INDEX

INTRODUCTION

AT THE CENTRE

2-7

The Ministry of Health and Family Welfare

The Directorate General of Health Services

The Central Council of Health and family welfare

STATE LEVEL

8-9

State Health Directorate

State Ministry of health

DISTRICT LEVEL

10-11

Panchayati Raj

11-13

Conclusion

14

Bibliography

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HEALTH SYSTEM IN INDIA

India is a union of 28 states and 7 union territories. Under the constitution of India, the
states are largely independent in matters relating to the delivery of health care to the
people. Each state has therefore developed its own system of health care delivery
independent of the central government. The central responsibility consists mainly of
policy making, planning, guiding, assisting, evaluating and co-coordinating the work of
the state health ministries, so that health services cover every part of the country and no
state lags behind for want of these services.
AT THE CENTRE
The official organs of the health system at the national level consists of :
1. The Ministry of Health and Family Welfare
2. The Directorate General of Health Services
3. The Central Council of Health and family welfare

Union Ministry of Health and Family Welfare

ORGANIZATION
The Union Ministry of Health and Family Welfare are:
1. Headed by a Cabinet Minister
2. Minister of state and,
3. Deputy Health Minister ,
DEPARTMENTS
Department Of Health
Department Of Family Welfare(Created in 1966)
Department Of Health
1.
2.
3.
4.

Secretary to the Government of India(Executive Head)

Joint Secretaries
Deputy Secretaries
Large administrative Staffs

Department Of Family Welfare

1. The Secretary to the Government of India(Overall charge)
2. Additional Secretary & Commissioner
3. One Joint Secretary
2

FUNCTIONS
The functions are set out in the 7th Schedule of Article 246 of the Constitution of India
under:
Union List
Concurrent List
Union List
1. International Health relations and Quarantine.
2. Administration of Central Institutes Such as National Institute for the Control of
Communicable diseases, Delhi.
3. Promotion of Research through the research centres &other bodies.
4. Regulation and development of medical, pharmaceutical, dental, and nursing
professions.
5. Establishment and Maintenance of Drug standards.
6. Census, and collection and publication of other statistical data.
7. Immigration and emigration
8. Regulation of labour in the working of mines and oil fields.
9. Co-ordination with States and with other ministries for the promotion of Health
Concurrent List
The functions listed under this list are the responsibility of both the Union and State
Governments. The centre and the State have simultaneous powers of legislation.
The power of the latter are restricted to the framework of such legislation as may be
undertaken by the centre.
Concurrent List includes:
1.
2.
3.
4.
5.
6.
7.
8.

Prevention of extension of Communicable disease from one unit to the other.

Prevention of adulteration of food stuffs.
Control of drugs and poisons.
Vital Statistics.
Labour welfare.
Ports other than major.
Economic and Social Planning.
Population control and Family planning.

Directorate General of health Services

ORGANIZATION
1. The Director General of Health Services (Principal adviser to Union Government
in both medical and public health matters)
2. Additional Director general of health services
3

3. A team of deputies
4. Large administrative staff
The Directorate comprises of 3 main units,
Medical care & Hospitals,
Public health
General administration
FUNCTIONS
GENERAL
Surveys, planning, co-ordination, programming and appraisal of all health
matters in the country.
SPECIFIC
1. International Health relations and Quarantine:
All the major ports in the country9kolkatta,vishakhapattanam, Chennai,Cochin,
Mumbai,,kandla) and International airports(Mumbai-Santa Cruz, Chennaimeenambakkam, Tiruchirapalli ,Delhi-Palam) are directly controlled by the
Directorate General of Health Services
2. Control of Drug standards
The Drugs Control Organization is part of the Directorate general of Health
Services, and is headed by the Drugs controller .Its Primary function is to lay
down and enforce standards and controls the manufacture and distribution of
drugs through both Central and State Government Officers. The Drugs Act
(1940) vests the central government with the powers to test the quality of the
imported drugs.
3. Medical store depots
The Union Government runs medical depots at Mumbai, Chennai, Kolkatta,
Carnal, Gauhati, and Hyderabad. These depots supply the civil medical
requirements of the Central Government and of the various State Governments.
These depots also carries supplies from foreign agencies
4. Post Graduate Training
The Directorate General of Health Services is responsible for the administration
of national Institutes, which also provide Post graduate training to different
categories of health personnel. Some of these Institutes are National Institute of
Mental Health at Bangalore, College of Nursing at Delhi, and National institute of
communicable Diseases at Delhi etc
5. Medical Education
4

The Central Directorate is directly in charge of the following medical Colleges in

