SEMINAR

PRESENTATION
ON
HEALTH CARE
DELIVERY
PRESENTATION BY
PRIYA KUMARI
M.SC NURSING
1ST YEAR
 Health Care Delivery
Introduction:
Health care services in general are rendered
by the Govt.through a network of health centres
from the grass root areas to the block level in the
rural areas and through
hospitals,dispensaries,maternal,child health and
family welfare centres in the urban areas.The
hospital in the subdivisional/Taluka level,district
level etc.provide referral services to the
infrastructure in the rural area.There are also
voluntary and private agencies which are
functioning to deal with the health problems of
the people.
 HEALTH
Health is a state of complete
physical,mental and social well being and not
merely an absence of disease or infirmity
which allows a person to live a socio –
economically productive life. WHO

Health is a condition of being sound in

body,mind,or spirit.

A relative state in which one is able to function
 well physically, mentally, socially, and spirituall
y in order to express the full range of one's uniqu
e potentialities within the environment in which
one is living.
HEALTH CARE DELIVERY
Health care delivery is defined as the aggregate of
institution,organization and person who enter,the health care
system,who has responsibility that include the promotion of
health,prevention of disease and rehabilition.

The concerns is to develop a system which ensure need based

comprehensive health care services to people at large specially those
living in remote and hilly areas,using available resources.

A health care delivery system is an organization of people,institution

and resources to deliver health care services to meet the health needs
of a target population.
India is a union of 28 states and 9 union territories.
States CARE
HEALTH are DELIVERY
largely independent
SYSTEM IN INDIA:in matters relating to
the delivery of health care to the people
The Central Government responsibility consists
mainly of policy making, planning, guiding, assisting,
evaluating and coordinating the work of the State
Health Ministries

The health system in India has 3

main links:-

1. Centre or National level

2. State level
3. Local or peripheral level
1.AT CENTRAL LEVEL:-

The health system at the central level consist of~

 Union ministry of health and family welfare.
 The directorate general of health services .
 The central council of health and family welfare
Organization of Health
At the National Level:-
Union Ministery of health and family welfare Organization setup:
Cabinet Minister
Deputy Health Minister

Dept.of Health Dept.of Family Welfare

Health secretary to the Govt.of India Secrataries to the Govt.of India

Assisted by Joint Secretary Assisted by additional secretary & commissioner

Deputy Secretary Joint secretory

Administrative Staff Administrative Staff

Union Ministry of Health and Family
Welfare-

 was created in 1966 within the ministry of health and

familywelfare.The secretory to the govt.of india in the
ministry of health and family welfare is the overall incharge
of the department of family welfare .He is assisted by the
additional secretory and commissioner and one joint
secretory .
Function:
1. International health relations & administration of port
quarantine.
2. Administration of central institutes such as the All India
institute of hygiene and public health, Kolkata, National
Institute for control of communicable diseases, Delhi etc.
3. Promotion of research through research center's and
other bodies.
4. Regulation & development of medical, pharmaceutical,
dental and nursing professions.
5. Establishment & m aintenance of drug
standards.
6. Census collection & publication of other
statistical data.
7. Immigration & emigration.
8. Regulation of labour in working of mines and
oil fields.
9. Coordination with states & with other
ministeries for promotion of health.
 Concurrent List
• Prevention of extension of communicable disease from one unit to
another.
 Prevention of adultration of foodstuffs.
 Control of drugs and poisons.
 Vital statstics.
 Labour welfare.
 Regulation of ports other than major.
 National medical library.
 Economic and social planning.
 Population control and family planing.
 Preparation of health education material for creating health awareness
through central health education bureu.
 Directorate General of health services
The DGHS is the principal advisor to the union Govt.in both
medical and public health matters.He is assisted by an additional
director general of health services,a team of deputies and a large
administrative staff.e.g~Medical care and hospitals,public health
and general health administration.
General Function:
a) survey
b) planning
c) co-ordination
d) programming and appraisal of all health matters in the country.
Specific Function of DGHS

1.International health relations & quarantine.

All major ports in the country (Kolkata ,Vishakhapatnam ,Chennai

,Mumbai ) & International airports ( Mumbai ,Kolkata ,Chennai ,Delhi )
are directly controlled by DGHS.

2. CONTROL OF DRUG STANDARDS

Headed by drug controller. It’s primary function is to lay down and enforce
standards and control the manufacture and distribution of drugs . the act
was passed in 1940 to empower the union govt. to test quality of imported
drugs.
3. MEDICAL STORE DEPOTS
The union govt. run the medical store depots at mumbai ,chennai
,kolkatta ,karnal ,gawhati.The function is to handle the supply from
foreign agencies and to ensure highest quality of drugs which is low cost
and promptly.

