HEALTH Committees recomendation supriya.pptx

HEALTH COMMITTEES
Presenter: B Supriya Chhetry
M.Sc. Nursing 2nd
year

INTRODUCTION
Health planning in India is an integral part of national
socio-economic planning
The guide-lines national health planning were
Provided by a number of committees dating back to
the Bhore committee in 1946
These committees were appointed by the
Government of India from time to time to review
the existing health situation and recommend
measures for further action.

Committee
 This committee were appointed to review
the existing health situation and
recommend measures for further action.
 The goal of National Health Planning in
India was to attain Health for all by the year
2000 by the Alma-Ata declaration on
primary health care.

MAJOR COMMITTEES
BHORE
COMMITTEE,
1946
MUDALIAR
COMMITTEE,
1962
CHADHA
COMMITTEE,
1963
MUKERJEE
COMMITTEE,
1965
JUNGALWALA
COMMITTEE,
1967
KARTAR
COMMITTEE,
1973
SHRIVASTAVA
COMMITTEE,
1975

BHORE COMMITTEE, 1946
• Chairman: Sir. Joseph Bhore, an Indian Civil servant.
• Setup in 1943
• Also known as ‘Health Survey and Development
committee’.
• During pre-independence era, to improve the
Comprehensive health care (preventive, promotive
and curative) health services of country, a National
Planning Commission was set up by the Indian National
Congress in 1938. The rulers of that time, the British
Empire realised the importance of Public Health and
instituted the ‘Health Survey and Development
Committee,’ in the year 1943.

BHORE COMMITTEE, 1946
 The committee was conducted the survey the about
health conditions and health organisations in the country,
and to make recommendations for future development.
The committee submitted its report in1946.
 The integration of preventive, promotive and curative
health services and establishment of Primary Health
Centres in rural areas were the major recommendations
made by this committee.
 School health.
 3 Months training in preventive and social medicine to
prepare social physicians.

OBSERVATION BY COMMITTEE:
• “If the nation’s health is to be build, the health programme should be
developed on a foundation of preventive health work and that such activities
should proceed side by side with those concerned with the treatment of the
patients.”
• Committee dealing with the subjects :-
o Medical relief
o Medical research
o Industrial health
o Professional educations
o Public health

OBSERVATIONS MADE BY THE COMMITTEE.
1.Health status of the country as indicated by various indicators was
poor.
2.Mortality rates were very high.
3.Life expectancy at birth was about 27yrs.
4.Incidence of communicable diseases was very high.
5.Many of the health problems were preventable.
6.Committee stated that health and development are interdependent.
7.Improvement in sector other than health will also lead to
improvement in health like water supply, sanitation improvement,
nutrition ,elimination of unemployment.

GUIDING PRINCIPLES ADOPTED
 No individual should be denied to secure adequate medical care because of
inability to pay.
 Facilities for proper diagnosis and treatment.
 Health programme must lay special emphasis on preventive work.
 As much medical relief and preventive health care should be provided to
the vast rural population.
 Health services should be located close to the people to ensure maximum
benefit to the community.
 Doctor should be a social physician protecting the people.
 Medical services should be free to all, without distinction.

PURPOSE
1.To survey the existing Health conditions and Health organization
and to give suggestions for future development.
2.Primarily to review those activities within the scope of health
administration.

BHORE COMMITTEE SUBMITTED ITS REPORT IN
1946
 First time proposed a national program for improving health
services in the country.
 The committee observed:
 “if the nation’s health is to be built, -the health program should
be developed.
1.On a foundation of Preventive health.
2.Preventive activities should proceed side by side with those
concerned with the treatment of patients.

BHORE COMMITTEE SUBMITTED ITS REPORT IN
1946
• The report consisted 4 volumes:
 Volume I - A survey of the State of the Public Health and the
existing health organisation.
 Volume II Recommendations.
 Volume III Appendices.
 Volume IV Summary.

