HEALTH CARE DELIVERY SYSTEM IN INDIA:
India is a union of 28 states and 7 union territories. States are largely independent in matters relating to the delivery of health care to the people. Each state has developed its own system of health care delivery, independent of the Central Government.
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
3.Local or peripheral
I. AT THE CENTER
The official 'organs' of the health system at the national level consist of
1.Ministry of Health and Family Welfare
2.The Directorate General of Health Services
3.The Central Council of Health and Family Welfare
1. International health relations and administration of port quarantine
2. Administration of Central Institutes such as All India Institute of Hygiene and Public Health, Kolkata.
3. Promotion of research through research centers
4. Regulation and development of medical, pharmaceutical, dental and nursing professions
5. Establishment and maintenance of drug standards
6. Census and collection and publication of other statistical data
7. Immigration and emigration
8. Regulation of labour in the working of mines and oil fields
9. Coordination with states and with other ministries for promotion of health
a. The functions listed under the concurrent list are the responsibility of both the union and state governments
2. Prevention and extension of communicable diseases
3. Prevention of adulteration of food stuffs
4. Control of drugs and poisons
5. Vital statistics
6. Labour welfare
7. Ports other than major
8. Economic and social planning
9. Population control and Family Planning
2.Directorate General of Health Services
1. International health relations and quarantine of all major ports in country and international airport
2. Control of drug standards
3. Maintain medical store depots
4. Administration of post graduate training programmes
5. Administration of certain medical colleges in India
6. Conducting medical research through Indian Council of Medical Research ( ICMR )
7. Central Government Health Schemes.
8. Implementation of national health programmes
9. Preparation of health education material for creating health awareness through Central Health Education Bureau.
10. Collection, compilation, analysis, evaluation and dissemination of information through the Central Bureau of Health Intelligence
11. National Medical Library
3.Central Council of Health
1. To consider and recommend broad outlines of policy regard to matters concerning health like environment hygiene, nutrition and health education.
2. To make proposals for legislation relating to medical and public health matters.
3. To make recommendations to the Central Government regarding distribution of grants-in-aid.
II) AT THE STATE LEVEL
The health subjects are divided into three groups: federal, concurrent and state. The state list is the responsibility of the state, including provision of medical care, preventive health services and pilgrimage within the state.
State health administration
At present there are 28 states in India, each state having its own health administration
1. State Ministry of Health
Two separate major departments, medical and public health are functioning in the state
The Directorate of Health Services or the Director of Medical and Health Services
The Directorate of Health and Family Welfare
The Directorate of Medical Education for the management of medical colleges and hospitals.
The Directorate of Public Health Services
III. AT THE DISTRICT LEVEL
There are 593 ( year 2001 ) districts in India. Within each district, there are 6 types of administrative areas.
Tehsils( Taluks )
Community Development Blocks
Municipalities and Corporations
Most district in India are divided into two or more subdivision, each incharge of an Assistant Collector or Sub Collector
Each division is again divided into taluks, incharge of a Thasildhar. A taluk usually comprises between 200 to 600 villages
The community development block comprises approximately 100 villages and about 80000 to 1,20,000 population, in charge of a Block Development Officer.
Finally, there are the village panchayats, which are institutions of rural local self-government.
The urban areas of the district are organized into
Town Area Committees (in areas with population ranging between 5,000 to 10,000)
Municipal Boards (in areas with population ranging between 10,000 and 2,00,000)
Corporations (with population above 2,00,000)
The Town Area Committees are like panchayats. They provide sanitary services.
The Municipal Boards are headed by Chairmen / President, elected by members.
The functions of Municipal Board
1. Construction and maintenance of roads
2. Sanitation and drainage
3. Street lighting
4. Water supply
5. Maintenance of hospitals and dispensaries
6. Education and
7. Registration of births and deaths etc
The Corporations are headed by Mayors, elected by councillors, who 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 municipalities, on a much wider scale.
Panchayat Raj -The panchayat raj is a 3-tier structure of rural local self-government in India, linking the village to the district
Panchayat (at the village level)
Panchayat Samiti( at the block level)
Zila Parishad(at the district level)
Panchayat (at the village level):
The Panchayat Raj at the village level consists of
The Gram Sabha
The Gram Panchayat
The Gram Sabha considers proposals for taxation, and elects members of The Gram Panchayat.
The Gram Panchayat covers the civic administration including sanitation and public health and work for the social and economic development of the village.
Panchayat Samiti (at the block level):
The Panchayat Samiti execute the community development programme in the block. The Block Development Officer and his staff give technical assistance and guidance in development work.
Zila Parishad (at the district level):
The Zila Parishad is the agency of rural local self-government at the district level . Its functions and powers vary from state to state.