INDEX 1 2 INTRODUCTION AT THE CENTRE The Ministry of Health and Family Welfare The Directorate General of Health Serv

ices 2 2-7 The Central Council of Health and family welfare 3 STATE LEVEL State Health Directorate State Ministry of health 8-9 4 5 6 7 DISTRICT LEVEL Panchayati Raj Conclusion Bibliography 10-11 11-13 14 14

HEALTH SYSTEM IN INDIA India is a union of 28 states and 7 union territories. Under the constitution of India, the states are largely independent in matters relating to the delivery o f health care to the people. Each state has therefore developed its own system o f health care delivery independent of the central government. The central respon sibility consists mainly of policy making, planning, guiding, assisting, evaluat ing and co-coordinating the work of the state health ministries, so that health services cover every part of the country and no state lags behind for want of th ese services. AT THE CENTRE The official organs of the health system at the nati onal level consists of : 1. The Ministry of Health and Family Welfare 2. The Dir ectorate General of Health Services 3. The Central Council of Health and family welfare Union Ministry of Health and Family Welfare ORGANIZATION The Union Ministry of Health and Family Welfare are: 1. Headed by a Cabinet Minister 2. Minister of state and, 3. Deputy Health Minister , DEPARTME NTS Department Of Health Department Of Family Welfare(Created in 1966) Departmen t Of Health 1. 2. 3. 4. Secretary to the Government of India(Executive Head) Joi nt Secretaries Deputy Secretaries Large administrative Staffs Department Of Family Welfare 1. The Secretary to the Government of India(Overall charge) 2. Additional Secretary & Commissioner 3. One Joint Secretary 2

FUNCTIONS The functions are set out in the 7th Schedule of Article 246 of the Co nstitution of India under: Union List Concurrent List Union List 1. Internationa l Health relations and Quarantine. 2. Administration of Central Institutes Such as National Institute for the Control of Communicable diseases, Delhi. 3. Promot ion of Research through the research centres &other bodies. 4. Regulation and de velopment of medical, pharmaceutical, dental, and nursing professions. 5. Establ ishment and Maintenance of Drug standards. 6. Census, and collection and publica tion of other statistical data. 7. Immigration and emigration 8. Regulation of l abour in the working of mines and oil fields. 9. Co-ordination with States and w ith other ministries for the promotion of Health Concurrent List The functions l isted under this list are the responsibility of both the Union and State Governm ents. The centre and the State have simultaneous powers of legislation. The powe r of the latter are restricted to the framework of such legislation as may be un dertaken by the centre. Concurrent List includes: 1. 2. 3. 4. 5. 6. 7. 8. Preven tion of extension of Communicable disease from one unit to the other. Prevention of adulteration of food stuffs. Control of drugs and poisons. Vital Statistics. Labour welfare. Ports other than major. Economic and Social Planning. Populatio n control and Family planning. Directorate General of health Services ORGANIZATION 1. The Director General of Health Services (Principal adviser to Un ion Government in both medical and public health matters) 2. Additional Director general of health services 3

3. A team of deputies 4. Large administrative staff The Directorate comprises of 3 main units, Medical care & Hospitals, Public health General administration FU NCTIONS GENERAL Surveys, planning, co-ordination, programming and appraisal of a ll health matters in the country. SPECIFIC 1. International Health relations and Quarantine: All the major ports in the country9kolkatta,vishakhapattanam, Chenn ai,Cochin, Mumbai,,kandla) and International airports(Mumbai-Santa Cruz, Chennai meenambakkam, Tiruchirapalli ,Delhi-Palam) are directly controlled by the Direct orate General of Health Services 2. Control of Drug standards The Drugs Control Organization is part of the Directorate general of Health Services, and is heade d by the Drugs controller .Its Primary function is to lay down and enforce stand ards and controls the manufacture and distribution of drugs through both Central and State Government Officers. The Drugs Act (1940) vests the central governmen t with the powers to test the quality of the imported drugs. 3. Medical store de pots The Union Government runs medical depots at Mumbai, Chennai, Kolkatta, Carn al, Gauhati, and Hyderabad. These depots supply the civil medical requirements o f the Central Government and of the various State Governments. These depots also carries supplies from foreign agencies 4. Post Graduate Training The Directorat e General of Health Services is responsible for the administration of national I nstitutes, which also provide Post graduate training to different categories of health personnel. Some of these Institutes are National Institute of Mental Heal th at Bangalore, College of Nursing at Delhi, and National institute of communic able Diseases at Delhi etc 5. Medical Education 4

