Q3. What is the function of NACO?
🅰️ HIV/AIDS prevention and control
✅ Q4. Which agency regulates drug approval in India?
🅰️ CDSCO
✅ Q5. What is the full form of NCDC?
🅰️ National Centre for Disease Control
🧠 Must-Know for NORCET, AIIMS, NHM, RRB, ESIC, NCLEX
The DGHS is the technical advisory body of the Ministry of Health & Family Welfare (MoHFW), Government of India, responsible for public health, medical education, and health infrastructure.
🏛️ Nirman Bhavan, New Delhi
👨⚕️ Headed by: Director General of Health Services
| 🔹 Area | ✅ Details |
|---|---|
| 💉 National Programs | Technical guidance for TB, leprosy, malaria, blindness, etc. |
| 🏥 Hospitals | Oversees Central Govt Hospitals (e.g., RML, Safdarjung) |
| 🎓 Medical Education | Coordinates with Medical Council, standard setting |
| 🚨 Health Emergencies | Disease outbreak response, disaster preparedness |
| 🧪 Drug Standardization | Works with CDSCO for medical supplies |
| 🧬 Family Welfare | Implements national health and family planning programs |
| 📦 Logistics & Supplies | Ensures supply chain of vaccines, drugs & diagnostics |
Established under Article 263 of the Indian Constitution, the Central Council of Health and Family Welfare is an inter-governmental advisory body for coordinated health planning between Centre and States.
| 🔹 Chairperson | Hon’ble Union Minister of Health
| 🔹 Members | Health Ministers of all States & UTs
| 🔹 Other Members | Experts from public health, education, social sectors
| 🧠 Function | 🔍 Details |
|---|---|
| 📜 Policy Discussion | Discuss & frame national health policy frameworks |
| 🤝 Centre–State Coordination | Improve collaboration between central & state govts |
| 📈 Review of Implementation | Monitor National Health Programmes performance |
| 🧠 Promote Research & Training | Guide medical, nursing, and paramedical education |
| 🗳️ Recommendations to MoHFW | Suggest policy actions and budgetary allocations |
✅ Q1. DGHS is the technical wing of which ministry?
🅰️ Ministry of Health and Family Welfare
✅ Q2. Where is the headquarters of DGHS?
🅰️ Nirman Bhavan, New Delhi
✅ Q3. Who chairs the Central Council of Health?
🅰️ Union Health Minister
✅ Q4. What is the primary role of DGHS?
🅰️ Provide technical advice and implement national health programs
✅ Q5. Under which article is the Central Council of Health formed?
🅰️ Article 263 of the Indian Constitution
🧠 Key for NORCET, AIIMS, NHM, RRB, ESIC, NCLEX Nursing Exams
The Central Level Health System refers to the national-level framework governed by the Ministry of Health & Family Welfare (MoHFW) to formulate policies, regulate health institutions, manage programs, and ensure nursing education and services in India.
| 🏢 Agency | 🎯 Function |
|---|---|
| MoHFW | Apex body for health and nursing policy in India |
| DGHS (Directorate General of Health Services) | Technical wing implementing national programs and hospitals |
| Indian Nursing Council (INC) | Regulatory body for nursing education and registration |
| Central Government Health Scheme (CGHS) | Healthcare for central govt employees |
| NHSRC (Health Systems Resource Centre) | Provides policy support and training in HR and nursing |
| AIIMS, JIPMER, PGIMER | Tertiary care, education, and nursing training institutions |
🔹 Indian Nursing Council (INC):
✔️ Prescribes syllabus for ANM, GNM, B.Sc., M.Sc. Nursing
✔️ Maintains National Register of Nurses
✔️ Inspects and recognizes nursing colleges
✔️ Centrally funded institutes like AIIMS, RAKCON, PGIMER provide:
🔹 High-standard nursing education
🔹 Advanced nursing specialties
🔹 Research and skill development
✔️ Nurses at central hospitals (RML, Safdarjung) and AIIMS are involved in:
🔹 National Health Programs – TB, Leprosy, RCH, NCDs
🔹 Immunization campaigns
🔹 Family planning services
🔹 Disaster management and trauma care
✔️ Handled by MoHFW & NHSRC:
🔹 Framing HR norms
🔹 Planning nurse-patient ratios
🔹 Recruitment rules for NORCET, ESIC, RRB
🔹 Promotions and postings in Central Govt. health facilities
✔️ Nurses participate in clinical research at:
🔹 ICMR Institutes
🔹 AIIMS
🔹 National programs (e.g., COVID care, NCDs)
✔️ Promote Evidence-Based Practice (EBP) in nursing care
| 👩⚕️ Designation | 📍 Posting Area |
|---|---|
| Staff Nurse (Level 7) | AIIMS, Central Govt. Hospitals |
| Nursing Officer (NORCET) | Group B – Permanent Central Govt Post |
| Senior Nursing Officer | ICU/OT/Trauma Centers |
| Assistant Nursing Superintendent | Supervisory level |
| Nursing Tutors | AIIMS, Central Nursing Colleges |
1️⃣ Nursing Officer
2️⃣ Senior Nursing Officer
3️⃣ Nursing Sister / Charge Nurse
4️⃣ Assistant Nursing Superintendent (ANS)
5️⃣ Deputy Nursing Superintendent
6️⃣ Nursing Superintendent
✅ Q1. Which body regulates nursing education in India?
