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HEALTH CARE DELIVERY
HEALTH  CARE  DELIVERY-dr tanvir new.ppt
Health status or
health problems
Curative
Preventive
Promotive
Public
Private
Voluntary
Indigenous
Changes
in health
status
Resources
Inputs Health care
services
Health care
system
Outputs
Model of a health care system
Health status and health problems
• Demographic profile
• Mortality profile
• Health problems-
1.Communicable disease problems-
• malaria
• Tuberculosis
• Diarrhoeal ds’s
• ARI
• Leprosy
• Filaria
• AIDS
• Others
2.Non-communicable ds’s
3.Nutritional problems-
• PEM
• Nutritional anaemia
• LBW
• Xerophthalmia
• IDD
• Others
4.Environmental sanitation
5.Medical care problems
6.Population problem
Resources
• Health manpower
• Money and material
• Time
Health care services
• Curative
• Preventive
• Promotive
Health care systems
• 1.PUBLIC HEALTH SECTOR
a) Primary Health Care
Primary health centres
Sub-centres
b) Hospitals/Health Centres
Community health centres
Rural hospitals
District hospital/health centre
Specialist hospitals
Teaching hospitals
c) Health Insurance Schemes
ESI
CGHS
d) Other agencies
defence services
railways
2. PRIVATE SECTOR
a) Private hospitals, polyclinics, nursing homes,
and dispensaries
b) General practitioners and clinics
3. INDIGENOUS SYSTEMS OF MEDICINE
Ayurveda and siddha
Unani and tibbi
Homeopathy
Unregistered practitioners
4. VOLUNTARY HEALTH AGENCIES
5. NATIONAL HEALTH PROGRAMMES
HEALTH SYSTEM IN INDIA
1. AT THE CENTRE
The ministry of health and family welfare
The directorate general of health services
The central council of health and family welfare
• Union ministry of health and family welfare
Dept. of health
Dept. of family welfare
Functions-
Union list
Concurrent list
• Directorate general of health services-
Organization
Functions-general , specific
• Central Council of health-
functions
2. AT THE STATE LEVEL
State ministry of health
State health directorate-
director of health services
director of medical education
3. AT THE DISTRICT LEVEL
Sub-divisions
Tehsils
Community development blocks
Municipalities and corporations
Villages
Panchayats
• PANCHAYATI RAJ
Panchayat-at the village level
Panchayat samiti-at the block level
Zilla parishad-at the district level
LEVELS OF HEALTH CARE
• PRIMARY CARE LEVEL
• SECONDARY CARE LEVEL
• TERTIARY CARE LEVEL
REFERRAL SYSTEM
HEALTH  CARE  DELIVERY-dr tanvir new.ppt
HEALTH  CARE  DELIVERY-dr tanvir new.ppt
PRIMARY HEALTH CARE
• “Is the essential health care made universally
accessible to individuals and acceptable to
them, through their fulll participation and at a
cost the community and country can afford.”
ELEMENTS
• Education of prevailing health problems and
methods of preventing and contolling them
• Promotion of food supply and proper nutrition
• Safe water and basic sanitation
• MCH +FP
• Immunization
• Locally endemic ds’s
• Common ds’s and injuries
• Essential drugs
PRINCIPLES
• Equitable distribution
• Community participation
• Intersectoral coordination
• Appropriate technology
Primary health care in India
• VILLAGE LEVEL-
village health guides scheme
Local dais
Anganwadi workers
ASHA
SUB-CENTRE LEVEL
• Immunization
• Antenatal care
• Natal care
• Post natal care
• Prevention of malnutrition
• Common childhood illnesses
• Family planning and counseling
• Drugs for ARI, diarrhoea,fever,worm
infestation
• NHPs
staff
• MHW(F)=ANM=1/2
• MHW(M)=BHW=1
• HA(F)=LHV
• HA(M)=SI
• VHW=1
•
• Total=2-3/3-4
services
• Maternal health care- ANC,INC,PNC
• Child health care
• FP and counseling
• MTP
• Adolescent health
• School health services
• Water quality monitoring
• Sanitation
• Field visits
• Community needs assessment
• Curative
• + AYUSH
• Training-TBA/ASHA
• NHP-
NACP,NVBDCP,NLEP,IDSP,RNTCP,NBCP,NCDCP
• Vital events
PRIMARY HEALTH CENTRE LEVEL
• Medical care
• MCH+FP
• Safe water and sanitation
• Local endemic ds’s
• Vital stats
• HE
• NHP
• Referral services
• Training
• Basic lab
IPHS standards
• Medical care- OPD, 24 hr emergency, referral,
IPD(6 beds)
• MCH- ANC-lab,nut & counseling,
supplementary, high risk, referral
• Intranatal
• PNC
• New born care
• IMNCI
• FP
• MTP
• HE
• Nutrition
• School health services
• Adolescent health services
• Ds surveillance and epidemic ds control
• Vital events
• Sanitation
• Water quality
• NHP
• Referral
