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Health committees and their recommendations

  1. Bhore committee, 1946 q
    1. Setting up of national programs for health system development in the country.
    2. Integration of preventive and curative services.
    3. Setting up of primary health centres (PHCs).
  1. Mudaliar committee, 1962
    1. Looked into progress made since the Bhore committee report.
    2. Strengthening of district hospitals and regional health services.
  1. Chadah committee, 1963
    1. Looked into the activities of the National Malaria Eradication Programme.
    2. Introduced the concept of a basic health worker per 10,000 population.
  1. Mukerji committee, 1965
    1. Recommended separate staff for family welfare programme.
    2. Recommended de linking of malaria activities from family planning activities.
  1. Jungalwalla committee, 1967
    1. Recommended integration of health services at all levels.
  1. Kartar singh committee, 1973
    1. Recommended that auxiliary nurse midwifes (ANMs) be replaced by ‘Female Health Workers’.
    2. Introduced the concept of ‘Multipurpose Workers’.
    3. One primary health center per 50,000 population, each divided into 16 sub centers of 3000 population each.
  1. Shrivastav committee, 1975
    1. Creation of bands of paraprofessional and semiprofessional workers from the community itself.
    2. Reforms in health and medical education.

Health system setup​

  1. At central level
  1. Union ministry of health and family welfare.
  2. Directorate General of Health Services (DGHS).
  3. Central Council of Health.
  1. At state level
  1. State ministry of health
  2. State Health Directorate
  1. At district level
    It is the principal unit of administration in India. Within district there are 6 types of administrative areas –
    1. Sub-divisions
    2. Tehsils
    3. Community Development Blocks in rural areas (100,000 population)
    4. Municipalities and Corporations in urban areas
    5. Villages
    6. Panchayats
  2. Health Statistics of India
    1. Districts: 642
    2. Subcentres: 146026
    3. PHCs: 23236
    4. CHCs: 3346
    5. Allopathic doctors: 767,500
    6. Doctors per lakh population: 70
    7. Doctor population: 1:1700
    8. WHO Recommended doctor population ratio: 1:300
    9. Beds per lakh population: 89
    10. Medical colleges: 242
  3. Elements of primary health care (also qualify as functions of PHC) Q
    1. Education about health problems and methods of controlling them.
    2. Promotion of food supply and proper nutrition.
    3. Adequate supply of safe drinking water and basic sanitation.
    4. Maternal and child health care.
    5. Immunization.
    6. Prevention and control of locally endemic diseases.
    7. Treatment of locally endemic diseases.
    8. Provision of essential drugs.
  1. Principles of primary health care
    1. Equitable distribution
      Health services must be shared by all people equally irrespective of their ability to pay.
    2. Community participation
      Involvement of individuals, families and communities is essential in promotion of their own health and welfare. An example of this effort is – village health guides and dai (midwife).
    3. Interpectoral coordination
      Besides health sector there is a need to involve other sectors in providing complete health services. These include – agriculture, animal husbandry, food industry, education, housing and public work departments etc.
    4. Appropriate technology
      It is defined as technology, which is scientifically sound, adaptable to local needs and acceptable to those who apply it and those who use it. E.g. oral rehydration salt.
  1. Primary health care in india – in rural areas
  1. Village level
    At village level there are three health functionaries chosen by the local community themselves. They are – village health guide, dai or midwife and anganwadi worker. Most of them are now women.
  2. Subcentre (SC) level
    Subcentre is the peripheral outpost of the health system in rural areas. One SC is established for a population of 5000 in general and 1 per 3000 population in hilly, tribal and backward areas. It is manned by 1 health worker male, 1health worker female and 1 voluntary worker. At present functions of a SC are limited to providing mother and child health care, immunization services and family planning.
  3. Primary health centre (PHC)
    The concept of a PHC was given by Bhore committee. Currently there is 1 PHC per 30,000 population in general and 1 per 20,000 in tribal, hilly and backward areas. It has a staff of 15 including a doctor.
  4. Community health centre (CHC)
    This is established at block level catering to a population of 80,000 to 120,000. these are the first referral units from PHCs. Total staffing strength is 25.
Some Important points:
  1. Diseases eliminated from India: Guinea worm (2000), Leprosy (2005), Yaws (2007)
  2. Diseases about to be eliminated: Polio, Neonatal tetanus, Kalazar, Measles (KlMNOP)
  3. Diseases eradicated: Small pox, Polio virus type II (SP)
  4. Diseases under IHR: Cholera, Plague, Yellow fever, Small pox, SARS, Polio due to WPV, Human Influenza
  5. Diseases under WHO Surveillance: Louse borne typhus fever, Relapsing fever, Malaria, Polio, Rabies, Human influenza & Salmonellosis
  6. Measles: has no carrier, no subclinical case, no extrahuman reservoir
  7. Healthy carriers are not seen in: Measles, Pertussis (MP)
  8. Epidemiological marker of Hepatitis B: HBsAg
  9. Commonest type of HIV found in India: HIV 1c
  10. Commonest mode of HIV transmission in India: Sexual
  11. Highest risk of HIV transmission is associated with: Blood transfusion
  12. Antitubercular drug contraindicated in HIV positives: Thiacetazone
  13. MC cause of blindness in India: Cataract
  14. MC cause of ocular morbidity in India: Refractive error
  15. Blindness by WHO: VA < 3/60 or inability to count fingers from a distance of 3 meters
  16. Blindness by NPCB: VA < 6/60 or inability to count fingers from a distance of 6 meters
  17. Economic Blindness or Work Vision: VA between 3/60 – 6/60
  18. Social Blindness or Walk Vision: VA between 6/60 – 1/60
  19. Rule of Halves applies to: Hypertension
  20. STEPS: Approach for assessment of Risk Factors of NCDs
  21. RNTCP: now has only 2 categories of TB treatment under DOTS
  22. NLEP: classification of leprosy is now based on clinical examination; only 2 categories-PB or MB

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