SOME IMPORTANT RECOMMENDATIONS
BY BHORE COMMITTEE
1. Integration of preventive and curative services at all administrative
levels.
• Minimum required ratio 567 hospital beds,62 doctors,151 nurses per
1,00,000 population.
2. Development of primary health centres in 2 stages:
A) Short term measures
B) Long term measures
3. Major changes in medical education which includes 3 - month training
in preventive and social medicine to prepare “social physicians”

SHORT TERM MEASURES
A progressive improvement of public
health depends largely on the
promotion of the hygienic mode of life
among the people
The bed-population ratio should be
raised from 0.24 per 1,000 to 1.03 at
the end of 10 years
Personal and impersonal health
services should be provided.
Dental sections should be established
in the hospitals at secondary health
center.
Provision of housing accommodation for health
staff is essential in the interests of efficiency.

CONT.
Village communications should be developed in order to
enable health organizations to provide efficient service
For each 30-bed hospital, there should be two motor
ambulances and one animal-drawn ambulance.
Traveling dispensaries should be provided to supplement
the health services rendered by primary health center in
sparsely populated areas.

LONG TERM MEASURES
Public
health
personnel:
Nutrition:
Health
education:
Physical
education:
School
health
services:
Occupatio
nal health
including
industrial
health:
Environm
ental
hygiene:

DEVELOPMENT OF PRIMARY HEALTH CENTRES IN 2 STAGES:
• 1. Primary health centre in the rural areas 1/40,000 population
2. Secondary health centre to serve as a supervisory, coordinating and referral
institution.
• The short term 1 PHC should cater to a population of 40,000, 30 beds, 3 subcentres.
Staff suggested for each PHC,
– 2medical officers,
– 4 public health nurses,
– 1nurse,
– 4 midwives,
– 4 trained dais,
– 2 sanitary inspectors,
– 2 health assistants,
– 1pharmacist, and
– 15 other class IV employees were recommended.
SHORT TERM
MEASURES

CONT..
• This primary unit would have adequate ambulatory support to link it
to the secondary unit when the need arises for secondary level care.
• Each province was given the autonomy to organize its primary units
in the way it deemed most suitable for its population, but there was
to be no compromise on quality and accessibility.

DEVELOPMENT OF PRIMARY HEALTH CENTRES IN 2 STAGES:
To setup primary units with 75 bedded hospitals for
each 10to20 thousand population and secondary
unit with 650 bedded hospital, again regionalized
around district hospital with 2500 beds.
 It was proposed to have major changes in medical
education which includes:-
“3 months training in preventive and social medicine
to prepare social physicians”.
Primary Unit – PHC, First Tier
Secondary Unit- CHC, Second Tier
District Hospital, Third Tier
LONG TERM
PROGRAMME
{Termed as “3
million plan”}

PRIMARY UNIT: PRIMARY HEALTH CENTRE
Every 10,000 to 20,000 population (depending on density from one area to
another) • would have a 75-bedded hospital.
Served by Six Medical Officers including medical, surgical and obstetrical
and gynaecological specialists.
This medical staff would be supported by 6 public health nurses, 2 sanitary
inspectors, 2 health assistants and 6 midwives to provide domiciliary
treatment.
At the hospital there would be a complement of 20 nurses, 3 hospital social
workers, 8 ward attendants, 3 compounders and other non-medical workers.

PRIMARY UNIT: PRIMARY HEALTH CENTRE
• The Two medical officers along with the public health nurses would engage in providing
preventive health services and curative treatment at homes of patients.
• The sanitary inspectors and health assistants would aid the medical team in preventive
and promotive work. Preferably at least three of the six doctors should be women.
 The 75 beds,
 25 would cater to medical problems,
 10 for surgical,
 10 for gynaecological,
 20 for infectious diseases,
 6 for malaria and four for tuberculosis.

SECONDARY UNIT
Click icon to add pictur
First level referral hospital.
 The secondary unit would be a 650-bedded hospital
having all the major specialities with: a staff of 140
doctors, 180 nurses and, 178 other staff including 15
hospital Social Workers, 50 ward attendants and 25
compounders.
 The secondary unit besides being a first level referral
hospital would supervise, both the preventive and
curative work of the primary units.