The Central Directorate is directly in charge of the following medical Colleges in India: the Lady Hardinge, the Maulana Azad and the Medical Colleges at Goa an d Pondicherry. Besides there are many medical Colleges in India which are guided and supported by the Centre. 6. Medical Research The Medical Research in India is largely organized through the Indian Council of Medical Research, founded in 1911 in New Delhi. The Council plays a significant role in aiding, promoting, an d promoting scientific research on human diseases, their causation, prevention a nd cure. The research work is done through the Councils permanent research insti tutes, Research Units, Field surveys, and a large number of ad-hoc research enqu iries financed by the Council. It maintains cancer Research Centre, Tuberculosis chemotherapy centre at Chennai etc. The funds of the council are wholly derived from the budget of the Union ministry of Health. 7. Central Government Health S cheme The Central Government health scheme for the Central Government employees was first introduced in 1954 in New Delhi.The Scheme is based on the principle o f co-operative effort by the employeeand the employer, to the mutual advantage o f both.The Facilities under the scheme are :1, Out patient care 2.supply of nece ssary drugs 3,lab & X-ray investigations 4.domicilliary visits 5.hospitalisation facilities at government as well as private facilities 6. Specialist consultati on 7.paediatric services including immunization 8.antenatal, natal, and postnata l services 9.post natal services 10. Emergency treatment 11. Supply of optical a nd dental aids at reasonable rate 12. Family welfare 8. National Health programm es The various national health programmes for the eradication of malaria, contro l of tuberculosis, filarial, leprosy, AIDS and other communicable disease involv es expenditure. The Central Directorate plays an important role in planning, gui ding and co-coordinating all the national health programmes in the country. 9. C entral health Education Bureau: Preparation of educational material for creation of health awareness among the people .The Bureau offers training courses in hea lth education to different categories of health workers. 10. Health Intelligence The Central Bureau of Health Intelligence was established in 1961 to centralize collection, compilation, analysis, evaluation and dissemination of all informat ion on health statistics for the nation as a whole. It disseminates epidemic Int elligence to states and International agencies. The Bureau has an epidemiologica l unit, a Health Economics unit, a National Morbidity Survey Unit, a Manpower Ce ll. 11. National Medical Library 5

The Central Medical Library of the Directorate General of Health services was de clared the National Library in 1966.The aim is to help the advancement of medica l, health and related sciences by collection, dissemination and exchange of info rmation. Central Council of Health The Central Council of Health was set up by a Presidential order on 9th August 1 952, under article 263 of the Indian Constitution for promoting co-ordinated 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. ORGANIZATIO N 1. The Union Health Minister 2. State Health Ministers FUNCTIONS 1. To conside r and recommend broad outlines of the policy in regard to matters concerning hea lth an all its aspects such as provision of remedial and preventive care, enviro nmental hygiene, nutrition, health education, and the promotion of facilities fo r training and research. 2. To make proposals for legislation in fields of activ ity relating to medical and public health matters and to lay down the pattern of development for the country as a whole 3. To make recommendations to the Centra l Government regarding distribution of available grants-in-aid for health purpos es to the states and to review periodically the work accomplished in different a reas through the utilization of these grantsin-aid . 4. To establish any organiz ation or organizations invested with appropriate functions for promoting and mai ntaining co-operation between the Central and State Health administration 6

Centre level Union ministry of health &family welfare Directorate General of Health Central C ouncil of health Headed by Cabinet Minister Minister of State & deputy health minister The Director Council of health services Union Health Minister (chairman) Additional Director General of Health Services Department of health Deputies & D epartment of family welfare Administrative staffs Secretary to the Govt of India Secretary to the Govt of India Union Health Minister State Health Minister Joint Secretaries Additional Secretary & Commissioner Deputy Secretary Joint Secretary Administrative staffs 7

AT THE STATE LEVEL At present there are 28 states in India with each state having its own health ad ministration .In all the States, the management sector comprises of : The State Ministry of Health State Health Directorate State Ministry of Health ORGANIZATION Headed by Minister of Health and family Welfare Deputy Minister of Health and Family Welfare Health Secretariat (Official Organ of State Ministry o f Health) 1. 2. 3. 4. Headed by Secretary Assisted by Deputy Secretariat Under S ecretaries Large Administrative staff State Health Directorate The Director of Health services (Known in some states as Director of Medical and Health Services) is the chief technical adviser to the state government on all matters relating to medicine and public health. He is also responsible for the o rganization and direction of all health activities. With the advent of family pl anning, the designation of the Director of health Services has been changed in s ome states as Director of Health and Family Welfare. A recent development in som e states is the appointment of a Director of Medical Education in view of the In creasing number of medical Colleges. ORGANIZATION 1. The Director of Health and family Welfare 2. Assisted by the Deputy and Assis tant Directors of Health. Regional Directors(Inspect all branches of public heal th within their jurisdiction, irrespective of their specialty. The Functional Di rectors are specialists in a particular branch of public health such as mother a nd child health, family planning, nutrition, tuberculosis, leprosy, health educa tion etc 8

