UNIT-II - Health Organization at Village Level, Disctrict Level, State and Central Level - Anand

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09/30/20 17:43 Yenepoya Nursing College 1
(
Unit –II:
Organization, staffing and functions of
Rural Health Services, District level,
State level and central level
Presented by : Mr.Ananda.S,Asst.Professor, YNC

Reviewed by : Mrs.Savitha, Asst.Professor, YNC
Mrs.Shycil Mathew, Lecturer, YNC
Date of Review-18.08.2020
LEARNING OBJECTIVE
At the end of the class the students will be able to:-

 describe health organization at Village level
 Explain health organization at district level
 describe health orgainzation at state level
 describe health orgainzation at centre level
09/30/20 17:43 (NAME) 3

Organization, staffing and functions
of Rural Health Services
09/30/20 ANANDA.S ASST.PROFESSOR YNC 4

• AT VILLAGE LEVEL
 Village health guide
 Local dais
 Anganwadi worker
 Asha

VILLAGE HEALTH GUIDE SCHEME
• Village health guide is a person with an aptitude for

social service and is not a full time government
functionary.
• The village health guides scheme was introduced on
2nd October 1977 with idea of securing peoples
participation in the care of their own health

The guidelines for their selection are
• Permanent residents of the local community

• Able to read and write, having minimum formal
education
• Acceptable to all section of the community
• Able to spare at least 2 to 3 hrs every day for health
work
• After selection, the Health Guides undergo a short
training in primary health care
• On completion of training they receive a working
manual and a kit of simple medicines.
FUNCTIONS OF VILLAGE HEALTH
GUIDE:
• The duties assigned include treatment of simple

ailments and activities in first aid, mother and child
health including family planning ,health education
and sanitation.

LOCAL DAIS
 Most deliveries in rural areas are still handled by
untrained dais who are often the only people
immediately available to women during perinatal
period.
 An extensive programme has been undertaken under
the Rural Health Scheme to train all categories of
local dais in the country to improve their knowledge
in the elementary concepts of maternal and child
health and sterilization, besides obstetric skills.

`
 During her training of 30 days each Dai is required to
conduct atleast 2 deliveries under the guidance and
supervision
 After training each Dai is provided with delivery kit and
a Certificate .
 They are also expected to play a vital role in
propagating small family norm.
ANGANWADI WORKER
 Under the ICDS scheme, there is an Anganwadi
worker for a population of 1000.
 The Anganwadi worker is selected from the community
she is expected to serve.
 She undergoes training in various aspects of health,
nutrition and child development for 4 months services
rendered include health education, nonformal pre-
school education and referral services.
 The beneficiaries are generally nursing mothers,
other women, adolescents and children below the age of 6
years.
ASHA
• ASHA (Accredited Social Health Activist) will be a health
activist in the community who will create awareness on
health
Selection of ASHA:
• ASHA must be the resident of the village
• A woman (married /widow /divorced) preferably in the
age group of 25 to 45 years with formal education up to
eighth class, having communication skills and
leadership qualities.
 The general norm of selection is one ASHA
for 1000 population.
Role and responsibilities of ASHA
• ASHA will take steps to create awareness and provide
information to the community
• She will counsel women on birth preparedness, importance
of safe delivery, breast-feeding and complementary
feeding, immunization, ·Contraception and prevention of
common infections including reproductive tract
infection/sexually transmitted infection and care of the
young child.
• ASHA will mobilize the community and facilitate them
in accessing health and health related services
available at the anganwadi /subcentre/primary
health centres, such as immunization, antenatal
check-up, postnatal check-up, supplementary
nutrition, sanitation and other services being
provided by the government.
• She will work with the village health and sanitation
committee of the gram panchayat to develop a
comprehensive village health plan.
• She will arrange escort/accompany pregnant women
and children requiring treatment /admission to the
nearest pre-identified health facility i.e. primary
health centre/community health centre/First
Referral Unit.
• ASHA will provide primary medical care for minor
ailments such as diarrhoea, fevers, and first-aid for
minor injuries. She will be a provider of directly
observed treatment short-course (DOTS) under
revised national tuberculosis control programme.
• She will also act as a depot holder for essential
provisions of medicine
• She will inform about the births and deaths in her
village and any unusual health problems/disease
outbreaks in the community to the sub-centre/primary
health centre.
• She will promote construction of household toilets
under total sanitation campaign.
AT DISTRICT LEVEL
• The principal unit of administration in India is the

district under a collector.
• There are 642 (year 2019) districts in India.
• Within each district again there are 6 types of

administrative areas

1. Sub – divisions
2. Tehsils (Talukas)
3. Community Development Blocks 4. Municipalities
and Corporations
5. Villages
6. Panchayats