CONT..
• Note:The 650 beds of the secondary unit hospital would be
distributed as follows: Medical 150, Surgical 200, Obs. & Gynae
100, Infectious Disease 20, Malaria 10, Tuberculosis 120, and
Paediatrics 50.Total 650.

DISTRICT HOSPITAL
 Every district centre would have a 2500
beds hospital providing largely tertiary care
with 269 doctors, 625 nurses, 50 Hospital
Social Workers and 723 other workers.
 The hospital would have 300 medical beds,
350 surgical beds, 300 obs. & gynae beds,
540 tuberculosis beds, 250 paediatric beds,
300 leprosy beds, 40 infectious diseases
beds, 20 malaria beds and 400 beds for
mental diseases.

CONT..
• A large number of these district hospitals would have
medical colleges attached to them. However, each of the
three levels would have functions related to medical
education and training, including internship and refresher
courses.

RECOMMENDATIONS
 3 months training in preventive and social
medicine to prepare ‘SOCIAL PHYSICIANS’
 Special emphasis on preventive work
(Integration of curative and preventive
services)
 Village Health Committee consisting of 5 to 7
individuals for procuring the active
participation of the people in the local health
programme.

CONT..
• Inter-sectoral Coordination.
• This document laid the utmost emphasis on primary health care; it needs
no emphasis that primary health care was later on recognised as the key
strategy to achieve Health for All (HFA) by 2000 during Alma-Ata
conference.
• The Bhore committee model was based on the allopathic system of
medicine.The traditional health practices and indigenous system of
medicine prevalent in rural India, which had great influence and were part
of their socio-cultural milieu were not included in the model proposed by
Bhore committee

POST INDEPENDENCE ERA:
With the beginning of health planning in India and first five-year plan formulation (1951-
55),
Community Development Programme was launched in 1952 for the all round
development of rural areas, where 80% of the population lived. Community Development
was defined as "a process designed to create conditions of economic and social progress
for the whole community with its active participation and the fullest possible reliance upon
the community's initiative".
The Community Development Programme was envisaged as a multipurpose programme
covering health and sanitation (through the establishment of primary health centres and
sub-centres) and other related sectors including agriculture, education, transport, social
welfare and industries. Each Community Development Block (CDB) comprised
approximately 100 villages with a total population of one lakh. For one CDB, one Primary
Health Centre was created.

MUDALIAR COMMITTEE, 1962
 The Mudaliar committee, popularly known as
the “Health Survey and Planning Committee.”
 Mudaliar Commission is an education
commission set up with the aim of examining
the system of secondary education in India.
 It is also called as Secondary Education
Commission which has been come in 1952-
1953.
 Chairman: Dr. A Laxman Swami Mudaliar.

MUDALIAR COMMISSION INTRODUCTION
• The Secondary Education commission known as Mudaliar
Commission was appointed by the government of India in
term of their Resolution to bring changes in the present
education system and make it better for the Nation. Dr. A.
Lakshmanswami Mudaliar was the Vice-Chancellor of Madras
University.
• After the Independence India needed a change in the
education system. Number of Secondary Schools were
increasing in India it was much a need to take care the
students of secondary school.

Commission Mudaliar Commission
Known as Secondary Education commission
Appointment Appointed by the Govt. Of India on
the recommendation of CABE on 23rd September, 1952
Chairman Dr. Lakshman Swami Mudaliar
Secretary A. N. Basu
Member secretary Principal Member Secretary, A.N.
Basu, Central Institute of Education, Delhi
Assistant secretary Dr. S. M. Assistant Dhari,
Education Officer, Ministry of Education, along with seven
members.
Report Submitted on 29th August, 1953, 15 chapters of about
240 to 250 pages

