VARIOUS COMMITTEES OF

HEALTH & FAMILY WELFARE

Sub: Community Health Nursing-II

1. Kartar Singh committee, 1973
2. Shrivastav Committee, 1975
3. Shetty Committee 1980
4. Mehta Committee 1983
5. Bajaj Committee 1986-87
6. Sarojini Varadapan Committee:
1. Kartar Singh committee, 1973

The Government of India constituted a committee

in 1972, known as the Committee on Multipurpose
Workers under Health and Family Planning, under
the Chairmanship of kartar Singh, Additional
Secretary, Ministry of Health and Family Planning,
Government of India.
The terms of reference of the Committee were to
study and make recommendation on:

a) The structure for integrated services to the peripheral

and supervisory levels;
b) The feasibility of having multipurpose, bipurpose
workers in the field;
c) The training requirements for such workers; and
d) The utilization of mobile service units set up under
family planning programme for integrated medical,
public health and family planning services operating in
the field.
 Recommendations
The committee submitted its report in September 1973. Its
main recommendation were:
The Present Auxiliary Nurse Midwives to be replaced by
the newly designated Female Health Workers, and the
present-day Basic Health Workers, Malaria Surveillance
Workers, Vaccinators, Health Education Assistants
(Trachoma)and the Family Planning Health assistants to
be replaced by Male Health Workers.
The program for having multipurpose workers to be first
introduced in areas where malaria is in maintenance phase
and smallpox has been controlled and later to other areas.
For proper coverage, there should be one primary health
centre for 50,000 populations.
Each PHC should be divided into 16 sub centres each having a
population about 3,000 to 3,500.
Each sub centre to be staffed by team of one male and one
female health worker.
There should be a male health supervisor to supervise the
work of 3 to 4 male health workers and one female health
supervisor to supervise the work of 4 female health workers.
The present-day lady health visitors to be designated as
female health supervisors.
The doctor in charge of a primary health centre should have
the overall charge of all the supervisors and health workers in
the area.

The recommendations of the Kartar Singh Committee were accepted

by the Government of India to be implemented in a phased manner
during the Fifth Five Year Plan.
 2. Shrivastav Committee, 1975
The Government of India in the Ministry of Health and Family
Planning had in November 1974 set up a “Group on Medical
Education and Support Manpower” popularly known as
Shrivastav Committee.

To device a suitable curriculum for training a cadre of health

assistance so that they can serve as a link between the qualified
medical practitioners and the multipurpose workers, thus forming an
effective team to deliver health care, family welfare and nutritional
services to the people;
To suggest steps for improving the existing medical educational
processes as to provide due emphasis on the problems particularly
relevant to national requirements, and
To make any other suggestions to realise the above objectives and
matters incidental thereto.
Recommendations
The group submitted its report in April 1975. It recommended
immediate action for:
 Creation of bands of para-professional and semi-professional
health workers from within the community itself (e.g. school
teachers, postmasters, gram sevaks) to provide simple, promotive,
preventive and curative health services needed by the community.
 Establishment of 2 cadres of health workers namely –
multipurpose health workers and health assistants between the
community level workers and doctors at PHC.
 Development of ‘Referral Services Complex’ by establishing
proper linkages between PHC and higher level referral service
centres.
 Establishment of a Medical and Health Education Commission for
planning and implementing the reforms needed in health and
medical education on the lines of the University Grants
Commission.
The committee felt that by the end of the sixth five
year plan, one male and one female health worker
should be available for every 5,000 population. Also,
there should be one male and female health assistant
for 2 male and 2 female health workers respectively.
The health assistants should be located at the sub
centre, and not at the PHC.
3. Shetty Committee, 1954

During the month of February 1954, the meeting of

the Central Council of Health held at Rajkot under the
chairmanship of Rajkumari Amrit Kaur, then Union
Minister for Health emphasised the need for the
importance of “Nursing” in Health Department and
made resolution to constitute a “Nursing Committee”
to review conditions, emoluments, etc., of “Nursing
Profession”. Accordingly, the Committee was
constituted under the chairmanship of Shri Shetty and
Smt. TK Andranwal, Nursing Advisor as member-
secretory.
The terms of reference of the Committee are given
below
To survey the existing facilities for teaching in nursing,
conditions of work and emoluments of the various grades
of nurses.
To assess the minimum requirements (qualifications for
entering, nurse training etc) of the country as a whole in
respect of nurses and to recommend specific measures to
overcome shortage.
To examine the existing conditions of service and
emoluments, admissible to nurses in the various states and
aided institutions and to make recommendations for their
improvement to attract young women from good families
to the profession by keeping in mind the financial
resources of the country.
The committee surveyed in some states, conducted
meeting with concerned authorities and obtained
information from some individual nurses and existed
state nursing councils. They made some observation
as follows:
Pay scales of nurses is very low and has not kept pace with
the rise in cost of living.
In almost all the States, there was shortage of nurses,
nurse-patient ratio has not been maintained.
In the hospitals, there were inadequate supply of medical
supplies and equipment for providing proper nursing
services.
Too lengthy hours of work of nurses (50 to 90 hours
night duty/week).
The nursing staff made responsible for all breakages and
loss in the hospitals and penalised.
No proper accommodations were found for nurses.
Very less or no promotional opportunities for nurses.
Few gazetted rank for nurses of senior positions.
More utilisation of male nurses.
INC standard not maintained in nurse’s training centres.
Student nurses utilised for regular nursing services.
Living conditions of students nurses are sub standards.
Recommendations
Appointment of a Superintendent of Nursing services
in each State.
Combining the Nursing service for hospitals and that
of public health field into one service. Inclusion of
experience of public health and domiciliary nursing in
the basic courses of nurses and mid-wives.
In planning to provide an adequate nursing service,
the immediate goal to be provision of a minimum
standard of nursing in the existing hospital and public
health services.
 The committee’s recommendations pertaining
to nursing education are as follows
Minimum standards for nursing services