Most districts in India are divided into two or more
sub divisions, each in charge of an assistant Collector
or sub collector. Each division is again divided in to
tehsils (talukas), in charge of a Tehsildar
A tehsil usually comprises between 200 to 600
villages.

• The rural areas of the district have been organized
into Blocks, known as Community development
blocks,
• The block is a unit of rural planning and development,
and comprises approximately 100 villages and about
80,000 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.

HEALTH ORGANIZATION AT DISTRICT
LEVEL
• Urban administration • Rural administration

 Municipal Board  Panchayat (at Village level)
 Municipal Corporation  Gram sabha
 Town area committee  Gram Panchayat
 Naya panchayat
 Panchayat samiti
(at block level)
 Zila parishad
(at District level)
Municipal Boards:
 Municipal boards are set up in the areas having

population between 10000-200000.
 The municipal board is headed chairman/ president,
elected usually by its members.
 The term of the members ranges from 3-5 years.
 The municipal board looks after sanitation, drainage,
water supply, construction and maintenance of roads,
registration of births and death, education, running of
hospital and dispensaries.

Municipal Corporation
 Corporation are set up in the areas having

population more than 2,00,000.
 The corporation is headed by a mayor.
 It members are councilors who are elected from
various wards of the city.
 It carries the similar function or that of municipal
board but on a large & wide scale

Town Area Committee:
• The town area committee are set up in areas having

population in the range of 5000-10000.
• These are like panchayats and provide sanitary
services in area.

Rural administration
•Panchayati Raj Institution

•The Panchayati Raj is a 3-tier structure of rural local
self government in India, linking the village to the
district.
•The three institutions are:
1.Panchayat-at the village level
2.Panchayat Samiti- at the block level
3.Zila Parishad- at the district level

• Panchayat (At the village level ) ---It consists of:
(a)The Gram Sabha
(b)The Gram Panchayat
(c)The Nyay Panchayat
• Gram Sabha-
 The assembly of all the adults of the village, which
meets at least twice a year.
 It considers proposals for taxation, discuss the annual
programme & elects members of it self.

GRAM PANCHAYAT
• An agency for planning & development at the

village level.
Its strength varies from 15 to 30, & population
covered varies widely from 5,000-15,000 or more.
The members hold office for a period of 3 to 4 years.
Every panchayat has an elected President (Sarpanch
/Sabhapati /Mukhiya), a vice President & a
Panchayat Secretary.

The functions-
They cover the entire field of civic administration,
including sanitation & public health & social &

economic development of the village.

Panchayat samiti
(at the block level)
It consists of about 100 villages & a population of
about 80,000 to 1,20,000.
The Panchayati Raj agency at the block level is the
Panchayat Samiti /Janpada Panchayat.
It consists of all Sarpanchas of the village
panchayats in the Block; MLAs, MPs residing in
the block area; representatives of women,
scheduled castes, scheduled tribes &
cooperative societies.

The Block Development Officer is the ex-officio
secretary of it, & his staff give assistant to the village

panchayats engaged in development programmes.
Function-
Execution of the community development programme
in the block

Zilla Parishad
(At the District level)
The Zilla Parishad is the agency of rural local self

govt. at the district level.
The members are all heads of the Panchayat
Samities in the district; MPs, MLAs of the district,
representatives of scheduled castes, scheduled
tribes & women , & 2 persons of experience in
administration, rural development.
The collector is a non voting member, the
members varying from 40-70.
Functions of PRIs
1. Agriculture
2. Supply of safe and clean drinking water
3. Women and child development
4. Adult and formal education
5. Poverty alleviation programme
6. Rural electrification
7. Health and sanitation
8. Water management
9. Rural housing
10. Roads and other means of communication

