health care delivery
TRANSCRIPT
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1,241,491,960
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HEALTH CARE DELIVERY SYSTEM
Prepared by Anu Issac
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Determinants of health care
Consumers of health care
Providers of health care
The funding sources
Other factors
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MODEL OF HEALTH CARE DELIVERY SYSTEM
Health status
CurativePreventivePromotive
PublicPrivate
VoluntaryIndigenous
Changes in health
statusResources
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SECTORS OF HEALTH CARE DELIVERY
PUBLIC HEALTH SECTOR
PRIVATE SECTOR
CO-OPERATIVE SECTOR
INDIGENOUS SYSTEM OF MEDICINE
VOLUNTARY HEALTH AGENCIES
NATIONAL HEALTH PROGRAMMES
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PUBLIC HEALTH SECTOR
Primary health care
Hospitals / health centres
Health insurance schemes
Other agencies – defense services, railways
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Primary health care Primary health centers Sub - centers
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Hospitals/ health centers Community health centers Rural hospitals District hospitals Specialist hospitals Teaching hospitals
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Health insurance schemes
o Voluntary health insurance scheme or private- for – profit schemes
o Employer based schemes
o Insurance offered by NGO’s/ community based health insurance
o Mandatory health insurance schemes or govt. run schemes
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Co- operative sector Co- operative hospitals Co- operative schemes
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Indigenous system of medicine
A- Y- U- S- H-
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PUBLIC SYSTEM
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VILLAGE LEVEL
• Village health guide scheme• Local dais• Anganwadi worker• ASHA – Accredited social health activist
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SUBCENTER – for every 5000 population in general and for every 3000 population in hilly and tribal areas
PHC – for every 30000 rural populations in the plains and for every 20000 population in hill and tribal areas
CHC – 80,000- 1.20 lakh population
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Health insurance General insurance corporation and its four
subsidiary companies• National India assurance• New India assurance company• United insurance company• Life insurance corporation
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Health insurance schemes
o Voluntary health insurance scheme or private- for – profit schemes
o Employer based schemes
o Insurance offered by NGO’s/ community based health insurance
o Mandatory health insurance schemes or govt. run schemes
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SOCIAL INSURANCE / MANDATORY HEALTH INSURANCE
• ESI scheme• CGHS• RSBY – Rashtriya Swasthya Beema Yojana• CHIS – Comprehensive Health Insurance
Scheme
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Co – operative sector SEWA – Self Employed Women’s Association Yeshaswini co- operative farmers health
scheme
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AYURVEDA
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Theory: Tridosa or Tidhatu
Kapha Pitta
vatha
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Yoga
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NATUROPATHY
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Treatment methods in naturopathy…..
Air therapy
Massage therapy Mud therapy
Space therapy Fire therapy
Watertherapy
Food therapy
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UNANI MEDICINE
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SIDDHA MEDICINE
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HOMEOPATHY
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Voluntary health agencies 1. Indian Red Cross 2. Bharat Sevak Samaj 3. All India Blind Relief Society 4. Hind Kusht Nivaran Sangh 5. The Kasturba Memorial Fund 6. TB Association Of India 7. All India Women’s Conference
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Functions of voluntary health agencies
Supplementing the work of government agencies.
Pioneering Education Demonstration Guarding the work of govt. agencies Advancing health legislation
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National health programmes
National malaria eradication programme National filaria control programme National leprosy eradication programme National tuberculosis control programme National AIDS control programme NRHM – national rural health mission
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Role of nurse in health care delivery
Identify the role of health agency where she works in providing specific services to deal with specific problem.
Participate in screening of high risk cases, identification of cases.
Ensure the patient is diagnosed, treatment is done, care is given.
Follow up of cases and defaulters. Maintain records, compile them and send to
authority.
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Refer the cases to the concerned health agency when necessary
Educate the patient and concerned family members regarding necessary care, preventive measures, precautions to be followed, disinfection of excrements, soiled articles and articles used by the patients as when necessary in certain conditions.
Participate in regular immunization programme
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Supervise , train multipurpose health workers, village health guides, dais and anganwadi workers
Participate in community surveys to determine the extent and nature of problems.