Area Requirements

Teaching Hospitals 1 Nurse:3 patients

General Hospitals 1 Nurse:5 Patients

Domiciliary midwifery 1 Midwife: 100 birth (rural area)

1 Midwife: 150 birth (compact area)

Public Health Services 1 PHN/HV: 10,000 Population

Increase of students in the existing nurse’s training
centre to increase nursing personnel.
Creation of additional posts of nursing staff in all the
nursing institutions like hospital and public health
agency to absorb trained nurses.
Appointment of ANMs to supplement the nursing
services in hospitals.
Improvement in conditions of training centres, i.e.,
adequate living accommodation and other proper
facilities and requirements to provide good training for
nurses.
Better publicity to the potentialities of nursing as a career.
Recruitment of students should be made by the
Committee consisting of Medical Superintendent,
Nursing Superintendent and Sister Tutor, preference to be
given to the students from good family background.
Minimum requirement of admissions according to INC.
Medium of instruction for nurse training according to the
State policy.
Counselling of students required, should be conducted
by Senior Tutor.
During training, hostel is compulsory.
Bond of two year service instigated after completion of
course.
In addition, certain recommendations have been made
by the Committee to improve nursing service
conditions as follows:

Decentralisation in recruitment, qualified nurses for

service, i.e., qualified nurses should be included in
selection of nurses.
Provision should be made for residential quarters, for
nurses at the premises of the hospital/ health agency.
Improvement of working conditions, i.e., increasing staff,
adequate medical supplies and equipment for nursing
services reducing working hours, provision of pension
and/or provident fund, etc.
Proper provision for periodical examination and
treatment for nurses.
Conduct of regular staff meetings, refresher courses,
and granting facilities for continuing education for
nurses.
Recruitment of men as student nurses be in
proportion to the employment open to them.
 4. Mehta Committee, 1983
This committee is known as “Medical Education Review
Committee”.
Part I of the report deals with medical education in all
aspects, its major recommendations are regarding the
establishment of universities of medical sciences and
medical and health education commission.
Part II of the report specifically deals with lack of
availability of health manpower data in India,
recommendations regarding methods for updating such
data, the manpower projections for doctors, nurses and
pharmacists.
5.Bajaj Committee, 1986-87
Keeping National Health Policy in view, an expert
committee was constituted by Government of India
under the chairmanship of Bajaj known as “Health
Man Power Planning, Production and
Management”.
It reviewed the existing situation and made the
following major recommendations:

A national policy on education in health sciences

(NPEHS) must be enunciated and the major focus
should be on policy guidelines for health manpower
developments.
A realistic health manpower survey should be carried
out.
The effective vocalisation of health and health-related
courses should be started and educational
infrastructure and technology should be improved.
Education Commission for Health Science (ECHS)
should be established on the lines of UGC and it
should liaise with all existing professional councils.
Health Science universities be established in each
State and groups of Union Territories as the
implementing arm of ECHS for production evaluation
and sustenance of health manpower policies.
In relation to nursing, the Bajaj Committee
recommended staffing norms for nursing man power
requirements for hospital nursing services and
requirements for community health centres and
primary health centres on the basis of calculations as
follow:

Hospital Nursing Services

Community Nursing Services
 6.Sarojini Varadapan Committee

A high power committee on Nursing and Nursing

profession was set up by the Govt. of India in July, 1987
under the Chairmanship of Dr. Jyothi former vice
chancellor of SNDT Women University, Mrs. Rajkumari
Sood, Nursing Advisor to Union Govt. as the member-
secretory and CPB Kurup, Principal, Govt. College of
Nursing, Bangalore and the then President, TNAI was
also one among the prominent members of this
committee was also one among the prominent members
of this committee.
Later on, due to some reasons, the committee was headed
by Smt. Sarojini Varadappan, former to Chairman of
Central Social Welfare Board. The terms of reference of
the Committee are:
To look into the existing working conditions of nurses
with, particular reference to the status of the nursing care
services both in the rural and urban areas.
To study and recommend the staffing norms necessary
for providing adequate nursing personnel to give the best
possible care, both in the hospitals and community.
To look into the training of all categories and levels of
nursing, midwifery personnel to meet the nursing
manpower needs at all levels of health services and
education.
To study and clarify the role of nursing personnel in
the health care delivery system including their
interaction with other members of the health team at
every level of health service management.
To examine the need for organised nursing services at
the national, state, district and local levels with
particular reference to the need for planning service
with the overall health care system of the country at
the respective levels.
To look into all other aspects, the Committee will
hold consultations with the State Govt.
 Accordingly, the Committee conducted periodical meetings and
visited different states in India and studied aspects related to the
terms of reference of the Committee and recommending many
measures to improve nursing and nursing profession in India.
 For community nursing service, the committee recommendations
are as follows:

Appointment of ANM/LHV/HS/PHC 1 ANM for 2500 population (2

per subcentre),
1 ANM FOR 1500 population in hilly areas,
1 health supervisor for 7500 population (for 3 ANMs),
2 district PHN officers in each district.
Specific standing orders be made available to ANM/LHV/HS.
Adequate provision of supplies of drugs.
Simplification of recording system.
Gazetted rank for the post of PHN and above grade.