LESSON PLAN

Name of supervisor: Respected Mrs. sandeep kaur

Name of student teacher: gurjeet kaur
Class: M.Sc. 1st year
Subject: community health nursing
Topic: health schemes
Date: 19-1-2019
Time: 45 min.
Place: B.Sc. 4th Year class room
A.V.Aids: flash cards , chart, black board
Method of teaching: Lecture cum discussion method
General Objective: At the end group will be able to answer the question related to health
schemes.
Specific Objective: At the end of the topic the group will be able to :
-Explain the definition
-describe the objective
-enlist the health schemes
-explain the ESI
-explain the CGHS
-describe the function of nurse

Se Spec T Content Teach A.V. eval

1
ria ific i ing Aids uati
l obje m learni on
nu ctive e ng
m activit
be ies
r
1) To 2 INTRODUCTION: My self Gurjeet kaur.I am Stude
mai m student of M.Sc. 2nd year in national institute of nt
ntai in nursing. teach
n er
IPR gave
with self
grou introd
p. uction

2) To 2 Ask the question like what you know about health lectur wha
revi m scheme e cum t are

ew in discus the
heal
the t sion
th
prev metho
sche
ious d.
mes
kno
?
wled
ge
of
grou
p

3) To 2 Today I am going to present my topic on health Stude

anno m scheme nt
unce in teach
the t er
topi annou

2
 c nce
the
topic

4) to 3 health scheme is a health insurance programme , lectur defi

defi m people who have the risk of certain event contribute e cum blac ne
ne in a small amount towards a health insurance fund . discus k heal
the this fund is then used to treat patients who sion boar th
topi experience that particular event. metho d sch
c d eme
s?

5) To 3 health schemes have two main objectives: Lectu Wh

enlis m -to increase the access to health care re blac at
t the in -to protect the employee from high medical expenses cum k are
obje at the time of illness. discus boar the
ctive sion d obj
of metho ecti
healt d ves
h of
sche heal
mes th
sch
eme
s?
6) To 6 the health schemes classified into following lectur blac ho
enlis m category: e cum k w
t the in -MANDATORY HEALTH INSURANCE SCHEME discus boar ma
healt -EMPLOYER BASED SCHEME sion d ny
h -VOLUNTARY HEALTH INSURANCE SCHEMES metho heal
sche d th
mes sch
in eme
inda s

3
 i wor
kin
g in
indi
a
7) expl 1 ESI Scheme Lectu trans Exp
ain 0 Social Security Benefits under ESI Act re pare lain
abou m The promulgation of Employees’ State Insurance cum ncy the
in
t Act. by the Parliament, in 1948 was the first major discus ESI
man legislation on comprehensive Social Security for sion .
dato workers in independent India. The Act envisages metho
ry social protection of workers deployed in the d
organized sector in conceivable contingencies, such
healt
as sickness, maternity and death or disablement
h
due to employment injury and occupational disease.
sche Based on the principal of “Pooling Of Risks And
mes Resources”, the unique, multidimensional health
insurance scheme guarantees a fair deal to the
covered members by providing full medical facilities
to the beneficiaries, besides, adequate cash
compensation to insured persons for loss of wages
or earning capacity in times of physical distress
arising out of sickness or employment injury
(including commuting accidents) or unemployment.
COVERAGE UNDER ESI ACT 1948
APPLICABILITY
Under Section 2(12) the Act is applicable to non-
seasonal factories employing 10 or more persons.
Under Section 1(5) of the Act, the Scheme has been
extended to shops, hotels, restaurants, cinemas
including preview theatres, road-motor transport
undertakings and newspaper establishments
employing 10 or more persons.

Further , under section 1(5) of the Act, the Scheme

has been extended to Private Medical and
Educational institutions employing 10 or more

4
persons in most of the States/UTs .In Goa state , ESI
Scheme is yet to be notified to Private Medical and
Educational institutions

The existing wage limit for coverage under the Act is

Rs. 15,000/- per month ( w.e.f. 01/05/2010).

