,Public Health skin, bright eyes, lustrous hair, firm flesh, good appetite; sound sleep, regular
and Related issues
activity of bowel and bladder, and coordinated movements of body. Mentally
healthy person feels satisfied with himself, he is well adjusted and has good self-
control. The concept of social health connotes abilities such as those of making
Sqrz$,rug and lasting friendships, assuming responsibilities in accordance with
one's capacluca, showing socially considerate behavior and living effectively with
others.
The constitution of India envisages that the state shall regard the raising of the level
of nutrition and standard of living of its people and the improvement of public
health as among its primary duties. This has resulted in a greater degree of state
involveinent in the establishment of nationwide health system of health care
services in the country. The term health care services includes not only the public
health services, but also medical care, and related education and research.
The services developed correspbnds to the health problems of the community. This
brings us to the crucial question what are the common health problems in our country?
By now you should be ahle to enlist them. Let us hriefly discuss each one of them.
Common Health Problems in India
The common health problems in India include :
i) Nutritional Disorders : Nearly 8 0 per cent of the children below the age of
five years are undernourished. 50 per cent of all pregnant and lactating
women have nutritional anaemia. Vitamin A deficiency is a major problem
in 1-3years age group children. Iodine deficiency disorders affect nearly 54
million people in India.
ii) Communicable Diseases : Malaria, Tuberculosis, Leprosy, Filaria, Cholera
etc. are few of communicable diseases which causes illnesses in the
community.
iii) Environmental Sanitation Problems: Lack of safe drinking water in many
areas of the country and unsafe methods of excreta disposal increases the
risk of infection and infestation. Unsanitary practice are the most common
causes of disease and death specially among children and women.
We have just gone through the common health problems affecting people in our
count@. In addition to these problems the increasing population of our country is
posing yet another health problem. Every year nearly 15 million people are added
to our population.
What is the government's response to these problems? What are the health care
facilities provided? Who are the health care functionaries working towards
improving health? The following discussion answers these questions:
19.2.1 Different Levels of Health Care
Health care is provided at three levels namely :
i) Primary level of Health Care : The most peripheral level of health care is
called primary level health care (Figure 19.1). In India a team of village level
functionaries namely village guide, trained dai, male and female multipurpose
worker provide primary level health care services to the community. Most of
the common health problems in the developing countries can he managed by
appropriately trained para-medical workers like those mentioned above
functioning at the village level. You will learn about these functionaries in
6 unit-section.
, ii) Secondary level of Health Care :There are only few health problems which Primary Health Care-1
require the services of professionals. This level of health care is called
secondary level of health care. These services are provided through primary
health centers, Community health centers, district hospitals etc. Figure 19.1
gives information regarding the population covered by this level of health care
and corresponding expenditure incurred on it.
iii) Tertiary level of Health Care : Very few health conditions requires highly
specialised type of health care services which are provided through
sophisticated hospitals like state hospitals and medical College hospital,
national institutes etc. This level of health care is called tertiary level of health
care which covers only one per cent population (Figure 19.1).
TerUary b u l t b we
(Specidired hoepitala)
Secondary b u l t b care
(general hapitll rewicu)
Fig 19.1 : Levels of Health Care
From our discussion above it is evident that the effort of our government is to
provide effective and comprehensive health care for all segments of the population.
To improve on their services the government has adopted the Alma Ata Declaration
I and is working towards providing health for all by the year 2000 A.D. What is
Alma Ata Declaration? Read the following discussion to gain knowledge on this.
!
I 19.2.2 Alma Ata Declaration
i
I
The Health Assembly of the World Health Organisation (WHO) adopted
1
I
I
resolutions in 1976, concerning the provision and promotion of effective
comprehensive health care for all people and expressed the need to hold an ' .
I
I
international conference to exchange experiences on the development of Primary
Health Care. The conference was held in Alma ~ t athe , capital of the erstwhile
t Kazakh state of Soviet Socialist Republic in 1978. The Intergovernmental
i
1
conference was attended by delegations from 134 governments and by
representatives of 67 United Nations Organisations, specialised agencies, and non-
governmental organisation.
!
i
The conference ended with the following declaration:
i) The conference strongly reaffirms that health, which is astate-of complete
physical, mental and social well being, and not merely the absence o f
disease or infirmity, is a fundamental human right and the attainment of the
highest possible level of health is a dost important worldwide social goal.
