Professional Documents
Culture Documents
Category Health Workers PDF
Category Health Workers PDF
Category Health Workers PDF
Introduction
Health is the birth right of every individual. Today health is considered more than a
basic human right; it has become a matter of public concern, national priority and political
action. Our health system has traditionally been a disease-oriented system but the current
trend is to emphasize health and its promotion.
Definition
Health:
WHO: defined health as “a state of complete physical, mental, social and spiritual well being
not merely the absence of disease or infirmity.”
WEBSTER: defined health as “ a quality of life resulting from total functioning of the
individual that empower him to achieve personally satisfying and socially useful life.”
H.S HAYMAN: defined health as “ a state of feeling sound in body, mind, and spirit with
sense of reserve power.”
Consumers are less informed about health services than anything else they purchase.
2) To raise and pool the resources accessible to pay for health care.
3) To generate human and physical sources that makes the delivery service possible.
4) To set and enforce rules of the game and provide strategic direction for all the different
players involved.
Characters of Health Care Delivery System
1) Orientation towards health.
2) Population perspectives.
4) Focus on consumer.
6) Constrained resources
HEALTH CARE DELIVERY SYSTEM IN INDIA
In India it is represented by five major sectors or agencies which differ from e ach other
by health technology applied and by the source of fund available. These are:
I. PUBLIC HEALTH SECTOR
A. Primary Health Care
Primary Health Centres, Sub- Centres.
B. Hospital/Health Centres
Community Health Centres, Rural Health Centres, District Hospitals/ District Health
Centre, Specialist Hospitals, Teaching Hospitals.
C. Health Insurance Schemes
Employees State Insurance
Ayurveda
Sidda
Unani
Homeopathy
Naturopathy
Yoga
Unregistered practioners
National level
Community Health
Centres Sub- District / Taluk Hospital
PHCs
Sub – Centres
People/ Community/
Society/ Villages
Health administration at the central level
The official organs of the health system at the national level consist of 3 units:
1. Union Ministry of Health and Family Welfare.
a. Department of Health
It is headed by a secretary to the Government of India as its executive head, assisted by
joint secretaries, deputy secretaries, and a large administrative staff.
Functions
This includes the Union list and the Concurrent list. (Article 246 of the Constitution of India)
Union list
1. International health relations and administration of port-quarantine
2. Administration of central health institutes such as All India Institute of Hygiene and Public
Health, Kolkata; National Institute for Control of Communicable Diseases, Delhi, etc.
4. Regulation and development of medical, nursing and other allied health professions.
4. Vital statistics.
5. Labour welfare.
2. Technical operations: looks after all components of the technical programme viz.
Sterilization/IUD/Nirodh, post partum, maternal and child health, UPI, etc.
4. Evaluation and intelligence: helps in planning, monitoring and evaluating the programme
performance and coordinates demographic research.
c. To educate every individual to develop a conviction that a small family size is valuable
and to popularize appropriate and acceptable method of family planning
FAMILY WELFARE
SECRETARY TO GOVERNMENT
ADNL. DIR. A.V ADNL. DIR. (P) ADNL. DIR. (PH) ADNL. DIR. (M)
ADG(ME)
DDA(C&B)
NSG ADV
DY.DIR(LIB)
ADG(OPT H)
DIR(CGHS)
ADG(CGHS)
DDA(CGHS)
CHIEFARCHT
DDG(ST ORES)
DIRECTOR A.V - Director Audio-Visual Aids.
Broad casting.
ADMIN - Administration.
CABINET MINISTER
Specific functions
1. International health relations and quarantine
All the major ports in the country and international airports are directly controlled by
Directorate General of Health Services. All matters relating to obtaining assistance
from International agencies and the coordination of their activities in the country are
undertaken by Directorate General of Health Services.
2. Control of drug standards
The Drugs Control Organization is a part of DGHS. Its primary function is to lay
down and enforce standards and control of the manufacture and distribution of drugs
through both Central and State Government Officers. It also has the powers to test the
quality of the imported drugs.
3. Medical store depot
The union government runs medical store depots at Mumbai, Chennai, and Kolkata
etc. These depots supply the civil medical requirements of the Central and State
Governments. The Medical Stores Organization endeavour to ensure the highest
quality, cheaper bargain and prompt supplies.