AREAS COVERED
The ESI Scheme is being implemented area-wise by
stages. The Scheme has already been implemented
in most of the areas in the various States/Union
Territories of Indian Union. Entire territory of Goa
state is notified under ESI Scheme at present.

ESIC at a Glance .
Details Whole India (31.3.2013)

No. of Insured Person/ family 18582000

units

No. of Employees 16504500

Total No. of Beneficiaries 72098160

No. of Employers, etc 666161

ADMINISTRATION
The comprehensive and multi-pronged social
security programme is administered by an apex
corporate body called the Employees' State
Insurance Corporation. It comprises members
representing vital interest groups, including,
employees, employers, the Central and State
Government, representatives of Parliament and
medical profession. The Corporation is headed by
the Union Minister of Labour, as its Chairman,

5
whereas the Director General, appointed by the
Central Government functions as its Chief Executive
Officer. The broad based corporate body is,
primarily, responsible for coordinated policy
planning and decision making for growth,
development and efficacy of the scheme. A Standing
Committee,constituted from among the members
of the Corporation, acts as an Executive Body. The
Medical Benefit Council, constituted by the Central
Government, is yet another Statutory Body that
advises the Corporation on matters related to
effective delivery of medical services to the
BeneficiaryPopulation.

The Corporation, with its Central Headquarters at

New Delhi, operates through a network of 52
Regional, Sub- Regional and Divisional Offices
located in various States. The administration of
Medical Benefit is taken care of by the respective
State Government except in case of Delhi and
Noida/Greater Noida area in Uttar Pradesh where
the Corporation administers medical facilities
directly. The Corporation has taken over the
administration of 23 ESI Hospitals in various States
for developing them as ESIC Model Hospitals and
also entered into Medical Education field by
opening various PG institutes and also on the
advanced stages of opening a number of ESI
Medical colleges across India to strengthen the
delivery of medical benefits to ESI beneficiaries.
FINANCE
ESI Scheme, like most of the Social Security Schemes
the world over, is a self financing health insurance
scheme. Contributions are raised from covered
employees and their employers as a fixed
percentage of wages. As of now, covered employees
contribute 1.75% of the wages, whereas, the
employers contribute 4.75% of the wages, payable

6
to their employees. Employees earning upto
Rs.100/- a day are exempted from payment of their
share of contribution. The State Governments, as
per provisions of the Act, contribute 1/8th of the
expenditure of medical benefit within a per capita
ceiling of Rs. 1500/- per Insured Person per annum.
Any additional expenditure incurred by the State
Governments, over and above the ceiling and not
falling within the shareable pool, is borne by the
State Governments concerned.
CONTRIBUTION
E.S.I. Scheme being contributory in nature, all the
employees in the factories or establishments to
which the Act applies shall be insured in a manner
provided by the Act. The contribution payable to the
Corporation in respect of an employee shall
comprise of employer's contribution and
employee's contribution at a specified rate. The
rates are revised from time to time. Currently, the
employee's contribution rate (w.e.f. 1.1.97) is 1.75%
of the wages and that of employer's is 4.75% of the
wages paid/payable in respect of the employees in
every wage period. Employees in receipt of a daily
average wage upto Rs.100/- are exempted from
payment of contribution. Employers will however
contribute their own share in respect of these
employees.
Collection of Contribution
An employer is liable to pay his contribution in
respect of every employee and deduct employees
contribution from wages bill and shall pay these
contributions at the above specified rates to the
Corporation within 21 days of the last day of the
Calendar month in which the contributions fall due.
The Corporation has authorized designated
branches of the State Bank of India and some other
banks to receive the payments on its behalf.
Contribution Period and Benefit Period

7
There are two contribution periods each of six
months duration and two corresponding benefit
periods also of six months duration as under.
Contribution period and Corresponding Cash Benefit period