, Puhlic Health ii) The existing gross inequality in the health status of the people is politically,
and Related Issues socially, and economically unacceptable and is, therefore, of common
concern to all countries.
iii) Economic and social development is of basic importance to the fullest
attainment of health for all and to the reduction of the gap between the
health status of the developing and developed countries.
iv) The people have the right and duty to participate individually and
collectively in the planning and implementation of their health care.
v) Governments have a responsibility for the health of their people which can
be fulfilled only by the provision of adequate health and social measures. A
main social targd of Governments, international organisations and the
whole world community in the coming decades should be the attainment of
a level of health by all people of the world by the year 2000 that will permit
them to lead a socially and economically productive life.
vi) Primary health care is the key to attain this target.
vii) All governments should formulate national policies, strategies and plans of
action to launch and sustain primary health care as part of comprehensive
I
national health system.
viii) All countries should cooperate in a spirit of partnership and service to
ensure primary health care for all people.
ix) An acceptable level of health for all the people of the world by the year
2000 can be attained through a fuller and better use of the world's
resources.
Our government abides by this declaration. Based on this, a national health policy
has been formulated. The policy is described in the following sub-section.
19.2.3 National Health Policy
To achieve the optimal utilisation of resources and co-ordinate efforts of different
departments and ministries participating in promotion of health of community
members, the Government of India developed a National Health Policy in 1983.
The salient features of the policy are as follows:
i) Recoganisation of health infrastructure on Primary Health Care approach.
ii) Reorientation of health personnel, involved in the delivery of government
health care services.
iii) Intersectoral co-ordination and involvement of other sectors such as food
and agriculture; water supply and sanitation; education; rural developmept;
social welfare in health care.
iv) Main thrust on priority areas. These include population control, maternal
and child health, immunisation, water supply and sanitation, school health,
nutrition and occupational health.
vj Applied research in the identified priority areas.
vi) Involvement of non-governmental organisation in Health and Family
Planning activities.
vii) Health and population education.
viii) Involvement of indigenous system of medicine.
ix) Relevant changes in medical education system to make it community
oriented.
x) Develement of national policy on drugs, nutrition, medical education and
children. *, s
i .'~
, ,
and Related issues
activity of bowel and bladder, and coordinated movements of body. Mentally
healthy person feels satisfied with himself, he is well adjusted and has good self-
control. The concept of social health connotes abilities such as those of making
Sqrz$,rug and lasting friendships, assuming responsibilities in accordance with
one's capacluca, showing socially considerate behavior and living effectively with
others.
The constitution of India envisages that the state shall regard the raising of the level
of nutrition and standard of living of its people and the improvement of public
health as among its primary duties. This has resulted in a greater degree of state
involveinent in the establishment of nationwide health system of health care
services in the country. The term health care services includes not only the public
health services, but also medical care, and related education and research.
The services developed correspbnds to the health problems of the community. This
brings us to the crucial question what are the common health problems in our country?
By now you should be ahle to enlist them. Let us hriefly discuss each one of them.
Common Health Problems in India
The common health problems in India include :
i) Nutritional Disorders : Nearly 8 0 per cent of the children below the age of
five years are undernourished. 50 per cent of all pregnant and lactating
women have nutritional anaemia. Vitamin A deficiency is a major problem
in 1-3years age group children. Iodine deficiency disorders affect nearly 54
million people in India.
ii) Communicable Diseases : Malaria, Tuberculosis, Leprosy, Filaria, Cholera
etc. are few of communicable diseases which causes illnesses in the
community.
iii) Environmental Sanitation Problems: Lack of safe drinking water in many
areas of the country and unsafe methods of excreta disposal increases the
risk of infection and infestation. Unsanitary practice are the most common
causes of disease and death specially among children and women.
We have just gone through the common health problems affecting people in our
count@. In addition to these problems the increasing population of our country is
posing yet another health problem. Every year nearly 15 million people are added
to our population.
What is the government's response to these problems? What are the health care
facilities provided? Who are the health care functionaries working towards
improving health? The following discussion answers these questions:
19.2.1 Different Levels of Health Care
Health care is provided at three levels namely :
i) Primary level of Health Care : The most peripheral level of health care is
called primary level health care (Figure 19.1). In India a team of village level
functionaries namely village guide, trained dai, male and female multipurpose
worker provide primary level health care services to the community. Most of
the common health problems in the developing countries can he managed by
appropriately trained para-medical workers like those mentioned above
functioning at the village level. You will learn about these functionaries in
6 unit-section.
