1,241,491,960

HEALTH CARE DELIVERY SYSTEM

Prepared by Anu Issac

Determinants of health care

Consumers of health care

Providers of health care

The funding sources

Other factors

MODEL OF HEALTH CARE DELIVERY SYSTEM

Health status

CurativePreventivePromotive

PublicPrivate

VoluntaryIndigenous

Changes in health

statusResources

SECTORS OF HEALTH CARE DELIVERY

PUBLIC HEALTH SECTOR

PRIVATE SECTOR

CO-OPERATIVE SECTOR

INDIGENOUS SYSTEM OF MEDICINE

VOLUNTARY HEALTH AGENCIES

NATIONAL HEALTH PROGRAMMES

PUBLIC HEALTH SECTOR

Primary health care

Hospitals / health centres

Health insurance schemes

Other agencies – defense services, railways

Primary health care Primary health centers Sub - centers

Hospitals/ health centers Community health centers Rural hospitals District hospitals Specialist hospitals Teaching hospitals

Health insurance schemes

o Voluntary health insurance scheme or private- for – profit schemes

o Employer based schemes

o Insurance offered by NGO’s/ community based health insurance

o Mandatory health insurance schemes or govt. run schemes

Co- operative sector Co- operative hospitals Co- operative schemes

Indigenous system of medicine

A- Y- U- S- H-

PUBLIC SYSTEM

VILLAGE LEVEL

• Village health guide scheme• Local dais• Anganwadi worker• ASHA – Accredited social health activist

SUBCENTER – for every 5000 population in general and for every 3000 population in hilly and tribal areas

PHC – for every 30000 rural populations in the plains and for every 20000 population in hill and tribal areas

CHC – 80,000- 1.20 lakh population

Health insurance General insurance corporation and its four

subsidiary companies• National India assurance• New India assurance company• United insurance company• Life insurance corporation

Health insurance schemes

o Voluntary health insurance scheme or private- for – profit schemes

o Employer based schemes

o Insurance offered by NGO’s/ community based health insurance

o Mandatory health insurance schemes or govt. run schemes

SOCIAL INSURANCE / MANDATORY HEALTH INSURANCE

• ESI scheme• CGHS• RSBY – Rashtriya Swasthya Beema Yojana• CHIS – Comprehensive Health Insurance

Scheme

Co – operative sector SEWA – Self Employed Women’s Association Yeshaswini co- operative farmers health

scheme

AYURVEDA

Theory: Tridosa or Tidhatu

Kapha Pitta

vatha

Yoga

NATUROPATHY

Treatment methods in naturopathy…..

Air therapy

Massage therapy Mud therapy

Space therapy Fire therapy

Watertherapy

Food therapy

UNANI MEDICINE

SIDDHA MEDICINE

HOMEOPATHY

Voluntary health agencies 1. Indian Red Cross 2. Bharat Sevak Samaj 3. All India Blind Relief Society 4. Hind Kusht Nivaran Sangh 5. The Kasturba Memorial Fund 6. TB Association Of India 7. All India Women’s Conference

Functions of voluntary health agencies

Supplementing the work of government agencies.

Pioneering Education Demonstration Guarding the work of govt. agencies Advancing health legislation

National health programmes

National malaria eradication programme National filaria control programme National leprosy eradication programme National tuberculosis control programme National AIDS control programme NRHM – national rural health mission

Role of nurse in health care delivery

Identify the role of health agency where she works in providing specific services to deal with specific problem.

Participate in screening of high risk cases, identification of cases.

Ensure the patient is diagnosed, treatment is done, care is given.

Follow up of cases and defaulters. Maintain records, compile them and send to

authority.

Refer the cases to the concerned health agency when necessary

Educate the patient and concerned family members regarding necessary care, preventive measures, precautions to be followed, disinfection of excrements, soiled articles and articles used by the patients as when necessary in certain conditions.

Participate in regular immunization programme

Supervise , train multipurpose health workers, village health guides, dais and anganwadi workers

Participate in community surveys to determine the extent and nature of problems.