4.POSTGRADUATE TRAINING
The DGHS is responsible for administration of various institutions in
India such as all India institute of hygiene & public health ,Kolkata and all
India institute of mental health ,Bangalore and the national tuberculosis
institute of control of communicable diseases ,Delhi and central research
institute at kasauli.
5. MEDICAL EDUCATION
The central directorate is directly in charge of national medical colleges
like the lady Harding ,the Maulana Azad ,AIIMS. These colleges are
guided and supported by the central government.
6. MEDICAL RESEARCH
It is organized largely through the Indian council of medical
research (set up in 1911 ).It maintain the research center's such as
tuberculosis chemotherapy centre at Chennai ,virus research
centre at Pune ,national institute of nutrition at Hyderabad.
 Central Council Of Health:
was set up by a Presidential order article 263 of the consitution of India
for promoting co-ordinated concerted action between the centre and
the states in 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.
ORGANISATIONAL PATTERN
~ Chairman(Union Health Minister)
~ Members(State Health Minister)
• Function:
1) To consider and recommend broad outline of policy in regard
to matters concerning health in all its aspects such as provision or
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 relating
to medical and public health matters.

3) To lay the pattern of development for the country as a whole.

4) To establish any organization invested with appropriate
function for promoting and maintaining cooperation between the
central &state health administration
 2.AT THE STATE
LEVEL
At present there are 29 state in India with
each state having its own health
administration .
 STATE LEVEL

STATE MINISTERY OF STATE HEALTH

HEALTH DIRECTORATE

MINISTERY OF HEALTH DIRECTOR OF HEALTH

AND FAMILY WELFAIR SERVICE

HEALTH SECRETATRIT
REGIONAL DEPUTY
DIRECTOR
DEPUTY HEALTH
SECRETATRIT
ASSISTANT DIRECTOR

ADMINSTRATION STAFF

Immu Family
Statisti lepros Nutriti
MCH PHC nizatio welfar
cs y on
n e
 FUNCTION OF STATE
MINISTERY HEALTH
Policy making and modify the policy
Coordination of policy and supervise
the health programmer
Budgeting and control of expenditure.
Maintaing contact with central level.
Farming legislation and rule and
regulation.
 FUNCTION OF STATE HEALTH
DIRECTORATE
 To provide adequate medical care through hospital and health centre
in rural and urban area.
 To make proper arrangement for medical education and research.
 Implementation of national health programme.
 central food and drug adulteration.
 setting up of laboratory.
 Supervision and central over local bodies.
 Coordination of all health service with other ministry of state.
 Promotion of health programme such as school health, family
planning & occupation health.
 provide presentation and curative services.
 Presentation of indigenous system.
 3.AT THE DISTRICT LEVEL

It is headed by single chief medical

officer(CMO) who is responsible for all
CMO service district. The district health
officer is a incharge of all health
administration. Health national
programmed are implemented in the
district for family welfare program.
There are six type of
administrative:
Subdivision
Tehsil
Community development block
Village
Panchyat
   District Health Organization:
Chief Medical Officer of HealthMedical Officer
Of Health
Deputy Medical Officer Of Health
Distt.Family Distt.
Welfare officer Program Medical
Health me
Distt. Public Suprintendent
Officer Officer
Health Nurse
Nurse
Officer
Suprintn-
Public Health dent
Nurse
Health Ward Sister
Supervisior
Male and
Female Staff Nurse

Health
Auxillary Nurse
Worker M
Midwife
$F

Trained DAI or Ward

Village Health Attendents
Guide
1.Urban area: the urban area of district are orgainsed into the
following instructions of local self government.

A) Towned Area Communitties:-

in area with population ranging between 5000-10000 the town area
community are like panchyat.
FUNCTION:-
-They provide sanitary service.
-Rational use of land.
-Social and economical development
B) Municipal boards: in area with population ranging between 10000-
200000 lkh. The municipal board are headed by chairman.
The function of municipal board are:-
1)construction and maintained of roads.
2)Sanitation and drainage.
3)Street lightning
4)Water supply.
5)Maintain of hospital and dispensaries.
6)Education
7)Registration of birth and death.
C)Corporation:-
area with population above 2,00,000 corporation are
headed by mayors.
Executive agency includes :-The member of executive
agency are selected from different area of city....
a) Commissioner
b) The secretary
c) The engineer
d) Head officer
RURAL AREA

Panchyati raj:
The panchyati raj is a three tier structure of their local self
government in India. Linking to the district. the three institutions
are—
1.Panchayat- at the village level
2.Panchayat Sammitee- at the block level
3.Zila Parisdh- at the district level
1.AT THE VILLAGE LEVEL:-(Panchayat)
The panchyat raj at the village level consist of:-
i)the gram Sabah
ii)gram panchayat
iii) nyaya panchyat
Gram sabah: It is the assembly of all the adults of the village which
meets at list twice a year. All the member will discuss important issues and
considered proposal regarding to various development aspects including
health matters.
- Discuss the annual programme.
-Elects members of gram panchayat.
i. Gram Panchayat:

1) It is exhitutive of the gram Sabah and agency fare planning and

development at the village level.
2) It consist 15 to 30 member.
3) It covered population from 5000 to 15000 are more.
4) The power and function of the panchyat are very wide. They covered the
entire field of civil administration including sanitation and public health and
development of village.