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The healthcare system consists of three broad links
CENTRAL LEVEL
STATE LEVEL
PERIPHERAL LEVEL
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AT THE CENTRAL LEVEL• MINISTRY OF HEALTH
AND FAMILY WELFARE
• DIRECTORATE GENERAL OF HEALTH SERVICES
• CENTRAL COUNCIL OF HEALTH AND FAMILY WELFARE
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1. MINISTRY OF HEALTH AND FAMILY
WELFARE ORGANISATION
DEPARTMENT OF HEALH
SECRETARY
Jt. SECRETARY
Dy. SECRETARY
ADMN. STAFF
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FUNCTIONSUNION LIST
o International health relations ; administration of port quarantine
o Administration of central instituteso Promotion of research through research centreso Regulation of medical, pharmaceutical, dental and
nursing professions
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CONTD…o Establishment of drug standardso Census and collection & publication of other
statistical datao Coordination with other states for promotion of
healtho Regulating labour in mines and oil mineso Immigration & emigration
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CONCURRENT LIST
o Prevention of extension of communicable diseases from one unit to another
o Prevention of adulteration of foodo Control drugs and poisons o Population control and family planningo Economic and social planningo Administration of ports other than majoro Labour welfare
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2. DIRECTORATE GENERAL OF HEALTH SERVICES
ORGANISATION: DGHS
Additional DGHS Dy.DGHS Dy.DGHS Dy.DGHS
(medi care) (public health) (gen .Admn.)
office staff office staff office staff
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FUNCTIONS
GENERAL:o Carrying out surveys o Planning, coordination, programming, and
appraisal of all health matters in the country
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SPECIFIC:
o Control of drug standardso Medical store depotso Post graduate trainingo Medical education & medical researcho National medical libraryo Health intelligenceo monitoring of national health programmes
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3. CENTRAL COUNCIL OF HEALTH AND FAMILY WELFARE
The Union Health Minister is the chairman & the State Health State Ministers are the members
FUNCTIONS: To recommend outlines of policy in regard to
matters concerning health To make proposals for legislation in fields of
activity relating to medical & public health matters
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To make recommendations to the central govt. regarding distribution of available grants-in-aid for health purposes to the state & to review the work established in different areas
To establish organizations invested with appropriate functions for promoting & maintaining cooperation between the Central and State administrations
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AT THE STATE LEVEL
STATE MINISTRY OF HEALTH
STATE HEALTH DIRECTORATE
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DISTRICT LEVEL The principal unit of administration in India is the
district under a Collector Within each district there are six types of
administrative areas -subdivisions - tehsils (taluks) - community development blocks - municipalities and corporations - villages - panchayats
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RURAL ADMINISTRATION PANCHAYATI RAJ
( 3 tier system of rural self govt.)
ZILA PARISHAD(district) PANCHAYAT SAMITI(block)
PANCHAYAT (village)
Gram sabha gram panchayat nyaya panchayat
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Bibliography PARK K, TEXTBOOK OF PREVENTIVE AND
SOCIAL MEDICINE, 20 TH EDITION, 2009, BANARSIDAS BHANOT PUBLISHERS, India, PAGE NO: 796- 815, 780- 783, 380
GULANI K.K, COMMUNITY HEALTH NURSING PRINCIPLES AND PRACTICES,FIRST EDITION,2005, KUMAR PUBLISHING HOUSE, India, PAGE NO: 616-623
MANIVANNAN C, RATHNMANI S, MANIVANNAN LATHA T, TEXTBOOK OF COMMUNITY
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HEALTH NURSING, VOLUME 2, FIRST EDITION, 2011, EMMESS MEDICAL PUBLISHERS, BANGALORE, PAGE NO: 72-77, 94-97, 39-50
SAXENA B. DEEPAK, COMMUNITY MEDICINE, SMART STUDY SERIES, 1ST EDITION, 2010,ELSEVIER PUBLICATIONS, India, PAGE NO: 38-40
SRIDHAR RAO B, COMMUNITY HEALTH NURSING, FIRST EDITION,2006, AITBS PUBLISHERS, DELHI,PAGE NO: 93- 115
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www.ncbi.nlm.nih.gov
www.mohfw.nic.gov