🅰️ Indian Nursing Council (INC)
✅ Q2. Who conducts NORCET recruitment exam?
🅰️ AIIMS (under MoHFW)
✅ Q3. Which central agency provides policy for HR in nursing?
🅰️ NHSRC
✅ Q4. Full form of DGHS?
🅰️ Directorate General of Health Services
✅ Q5. What is the level of Staff Nurse in central govt?
🅰️ Level 7 (7th CPC)
🧠 Important for NORCET, AIIMS, NHM, RRB, ESIC & State PSC Exams
The State Health System in India functions under the State Ministry of Health and Family Welfare. It is responsible for the planning, implementation, supervision, and evaluation of health services within the state.
🔹 Works in coordination with central policies but has its own administrative authority
🔹 Covers both rural and urban populations
🔹 Focuses on primary to tertiary care, training, and public health management
| 🧑⚕️ Level | 👤 Key Authority |
|---|---|
| State Level | Health Minister of the State |
| Administrative Head | Principal Secretary / Health Secretary |
| Technical Head | Director of Health Services (DHS) |
| Other Heads | Director of Medical Education (DME), Public Health, Family Welfare |
✔️ Supervises medical & public health programs
✔️ Coordinates primary and secondary care centers
✔️ Oversees rural health delivery, epidemic control, maternal-child health
✔️ Manages medical & nursing education
✔️ Governs nursing schools, paramedical & allied health training
✔️ Supervises teaching hospitals and medical colleges
✔️ Executes National Health Mission (NHM) at state level
✔️ Focus on RCH, NCDs, immunization, adolescent health, nutrition
| 🏥 Facility | 📍 Function |
|---|---|
| Primary Health Centres (PHC) | First-level doctor-led outpatient services |
| Community Health Centres (CHC) | Referral unit with specialists (OBG, medicine) |
| Sub-District / Taluka Hospitals | Secondary-level services |
| District Hospital | Full-fledged secondary/tertiary care |
| Medical Colleges | Advanced tertiary care + education |
| 👤 Designation | 📍 Posting Area |
|---|---|
| Auxiliary Nurse Midwife (ANM) | Sub-centres, village level |
| Staff Nurse | PHC, CHC, District Hospitals |
| Public Health Nurse | Supervisory role in immunization & MCH |
| Sister-in-charge / Matron | Supervises ward-level nursing |
| Nursing Superintendent (State/District) | Nursing administration and planning |
| Nursing Tutors | State Govt. Nursing Colleges/Schools |
✔️ Implementation of National Health Programs
✔️ Recruitment and training of health personnel
✔️ Maintain hospital services at all levels
✔️ Control of communicable & non-communicable diseases
✔️ Promote maternal and child health
✔️ Monitor health indicators like IMR, MMR, TFR
✔️ Health budgeting and drug procurement
✔️ Conduct health awareness campaigns
✔️ States adapt and implement central schemes (e.g., Ayushman Bharat, JSY, RMNCH+A)
✔️ Report to MoHFW through HMIS (Health Management Information System)
✔️ Participate in CCHFW (Central Council of Health & Family Welfare)
✅ Q1. Who is the administrative head of health at the state level?