Health organization at state level
09/30/20 17:43 (NAME) 33

Health organization at state level
• STATE HEALTH ADMINISTRATION

 At present there was 28 states in India, with each
state having its own health administration,
 In all states, the management sector comprises
the State ministry of health and a Directorate of
health or state health directorate

STATE MINISTRY OF HEALTH
• The state ministry of health is headed by a Minister of

health and family welfare and a Deputy minister of
Health and family welfare.
• The health secretariat is the official organ of the state
ministry of health and is headed by a Secretary who is
assisted by deputy Secretaries. Under Secretaries, a
large administrative staff.
STATE MINISTRY OF HEALTH
(Organization structure )

STATE HEALTH DIRECTORATE
• For a long time, two departments, medical and

public health, were functioning in the states;
• The heads of these departments were known as
• Surgeon general and inspector general of Civil

Hospitals
• Director of public health respectively.

 The Director of health services or 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 organization and
direction of all health activities.
 With the advent of family planning as an important
programme, the designation of director of health
services has been changed in some states and is now
know as Director of health and family welfare

 A recent development in some states in the
appointment of a Director of medical education in
view of the increasing number of medical colleges.
 The Director of health and family welfare is assisted
by a suitable number of deputies and Assistants.
 The Deputy and assistants Directors of health may be
two types—Regional and Functional.
 The regional directors inspect all the branches of
public health.
 The functional directors are usually specialists in a
particular branch of public health such MCH, family
planning, Nutrition,TB, leprosy, health education.

HEALTH ORGANIZATION AT CENTRAL
LEVEL

AT THE CENTRAL
The official “organs” of the health system at the
Central level consist of:
 The Union ministry of health and family
welfare
The directorate general of health services
(DGHS)
The central council of health and family welfare
UNION MINISTRY OF HEALTH AND FAMILY
WELFARE
(1). ORGANIZATION
 The union ministry of health and family welfare is
headed by a cabinet minister, a minister of state
and a deputy health minister.
 These are political appointments. Currently, the
union health ministry has the following
departments:
 Department of health and
 Department family welfare.
The department of health is headed by a secretary to

the government of India as its executive head, assisted
by joint secretaries, deputy secretaries and a large
administrative staff.
• The department of family welfare was created in 1966
with in the ministry of health and family welfare

The secretary to the government of India in the
ministry of health and family welfare is in over all in-
charge of the department of family welfare.
He is assisted by an additional secretary and

commissioner (family welfare), and one joint
secretary

Organization Structure

Functions of UMoHFW
• Union list (Central govt Only)

 International health relations and administration of
port quarantine
 Administration of Central Institutes
 Promotion of research
 Regulation and development of medical,

 Establishment and maintenance of drug standards
 Census and collection and publication of other
statistical data
 Coordination with states
09/30/20 17:43 (NAME) 48

Concurrent List (Both Central &
State Govt.)
• Prevention of Communicable disease
• Prevention of food adulteration
• Control of drug and poison
• Vital statistics
• Labour welfare
• Economic and social planning
• Population control and family planning

Directorate General of Health
Services
(DGHS)

DIRECTORATE GENERAL OF
HEALTH SERVICES
ORGANIZATION :
The Director general of health services is the
principal adviser to the union government in both
medical and public health matters.
The directorate comprises of three main units, e.g.,
medical care and hospitals, public health and
general administration .

Organization structure


Functions of Directorate General
of Health services
General functions
 Surveys

 Planning
 Coordination
 Programming and appraisal of all health matters

• Specific function
 International health relations and quarantine of all
major
• Ports in country and international airport.
• Control of drug standards
• Maintain medical store depots
• Administration of post graduate training
programmes
09/30/20 17:43 (NAME) 54

Administration of certain medical colleges in India
Conducting medical research through Indian Council of

Medical Research ( ICMR )
Central Government Health Schemes.
 Implementation of national health programmes
Preparation of health education material for creating
health awareness through Health Education Bureau

 Collection, compilation, analysis, evaluation and
dissemination of information
National Medical Library.
 3. Central Council of Health and
family welfare

Central Council Of Health and
family welfare
• It as set by presidential order on 9th Aug 1952

• Purpose is to promote the coordination between the
Centre and States in the implementation of national
programmes and measures pertaining to health
• Union Minister of Health is the chairman and State

Health Ministers are its members
09/30/20 ANAND, ASST.PROFESSOR YNC 57

Functions of CCH & FW
• Preparing proposals for making laws in areas of

medicine and health
• Making plans for development of health in entire

nation
• Preparing recommendations for providing grants and

financial assistance to state for medical services.