State Level Administration State Ministry of Health State health Directorate Minister of Health and Family Welfare Deputy Minister of Health and Family Welfa re Director of health and family welfare Deputies and Assistants Health Secretariat Secretary Deputy Secretaries Under secretaries and Administrative staffs 9

AT THE DISTRICT LEVEL The Principal unit of administration in India is the District under a Collector. Districts vary widely in area and population. Within each District,there are ag ain 6 administrative areas: 1. 2. 3. 4. 5. 6. Sub divisions Tehsils (taluks) Com munity Development Blocks Municipalities and Corporations. Villages Panchayats Sub divisions; Most Districts in India are divided into two or more subdivisions each in charge of an Assistant collector or Sub Collector Tehsils(Taluks) Each division is again divided into tehsils (taluks) headed by Tehsildar. It comprise s 200 to 600 villages. Community Development Blocks The Block is a unit of rural planning and development, and comprises about 100 villages and about 80,000 to 20,000 population. The Urban areas of the district are organized into following institutions of local Self Government: Town area committees: In areas with popula tion ranging between 5000 and 10,000. Municipal Boards : In areas with population ranging from 10,000 to 2 lakhs, headed by Chairman or t he President Corporations: With population above 2 lakhs headed by Mayors. 10

FUNCTIONS OF MUNICIPAL BOARDS: Construction Maintenance of roads Sanitation a drainage Street Lighting Water supply Maintenance of hospitals and dispensaries Education Registration of Births and Deaths. PANCHAYATI RAJ This is a three tier system of Rural Local self Government, linking the Village to The District. These are: 1. Panchayat (at the Village Level) 2. Panchayat Sam iti( at the Block Level) 3. Zila Parishad ( at the District Level) At the Villag e Level The Gram sabha The Grama Panchayat The Nyaya Panchayat Gram sabha: the assembly of all the adults of the village which meets at least twice a year . It considers proposals for taxation, discusses the annual programme and elects members of Grama Panchayat.

It is

Gram Panchayat: It is an Executive organ of the gramsabha, an agency for the pla nning and development at the village level. Its strength varies from 15 to 30, a nd population varies from 5000 to 15000 or more. The members of the Gram Panchay at hold office for a period of 3 to 4 years. Every Panchayat has an elected Pres ident, Vice-President and Panchayat Secretary. 11

At the Block Level The Block consists of about 100 villages. Its population vari es from 80,000 to 1,20,000. Panchayati Raj agency at the Block level is the Panc hayat Samiti ( Janpada Panchayat) The Panchayat Samiti consists of all Sarpanchas (head)of the village, MLAs, MPs residing in the block area, representatives of wom en, Scheduled castes , Scheduled Tribes, and Co-operative Societies. The Block D evelopment Officer is the Ex Officio Secretary of the Panchayat Samiti. Functions of Panchayat Samiti Execution of Community Development Programme in th e Block. Funds provided for stage 1 and stage11 are channeled through the Pancha yat Samiti. At the District Level It is the agency of rural local self Government at the Dis trict level. Members include all heads of Panchayat Samitis of the District, MPs, MLAs of the District, representatives of Scheduled tribes and women, and 2 person s of experience in administration, public life or rural development Functions: I t is primarily supervisory and coordinating body. Its function varies from state to state. 12

AT THE DISTRICT LEVEL Headed by Collector. Sub divisions Tehsils Community Development Blocks Municipalities Corporations V illages Panchayats Assistant Tehsildar collector (Sub Collector) Chairman Mayors or the President 200 - 600 villages 100 villages 80,000 - 20,000 population. 10,000 to 2 lakhs Population population above 2 lakhs . PANCHAYATI RAJ (At the Village Level) Panchayat The Gram Sabha The Grama Panchay at The Nyaya Panchayat ( At the Block Level) Panchayat Samiti ( Janpada Panchaya t) ( At the District Level) Zila Parishad 13

CONCLUSION Various levels of health care has been discussed. Each state has its own system of health care delivery independent of the central Government. BIBLIOGRAPHY K Pa rk 2005, The Text book of Preventive Medicine 18th edition, pp. 674-677 http://www .healthsystem.com/delivery/agencies.html 14