The system of successive 5-year plans
– For organized development of the
country –Started in 1951.
As the Second Five Year Plan (1956-61)
was ending
– >10 yrs. had elapsed following Bhore
committee report.
Guidelines for further development of
National health services were needed
– In the context of the Five year Plans.
In 1959, the Government of India appointed
another Committee known as – "Health
Survey and Planning Committee", – Popularly
known as the Mudaliar Committee
1. To survey the progress made in the field of
health
– Since submission of the Bhore Committee's
Report (1946)
2. To make recommendations for future
development and expansion of health
services.
The committee submitted its report in 1962

THE MUDALIAR COMMITTEE FOUND:
• Quality of healthcare provided by the primary health centres was
unsatisfactory. Felt the need for strengthening the:
1. Existing primary health centres
– Before new centres were established.
2. Sub-divisional and district hospitals
– so that they may effectively function as referral centres.

THE COMMITTEE WAS SUB-DIVIDED INTO DIFFERENT
SUB-COMMITTEES TO DEAL WITH DIFFERENT SUBJECTS:
1.Medical
Care
1.Public
Health
1.Control of
communicabl
e disease
1.Population
control
1.Profession
and research

THE COMMITTEE WAS SUB-DIVIDED INTO DIFFERENT
SUB-COMMITTEES TO DEAL WITH DIFFERENT SUBJECTS:
1.Indigenous
system of
medicine
1.Drugs and
medical
supplies
1.Legislation
1.Health
administratio
n
1.Medical
research

MAIN RECOMMENDATIONS OF THE MUDALIAR
COMMITTEE, 1962
• (1) Consolidate the progress made in first 2 five-year plans.
(2) Strengthen the district hospitals with Specialists
– So that they can act as good referral centers and
– To serve as central base of regional services
(3) Create a regional administrative level in between the
headquarters at state level and the district level.
– In charge of a Regional Deputy or Assistant Directors
– Each to supervise 2 or 3 district medical and health officers.

MAIN RECOMMENDATIONS OF THE MUDALIAR
COMMITTEE, 1962
(4) Each primary health centre should cater to a maximum of 40,000
population.
(5) To improve the quality of health care provided by the primary
health centres.
(6) Integration of medical and health services as recommended by
the Bhore Committee.
(7) Constitution of an ‘All India Health Service’ on the pattern of
‘Indian Administrative Service’ (IAS).

RECOMMENDATIONS RELATED TO
NURSING SECTORS ARE AS FOLLOWS
There should be 3 grades of nurse viz
the basic nurses (with 4 year
training)the auxiliary nurse wife (2 year
training )and the nurse with a degree
qualification
The medium of instruction
should preferably be English for
the general nursing course,
while the degree course should
be taught only in English.
In view of the need for securing a larger
number of recruits for the nursing
profession the age of at mission can be
reduced to 16 in suitable cases as a
transitional measure particularly in states
where there are difficulties in recruiting
candidates at the age of 17.
. Candidates admitted to the general
nursing course should have the
minimum qualification of
matriculation or equivalent and the
candidates degree course should have
passed the higher secondary or
preuniversity examination

CONT..
5. Nurse pupils
should not be
overburdened with
the routine duties
in hospitals, but
more attention
should be given to
training and
practical
experience.They
should not be
subjected to too
many spells of
night duties in
hospitals.
6.To train more
nurses a large
number of hospitals
in the country could
be utilized for
nursing schools.
District
headquarters
hospitals with a bed
strength of 75-100
should also be
utilized for this
purpose.
7. Student nurses should
be provided free
furnished accommodation
in hospitals, free board,
free supply of uniforms,
laundry arrangements,
free books, free medical
services, medical
checkup twice a year and
suitable recreational
facilities.The stipend
during training should be
a minimum of 35
₹
increasing by *10 every
year.
8.The
minimum of
admission to
the course
should be 12.

CONT..
9. The recommendations of the committee set up by the Central Council of Health (Shetty
committee) in regard to pay scales and ratio of nurses to hospital beds, etc. are enclosed.
10.There should be a nursing advisory committee in each school for advising on admission
and welfare of the trainees.
11. Each nursing school should have its own separate budget.
12.The training of auxiliary nurse midwives should be continued and extended, because it
will be necessary for a long time to come to have a second line of trained personnel to meet
the needs of the country.

