RF_COM_H_66_A__SUDHA.pdf
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1 askforce on Health
http://www.dhskhsdp.com/news.htrr
TFHFW/5/2000.
PRESS RELEASE
The State of Karnataka has endeavored to develop itself into a welfare state. The bold
initiatives taken during under the princely state of Mysore has been a precursor for
many national level endeavors: The Urban Family Welfare Centres, the five-year plans,
the primary health units, water and sanitation, Electrification, Local self governments.
The state has experimented with and has implemented the Panchayathi Raj system for
promoting decentralised governance.
The Government of Karnataka has constituted the Taskforce on Health and Family
Welfare (vide Government order Health and Family Welfare 545 CGM 99, Bangalore
dated 14-12-99). The terms of reference are broad. These include the following:
a.
a
1 of 6
Suggestions for delineating policy measure for
improving the Public Health system in the
state. There is a need to strengthen the Primary
Health Care Delivery system, making it more
accessible to the poor and the poorest of the poor.
We need to think, develop and implement services
and systems that respond to the needs and
aspirations of the larger sections of the society.
2/16/00 4:29 PM
Taskforce on Health
http://www.dhskhsdp.com/news.htrr
b.
Suggestions for improvement in the management and
administration of the Department of Health
and Family Welfare.
Recommend changes in the Health and Medical
Education system so that it fulfils the
requirements of the people at the grass root level
and simultaneously keeping up with the ever
expanding vista of science and Technology, so
that it could sincerely contribute to the Human
Resources Development
2 of 6
2/16/00 4:29 PM
Taskforce on Health
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In achieving its endeavor the task force intends to document the current health status
of the people of Karnataka, review the situation with experts and different
stakeholders and derive suitable, appropriate, pragmatic and meaningful
recommendations so as to improve the quality of life of the people of Karnataka not
just in the short term, but also in the long run. The terms of reference give the Task
Force the mandate to monitor the implementation of its recommendations. The Task
Force also plans to produce a draft health policy for the state in consonance with the
National Health Policy and the new revised draft National Health Policy.
The members of the Taskforce have initiated the process of consultations. In this
context we would like to request concerned individuals / organisations / institutions /
Citizen groups / Professional bodies and all the people of the state to contribute
towards the recommendations of the Task Force. The opinions / suggestions /
comments / notes / thoughts or any related matter may be kindly be sent to the
following address:
Dr. H Sudarshan,
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2/16/00 4:29 PM
Taskforce on Health
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Chairman, Task Force on Health and Family Welfare,
Ground Floor, PHI Building Annexe,
4 of 6
2/16/00 4:29 PM
Taskforce on Health
http://www.dhskhsdp.com/news.htm
Sheshadri Road, Bangalore - 560 001
Phone : Extension 225 of (+80) 2271021 / 2277390 / 2274883 / 2245041 / 2245042
5 of 6
2/16/00 4:29 PM
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Taskforce on Health
Fax
: (+80) 2277389
Email : khsdp@vsnl.com
healthtaskforce@indiatimes. com
(Dr. Sudarshan)
Subram anya)
(Dr. S.
Chairman - Taskforce on Health
Convenor
Member -
Back
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KHSDP Home
http://www.dhskhsdp.coro
Department of Health & Family Welfare Services
Evolution of Health System in Karnataka
Karnataka has developed its own Health
care delivery system based on timely
guidelines issued by the Government of
India.The recomendations of SHORE'S
committe, MUDAL1AR committee and
many other committees have been taken
into
considerations
in
providing
comprehensive Health care at the door
steps of community.During the previous
five year planperiods a large network of
primary health care infrastructure
institutions covering the entirestae have
been
established.Wide
range
of
communicable diseases namely Malaria,
Filaria, Tuberculosis, Cholera and
several other vaccine preventable
diseases like Diptheria, Purtosis, Polio,
Measles & Tetanus are given due
importance. Several important
non-communicable disease like Iodine
deficiency disorder, Blindness, Cancer,
Diabetes are also given due importance.