🅰️ Health Secretary / Principal Secretary
✅ Q2. Which directorate manages nursing education in the state?
🅰️ Directorate of Medical Education (DME)
✅ Q3. Who supervises PHCs and CHCs at the district level?
🅰️ Chief Medical Officer (CMO) / Civil Surgeon
✅ Q4. What is the state-level body for implementing NHM?
🅰️ State Health Mission (SHM)
✅ Q5. What is the role of the State DHS?
🅰️ Implements public health programs and oversees service delivery
🧠 Important for NORCET, AIIMS, NHM, RRB, ESIC, GPSC Nursing Exams
The District Health System is the operational unit of the state health system, responsible for delivering primary and secondary healthcare services to people within the district through coordinated institutions and personnel.
📌 It plays a key role in the implementation of National Health Programs and monitoring health indicators at the local level.
| 🧑⚕️ Level | 👤 Key Authority |
|---|---|
| District Health Officer (DHO) | In charge of public health and prevention programs |
| Chief Medical Officer (CMO) | In charge of district hospitals and curative services |
| District Program Manager | NHM programs & logistics |
| District Immunization Officer | Immunization campaigns (UIP, RI) |
| District Nursing Officer | Supervises nursing personnel and services |
| Civil Surgeon (optional) | In some states, heads curative and clinical services |
| 🏢 Facility | 🧾 Function / Coverage |
|---|---|
| District Hospital (DH) | Tertiary referral hospital for the district |
| Sub-District Hospital | Located in Taluka/Block – 100-bed capacity |
| Community Health Centre (CHC) | 4 doctors (medicine, surgery, OBG, pediatrics), mini-hospital for 1.2 lakh |
| Primary Health Centre (PHC) | First-level doctor-led care; 6-bed facility |
| Sub-Centre (SC) | Most peripheral post; 1 ANM + 1 MPHW per 5,000 population |
1️⃣ Planning & Implementation of national and state health programs
2️⃣ Monitoring & evaluation of health schemes (JSY, RCH, PMJAY, etc.)
3️⃣ Supervision of CHC, PHC & SC
4️⃣ Disease surveillance under IDSP (Integrated Disease Surveillance Programme)
5️⃣ Conduct vaccination campaigns (UIP, Pulse Polio)
6️⃣ Maintain birth/death and disease records
7️⃣ Health awareness through IEC/BCC campaigns
8️⃣ Training and capacity building of healthcare staff
9️⃣ Implementation of Ayushman Bharat at district level (HWC, PM-JAY)
| 👩⚕️ Cadre | 🧠 Key Responsibilities |
|---|---|
| Staff Nurse (PHC/CHC/DH) | Patient care, immunization, deliveries, outpatient support |
| Public Health Nurse (PHN) | MCH programs, ANC/PNC, health education |
| District Nursing Officer | Manages deployment, training, and supervision |
| ANM (at SC) | Home visits, antenatal care, immunization, FP |
| Nurse Educators | Training of ANMs and MPHWs in district training centers |
🔹 Coordination with State Health Mission (SHM)
🔹 Reports through HMIS (Health Management Information System)
🔹 Participates in district health planning meetings
🔹 Collaboration with NGOs and private sector (PPP)
🔹 Funds managed under Rogi Kalyan Samiti (RKS)
✅ Q1. Who is the technical head of the district health system?
🅰️ District Health Officer (DHO)
✅ Q2. What is the population coverage of one CHC?
🅰️ 1.2 lakh people
✅ Q3. Which officer handles immunization at the district level?
🅰️ District Immunization Officer
✅ Q4. Name the supervisory nursing officer at district level.
🅰️ District Nursing Officer
✅ Q5. What is the referral center for PHC and CHC in a district?
🅰️ District Hospital
🧠 Important for NORCET, AIIMS, NHM, RRB, ESIC & State PSC Nursing Exams
The Block Level Health System acts as a vital link between the district and village-level health services. It ensures supervision, monitoring, and implementation of national health programs across Primary Health Centres (PHCs), Sub-Centres (SCs), and Community Health Centres (CHCs) in the block.