CONT..
13.The number of auxiliary nurse midwives to be trained should be phased in such a way
that there will be one auxiliary nurse midwife for 5,000 population by the end of 15 years.
14.The training of midwives should also be continued and they should replace the dais, who
is now being utilized at certain places.
15.The time is come when fresh thinking on the type of training at present given to health
visitors should be done.There should, instead, be public health nurse with a basic nursing
qualification and 1 year's further training particularly in domiciliary care and other public
health aspects of community work.
16.The continuance of the training of dais in certain states as a temporary measure is
recommended, till such time a sufficient number of midwives are trained to replace them

CONT..
17.Any person
trained in one
category of
nursing should get
an opportunity of
being trained in
the next higher
grade, under
conditions to be
specified by the
Indian nursing
council.
18.There should also
be higher training
for the general sick
nurse, public health
nurse, pediatric
nurse, mental
diseases nurse,
theater sister, tutor
and nursing
administrator.
19. Promotion of
degree course nurses
and of basic nurses to
posts of higher
responsibility should
be considered only
after a minimum of 3-
5 years of practical
experience after
qualification has been
obtained.

CHADHA COMMITTEE, 1963
 Also known as “special committee on the
preparation of entry of National Malaria
Eradication Program into Maintenance Phase”.
 Appointed by the Government of India in 1963
– Under the Chairmanship of Dr. M.S. Chadah.
– The then Director General of health Services
 To study the arrangements necessary for
– the maintenance phase of the National
Malaria Eradication Programme (NMEP).

WHY THE CHADHA COMMITTEE?
• • Malaria used to be rampant in India in 1950’s
– It was the greatest handicap in the socio-economic
development of the country
• National Malaria Control Program (later NMCP) was
launched in 1953
– to control the extremely high levels of Malaria infections

PURPOSE OF CHADHA COMMITTEE:
•Study the requirement related to:
a)PHCs planning & priority according to needs
of Maintenance Phase of NMEP.
b)Staffing pattern for NMEP and how to utilise
NMEP staff post eradication status.

KEY OBSERVATIONS:
Wide variations in malaria situation & control.
Re-emergence likely unless eradicated globally.

THE COMMITTEE CONSIDERATE TO:-
a. The absorption of the activities of the maintenance phase into
the general health services.
b.Strengthening of basis rural health services.
c. Training of personnel engaged in specialized mass campaigns
to become multipurpose workers to that they can continue to
follow-up the measures required for the maintenance phase
as a part of the routine health activities.

THE PROGRAM OPERATED IN 4 PHASES
• 1. Preparatory
2. Attack
3. Consolidation
4. Maintenance: House to house visits to identify fever cases (Vigilance)
• • A special organization was established for the first 3 phases
• The ‘Maintenance’ phase: the responsibility for the activities was to be
passed on to the General health services of the country in 1964
• • Chadha committee was appointed
– To identify the arrangements for this important hand over of the
maintenance phase.

THE COMMITTEE RECOMMENDED:
• • ‘Vigilance’ operations under NMEP.
– Should be the responsibility of the general health
services i.e.
– Primary health centres at the block level.
• Vigilance operations included:
– Monthly home visits to identify fever cases
– To be carry out through separate workers

• • The ‘basic health workers’.
– One basic health worker per 10,000 population
was recommended.
• The Basic health workers were seen as
‘multipurpose workers’ i.e.
1. In addition to malaria vigilance, have duties of
2.Collection of vital statistics and
3.Family planning
• The Family Planning Health Assistants were
– To supervise 3 or 4 of these basic health
workers.
• • From the district level upwards:
– The general health services were to take the
responsibility for the maintenance phase.

MUKERJEE COMMITTEE, 1965
 Also known as ‘to review strategy of family planning’
 Appointed on 31st
December, 1965.
 Under the Chairmanship of Shri B. Mukherji the then Secretary,
Ministry of Health and Family Planning, government of India,
was appointed to review the strategy for the family planning
programme.
 In a short time after implementation of Multiple Health Worker
(MPHW) scheme it was realised that malaria vigilance operations
& family planning program could not be carried out effectively.