Summary

Conclusion

Evaluation
• Name 3 tire structure of Health organization in India
• Explain Organization pattern at State level
• List the functions of Union ministry of health and

welfare

THANK YOU
09/30/20 17:43 (NAME) 62

UNIT-II - Health Organization at Village Level, Disctrict Level, State and Central Level - Anand

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https://www.yenepoya.edu.

Presented by : Mr.Ananda.S,Asst.Professor, YNC

At the end of the class the students will be able to:-

 Explain health organization at district level

 describe health orgainzation at state level

 describe health orgainzation at centre level

09/30/20 17:43 (NAME) 3

09/30/20 ANANDA.S ASST.PROFESSOR YNC 4

 Village health guide

09/30/20 ANANDA.S ASST.PROFESSOR YNC 5

• Village health guide is a person with an aptitude for

09/30/20 ANANDA.S ASST.PROFESSOR YNC 6

• Permanent residents of the local community

• The duties assigned include treatment of simple

09/30/20 ANANDA.S ASST.PROFESSOR YNC 8

09/30/20 ANANDA.S ASST.PROFESSOR YNC 9

• The principal unit of administration in India is the

• Within each district again there are 6 types of

09/30/20 ANANDA.S ASST.PROFESSOR YNC 17

09/30/20 ANANDA.S ASST.PROFESSOR YNC 18

09/30/20 ANANDA.S ASST.PROFESSOR YNC 19

09/30/20 ANANDA.S ASST.PROFESSOR YNC 20

• Urban administration • Rural administration

 Municipal boards are set up in the areas having

09/30/20 ANANDA.S ASST.PROFESSOR YNC 22

 Corporation are set up in the areas having

09/30/20 ANANDA.S ASST.PROFESSOR YNC 23

• The town area committee are set up in areas having

09/30/20 ANANDA.S ASST.PROFESSOR YNC 24

•Panchayati Raj Institution

3.Zila Parishad- at the district level

09/30/20 ANANDA.S ASST.PROFESSOR YNC 25

09/30/20 ANANDA.S ASST.PROFESSOR YNC 26

• An agency for planning & development at the

09/30/20 ANANDA.S ASST.PROFESSOR YNC 27

They cover the entire field of civic administration,

including sanitation & public health & social &

09/30/20 ANANDA.S ASST.PROFESSOR YNC 28

09/30/20 ANANDA.S ASST.PROFESSOR YNC 29

secretary of it, & his staff give assistant to the village

09/30/20 ANANDA.S ASST.PROFESSOR YNC 30

The Zilla Parishad is the agency of rural local self

09/30/20 ANANDA.S ASST.PROFESSOR YNC 32

09/30/20 17:43 (NAME) 33

• STATE HEALTH ADMINISTRATION

09/30/20 ANANDA.S ASST.PROFESSOR YNC 34

• The state ministry of health is headed by a Minister of

09/30/20 ANANDA.S ASST.PROFESSOR YNC 36

• For a long time, two departments, medical and

• Surgeon general and inspector general of Civil

09/30/20 ANANDA.S ASST.PROFESSOR YNC 37

09/30/20 ANANDA.S ASST.PROFESSOR YNC 38

09/30/20 ANANDA.S ASST.PROFESSOR YNC 40

09/30/20 ANANDA.S ASST.PROFESSOR YNC 41

The department of health is headed by a secretary to

09/30/20 ANANDA.S ASST.PROFESSOR YNC 44

He is assisted by an additional secretary and

09/30/20 ANANDA.S ASST.PROFESSOR YNC 45

09/30/20 ANANDA.S ASST.PROFESSOR YNC 46

• Union list (Central govt Only)

 Regulation and development of medical,

 Census and collection and publication of other

09/30/20 17:43 (NAME) 48