Major initiatives were taken to reach the
goal of health for all by 2000 AD on the
lines of policy directives issued by the
Govenment of India keeping national
health policy as a major objective.During
the eighth plan period due emphasis was
given to reach the entire population
including the high risk venerable group
e., Mother & Children and also to focus
i.
attention in the under previelaged
segments of population in tribal areas.
The state Govt, keeping all the above
factors into picture has created the
Department of Health & Family Welfare
under the leadership of Honourable
Minister for health & Family Welfare &
a seperate Minister for Medical
education to fulfill the needs of the
department. Next in order to reach all the
activities of the Department of Health &
Family Welfare, a seperate Directorate
has been established to implement the
programmes of the department.
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KHSDP
W ipp
2/16/00 10:48 AM
KHSDP Home
http://www.dhskhsdp.com,
Next in order to reach all the activities of
the Department of Health & Family
Welfare, a seperate Directorate has been
established to implement the
programmes of the department.
OPEC
Tkew
ZorTcflUER^TuiDE^
To supplement the Health Care Delivery
System the following departments are
also established.
Directorate
of
Medical
Directorate of Indian
Medicine & Homeopathy
Education
System
of
Drugs Control Department
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2/16/00 10:48 AM
KHSDIj Home
http://www.dhskhsdp.com/khsdp/index.hti
Health sendees in Karnataka are being provided by the State at three levels, Primary, Secondary
and Tertiary. Over the years, Primary Health Care has received considerable attention and
resources through the State's own funding as also external agencies, through various India
Population Projects. The main objective of these projects is to promote integrated family welfare
through strengthening of the health infrastructure and planned improvement of the delivery
system and the quality of health services at the primary level.
The Secondary Level of Health Care, comprising all rural hospitals of varying types and
magnitude, has not, however, received attention and assistance on a similar scale. There are also
marked disparities in the availability of infrastructure and the quality of services provided by
these hospitals, across different regions in the State. The fact that the broad network of the
secondary hospitals discharging, as they do, the essential first referral services all over the State,
is only a natural and organic extension of the Primary Health Care system has now been
recognised all over the world.
The Karnataka Health Systems Development Project (KHSDP) has been formulated for filling
the glaring gaps within our Health Care System and also its thorough restructuring, in
accordance with modem norms and the felt needs of the present day. Renovation and expansion
of buildings, augmenting equipment and providing full complement of trained staff are planned
to upgrade the secondary level hospitals. Several new components, such as formulation of an
effective surveillance system, specific interventions for the disadvantaged sections, e.g. the
scheduled castes and tribes, and, women, and measures to strengthen the institutional capability
at various levels, as also an outline of the needed reforms in the Health sector.
The broad objectives of the project are to:
1. Improving the performance and quality of health care services at the
district and sub-district level of the health care system,
2. Narrowing the current coverage gaps by facilitating access to health
care delivery, and
3. Achieving better efficiency in the allocation and use of health
resources.
The emphasis of this project will be on district and sub-district (or secondary) level health care
institutions as the interventions at this level provide critical support to the entire primary health
care network, enhancing its effectiveness and credibility and establishing essential linkages with
the tertiary level.
The project components and sub-components are:
a). Management Development and Institutional Strengthening:
1. Improving the institutional framework for policy
Development;
2. Strengthening
capacity; and
management
3. Developing surveillance
communicable diseases.
b).
and
capacity
implementation
for
major
Improving Service Quality, Access and Effectiveness.
1. Extending/renovating Community, Taluka and District hospitals;
2.
1 of3
Upgrading their clinical effectiveness;
2/16/00 4:27 PM
KHSde Home
http://www.dhskhsdp.com/khsdp/index.htr)
3.
Improving referral mechanism and linkages with primary and tertiary
level; and
4.
Improving access and equity to disadvantaged sections.