India: the Lady Hardinge, the Maulana Azad and the Medical Colleges at Goa
and Pondicherry. Besides there are many medical Colleges in India which are
guided and supported by the Centre.
6. Medical Research
The Medical Research in India is largely organized through the Indian Council of
Medical Research, founded in 1911 in New Delhi. The Council plays a significant
role in aiding, promoting, and promoting scientific research on human diseases,
their causation, prevention and cure. The research work is done through the
Councils permanent research institutes, Research Units, Field surveys, and a
large number of ad-hoc research enquiries financed by the Council. It maintains
cancer Research Centre, Tuberculosis chemotherapy centre at Chennai etc. The
funds of the council are wholly derived from the budget of the Union ministry of
Health.
7. Central Government Health Scheme
The Central Government health scheme for the Central Government employees
was first introduced in 1954 in New Delhi.The Scheme is based on the principle
of co-operative effort by the employeeand the employer, to the mutual advantage
of both.The Facilities under the scheme are :1, Out patient care 2.supply of
necessary drugs 3,lab & X-ray investigations 4.domicilliary visits 5.hospitalisation
facilities at government as well as private facilities 6. Specialist consultation
7.paediatric services including immunization 8.antenatal, natal, and postnatal
services 9.post natal services 10. Emergency treatment 11. Supply of optical
and dental aids at reasonable rate 12. Family welfare
8. National Health programmes
The various national health programmes for the eradication of malaria, control of
tuberculosis, filarial, leprosy, AIDS and other communicable disease involves
expenditure. The Central Directorate plays an important role in planning, guiding
and co-coordinating all the national health programmes in the country.
9. Central health Education Bureau:
Preparation of educational material for creation of health awareness among the
people .The Bureau offers training courses in health education to different
categories of health workers.
10. Health Intelligence
The Central Bureau of Health Intelligence was established in 1961 to centralize
collection, compilation, analysis, evaluation and dissemination of all information
on health statistics for the nation as a whole. It disseminates epidemic
Intelligence to states and International agencies. The Bureau has an
epidemiological unit, a Health Economics unit, a National Morbidity Survey Unit,
a Manpower Cell.
11. National Medical Library
5

The Central Medical Library of the Directorate General of Health services was
declared the National Library in 1966.The aim is to help the advancement of
medical, health and related sciences by collection, dissemination and exchange
of information.

Central Council of Health

The Central Council of Health was set up by a Presidential order on 9th August
1952, under article 263 of the Indian Constitution for promoting co-ordinated and
concerted action between the centre and the states in the implementation of all
the programmes and measures pertaining to the health of the nation.
ORGANIZATION
1. The Union Health Minister
2. State Health Ministers
FUNCTIONS
1. To consider and recommend broad outlines of the policy in regard to matters
concerning health an all its aspects such as provision of remedial and preventive
care, environmental hygiene, nutrition, health education, and the promotion of
facilities for training and research.
2. To make proposals for legislation in fields of activity relating to medical and
public health matters and to lay down the pattern of development for the country
as a whole
3. To make recommendations to the Central Government regarding distribution of
available grants-in-aid for health purposes to the states and to review periodically
the work accomplished in different areas through the utilization of these grantsin-aid .
4. To establish any organization or organizations invested with appropriate
functions for promoting and maintaining co-operation between the Central and
State Health administration

Centre level
Union ministry of
health &family welfare

Directorate General
of Health

Headed by Cabinet Minister

Minister of State &
deputy health minister

The Director Council

of health services

Additional Director General

of Health Services
Department
of health
Deputies &

Department
of family welfare
Administrative staffs

Secretary to the
Govt of India

Secretary to the
Govt of India

Joint Secretaries

Additional Secretary
&
Commissioner

Deputy Secretary

Joint Secretary

Administrative staffs

Central Council
of health

Union Health Minister

(chairman)

Union Health Minister

State Health Minister

AT THE STATE LEVEL

At present there are 28 states in India with each state having its own health
administration .In all the States, the management sector comprises of :
The State Ministry of Health
State Health Directorate

State Ministry of Health

ORGANIZATION
Headed by Minister of Health and family Welfare
Deputy Minister of Health and Family Welfare
Health Secretariat (Official Organ of State Ministry of Health)
1.
2.
3.
4.

Headed by Secretary
Assisted by Deputy Secretariat
Under Secretaries
Large Administrative staff

State Health Directorate

The Director of Health services (Known in some states as 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, the designation of the
Director of health Services has been changed in some states as Director of Health and
Family Welfare.
A recent development in some states is the appointment of a Director of Medical
Education in view of the Increasing number of medical Colleges.