MUKERJEE COMMITTEE, 1965
A committee known as Mukerjee
committee was formed in 1965 & it
recommended separate staff for Family
planning activities so that malaria activities
could receive undivided attention of its
staff.
In 1966 Basic health services should be
provided at the block level.

PURPOSE OF MUKERJI COMMITTEE
• To review what changes are necessary in staffing pattern,
financial provisions, etc. due to IUCD gaining prominence
in the Family Planning Programme.

KEY OBSERVATIONS OF MUKERJI COMMITTEE
• Great shortage of staff for Family Planning (FP) Programme
Doctors are reluctant to take up Family Plannings duties
Training, infrastructure lacking/deficient.

 Strengthening of state health department by providing additional
staff sanctioned by central government.
 There should be a separate cell in the state sectorial for by under
secretarial/assistant secretary with a small supporting staff, which
are:-
• -Under secretariat/assistance Secretary-1
• -U.D. assistant-1
• -Stenotypical-1
• -Orderly person-1
 Creation of post of lady health visitor (LHV)

 There should be one family planning field worker (FPFW) for
every 2 subcenters
 Part-time workers for motivating population for acceptance of
IUD (intrauterine device).
 Block and district level education leaders be appointed for
intensifying motivation campaign and be paid honorarium of
rupee 600/- per annum.
 Government dr. may be provided incentives which should also
be available to part-time private medical practitioners in terms
of honorarium of rupee 100.

HEALTH Committees recomendation supriya.pptx

JUNGALWALA COMMITTEE, 1967
This committee is also known as
“Committee on Integration of
Health Services”.
Appointed on 1964.
Chairperson: Dr. Nowshir
Jungalwalla.

AIMS:-
To integrate the health
services and elimination of
private practice by
government doctors.

PURPOSE OF JUNGALWALA COMMITTEE:
To examine various problems including service
conditions; elimination of private practice.

KEY OBSERVATION:
•Non-practice allowance should be reasonable
and realistic to prevent private practice.

RECOMMENDATION OF THIS COMMITTEE:
1.Equal pay for equal work
2.Abolition of private practices by govt. doctors.
3.Recognition of extra qualification
4.Common seniority
5.Special pay for specialized work.
6.Improvement in their service conditions
7.Unified cadre.

KARTAR COMMITTEE, 1973
This committee is also known
as “The Committee on
Multipurpose Workers (MPW)
under the Health and Family
Planning Programme”.
Appointed on 28 October 1972.
Chairperson: Mr. Kartar Singh

PURPOSE OF KARTAR COMMITTEE:
• To study & make recommendations on:
 The structure for integrated services at the peripheral & supervisory
levels.
 The feasibility of having multipurpose, bi-purpose workers in the field
 The training req. for such workers
 The utilization of mobile service units under FP programme for
integrated national, public health & FP services operating from taluk
level.

KEY OBSERVATION:
 Generally, 1 PHC/80k-110k or more .
 There are wide disparities in staffing; wide variation in pay
scales between states Community leaders unhappy with many
workers visiting homes under individual programmes, prefer
single visit FP, malaria, smallpox workers feel ability to provide
treatment for minor ailments during field visits will increase
acceptability in community.
 Poor performance of peripheral workers largely due to
inadequate supervision.

MAJOR RECOMMENDATION:
 Having multipurpose workers is desirable & feasible
 Integrate vertical programmes at all levels
 Create new job description and designations:
 ANM Health Worker (Female)
→
 Male MPW Health Worker (Male)
→
 Supervisors Health Supervisor (Male/Female)
→
 1 Health Supervisor/ 4 Health Workers
 1 PHC/6 Sub-centres (3100 pop each) [1PHC/50k pop.]

•Impact: Many vertical progs. suffered as
MPWs were unable to do work previously
done by dedicated staff. Resurgence of
malaria. Resentment from dedicated staff as
they were used for general health activities.