🔹 A “block” is a subdivision of a district for administrative and healthcare purposes.
| 🏥 Facility | 📍 Population Coverage | 🧾 Services Offered |
|---|---|---|
| Community Health Centre (CHC) | ~1.2 lakh | Specialist care, referral from PHCs |
| Primary Health Centre (PHC) | ~30,000 (plain), 20,000 (hilly) | OPD, minor surgeries, MCH care, immunization |
| Sub-Centres (SCs) | ~5,000 (plain), 3,000 (hilly) | Most peripheral – ANM-led services |
| 👨⚕️ Post | 🎯 Responsibility |
|---|---|
| Block Medical Officer (BMO) | Head of all health activities in the block |
| Medical Officers (MO) | Clinical and administrative services in PHCs |
| Block Program Manager (NHM) | Planning, HR, and program implementation |
| Block ASHA Facilitator | Supervises and mentors ASHAs |
| Public Health Nurse (PHN) | MCH services, family planning, IEC/BCC |
| Staff Nurse / ANM | OPD, deliveries, immunization, nursing care |
1️⃣ Implement National Health Programs (JSY, RCH, TB, Leprosy, NCD, etc.)
2️⃣ Ensure functioning of PHCs and SCs
3️⃣ Monitor maternal and child health indicators
4️⃣ Organize health camps, outreach activities
5️⃣ Supervise ASHA, ANM, MPHW activities
6️⃣ Maintain birth and death records, HMIS reporting
7️⃣ Ensure availability of vaccines, drugs, logistics
8️⃣ Train frontline workers in skill development & protocols
9️⃣ Promote health education and IEC/BCC activities
🔹 RMNCH+A
🔹 Universal Immunization Program (UIP)
🔹 Rashtriya Bal Swasthya Karyakram (RBSK)
🔹 National Tuberculosis Elimination Program (NTEP)
🔹 Non-Communicable Disease Control (NPCDCS)
🔹 Janani Suraksha Yojana (JSY)
🔹 Ayushman Bharat – HWCs
✔️ Monthly review meetings led by BMO
✔️ Include ANMs, ASHAs, PHC MOs, Lab Techs
✔️ Discuss:
✔️ Conduct ANC, PNC, deliveries
✔️ Administer vaccines, family planning counseling
✔️ Health education in schools and communities
✔️ Participate in VHNDs (Village Health Nutrition Days)
✔️ Support epidemic response & outbreak control
✔️ Train ASHAs and maintain registers
✅ Q1. Who is the head of health services at block level?
🅰️ Block Medical Officer (BMO)
✅ Q2. Which health center covers ~1.2 lakh population?
🅰️ Community Health Centre (CHC)
✅ Q3. Who supervises ASHAs at the block level?
🅰️ Block ASHA Facilitator
✅ Q4. What is the role of a PHN at block level?
🅰️ MCH, immunization, health education supervision
✅ Q5. Which program focuses on school health screening at block level?
🅰️ RBSK (Rashtriya Bal Swasthya Karyakram)
🧠 Essential for NORCET, AIIMS, NHM, RRB, ESIC, GPSC & CHO Nursing Exams
🗓️ Panchayati Raj is the rural local self-government system in India. It empowers villages to plan and manage their own development and welfare activities, including health, sanitation, nutrition, and education.
✅ Based on the 73rd Constitutional Amendment Act, 1992
✅ Came into force in 1993
| 🏛️ Level | 📍 Coverage | 👤 Head |
|---|---|---|
| Gram Panchayat | Village level | Sarpanch / Gram Pradhan |
| Panchayat Samiti | Block level | Chairperson |
| Zila Parishad | District level | President / Adhyaksh |
🔹 Decentralized governance at grassroots
🔹 Conduct of regular elections every 5 years
🔹 Reservation for SC/ST and women (33%)
🔹 Gram Sabha – open assembly of all adults in village
🔹 Financial autonomy to implement schemes
✅ Panchayats play a vital role in rural health through:
| 🔬 Activity | ✅ Contribution |
|---|---|
| Immunization & MCH | Supporting outreach and mobilization |
| Sanitation & Hygiene | Promoting latrines, water safety, waste mgmt |
| Nutrition & ICDS | Supervising Anganwadi services |
| Health Infrastructure | Building/maintaining PHC, SC, HWC |
| Village Health Sanitation & Nutrition Committee (VHSNC) | Budgeting & monitoring local health plans |
| Disease Surveillance | Reporting outbreaks and facilitating camps |
✔️ Participate in Gram Sabha and VHSNC
✔️ Conduct health awareness drives
✔️ Coordinate with Panchayat for Vaccine Days & JSY
✔️ Maintain birth & death registration
✔️ Report MCH indicators & health data to panchayat
✅ Q1. Which Constitutional Amendment gave legal status to Panchayati Raj?