ORGANIZATION
1. The Director of Health and family Welfare
2. Assisted by the Deputy and Assistant Directors of Health.
Regional Directors(Inspect all branches of public health within their
jurisdiction, irrespective of their specialty.
The Functional Directors are specialists in a particular branch of public
health such as mother and child health, family planning, nutrition,
tuberculosis, leprosy, health education etc
8

State Level Administration

State Ministry of Health

Minister of Health
and Family Welfare

State health Directorate

Director of health and family welfare

Deputy Minister of Health

and Family Welfare

Deputies and Assistants

Health Secretariat

Secretary

Deputy Secretaries
Under secretaries and Administrative staffs

AT THE DISTRICT LEVEL

The Principal unit of administration in India is the District under a Collector.
Districts vary widely in area and population.
Within each District,there are again 6 administrative areas:
1.
2.
3.
4.
5.
6.

Sub divisions
Tehsils (taluks)
Community Development Blocks
Municipalities and Corporations.
Villages
Panchayats

Sub divisions;
Most Districts in India are divided into two or more subdivisions each in charge of an
Assistant collector or Sub Collector
Tehsils(Taluks)
Each division is again divided into tehsils (taluks) headed by Tehsildar. It comprises 200
to 600 villages.
Community Development Blocks
The Block is a unit of rural planning and development, and comprises about 100 villages
and about 80,000 to 20,000 population.
The Urban areas of the district are organized into following institutions of local Self
Government:
Town area committees:
In areas with population ranging between 5000 and 10,000.
Municipal Boards

In areas with population ranging from 10,000 to 2 lakhs, headed by Chairman or

the President
Corporations:
With population above 2 lakhs headed by Mayors.
10

FUNCTIONS OF MUNICIPAL BOARDS:

Construction
Maintenance of roads
Sanitation and drainage
Street Lighting
Water supply
Maintenance of hospitals and dispensaries
Education
Registration of Births and Deaths.

PANCHAYATI RAJ
This is a three tier system of Rural Local self Government, linking the Village to The
District. These are:
1. Panchayat (at the Village Level)
2. Panchayat Samiti( at the Block Level)
3. Zila Parishad ( at the District Level)
At the Village Level
The Gram sabha
The Grama Panchayat
The Nyaya Panchayat
Gram sabha:

It is the assembly of all the adults of the village which meets at least twice a year.
It considers proposals for taxation, discusses the annual programme and elects
members of Grama Panchayat.

Gram Panchayat:

It is an Executive organ of the gramsabha, an agency for the planning and

development at the village level.
Its strength varies from 15 to 30, and population varies from 5000 to 15000 or
more.
The members of the Gram Panchayat hold office for a period of 3 to 4 years.
Every Panchayat has an elected President, Vice-President and Panchayat
Secretary.

11

 At the Block Level

The Block consists of about 100 villages. Its population varies from 80,000 to
1,20,000.
Panchayati Raj agency at the Block level is the Panchayat Samiti
( Janpada Panchayat)

The Panchayat Samiti consists of all Sarpanchas(head)of the village, MLAs,

MPs residing in the block area, representatives of women, Scheduled castes ,
Scheduled Tribes, and Co-operative Societies.
The Block Development Officer is the Ex Officio Secretary of the Panchayat
Samiti.

Functions of Panchayat Samiti

Execution of Community Development Programme in the Block.

Funds provided for stage 1 and stage11 are channeled through the Panchayat
Samiti.

At the District Level

It is the agency of rural local self Government at the District level.
Members include all heads of Panchayat Samitis of the District, MPs, MLAs of the
District, representatives of Scheduled tribes and women, and 2 persons of
experience in administration, public life or rural development
Functions:
It is primarily supervisory and coordinating body.
Its function varies from state to state.

12

AT THE DISTRICT LEVEL

Headed by Collector.
Sub divisions

Tehsils

Community
Development
Blocks

Assistant
Tehsildar
collector
(Sub Collector)

200 - 600
villages

Municipalities Corporations Villages

Panchayats

Chairman Mayors
or
the President

100 villages
80,000 - 20,000
population.

10,000 to 2 lakhs Population

population
above
2 lakhs

PANCHAYATI RAJ
(At the Village Level)
Panchayat

( At the Block Level)

Panchayat Samiti
( Janpada Panchayat)

The Gram Sabha

The Grama Panchayat
The Nyaya Panchayat

13

( At the District Level)

Zila Parishad

CONCLUSION
Various levels of health care has been discussed. Each state has its own system of
health care delivery independent of the central Government.
BIBLIOGRAPHY

K Park
2005, The Text book of Preventive Medicine 18th edition, pp. 674-677

http://www.healthsystem.com/delivery/agencies.html

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