• Training
• Basic lab
• Monitoring and supervision
• Selected surgical
• AYUSH
staff
• MO=1/3(1 F)
• AYUSH=0/1
• Pharmacist=1/2
• Nurse=1/5
• HW(F)=1/1
• HA(M&F)=1/2
• HE=1/1
• Account manager=0/1
• Clerk=2/2
• LT=1/2
• Driver=1/optional
• Class IV=4/4
Total=15/24-25
COMMUNITY HEALTH CENTRES
IPHS std:
• Care of routine & emergency surgery cases
• Care of routine & emergency medicine cases
• 24 hr delivery-normal &CS
• Essential & emergency obstetric care
• FP+ laparoscopic sterilization
• Safe abortion
• New born care
• Sick children
• Others- tracheostomy, nasal packing, FB
removal
• NHPs
• Others- blood storage,
essential lab
referral(transport)
staff
• Surgeon=1/1
• Physician=1/1
• Obs/gynaecologist=1/1
• Paediatrician=1/1
• Anaesthetist=0/1
• PHM=0/1
• Opthalmologist= 0/1 for 5 CHCs
• Dental surgeon=0/1
• MO=6 MBBS(2F)
• AYUSH=0/2(1 ug+1pg)
Total=4/15-16
• Nurse=7+2
• Dresser=1
• LT=1
• Radiographer=1
• OA=0-1
• Ward boy=2
• Sweeper=3
• OPD att./stat asst./data entry operater/OT
att./reg clerk=5
Total=21-22+2
• SN=19
• PHN=1
• ANM=1
• Pharmacist=3
• Pharmacist AYUSH=1
• LT=3
• Radiographer=2
• OA=1
• Dresser=2
• Ward boy=5
• Sweeper=5
• Chowkidar=5
• Dhobi=1
• Mali=1
• Aya=5
• Peon=2
• OPD asst.=1
• Reg clerk=2
• Stat asst.=2
• Accountant=1
• OT tech=1
Total=64
Job descriptions
MO, PHC
HW(F)-
• MCH
• FP
• MTP
• Nutrition
• UIP
• Dai training
• Communicable ds’s
• Vital events
• Record keeping
• Treatment
• Team activity
HW(M)
• Record keeping
• Vector borne ds’s-malaria,filaria,JE,KA
• Communicable ds
• Leprosy
• TB
• NBCP
• Environmental sanitation
• EPI
• FP
• ASHA
• HA(M&F)
• HOSPITAL Vs HEALTH CENTRE

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HEALTH CARE DELIVERY-dr tanvir new.ppt

  • 3. Health status or health problems Curative Preventive Promotive Public Private Voluntary Indigenous Changes in health status Resources Inputs Health care services Health care system Outputs Model of a health care system
  • 4. Health status and health problems • Demographic profile • Mortality profile
  • 5. • Health problems- 1.Communicable disease problems- • malaria • Tuberculosis • Diarrhoeal ds’s • ARI • Leprosy • Filaria • AIDS • Others 2.Non-communicable ds’s
  • 6. 3.Nutritional problems- • PEM • Nutritional anaemia • LBW • Xerophthalmia • IDD • Others 4.Environmental sanitation 5.Medical care problems 6.Population problem
  • 7. Resources • Health manpower • Money and material • Time
  • 8. Health care services • Curative • Preventive • Promotive
  • 9. Health care systems • 1.PUBLIC HEALTH SECTOR a) Primary Health Care Primary health centres Sub-centres b) Hospitals/Health Centres Community health centres Rural hospitals District hospital/health centre Specialist hospitals Teaching hospitals
  • 10. c) Health Insurance Schemes ESI CGHS d) Other agencies defence services railways
  • 11. 2. PRIVATE SECTOR a) Private hospitals, polyclinics, nursing homes, and dispensaries b) General practitioners and clinics
  • 12. 3. INDIGENOUS SYSTEMS OF MEDICINE Ayurveda and siddha Unani and tibbi Homeopathy Unregistered practitioners
  • 13. 4. VOLUNTARY HEALTH AGENCIES 5. NATIONAL HEALTH PROGRAMMES
  • 14. HEALTH SYSTEM IN INDIA 1. AT THE CENTRE The ministry of health and family welfare The directorate general of health services The central council of health and family welfare
  • 15. • Union ministry of health and family welfare Dept. of health Dept. of family welfare Functions- Union list Concurrent list
  • 16. • Directorate general of health services- Organization Functions-general , specific • Central Council of health- functions
  • 17. 2. AT THE STATE LEVEL State ministry of health State health directorate- director of health services director of medical education
  • 18. 3. AT THE DISTRICT LEVEL Sub-divisions Tehsils Community development blocks Municipalities and corporations Villages Panchayats
  • 19. • PANCHAYATI RAJ Panchayat-at the village level Panchayat samiti-at the block level Zilla parishad-at the district level
  • 20. LEVELS OF HEALTH CARE • PRIMARY CARE LEVEL • SECONDARY CARE LEVEL • TERTIARY CARE LEVEL REFERRAL SYSTEM
  • 23. PRIMARY HEALTH CARE • “Is the essential health care made universally accessible to individuals and acceptable to them, through their fulll participation and at a cost the community and country can afford.”