The healthcare system consists of three broad links

CENTRAL LEVEL

STATE LEVEL

PERIPHERAL LEVEL

AT THE CENTRAL LEVEL• MINISTRY OF HEALTH

AND FAMILY WELFARE

• DIRECTORATE GENERAL OF HEALTH SERVICES

• CENTRAL COUNCIL OF HEALTH AND FAMILY WELFARE

1. MINISTRY OF HEALTH AND FAMILY

WELFARE ORGANISATION

DEPARTMENT OF HEALH

SECRETARY

Jt. SECRETARY

Dy. SECRETARY

ADMN. STAFF

FUNCTIONSUNION LIST

o International health relations ; administration of port quarantine

o Administration of central instituteso Promotion of research through research centreso Regulation of medical, pharmaceutical, dental and

nursing professions

CONTD…o Establishment of drug standardso Census and collection & publication of other

statistical datao Coordination with other states for promotion of

healtho Regulating labour in mines and oil mineso Immigration & emigration

CONCURRENT LIST

o Prevention of extension of communicable diseases from one unit to another

o Prevention of adulteration of foodo Control drugs and poisons o Population control and family planningo Economic and social planningo Administration of ports other than majoro Labour welfare

2. DIRECTORATE GENERAL OF HEALTH SERVICES

ORGANISATION: DGHS

Additional DGHS Dy.DGHS Dy.DGHS Dy.DGHS

(medi care) (public health) (gen .Admn.)

office staff office staff office staff

FUNCTIONS

GENERAL:o Carrying out surveys o Planning, coordination, programming, and

appraisal of all health matters in the country

SPECIFIC:

o Control of drug standardso Medical store depotso Post graduate trainingo Medical education & medical researcho National medical libraryo Health intelligenceo monitoring of national health programmes

3. CENTRAL COUNCIL OF HEALTH AND FAMILY WELFARE

The Union Health Minister is the chairman & the State Health State Ministers are the members

FUNCTIONS: To recommend outlines of policy in regard to

matters concerning health To make proposals for legislation in fields of

activity relating to medical & public health matters

To make recommendations to the central govt. regarding distribution of available grants-in-aid for health purposes to the state & to review the work established in different areas

To establish organizations invested with appropriate functions for promoting & maintaining cooperation between the Central and State administrations

AT THE STATE LEVEL

STATE MINISTRY OF HEALTH

STATE HEALTH DIRECTORATE

DISTRICT LEVEL The principal unit of administration in India is the

district under a Collector Within each district there are six types of

administrative areas -subdivisions - tehsils (taluks) - community development blocks - municipalities and corporations - villages - panchayats

RURAL ADMINISTRATION PANCHAYATI RAJ

( 3 tier system of rural self govt.)

ZILA PARISHAD(district) PANCHAYAT SAMITI(block)

PANCHAYAT (village)

Gram sabha gram panchayat nyaya panchayat

Bibliography PARK K, TEXTBOOK OF PREVENTIVE AND

SOCIAL MEDICINE, 20 TH EDITION, 2009, BANARSIDAS BHANOT PUBLISHERS, India, PAGE NO: 796- 815, 780- 783, 380

GULANI K.K, COMMUNITY HEALTH NURSING PRINCIPLES AND PRACTICES,FIRST EDITION,2005, KUMAR PUBLISHING HOUSE, India, PAGE NO: 616-623

MANIVANNAN C, RATHNMANI S, MANIVANNAN LATHA T, TEXTBOOK OF COMMUNITY

HEALTH NURSING, VOLUME 2, FIRST EDITION, 2011, EMMESS MEDICAL PUBLISHERS, BANGALORE, PAGE NO: 72-77, 94-97, 39-50

SAXENA B. DEEPAK, COMMUNITY MEDICINE, SMART STUDY SERIES, 1ST EDITION, 2010,ELSEVIER PUBLICATIONS, India, PAGE NO: 38-40

SRIDHAR RAO B, COMMUNITY HEALTH NURSING, FIRST EDITION,2006, AITBS PUBLISHERS, DELHI,PAGE NO: 93- 115

www.ncbi.nlm.nih.gov

www.mohfw.nic.gov