SHRIVASTAVA COMMITTEE, 1975
• The issue of developing alternative strategy for the delivery of health services and
rationalisation of the health manpower both in terms of number of personnel as
well as categories of personnel had been engaging the attention of the Govt. of
India from time to time.
• The Govt. of India in the Ministry of Health and Family Planning had in November
1974 set-up a "Group on Medical Education and Support Manpower"
• under the chairmanship of Dr JB Shrivastav, then the DGHS was established
to focus on this issue.

• The terms of reference of this committee were as follows:
1.To devise a suitable curriculum for training a cadre of health
assistant conversant with basic medical aid preventive and
nutritional services, family welfare, maternity and child
welfare activities so that they can serve as link between the
qualified medical practitioners and the multipurpose
workers, thus forming an effective team to deliver health
care, family welfare and nutritional services to the people.

• The terms of reference of this committee were as follows:
1.Keeping in view the recommendations made by the earlier
committees on Medical Education, specially the Medical
Education Committee (1968) and the Medical Education
conference (1970), to suggest suitable ways and means for
implementation of these recommendations, and to suggest
steps for improving the existing medical educational processes
so as to provide due emphasis on the problems particularly
relevant to national requirements, and
2.To make any other suggestions to realise the above objectives
and matters incidental thereto.

RECOMMENDATIONS BY THE COMMITTEE
• After carefully examining various reports and papers relevant to the subject including the
recommendations of as many as 12 conferences and committees, held earlier, Shrivastav
Group, made following major recommendations:
1. A nationwide network of efficient and effective services suitable for our conditions,
limitations and potentialities should be evolved
2. Steps should be taken to create bands of paraprofessionals or semi-professional health
workers from the community itself to provide simple, protective, preventive and curative
services which are needed by the community.
3. Between the community and the primary health center, there should be two cadres, health
workers and health assistants.
- Health workers should be trained and equipped to give simple, specified remedies for day-
to-day illness.

RECOMMENDATIONS BY THE COMMITTEE
- Health assistants would work as intermediaries between the
health workers and primary health centres. They also should be
trained and equipped to give simple specified remedies for
simple illnesses according to their level of technical competence.
 The primary health center should be provided with an additional
doctor and nurse to look after the maternal and child health
services.
 The possibility of utilizing the services of senior doctors at the
Medical college, regional, district/ taluk hospitals for brief periods
at PHC should be explored.

• Acceptance of the
recommendations of
the Shrivastava
Committee in 1977 led
to the launching of the
Rural Health Service.

RESEARCH STUDY
1. Using Community-based Evidence For Decentralized Health Planning: Insights from Maharashtra, India
• Abhay Shukla,1* Renu Khanna2 and Nitin Jadhav1
1.Support for Advocacy and Training to Health Initiatives (SATHI), 3&4 Aman Terrace-E, Dahanukar
Colony, Kothrud, Pune 411029, India,
2.AHAJ - Society for Health Alternatives, Vadodara-390007, Gujarat, India.Accepted 29 July 2014
• Health planning is generally considered a technical subject, primarily the domain of health officials
with minimal involvement of community representatives.The National Rural Health Mission launched
in India in 2005 recognized this gap and mandated mechanisms for decentralized health planning.
However, since planning develops in the context of highly unequal power relations, formal spaces for
participation are necessary but not sufficient. Hence a project on capacity building for decentralized
health planning was implemented in selected districts of Maharashtra, India during 2010–13.
• This process developed on the platform of officially supported community-based monitoring and
planning, a process for community feedback and participation towards health system change. A
specific project on capacity building for decentralized planning included a structured learning course
and workshops for major stakeholders.

