Public Health Care Delivery

System in India

Lecture on 22nd August 2019

Basic Concepts

 Promotive
 Preventive
 Curative
 Rehabilitative
 Population Norms for Rural Health System

Health Plain Areas Difficult/Tribal/

Institution Hilly Areas
Sub Centre 5000 3000

Primary Health 30000 20000

Centre
Community 120000 80000
Health Centre

Source: Rural Health Statistics, MoHFW, Government of India, 2017

From Sub-Centres to Health and Wellness Centers
It is the first contact point between the health care
system of India and the community.
The Sub-centres are vital peripheral institutions for
providing primary health care to the people at the
grassroots level.
Manpower: One Auxiliary Nurse Midwife(ANM); One
Male Health Worker also known as Multi-Purpose
Worker(MPW).
A Medical Officer (MO) from the PHC will either visit
the Sub Centre either once or twice in a month.
A Sub-Centre must have its own building with separate
rooms for observation, clinic and residence of the
ANM
 From SCs to HWCs

 Sub-centres are expected to provide

promotive, preventive and few curative
primary health care services
 Focus in on providing Outreach Services-
Door to Door visits
 Maternal and Child Health; Nutrition
Diarrhoea Control, Family Welfare,
Immunization, Control of Communicable
and Non Communicable Diseases
 In February 2018, Government of India
decided to convert 1.5 lakhs Sub-Centres Outpatients at the health sub-centre at
Viralimalai block in Pudukottai district in
to Health and Wellness Centres Tamil Nadu.
Source: Scroll.in
 Primary Health Centres
 PHC is the first contact point between village community and the
Medical Officer-Doctor
 The PHCs were envisaged to provide an integrated curative and
preventive health care to the rural population
 It has around 4-6 beds for inpatient care.
 Manpower: 1or 2 Medical Officers with 12-14 Paramedical staff.
 PHC provides 24*7 services to its population.
 Outpatient Services, In-patient Services, Emergency Medical
Care, Basic laboratory and diagnostic services, MCH Services.
 Manpower at PHC in India

Sr.N Staff Essential

o
1 Medical Officer-MBBS 1
2 Medical Officer-AYUSH 1
3 Accountant cum Data Entry Operator 1
4 Pharmacist 1
5 Pharmacist-AYUSH 1
6 Nurse Midwife(Staff Nurse) 3
7 Health Worker (Female) 1
8 Health Assistant(Female) 1
9 Health Assistant/Lady Health Visitor 1
10 Health Educator 1
11 Laboratory Technician 1
12 Cold Chain Vaccine Logistic Assistant 1
13 Multi-Skilled Group D Worker 2
14 Sanitary Worker-Watchman 1

An Auxiliary Nurse Midwife conducts a

Source: IPHS –GoI 2012
health check at a primary health Centre in
Rajasthan. Source: Scroll.in
 PHCs-Contd

PHC acts as a Referral Unit for 6

Sub Centres.
It refers out cases to CHC (30
bedded hospital)

PHC constitutes the backbone of

the present health services in
India
Anaemic pregnant women get their
doses of iron-sucrose intravenously in
Dalot PHC, Pratapgarh district-
Source Scroll.in
Community Health Centres(CHCs)
 CHC is a 30-bedded hospital providing specialist care in Medicine,
Obstetrics and Gynecology, Surgery, Pediatrics, Dental and AYUSH
 4 PHCs are included under each CHC thus catering to approximately
80,000 populations in tribal/hilly/desert areas and 1,20,000 population
for plain areas
 CHCs acts as block level health administrative unit and gatekeeper
for referrals to higher level of facilities
 Services: Inpatient and Outpatient services.
 It should have one Operation Theatre, X-ray, Labour Room, Blood
Storage Services and Laboratory facilities.
 Pharmacy-with all the essential drugs; Wards-Males and Female;
Residential Quarters.
 Manpower: CHC is required to be manned by four medical specialists
i.e. Surgeon, Physician, Gynecologist and Pediatrician supported by 21
paramedical and other staff.
Thank You