🅰️ 73rd Amendment Act, 1992
✅ Q2. What is the lowest unit in the Panchayati Raj system?
🅰️ Gram Panchayat
✅ Q3. What percentage of seats are reserved for women in Panchayati Raj?
🅰️ 33%
✅ Q4. What is the role of VHSNC?
🅰️ Prepare and monitor village health plans
✅ Q5. Who heads the Zila Parishad?
🅰️ Zila Adhyaksh (President)
🧠 Crucial for NORCET, NHM-CHO, RRB, GPSC, AIIMS Nursing Exams
The Village-Level Health System is the foundation of India’s public health delivery, ensuring basic healthcare, health promotion, disease prevention, and maternal-child services directly within the rural population.
✅ Focus on community-based, preventive & promotive care
✅ Supported by Village Health, Sanitation & Nutrition Committees (VHSNCs)
| 👤 Worker | 🎯 Function |
|---|---|
| ASHA (Accredited Social Health Activist) | Community mobilizer, health education, linkage to PHC |
| ANM (Auxiliary Nurse Midwife) | Provides MCH care, immunization, FP, disease surveillance |
| AWW (Anganwadi Worker) | Provides nutrition, preschool education, growth monitoring |
| MPHW (Male) | Environmental sanitation, malaria surveillance, reporting |
| Village Health Guide / Traditional Birth Attendant (TBA) | Basic health services & referrals (in some areas) |
| 🏥 Facility | 👥 Coverage | 🧾 Key Services |
|---|---|---|
| Sub-Centre (SC) | 5,000 (plain) / 3,000 (hilly) | First contact point with trained worker (ANM) |
| Health & Wellness Centre (HWC) | Covers SC or PHC area | Expanded services incl. NCD screening, OPD |
| Anganwadi Centre (AWC) | One per ~1,000 population | Nutrition, health checkups, referral |
1️⃣ Maternal & Child Health (MCH)
2️⃣ Immunization (RI, Pulse Polio)
3️⃣ Family Planning & Counseling
4️⃣ Basic OPD Care & Referrals
5️⃣ Nutrition Supplementation (ICDS)
6️⃣ Health Education & Awareness
7️⃣ Water, Sanitation & Hygiene (WASH)
8️⃣ Village Health Nutrition Days (VHNDs)
9️⃣ NCD Screening (at HWCs)
🔟 Birth, Death & Disease Reporting
🔹 A subcommittee under Gram Panchayat
🔹 Ensures community participation in health planning
🔹 Utilizes untied funds for local needs (cleaning, minor repairs)
🔹 Monitors nutrition, sanitation, and hygiene programs
✔️ Conduct antenatal/postnatal checkups
✔️ Organize immunization sessions with ASHA & AWW
✔️ Track high-risk pregnancies
✔️ Provide health talks during VHNDs
✔️ Maintain records (ANC, delivery, immunization)
✔️ Train ASHAs and monitor home visits
✔️ Referral to PHC/CHC in complications
✅ Q1. Who is the first health contact person in the village?
🅰️ ASHA
✅ Q2. Which center provides basic maternal care in a village?
🅰️ Sub-Centre (SC)
✅ Q3. What is the population norm for one Anganwadi Centre?
🅰️ 1,000 people
✅ Q4. What committee monitors village health services?
🅰️ VHSNC (Village Health Sanitation & Nutrition Committee)
✅ Q5. Who organizes VHND in the village?
🅰️ ANM, ASHA, and AWW together