Strengthening ofInfrastructure Facilities:
Renovation of buildings and expansion of physical space will be carried out in 253 hospitals of
the State with assistance from the World Bank in 201 hospitals in the Bangalore, Belgaum and
Mysore Divisions, 52 hospitals in Oulbarga Division with assistance from KfW. A super
speciality' hospital will be constructed at Raichur with financial assistance from OPEC. During
the project period over 5,600 beds will be added. All the facilities are also provided with
adequate equipment and manpower. Based on the norms developed for equipment and staffing
the facilities are being strengthened.
Maintenance of Facilities
Maintenance of facilities (building & equipment) being one the critical issue in providing better
health care, concrete measures will be taken to address them as part of the Health Systems
Project. For the first time a complete in-house maintenance set-up is provided for maintaining
both building and equipment. As the management and disposal of hospital waste is a critical
element in the effective functioning of a high quality health care system, it is proposed to
establish a hospital waste disposal system on efficient and scientific lines.
Quality ofServices
CIVIL WOR!
[WASTE MCI.
[protocol
[EQUIPMEHT
[drugs
[STflFF^
^TRAINING
In order to improve the quality and effectiveness of hospital services in the government sector, a
system of regular in-service training of all categories of staff is provided to update their clinical,
managerial and maintenance skills. Training is focused on the clinical and practical skills so as to
enable staff to provide good quality care in the range of services. Training also covers on the use
of equipment by medical and paramedical staff and to carry out simple maintenance checks.
[finance
[MANUALS
A systematic programme of quality assurance will be developed and implemented to cover
aspects of clinical quality, user satisfaction and management of resources. This is to ensure that
the interventions such as physical resources, implementation of staffing and equipment norms,
training, and strengthening of management, etc., are actually translated into better quality of
care. Such a system will empower managers, clinicians and technicians to monitor the quality of
care provided by their own hospitals and assist in instituting rapid remedial measures wherever
shortfalls in quality are noticed.
[REIATEDPR
Referral Mechanism
A credible and an effective Referral System will be established in the State with new guidelines
on the referral system. Such a system would provide patients access to levels of health care
facilities that are appropriate for their need at minimum cost and delay. Continuity of care is
ensured which includes follow up and long term therapy and rehabilitation.
Innovative Schemes
The state has also come up with innovative ideas to provide access and health care to
disadvantaged sections of the population. Large number of such innovative schemes are planned
to be launched throughout the state and continued on a permanent basis
The Project Budget
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KH3DP Home
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Components
Million Rs
Policy Frame Work & Implementation Capacity
522
Policy Frame Work
49
Implementation Capacity 43.32
473
Improving
Sendee
Quality
Access
and
Extending / renovating Community/ Taluka and
Effectiveness
3898
2982
District Hospitals 276.34
Upgrading their clinical effectiveness
316
Improving referral mechanism and linkages
106
with primary and tertiary level.
Improving access and equity to disadvantaged
494
areas
Physical & Price Contingencies
Physical Contingency 32.33
709
Price Contingency 105.00
1090
Total Project cost including contingencies
3 of 3
1499
5919
2/16/00 4:27 PM
http://www.dhskhsdp.com/hier.htm
Organisation of Health & Family Welfare Department
Directorate ot Health & Family Welfare
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Directorate of Health & Family Welfare Services
http://www.dhskhsdp.com/dhs.htir
Directorate ofHealth & Family Welfare Services
The Directorate of Health & Family Welfare Services is responsible for:
• Providing Health Care Services through various types of institutions.
• Providing Family Welfare and Immunisation Services.
. Implementing National Programmes for eradication/control of diseases.
• Implementing Externally Aided Projects.
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Health'Gare Services
http://www.dhskhsdp.com/hc.htrr
Health Care Services
Curative services under allopathic system of medicine are provided by Hospitals in large and medium
urban centres and by Three Tiered Health Infrastructure in smaller urban centres and villages.
There are 176 hospitals (including those attached to medical colleges) with total bed strength of 23,223.