Contribution Period

1st April to 30th Sept

1st Oct to 31st March of the year

BENEFITS
The section 46 of the Act envisages following six
social security benefits :-

(a) Medical Benefit: Full medical care is provided to

an Insured person and his family members from the
day he enters insurable employment. There is no
ceiling on expenditure on the treatment of an
Insured Person or his family member. Medical care
is also provided to retired and permanently disabled
insured persons and their spouses on payment of a
token annual premium of Rs.120/- .
1. System of Treatment
2. Scale of Medical Benefit
3. Benefits to Retired IPs
4. Administration of Medical Benefit in a
State
5. Domiciliary treatment
6. Specialist consultation
7. In-Patient treatment
8. Imaging Services
9. Artificial Limbs & Aids
10. Special Provisions
11. Reimbursement
(b) Sickness Benefit(SB): Sickness Benefit in the
form of cash compensation at the rate of 70 per
cent of wages is payable to insured workers during
the periods of certified sickness for a maximum of
91 days in a year. In order to qualify for sickness

8
benefit the insured worker is required to contribute
for 78 days in a contribution period of 6 months.
1. Extended Sickness Benefit(ESB): SB
extendable upto two years in the case of 34
malignant and long-term diseases at an
enhanced rate of 80 per cent of wages.
2. Enhanced Sickness Benefit: Enhanced
Sickness Benefit equal to full wage is payable
to insured persons undergoing sterilization
for 7 days/14 days for male and female
workers respectively.
(c) Maternity Benefit (MB): Maternity Benefit for
confinement/pregnancy is payable for three
months, which is extendable by further one month
on medical advice at the rate of full wage subject to
contribution for 70 days in the preceding year.

(d) Disablement Benefit

1.Temporary disablement benefit (TDB):
From day one of entering insurable
employment & irrespective of having paid
any contribution in case of employment
injury. Temporary Disablement Benefit at
the rate of 90% of wage is payable so long as
disability continues.
2.Permanent disablement benefit (PDB):
The benefit is paid at the rate of 90% of
wage in the form of monthly payment
depending upon the extent of loss of earning
capacity as certified by a Medical Board
(e) Dependants' Benefit(DB): DB paid at the rate of
90% of wage in the form of monthly payment to the
dependants of a deceased Insured person in cases
where death occurs due to employment injury or
occupational hazards.

(f) Other Benefits

Funeral Expenses : An amount of Rs.10,000/- is

9
 payable to the dependents or to the person who
performs last rites from day one of entering
insurable employment.
Confinement Expenses : An Insured Women or an
I.P. in respect of his wife in case confinement
occurs at a place where necessary medical facilities
under ESI Scheme are not available. Rs. 5000/- per
case for two confinements only.

In addition, the scheme also provides some other

need based benefits to insured workers.

Vocational Rehabilitation :To permanently disabled

Insured Person for undergoing Vocational
Rehabilitation Training at VRS.

Physical Rehabilitation:In case of physical

disablement due to employment injury.
Old Age Medical Care :For Insured Person retiring
on attaining the age of superannuation or under
VRS/ERS and person having to leave service due to
permanent disability insured person & spouse on
payment of Rs. 120/- per annum.
Rajiv Gandhi Shramik Kalyan Yojana : This scheme
of Unemployment allowance was introduced w.e.f.
01-04-2005. An Insured Person who become
unemployed after being insured three or more
years, due to closure of factory/establishment,
retrenchment or permanent invalidity are entitled
to :-
 Unemployment Allowance equal to 50% of wage
for a maximum period of upto one year.
 Medical care for self and family from ESI
Hospitals/Dispensaries during the period IP
receives unemployment allowance.
 Vocational Training provided for upgrading skills -
Expenditure on fee/travelling allowance borne by
ESIC.

