Health Care of the community Dr Abhay Nirgude
Specific Learning Objectives • Enumerate the components of health care delivery system. • Write the functions of Health worker Male/Female. • Write the functions of Health assistant Male/Female
Model of Health Care Delivery System Inputs Health status or health problems Health care services Curative Preventive Promotive Resources Health care systems Outputs Public Private Voluntary Indigenous Changes in health status
Health status & health problems Known as Community diagnosis • Demographic • Morbidity & mortality profile • Environmental • Socio economic and cultural • Medical & health services available
Resources • • Manpower Money Materials Minutes
Manpower • Includes both professional and auxiliary • Based on a series of accepted ratios
Money and materials • Developed countries – 6 -12% GNP • In underdeveloped countries - <1% • In India – 3%
Health care services In India, 5 major sectors A. Public health sector – Primary health care • PHC and subcentres – Hospitals/ health centres • CHC, rural hospitals, district hospitals, specialist and teaching hospitals – Health insurance schemes • ESI, Central Govt Health Scheme – Other agencies • Defence , Railways
Health care services B. Private sector • Private clinics, nursing homes, GP C. Indigenous systems of medicine • Ayurveda, Unani, Homeopathy, Unregistered practitioners D. Voluntary health Agencies E. National Health Programmes
Primary health care • Govt has laid down National Health goals so as to achieve Health for All by 2000 • Laid down plan of action To achieve universal coverage and equitable distribution at the village level • Village health guides • Training of local dais • ICDS Scheme
Village level Village Health Guides • Criteria for selection • Post selection • Duties include • Treatment • MCH and FP • Health education and sanitation
Village level Local Dais • Train all categories of TBA • Dai kit Anganwadi worker ASHA/USHA
Subcentre level • 1 subcentre for 5000 population • 1 Male and 1 female HW • MCH , FP, Immunization
Primary health centre • In 1953 PHC covered a population of 100, 000 • In 1977 reorganised based on Alma atta conference to 30, 000 for plains and 20, 000 for hilly areas
Primary health centre Staffing pattern • Medical Officer • ANM • Block extension educator • Health assistant (male and female) 1 • UDC & LDC 1 2
Primary health centre Functions • Medical care • MCH , FP • Safe water and basic sanitation • Prevention and control of loclly endemic diseases • Collection and reporting of vital statistics • Education about health • National Health programmes • Referral services • Training of health guides, health workers • Basic lab services
Community health centres Staff • MO 4 • Nurse midwives 7 • Lab technician 1 • Radiographer 1
Hospitals • Preventive , promotive, Curative • Specific catchment area • Medical & paramedical workers
CGHS Insurance • • • OPD care Supply of drugs Lab and X ray investigation Domiciliary visit Hospitalization facility at Govt Specialist consultation Paediatric Antenatal, postnatal Emergency treatment Supply of optic and dental aids Family welfare services
Voluntary Health agencies An organisation administered by an autonomous board which holds meeting, collects funds chiefly from private sources, works with or without paid workers and helps in providing health services, health education, legislation or research.
Voluntary Health agencies Functions • Supplementing the work of the Govt services • Pioneering • Education • Demonstration • Legislation
Voluntary Health agencies • Indian Red Cross Society • Hind Kusht Nivaran Sangh • Indian Council of Child welfare • TB Association of India • Bharat Sevak Samaj • Central Social Welfare Board • Kasturba Memorial fund • FPA of India
Indian Red Cross Society • Relief Work • Milk and Medical supplies • Armed Forces • Maternal and child welfare services • Family planning • Blood bank and first aid
Job description – HW Female • Registration • Care at Home – – – – Nutritional advice IFA and TT, Vit A Referral for complicated preg and deliveries Conduct deliveries Give postnatal advice Supervise deliveries by dais FP advice Distribute contraceptives Growth monitoring camps Immunization Management of minor ailments Vital statistics Basic investigations Referral for MTP
Job description – HW Female • Care at clinic – Arrange MCH & FP clinics – Health education • Care in community – Set up depots for condom distribution – Health education
Job description – HW Male • • • Record maintainence Malaria Leprosy Tuberculosis Communicable diseases – Identify - diarrhoea, dysentry, diptheria, jaundice – Control measures – Identify cases of blindness and STDs
Job description – HW Male • Environmental sanitation – Chlorinate wells – Educate about sanitation • Immunisation • FP
Job description – H Assistant Male • Malaria – Supervise spraying of insecticides – Give radical treatment – Surveillance • Take control measures for communicable diseases • Ensure regular treatment of leprosy and TB patients • Help construction of sanitary latrines
Job description – H Assistant Female • Supervisory house visits and subcentre visits • Guide in holding contraceptive depots, MCH and FP clinics, training for dais, Immunization clinics • Motivate resistant cases for FP
Summary
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