|
|
| |
National
Health Committees |
| |
|
| |
|
Various
committees of experts have been appointed by the government
from time to time to render advice about different health
problems. The reports of these committees have formed an important
basis of health planning in India. The goal of National Health
Planning in India is to attain Health for All by the year
2000. |
| |
|
|
| |
1. |
BHORE COMMITTEE. 1946. |
| |
|
| |
|
This committee,
known as the Health Survey & Development Committee, was
appointed in 1943 with Sir Joseph Bhore as its Chairman. It
laid emphasis on integration of curative and preventive medicine
at all levels. It made comprehensive recommendations for remodelling
of health services in India. The report, submitted in 1946,
had some important recommendations like :- |
| |
|
|
| |
|
| 1. |
Integration of preventive and curative services
of all administrative levels. |
| |
|
| 2. |
Development of Primary Health Centres in
2 stages : |
| |
|
| |
a. |
Short-term
measure – one primary health centre as suggested
for a population of 40,000. Each PHC was to be manned
by 2 doctors, one nurse, four public health nurses,
four midwives, four trained dais, two sanitary inspectors,
two health assistants, one pharmacist and fifteen other
class IV employees. Secondary health centre was also
envisaged to provide support to PHC, and to coordinate
and supervise their functioning. |
| |
|
|
| |
b. |
A
long-term programme (also called the 3 million plan)
of setting up primary health units with 75 – bedded
hospitals for each 10,000 to 20,000 population and secondary
units with 650 – bedded hospital, again regionalized
around district hospitals with 2500 beds. |
| |
|
|
| 3. |
Major
changes in medical education which includes 3 - month
training in preventive and social medicine to prepare
“social physicians”. |
| |
|
|
| |
2. |
MUDALIAR
COMMITTEE. 1962. |
| |
|
|
| |
|
This committee
known as the “Health Survey and Planning Committee”,
headed by Dr. A.L. Mudaliar, was appointed to assess the performance
in health sector since the submission of Bhore Committee report.
This committee found the conditions in PHCs to be unsatisfactory
and suggested that the PHC, already established should be
strengthened before new ones are opened. |
| |
|
|
| |
|
Strengthening
of sub divisional and district hospitals was also advised.
It was emphasised that a PHC should not be made to cater to
more than 40,000 population and that the curative, preventive
and promotive services should be all provided at the PHC.
The Mudaliar Committee also recommended that an All India
Health service should be created to replace the erstwhile
Indian Medical service. |
| |
|
|
| |
3. |
CHADAH COMMITTEE, 1963. |
| |
|
|
| |
|
This committee
was appointed under chairmanship of Dr. M.S. Chadah, the then
Director General of Health Services, to advise about the necessary
arrangements for the maintenance phase of National Malaria
Eradication Programme. The committee suggested that the vigilance
activity in the NMEP should be carried out by basic health
workers (one per 10,000 population), who would function as
multipurpose workers and would perform, in addition to malaria
work, the duties of family planning and vital statistics data
collection under supervision of family planning health assistants. |
| |
|
|
| |
4. |
MUKHERJEE COMMITTEE. 1965. |
| |
|
| |
|
The recommendations
of the Chadah Committee, when implemented, were found to be
impracticable because the basic health workers, with their
multiple functions cound do justice neither to malaria work
nor to family planning work. The Mukherjee committee headed
by the then Secretary of Health Shri Mukherjee, was appointed
to review the performance in the area of family planning.