10
 Incentive to employers in the Private Sector for
providing regular employment to the persons with
disability :
 Minimum wage limit for Physically Disabled
Persons for availing ESIC Benefits is 25,000/-.
 Employers' contribution is paid by the Central
Government for 3 years.
Benefits & Contributory Conditions :
An interesting feature of the ESI Scheme is
that the contributions are related to the paying
capacity as a fixed percentage of the workers’
wages, whereas, they are provided social security
benefits according to individual needs without
distinction.
Cash Benefits are disbursed by the Corporation
through its Branch Offices (BOs) / Pay Offices (POs),
subject to certain contributory conditions
.
8) expl 1 lectur chart wha
About CGHS
ain 0 Back e cum t is
the m discus CG
For the last six decades Central Government
cent in Health Scheme is providing comprehensive sion HS
ral medical care to the Central Government metho ?
employees and pensioners enrolled under the
gove scheme. In fact CGHS caters to the healthcare d
needs of eligible beneficiaries covering all four
rnm pillars of democratic set up in India namely
Legislature, Judiciary, Executive and Press. CGHS
ent
is the model Health care facility provider for
healt Central Government employees & Pensioners and
is unique of its kind due to the large volume of
h beneficiary base, and open ended generous
approach of providing health care.
sche
me CGHS provides health care through following
systems of Medicine

 Allopathic
 Homoeopathic
 Indian system of medicine
o Ayurveda
o Unani
o Siddha and

11
Eligibility for Joining CGHS
Back

 All Central Govt. employees drawing their

salary from Central Civil Estimates and
their dependant family members residing
in CGHS covered areas.
 Central Govt. Pensioners/family pensioners
receiving pension from central civil
estimates and their eligible dependent
family members.
 Sitting and Ex-members of Parliament.
 Ex-Governors & Lt. Governors.
 Freedom Fighters.
 Ex-Vice Presidents.
 Sitting and Retired Judges of Supreme
Court.
 Retired Judge of High Courts.
 Journalists accredited with PIB (in Delhi).
 Employees and pensioners of certain
autonomous/statutory bodies which have
been extended CGHS facilities in Delhi.
 Delhi Police Personnel in Delhi only.
 Railway Board employees
 Post and Telegraph Department
employees.

Facilities available under CGHS

Back

 OPD Treatment including issue of

medicines.
 Specialist Consultation at Polyclinic/Govt.
Hospitals.
 Indoor Treatment at Government and
Empanelled Hospitals.
 Investigations at Government and
Empanelled Diagnostic centers.
 Cashless facility available for treatment in
empanelled hospitals and diagnostic
centers for Pensioners and other identified
beneficiaries.
 Reimbursement of expenses for treatment
availed in Govt. /Private Hospitals under
emergency.
 Reimbursement of expenses incurred for
purchase of hearing aids, artificial limbs,
appliances etc. as specified.
 Family Welfare, Maternity and Child Health
Services.
 Medical consultation and dispensing of
medicines in Ayurveda, Homeopathy,
Unani and Siddha system of medicines

12
 (AYUSH)

CGHS Covered Cities

Back

CGHS, presently provides Comprehensive Health

Care to more than 30 Lakh Beneficiaries in
following Cities

1. Agartala
2. Ahmedabad
3. Aizwal
4. Allahabad
5. Bengaluru
6. Bhopal
7. Bhubaneshwar
8. Chandigarh
9. Chennai
10. Dehradun
11. Delhi & NCR
12. Gandhinagar
13. Gangtok
14. Goa
15. Guwahati
16. Hyderabad
17. Imphal
18. Indore
19. Jabalpur,
20. Jaipur
21. Jammu
22. Kanpur
23. Kolkata
24. Kohima
25. Lucknow
26. Meerut
27. Mumbai
28. Nagpur
29. Patna
30. Pune
31. Puduchery
32. Raipur
33. Ranchi
34. Shillong
35. Shimla
36. Thiruvananthapuram
37. Vishakhapatnam

9) To 2 on the base of employees there are two major scheme lectu blac Exp
expl m -defence scheme re k lain
ain in -railway scheme cum boar abo
the disc d ut