FUNCTION :
-To prepare annual plan for the development of gram panchayat.
-To prepare annual budget.
-To prepare relief from natural calamities.
-To remove illegal encroachments from public property.
- To collect necessary data about the village.
i.

ii ) NYAYA PANCHAYT:-

It consist of 5 member from the panchayt.

function:
it strives to solve pitty criminal and civil cases,where in the
parties in dispute explain thier sides to the members of the
Panchyat and solve dispute between group and individual.

2. PANCHYAT SAMITTEE-
it include block level hospitals.
Block Level:-
The block consist of about 100 village and population
80,000-1,20000 . The pancahayt sammitee consist of all
sarpanch of the village. MLA,MP representative of women
schedule cast and cooperative societies.
The panchayt samiti is responsible for block development
of activity under the community development programme.
The block development officer and his staff give technical
assistance and guide to the village, panchyat engaged
development work.
THE MODEL OF HEALTH CARE
DELIVERY SYSTEM

Public Private
system system

Co-
Voluntar
operativ
y
e
system
system
1.Public system.
This system is typically funded and aparted by the govt.It provide services
through agencies at various level.The funds are drived from general tax.The
system is inresponse to state obligation to provide health care service to entire
population.
2.Private system.
The services are provided by private clinical nursing home,hospitals,homecare
agencies etc.
3.Co-operative system.
In this system funding is done by the employer employee and the govt. e.g
ESI scheme and central Govt.health schemr for central govt.employs.
4.Voluntary system.
This system is non-govt. Non profit system,initiated,establish and administrative
by private citizen.Their financial support comes from voluntary contribution.
E.g-cancer society of India,Tuberculosis association of India etc.
Health care delivery system in India~
It includes management sector and involve organisational matter.It
India it is represented by five majorsector or agencies which differ from each other
technology and by the source of fund for operation these are:
1.Public health sector....
i)Primary health care
1)Primary health centres
2)Subcentre
ii)Hospitals or health centre
1)Community health centre
2)Rural hospital
3)District hospital
4)Specialist hospital
5)Teaching hospital
iii)Health Insurance scheme
ESI and CGHS
iv)other agencies
1)difence services
2)railway
2.Private sector...
Private hospitals,polyclinics,nursing homes and dispensaries
General practitioners and clinics
 3.Indigious systems of medicine
Ayurveda and siddha
Unani
Homeopathy
4.Voluntary health agencies...
some of the voluntary health agencies include Tuberculosis Association of
India,Family Planning Association of India,Indian Red Cross Society,Hind Kust
Nivaran Sangh,The Trained Nurses Association etc.
5.National health programmes...
Eradication Programme:-
-National Filaria Control Programme
-National Leprosy Eradication Programme
-Polio Eradication Programme
Control Programme:-
~National Tuberculosis Control Programme
~National Diarrhoreal Control Program
~National Cancer Control Programme
~Anaemia Control Programme
Role of Nurse In Health Care Delivery
Services:
 Supervise $ guide the health workers in the delivery of health care
services to the community.
 Strengthen the knowlrdge $ skill of the health workers in different
areas.
 Promote team work among the health workers.
 Co-ordinate the activities with other agencies and health personnel.
 Assist With M.O of the P.H.C In the organisation to provide health
services to community.
 Provide all the health facility and health services to all people
without any discrimination.
 Educate the mothers individually and in group in better family
health including maternal and child health,family
planning,nutrition,immunization,personal environmental hygiene.
 Summarisation
o Introduction.
o Definition
o Health Care Delivery System in India
-At Central or National Level
- At State Level
- At District Level
o Model of Health Care Delivery System
o Role of nurse in health care delivery system
BIBLIOGRAPHY....
https://en.m.wikipedia.org
https://brainkart.com
https://sciencedirect.com
Basheer.P.Shebeer , “ A concise textbook of advanced
nursing practice” , “Published by Emmess” , 2 nd Edition ;
Page no 79-84.
Park.k., “A textbook of preventive and social medicine,
“Published by Bhanot”, 18th Edition ; Page no 674-699.
Basvant-happa BT, “A textbook of Community health
nursing”, “Published by Jaypee, 6 th Edition ; Page no 584-
605.
Thank you