4. Post graduate training
The DGHS is responsible for the administration of the national institutes. Such as All
India Institute of Hygiene and Public Health at Kolkata, National Institute of Mental
Health Science at Bangalore etc.
5. Medical education
The DGHS is directly in charge of the following medical colleges in India; the Lady
Hardinge, the Maulana Azad and the medical colleges at Pondicherry and Goa and
many medical colleges in country are guided and supported by the centre.
6. Medical research
The council plays a significant role in aiding, promoting and coordinating scientific
research on human diseases, their causation, prevention and cure. The research work
is done through the councils several permanent research institutes, research units,
field surveys etc. It maintains Cancer Research Centre, Tuberculosis Chemotherapy
Centre at Chennai.
7. Central government health scheme
8. National health programmes
The various health programmes for the eradication of the malaria and for the control
of tuberculosis, filaria, leprosy, AIDS and other communicable diseases are going on.
The DGHS plays a very important role in planning, guiding and coordinating all the
national health programmes in the country.
9. Central health education bureau
An outstanding activity of bureau is the preparation of education material for creating
health awareness among the people.
10. Health statistics
The DGHS is responsible for maintenance of statistics regarding health.
11. National medical library
The central medical library of DGHS was started in 1966, to help in advancement of
medical health and related sciences by collection, dissemination, and exchange of
information.
DIRECTORATE GENERAL OF HEALTH SERVICES (DGHS)
Organization:
HEALTH MATTERS
TEAM OF DEPUTIES
The Central Council of Health was set up by a Presidential Order on August 9, 1952,
under Article 263 of the Constitution of India for promoting coordinated and concerted action
between the centre and the states in the implementation of all the programmes and measures
pertaining to the health of the nation. The Union Health Minister is the chairman and the state
health ministers are the members.
Functions
1. To consider and recommend broad outlines of policy in regard to matters concerning
health in all its aspects such as the provision of remedial and preventive care,
environmental hygiene, nutrition, health education and the promotion of facilities for
training and research.
2. To make proposals for legislation in fields of activity related to medical and public health
matters and to lay down the pattern of development for the country as a whole.
The major functions which are performed by the secretariat which includes the following
LEGISLATION&RECORDING
OFFICER
MC(5)
JD FW RCH JD JD JD JD JD
JD JD
CMD M
R HET TB H&P
HFW LEP LAB
TH(14)
TC(5) R
DD DD DD DD DD
DC(1)
DTC(24) DD FW TB H&P LEP M PHA
Ns g.C(4)
ADNS(2)
Nsg.S(11)
AD - Additional Director.
JD - Joint Director.
MC - Medical Colleges.
TH - Teaching Hospitals.
DC - Dental Colleges.
Regional
Functional.
The regional directors inspect all the branches of public health within their
jurisdiction, irrespective of their specialty. The functional directors are usually specialists in a
particular branch of public health such as mother and child health, family planning, nutrition,
tuberculosis, leprosy, health education, etc.
Responsibilities
1. It studies in depth the health problems and needs in the state and plans schemes to solve
them.
2. Provide curative and preventive services.
3. Provision for control of milk and food sanitation.
4. Assumes total responsibility for taking steps in prevention of outbreak of communicable
diseases.
5. Establishment and maintenance of central laboratories for preparation of vaccines.
6. Promotion of health education.
7. Promotion of health programmes such as family planning and school health.
8. Recruitment of personnel for rural health services.
9. Planning and carrying out surveys in relation to nutrition, health education etc.
10. Collection, tabulation and publication of vital statistics.
11. Establishing training courses for health personnel and formulating job descriptions.
Eg; for health worker, sanitary inspector.
12. Coordination of all health services with other ministeries of state such as minister of
education, agriculture with the central health ministry and voluntary agencies.
AT THE DISTRICT LEVEL
The district is the most crucial level in the administration and implementation of
medical /health services. At the district level there is a district medical and health officer or
CMO who is overall Subdivisions
i. Tehsils (talukas)
iv. Villages
v. Panchayaths
Most of the districts in India are divided into two or more subdivisions, each in
charge of an assistant collector or sub-collector. Each division is again divided into tehsils in
charge of a Tehsildar. A tehsil usually comprises between 200 and 600 villages. Finally, there
are the village panchayaths, which are institutions of rural local self- government. The urban
areas of the district are organised into the following local self-government:
o Town area committee – 5,000 – 10,000
The town area committees are like panchayaths. They provide sanitary services.