  • 24. ELEMENTS • Education of prevailing health problems and methods of preventing and contolling them • Promotion of food supply and proper nutrition • Safe water and basic sanitation • MCH +FP
  • 25. • Immunization • Locally endemic ds’s • Common ds’s and injuries • Essential drugs
  • 26. PRINCIPLES • Equitable distribution • Community participation • Intersectoral coordination • Appropriate technology
  • 27. Primary health care in India • VILLAGE LEVEL- village health guides scheme Local dais Anganwadi workers ASHA
  • 28. SUB-CENTRE LEVEL • Immunization • Antenatal care • Natal care • Post natal care • Prevention of malnutrition • Common childhood illnesses • Family planning and counseling • Drugs for ARI, diarrhoea,fever,worm infestation • NHPs
  • 29. staff • MHW(F)=ANM=1/2 • MHW(M)=BHW=1 • HA(F)=LHV • HA(M)=SI • VHW=1 • • Total=2-3/3-4
  • 30. services • Maternal health care- ANC,INC,PNC • Child health care • FP and counseling • MTP • Adolescent health • School health services • Water quality monitoring • Sanitation
  • 31. • Field visits • Community needs assessment • Curative • + AYUSH • Training-TBA/ASHA • NHP- NACP,NVBDCP,NLEP,IDSP,RNTCP,NBCP,NCDCP • Vital events
  • 32. PRIMARY HEALTH CENTRE LEVEL • Medical care • MCH+FP • Safe water and sanitation • Local endemic ds’s • Vital stats • HE • NHP • Referral services • Training • Basic lab
  • 33. IPHS standards • Medical care- OPD, 24 hr emergency, referral, IPD(6 beds) • MCH- ANC-lab,nut & counseling, supplementary, high risk, referral • Intranatal • PNC • New born care • IMNCI
  • 34. • FP • MTP • HE • Nutrition • School health services • Adolescent health services • Ds surveillance and epidemic ds control • Vital events
  • 35. • Sanitation • Water quality • NHP • Referral • Training • Basic lab • Monitoring and supervision • Selected surgical • AYUSH
  • 36. staff • MO=1/3(1 F) • AYUSH=0/1 • Pharmacist=1/2 • Nurse=1/5 • HW(F)=1/1 • HA(M&F)=1/2 • HE=1/1 • Account manager=0/1
  • 37. • Clerk=2/2 • LT=1/2 • Driver=1/optional • Class IV=4/4 Total=15/24-25
  • 38. COMMUNITY HEALTH CENTRES IPHS std: • Care of routine & emergency surgery cases • Care of routine & emergency medicine cases • 24 hr delivery-normal &CS • Essential & emergency obstetric care • FP+ laparoscopic sterilization • Safe abortion
  • 39. • New born care • Sick children • Others- tracheostomy, nasal packing, FB removal • NHPs • Others- blood storage, essential lab referral(transport)
  • 40. staff • Surgeon=1/1 • Physician=1/1 • Obs/gynaecologist=1/1 • Paediatrician=1/1 • Anaesthetist=0/1 • PHM=0/1 • Opthalmologist= 0/1 for 5 CHCs • Dental surgeon=0/1 • MO=6 MBBS(2F) • AYUSH=0/2(1 ug+1pg) Total=4/15-16
  • 41. • Nurse=7+2 • Dresser=1 • LT=1 • Radiographer=1 • OA=0-1 • Ward boy=2 • Sweeper=3 • OPD att./stat asst./data entry operater/OT att./reg clerk=5 Total=21-22+2
  • 42. • SN=19 • PHN=1 • ANM=1 • Pharmacist=3 • Pharmacist AYUSH=1 • LT=3 • Radiographer=2 • OA=1 • Dresser=2 • Ward boy=5 • Sweeper=5
  • 43. • Chowkidar=5 • Dhobi=1 • Mali=1 • Aya=5 • Peon=2 • OPD asst.=1 • Reg clerk=2 • Stat asst.=2 • Accountant=1 • OT tech=1 Total=64
  • 44. Job descriptions MO, PHC HW(F)- • MCH • FP • MTP • Nutrition
  • 45. • UIP • Dai training • Communicable ds’s • Vital events • Record keeping • Treatment • Team activity
  • 46. HW(M) • Record keeping • Vector borne ds’s-malaria,filaria,JE,KA • Communicable ds • Leprosy • TB • NBCP • Environmental sanitation • EPI • FP
  • 48. • HOSPITAL Vs HEALTH CENTRE