CONTD
• •An evaluation of the project, including in-depth interviews of various participants and analysis of
change in local health planning processes, revealed positive changes in intervention areas, including
increased capacity of key stakeholders leading to preparation of evidence-based, innovative planning
proposals, significant community-oriented changes in utilization of health facility funds, and inclusion of
community-based proposals in village, health facility-based block and district plans.Transparency
related to planning increased along with responsiveness of health providers to community suggestions.
• •A key lesson is that active facilitation of decentralized health planning and influencing the health
system to expand participation, are essential to ensure changes in planning. Effective strategies
included: identifying people’s health service-related priorities through community-based monitoring,
capacity building of diverse stakeholders regarding local health planning, and advocacy to enable
participation of community-based actors in the planning process.This combination of strategies draws
upon the framework of ‘empowered participatory governance ‘which necessitates combining a degree
of ‘countervailing power’ and acceptance of participation by the system, for new forms of governance to
emerge

Health and Human Rights Journal
2. Using Health Committees to Promote Community Participation as a Social Determinant of the Right to
Health: Lessons from Uganda and South Africa
• Moses mulumba, leslie london, juliana nantaba, and charles ngwena
• Abstract
• Community participation is not only a human right in itself but an essential underlying determinant for
serves them efficiently. As acknowledged by the Rio Political Declaration on Social Determinants of
Health, participatory processes are important in policy making and in the implementation of laws relating
to health. Collective deliberation improves both community development and health system governance,
resulting in more reasoned, informed, and public-orienteddecisions.1 More recently, attention has
focused on the elements of health system governance that enable greater responsiveness to community
needs. However, there is relatively little by way of interventions linking human rights approaches to
governance in ways that recognize participation as a critical social determinant of the right to health.This
paper provides perspectives from a three-year intervention whose general objective was to develop and
test models of good practice for health committees in South Africa and Uganda. It describes the aspects
that we found critical for enhancing the potential of such ommittees in driving community participation
as a social determinant of the right to health.

QUIZ QUESTION
• Which committee is known as health survey and developmental committee?
1. Bhore Committee
2.Chadha Committee
3. Mukerji Committee
4. Jungalwalla Committee
5. Kartar Singh Committee
Right Answer is :
1. Bhore Committee

• Three tier system of health care delivery in rural area based on the
recommendations of
• A. Bhore committee
• B. Mudalir committee
• C. Srivastav committee
• D. Kartar Singh Committee
• Right Answer is :
• ✓ C. Srivastav committee

• Chairman of health survey and planning committee was
• A. Sir Joseph Bhore
• B. Dr. A.L. Mudaliar
• C. Kartar Singh
• D. Srivastav
• Right Answer is :
• ✓ B. Dr. A.L. Mudaliar

•What was the goal of National Health Planning?
•The goal of National Health Planning in India is to
attain Health for all by the year 2000

• What does NITI Aayog stand for?
1.National Institute for Technology India
2.National Institute for Transforming India
3.National Interest for Technology India
4.National Interest for Transforming India

Which was the last 5 year planned and when did it
ended?
Ans :Twelfth Five-Year Plan (2012-2017)

REFERNCE:
 Government of India, Health Survey and Development (Bhore) Committee, Report, Volume-1, Delhi, Publications Division, 1946
 National Planning Committee, Subcommittee on National Health (Sokhey) Committee, Report, Bombay, Vora, 1948
 World Health Organization, Primary Health Care. Report of International Conference on Primary Health Care, Alma Ata, USSR, September 6-12, 1978,
Geneva, WHO, 1978.
 Government of India. National Health Policy 2002, New Delhi, Ministry of Health and Family Welfare, 2002.
 Government of India, National Rural Health Mission: Mission Document, New Delhi, MOHFW, 2005
 Indian Public Health Standards (IPHS) for Community Health Centers, Draft Guidelines, Directorate General of Health Services, MOHFW, GOI, April
2005 http://www.nihfw.org/reportsofncc.aspx
 https://gmch.gov.in/estudy/e%20lectures/Community%20Medicine/Health%20Plann
 https://www.nhp.gov.in/miscellaneous/committees-and-commissions
• Mulumba, M., London, L., Nantaba, J., & Ngwena, C. (2018). Using Health Committees to Promote Community Participation as a Social Determinant of
the Right to Health: Lessons from Uganda and South Africa. Health and human rights, 20(2), 11–17.

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