The municipal boards are headed by a chairman/president, elected usually by the members.
Corporations are headed by mayors. The councilors are elected from different wards of the city.
The executive agency includes the commissioner, the secretary, the engineer, and the health officer.
The activities are similar to those of the municipalities but on a much wider scale.
HEALTH ORGANIZATION AT DISRICT LEVEL
HEALTH MINSTER
HEALTH SECRETARY
DIRECTOR OF H&FW
DISTRICT COMMISSIONER
PHN
WARD SISTER
TD/CHV/AWW
DHO - District Health Officer.
TD - Trained Dias.
The panchayathi Raj institutions are accepted as agencies of public welfare. All
development programmes are channelled through these bodies. The panchayathi Raj institutions
strengthen democracy at its root and ensure more effective and better participation of the people in
the government.
Gram sabha: It is the assembly of all the adults of the village,which meets atleast twice a
year. It considers proposals for taxation, discusses the annual programme and elects members
of the gram panchayat.
Gram panchayat: it is an executive organ of the gram sabha, and an agency for planning and
development at the village level. Its strength varies from 15 to 30 and covers 5000 and 15,000
population and more. Members of panchayat hold office for a period of 3 to 4 years.every
panchayat has an elected president(sarpanch), a vice president, and a panchayat secretary.
The power of panchayat secretary cover the entire field of civic administration, including
sanitation and public health and social and economic development of village.
Nyaya panchayat: it consists of 5 members from the panchayat. Its functions includesolving
of disputes between two groups, two parties etc.
At the block level
The panchayathi raj agency at the block level is the panchayath samithi. The
panchayathi samithi consists of all sarpanchs of the village panchayaths in the block. The block
development officer is the ex-officio secretary of the panchayath samithi.
The prime function of the panchayat samiti is the execution of the community development
programme in the block.
The block development officer and his staff give technical assistance and guidance to the
village panchayaths engaged in the development work.
The zilla parishad is the agency of rural local self- government at the district level. The
members of the zilla parishad include all leaders of the panchayath samithis in the district, MPs,
MLAs of the district, representatives of SC, SD and women, and 2 persons of experience in
administration. The collector of the district is a non-voting member. Thus, the membership of the
zilla parishad is fairly large varying from 40 to 70.
The zilla parishad is primarily supervisory and coordinating body. Its functions and
powers vary from state to state. In some states, the zilla parishads are vested with the administrative
functions.
Healthcare systems
The healthcare system is intended to deliver the healthcare services. It constitutes the
management sector and involves the organisational matters. It operates in the context of the
socioeconomic and political framework of the country. In India, it is represented by five
major sectors and agencies which differ from each other by the health technology applied and
by the source of funds for the operation.
i. Public health sector
c. ICDS scheme
2. Sub-centre level:
This is the peripheral outpost of the existing health delivery system in rural areas.
They are being established on the basis of one sub-centre for every 5000 population in
general and one for every 3000 population in hilly tribal and backward areas. Each sub-
centre is manned by one male and one female multipurpose health worker.
Functions
a. Mother and child healthcare
b. Family planning
c. Immunization
d. IUD insertion
h. Referral services.
i. Training of health guides, health workers, local dais, and health assistants.
MAIN PHC
Medical officer -1
Staff nurse -3
Pharmacist -1
Driver - 1
Group D worker - 4
ORGANIZATION CHART OF PRIMARY HEALTH CENTER
ZILLA PARISHAD
SDA (1)
DRIVER(1)
GROUP D
OFFICIALS(4)
Sr. HAM : Senior Health Assistant Male
1. Conduct survey of the sub centre area and maintain records of all families.
2. Maintain information of all vital events.
3. Participate in malaria control programme.
4. Participate in leprosy control programme.
5. Participate in family planning services by keeping list of eligible couples, provide
information on the family planning method and follow up of family planning
acceptors.