13
 emp ussi the
loye on em
e met plo
base hod. yee
d bas
sche ed
me sch
eme
10 To 3 Lect blac Wh
) desc m Roles and Responsibilities of a Community Health ure k at
ribe in Nurse cum boar are
the disc d the
1. The main focus of community health nurse is health
func promotion. ussi fun
tion on ctio
Programmer/Planner
of met n of
nurs  Identifies the needs and concerns of hod nur
e individuals, groups, families, and the se?
community
 Formulates health plans, especially in the
absence of a community physician
 Interprets and implements nursing plans
and programs
 Assists other health team members in
implementing health programs in the
setting
Health Educator/Trainer/ Counsellor

 Acts as resource speaker on health and

health related services
 Advocates health programs in the
community through dissemination of IEC or
Information Education and Communication
materials
 Conducts advocacy educations concerning
premarital, breastfeeding, and
immunization counsellings
 Organizes orientation/ training of
concerned groups like pregnant mothers
 Identifies and interprets training needs of

14
 health team members and formulate
appropriate training program for them
 Conducts and facilitates necessary training
or educational orientation to other health
team members in the community
2. The recipient of care of community public health
nursing practice is extended not only the individual
but also to benefit the whole family and community.

Community Organizer

 Promotes self- reliance of community and

emphasizes their involvement and
participation in planning, organizing,
implementing and evaluating of health
services
 Initiates and implements community
development activities
Coordinator of services

 Coordinates health services with concerned

individuals and families through the
community health team members,
government organizations and non-
government organizations
 Coordinates nursing plans and programs
with other health programs
3. Community health nurse are generalists in terms of
their practice through life’s continuum.

Provider of Nursing Care

 Renders direct care to various clients with

different needs, may it be at home, in
school, clinics or work settings
 Involves the family in the care of the sick
or dependent individual, i.e. sick child
4. Continuity of care with the client, family or and the
community extends for a longer time involving
individuals of all ages and health needs.

Health Monitor

 Monitors and detects presence of health

15
 concerns in the community through
contacts or home visits.
 Utilizes various effective data gathering
techniques in keeping an eye on the health
status of all recipients of care.
 Records and reports health status and
presence of health problems in the
community
5. The nature of nursing practice in the community
needs the knowledge of biological and social sciences,
ecology, clinical nursing, and community organizing,
for it to be effective.

Researcher

 Follows a systematic process of monitoring

the health status of the community
through the conduct of surveys and home
visits
 Conducts researches concerning the health
of the community
 Coordinates with government and non-
government organizations in the conduct
and implementation of studies
Statistician

 Records data systematically and ensures its

validity through accurate and complete
data gathering
 Reports prepared reports to concerned
organizations i.e. government organization
for immediate necessary plans or programs
 Consolidates and reviews reports
efficiently.
 Analyzes and interprets consolidated data
for monitoring the development in the
health matters of the whole community
6. This field of nursing practice utilizes a dynamic
process (assessment, planning, implementation, and
evaluation) in the provision of continuous care until
termination is implicit.

Change Agent

16
  Promotes and motivates change in the
community in their health practices and
lifestyle behaviours for them to promote
and maintain good health, be
knowledgeable and has initiative in
accessing health services
 Inculcates self- reliance to brought about
development and improvement in the
community

11 To 2 student teacher summarize the topic lectur defi

) sum m e cum ne

mari in discus ESI

?
ze sion
CG
the
HS?
topi
c

bibliography:
R.P. sexana a book of community health nursing ; edition 1st; lotus publishing house

www.slideshare.com

www.wikipedia.com

NATIONAL INSTITUTE OF NURSING

17
 LESSON PLAN
ON
SCHOOL HEALTH SERVICES

SUBJECT:COMMUNITY HEALTH NURSING

SUBMITTED TO : RESPECTED Mrs.HARPREET KAUR(H.O.D. CHN)

SUBMITTED BY:
GURJEET KAUR

MSc. NURSING

2ND YEAR

18