The committee recommended separate staff for the family planning
programme. The family planning assistants were to undertake
family planning duties only. The basic health workers were
to be utilised for purposes other than family planning. The
committee also recommended to delink the malaria activities
from family planning so that the latter would received undivided
attention of its staff. |
| |
|
|
| |
5. |
MUKHERJEE COMMITTEE. 1966. |
| |
|
|
| |
|
Multiple
activities of the mass programmes like family planning, small
pox, leprosy, trachoma, NMEP (maintenance phase), etc. were
making it difficult for the states to undertake these effectively
because of shortage of funds. A committee of state health
secretaries, headed by the Union Health Secretary, Shri Mukherjee,
was set up to look into this problem. The committee worked
out the details of the Basic Health Service which should be
provided at the Block level, and some consequential strengthening
required at higher levels of administration. |
| |
|
|
| |
6. |
JUNGALWALLA COMMITTEE,
1967. |
| |
|
|
| |
|
This committee,
known as the “Committee on Integration of Health Services”
was set up in 1964 under the chairmanship of Dr. N Jungalwalla,
the then Director of National Institute of Health Administration
and Education (currently NIHFW). It was asked to look into
various problems related to integration of health services,
abolition of private practice by doctors in government services,
and the service conditions of Doctors. The committee defined
“integrated health services” as :- |
| |
|
|
| |
|
| a. |
Aservice with a unified approach for all problems instead
of a segmented approach for different problems. |
| |
|
| b. |
Medical care and public health programmes should be
put under charge of a single administrator at all levels
of hierarchy. |
| |
|
|
| |
|
Following
steps were recommended for the integration at all levels of
health organisation in the country |
| |
|
|
| |
|
| 1 |
Unified Cadre |
| |
|
| 2 |
Common Seniority |
| |
|
| 3 |
Recognition of extra
qualifications |
| |
|
| 4 |
Equal pay for equal work |
| |
|
| 5 |
Special pay for special
work |
| |
|
| 6 |
Abolition of private
practice by government doctors |
| |
|
| 7 |
Improvement in their
service conditions |
| |
|
|
| |
7. |
KARTAR SINGH COMMITTEE.
1973. |
| |
|
|
| |
|
This committee,
headed by the Additional Secretary of Health and titled the
“Committee on multipurpose workers under Health and
Family Planning” was constituted to form a framework
for integration of health and medical services at peripheral
and supervisory levels. Its main recommendations were :- |
| |
|
|
| |
|
| a. |
Various categories
of peripheral workers should be amalgamated into a single
cadre of multipurpose workers (male and female). The erstwhile
anxiliary nurse midwives were to be converted into MPW(F)
and the basic health workers, malaria surveillance workers
etc. were to be converted to MPW(M). The work of 3-4 male
and female MPWs was to be supervised by one health supervisor
(male or female respectively). The existing lady health
visitors were to be converted into female health supervisor. |
| |
|
| b |
One Primary Health Centre
should cover a population of 50,000. It should be divided
into 16 subcentres (one for 3000 to 3500 population) each
to be staffed by a male and a female health worker. |
| |
|
|
| |
8 |
SHRIVASTAV COMMITTEE. 1975. |
| |
|
|
| |
|
This committee
was set up in 1974 as “Group on Medical Education and
Support Manpower” to determine steps needed to (i) reorient
medical education in accordance with national needs &
priorities and (ii) develop a curriculum for health assistants
who were to function as a link between medical officers and
MPWs. It recommended immediate action for : |
| |
|
|
| |
|
| 1. |
Creation
of bonds of paraprofessional and semiprofessional health
workers from within the community itself. |
| |
|
| 2. |
Establishment of 3 cadres of health workers namely –
multipurpose health workers and health assistants between
the community level workers and doctors at PHC. |
| |
|
| 3. |
Development of a “Refferal Services Complex” |
| |
|
| 4. |
Establishment of a Medical and Health Education Commission
for planning and implementing the reforms needed in
health and medical education on the lines of University
Grants Commission. |
| |
|
|
| |
|
Acceptance of the recommendations
of the Shrivastava Committee in 1977 led to the launching of
the Rural Health Service. |
| |
|
|
| |
9. |
BAJAJ
COMMITTEE, 1986. |
| |
|
|
| |
|
An “Expert
Committee for Health Manpower Planning, Production and Management”
was constituted in 1985 under Dr. J.S. Bajaj, the then professor
at AIIMS. Major recommendations are :- |
| |
|
|
| |
|
| 1 |
Formulation
of national medical & health education policy. |
| |
|
| 2 |
Formulation of national
health manpower policy. |
| |
|
| 3 |
Establishment of an educational
commission for health sciences (ECHS) on the lines of
UGC. |
| |
|
| 4 |
Establishment of health
science universities in various states and union territories. |
| |
|
| 5 |
Establishment of health
manpower cells at centre and in the states. |
| |
|
| 6 |
Vocationalization of
education at 10+2 levels as regards health related fields
with appropriate incentives, so that good quality paramedical
personnel may be available in adequate numbers. |
| |
|
| 7 |
Carrying out a realistic
health manpower survey. |
| |
|
|