6. Identifying and reporting of all communicable diseases.
7. Co ordinate the activities with health workers and the block staff.
8. Maintaining records.
1. Registration and care of prenatal, intranatal, and postnatal mothers and children at
home.
2. Registration and follow up of all eligible couples.
3. Conduct and supervise deliveries conducted by dais.
4. Immunize pregnant mother and children.
5. Refer mother and children at the time of need to hospitals and follow up them after
discharge.
6. Carry out family planning services including the distribution of contraceptives.
7. Treatment for minor ailments.
8. Prevent communicable diseases.
9. Maintenance of records and registrs of all the services provided and also of vital
events such as births and deaths.
SUB CENTRE
The Sub Centre is the peripheral outpost of the existing health care delivery system in rural
areas. They are being established on the basis of one Sub Centre for every 5000 population in
plains and one for every 3000 population in hilly, tribal and backward areas.
STAFFING PATTERN:
M.P.H.W/ V.H.N - 1
M.P.H.W/ H.W(M) – 1
VILLAGE LEVEL
The above schemes are in operation for universal coverage and equitable distribution of
health resources so that health care must penetrate into the farthest reaches of rural areas
They are from the same community and serve as a link between community and
governmental infrastructure. They undergo training in primary health centre, subcentre for
knowledge regarding primary health care. The national target is to achieve one health guide
for each village or 1000 rural population. Guidelines for selection include three months
training with stipend rupees 200 per month.
Under rural health scheme training is given for all local dais in the country to improve
their knowledge in the elementary concepts of maternal and child health and sterilization,
besides obstetric skills. Training is given for 30 days with stipend of rupees 300. Training
is given at PHC, sub centre, or MCH centre. During training each dai is required to
conduct at least two deliveries under guidance and supervision of health worker female,
ANM or health assistant female. They should practice asepsis. On successful completion
of training each dais is provided a delivery kit and a certificate. They should propagate
small family norm needs. The national target is to train one local dais in each village.
3. ANGANWADI WORKERS
Angan literally means a courtyard. Under integrated child developmental service, there is
an anganwadi worker for a population of 1000. The anganwadi worker is selected from
the community she is expected to serve. She under goes training in various aspects of
health, nutrition, and child development for four months. She must have passed SSLC.
OBJECTIVES:
FUNCTIONS:
Nursing mothers
Pregnant women
Other women(15 to 45 years)
Children below the age of 6 years
Adolescent girls
As on 31st March 2003, 3076 community health centres were established by upgrading
the primary health centres, each CHC covering a population of 80,000 to 1.20 lakh with 30 beds
and specialist in surgery, medicine, obstetrics and gynecology, and pediatrics‘ with x-ray and
laboratory facilities.
Functions
1. Care of routine and emergency cases in surgery.
7. Newborn care.
8. Routine and emergency care of sick children.
9. Other management including nasal packing, tracheostomy, foreign body removal, etc.
Essential qualification
B.Sc degree in nursing from any university or institute or certificate in Public Health
Nursing from any recognised institution.
Professional qualification
Pay scales
The pay scale should be the same as prescribed by State Government for similar
categories of personnel under them.
Membership
The Public Health Nurse should be a member of the District Health and Family
Welfare Team in the District Health Organization and will enjoy the status equivalent to that
of the District Mass E ducation and the Information Officer.
Educational qualification
OR
OR
Standard norms
There should be one NS grade I for 200 bedded hospital, one NS grade I for 2-4 NS grade II.
Job summary
Maintain necessary records concerning the nursing staff, student, confidential report
and health records etc.
Submit annual report of nursing service department of Medical Superintendent, INC
and Nurses Registration Council.
Participate in professional and community activities.
Maintain cordial relation with public and voluntary workers.
Nursing Services
Educational qualification
OR
OR
Since it is the second level nursing supervisory role, it needs at least the Nursing
Superintendent group II for three senior staff nurse (1:3).
Job Summary
Educational function
Arrange classes and clinical teaching of nursing students in the department related to
the speciality experiences
Implement the ward teaching programme and clinical experience of the students with
the help of doctors and nurses.
Does counselling and guidance of staff and the students.
Arrange and conduct staff development programmes.
Assist in planning for and participation in the training of auxiliary personnel.
General
BIBLIOGRAPHY