, ii) Secondary level of Health Care :There are only few health problems which Primary Health Care-1
require the services of professionals. This level of health care is called
secondary level of health care. These services are provided through primary
health centers, Community health centers, district hospitals etc. Figure 19.1
gives information regarding the population covered by this level of health care
and corresponding expenditure incurred on it.
iii) Tertiary level of Health Care : Very few health conditions requires highly
specialised type of health care services which are provided through
sophisticated hospitals like state hospitals and medical College hospital,
national institutes etc. This level of health care is called tertiary level of health
care which covers only one per cent population (Figure 19.1).
TerUary b u l t b we
(Specidired hoepitala)
Secondary b u l t b care
(general hapitll rewicu)
Fig 19.1 : Levels of Health Care
From our discussion above it is evident that the effort of our government is to
provide effective and comprehensive health care for all segments of the population.
To improve on their services the government has adopted the Alma Ata Declaration
I and is working towards providing health for all by the year 2000 A.D. What is
Alma Ata Declaration? Read the following discussion to gain knowledge on this.
!
I 19.2.2 Alma Ata Declaration
i
I
The Health Assembly of the World Health Organisation (WHO) adopted
1
I
I
resolutions in 1976, concerning the provision and promotion of effective
comprehensive health care for all people and expressed the need to hold an ' .
I
I
international conference to exchange experiences on the development of Primary
Health Care. The conference was held in Alma ~ t athe , capital of the erstwhile
t Kazakh state of Soviet Socialist Republic in 1978. The Intergovernmental
i
1
conference was attended by delegations from 134 governments and by
representatives of 67 United Nations Organisations, specialised agencies, and non-
governmental organisation.
!
i
The conference ended with the following declaration:
i) The conference strongly reaffirms that health, which is astate-of complete
physical, mental and social well being, and not merely the absence o f
disease or infirmity, is a fundamental human right and the attainment of the
highest possible level of health is a dost important worldwide social goal.
, Puhlic Health ii) The existing gross inequality in the health status of the people is politically,
and Related Issues socially, and economically unacceptable and is, therefore, of common
concern to all countries.
iii) Economic and social development is of basic importance to the fullest
attainment of health for all and to the reduction of the gap between the
health status of the developing and developed countries.
iv) The people have the right and duty to participate individually and
collectively in the planning and implementation of their health care.
v) Governments have a responsibility for the health of their people which can
be fulfilled only by the provision of adequate health and social measures. A
main social targd of Governments, international organisations and the
whole world community in the coming decades should be the attainment of
a level of health by all people of the world by the year 2000 that will permit
them to lead a socially and economically productive life.
vi) Primary health care is the key to attain this target.
vii) All governments should formulate national policies, strategies and plans of
action to launch and sustain primary health care as part of comprehensive
I
national health system.
viii) All countries should cooperate in a spirit of partnership and service to
ensure primary health care for all people.
ix) An acceptable level of health for all the people of the world by the year
2000 can be attained through a fuller and better use of the world's
resources.
Our government abides by this declaration. Based on this, a national health policy
has been formulated. The policy is described in the following sub-section.
19.2.3 National Health Policy
To achieve the optimal utilisation of resources and co-ordinate efforts of different
departments and ministries participating in promotion of health of community
members, the Government of India developed a National Health Policy in 1983.
The salient features of the policy are as follows:
i) Recoganisation of health infrastructure on Primary Health Care approach.
ii) Reorientation of health personnel, involved in the delivery of government
health care services.
iii) Intersectoral co-ordination and involvement of other sectors such as food
and agriculture; water supply and sanitation; education; rural developmept;
social welfare in health care.
iv) Main thrust on priority areas. These include population control, maternal
and child health, immunisation, water supply and sanitation, school health,
nutrition and occupational health.
vj Applied research in the identified priority areas.
vi) Involvement of non-governmental organisation in Health and Family
Planning activities.
vii) Health and population education.
viii) Involvement of indigenous system of medicine.
ix) Relevant changes in medical education system to make it community
oriented.
x) Develement of national policy on drugs, nutrition, medical education and
children. *, s
i .'~
, ,