1 oft
Institutions
Beds
District Hospitals
16
5788
Teaching Hospitals
9
5907
Major Hospitals
8
1521
Specialised Hospitals
16
3330
General / Maternity Hospitals
127
6677
All
176
23223
2/16/00 10:53 AM
Three tier architecture
http://www.dhskhsdp.com/tier.htrr
Three Tiered Health Infrastructure
The Three Tired Infrastructure to provide curative, preventive and promotive health services consists of Community Health
Centres, Primary’ Health Centres and Sub-centres have been patterned along the guidelines provided by the Government of
India. In addition there are institutions known as Primary Health Units which also provide curative, preventive and
promotive health sendees.
Institutions
Beds
130
4,263
Primary Health Centres
1,561
11,297
Primary Health Units
569
702
8,143
0
Community Health Centres
Sub-centres
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National Programs
http://www.dhskhsdp.com/np.htrr
National Programmes From Central Govt.
• National Aids Control Programme
• National Leprosy Eradication Programme
. National Tuberculosis Control Programme
. National Programme for Control of Blindness
• National Malaria Eradication Programme
. National Family Welfare Programme
• National Filaria Control Programme
Home | Org.Chart
1 of 1
2/16/00 10:54 AM
Primary Health Centre
http://www.dhskhsdp.com/phc.htn
Primary Health Care Centres
Details of Primary Health Centres
1. Members'.
o Medical Officer
o Paramedical Staff + Other Staff
2. Number ofBeds: 4-6
3. Population:
o Plain Area:30000
o Hilly/Tribal Area:20000
4. Activities
o Curative & Preventive Services
o Promotive Services
o Family Welfare Services
Home | Org.Chart
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Curative & Prevantive Services
http://www.dhskhsdp.com/phc 1 .htrr
Different Types of Curative & Preventive Services
Preventive Services
The various programs that come under preventive services are as follows:
• DPT VaccinationfFirst,Second,Third & Booster doses)
• Polio Vaccination(First,Second,Third & Booster doses)
• BCG Vaccination
• Measles Vaccination
• DT Vaccination(For children below 5 year's)
. TT Vaccination(For children of 10 & 16 years of age)
• EFA to chidren(l,2,3
Doses)
• Vitamin 'A' to children(l,2,3
Doses)
Curative Services
The various programs that come under curative services are as follows:
• Registration,Referral & Follow-Up of TB cases
• Registration,Referral & Follow-Up of Leprosy cases
• Malaria Blood Smear collection,presumptive & radical treatment
. Providing ORS
. Recording communicable diseases & follow-up
. Registration,Referral & Follow-Up of disability cases
* Registration,Referral & Follow-Up of Acurate respiratory infection cases
• RTI/STD ases recorded
Different Types of Promotive Services
. Registration & follow-ups of Ante-Natal Care(Follow-up No: 1,2,3)
• TT doses for Mothers( 1,2,booster)
. Initiation & completion of IF A for mothers
• Conducting Deliveries
• Post-Natal Care
O
Different Types of Family Planning Services
The various programs that come under Family Welfare services are as follows:
. Contacting Eligible Couples
• Family Welfare folloe-Up
• Referring for Vasectomy & Tubectomy
. IUD insertion & Removal
• Supply of Condoms & Oral Pills
• Registration & Follow-Up of MTP
Home | Org.Chart | PHC
1 of 1
2/16/00 4:21 PIV
Curative & Prevantive Services
http://www.dhskhsdp.com/phc 1 .htn
Different Types of Curative & Preventive Services
Preventive Services
The various programs that come under preventive services are as follows:
• DPT Vaccination(First,Second,Third & Booster doses)
• Polio Vaccination(First,Second,Third & Booster doses)
• BCG Vaccination
• Measles Vaccination
• DT Vaccination(For children below 5 years)
• TT Vaccination(For children of 10 & 16 years of age)
• IFA to chidren(l,2,3
Doses)
• Vitamin 'A' to children(l,2,3
Doses)
Curative Services
The various programs that come under curative services are as follows:
. Registration,Referral & Follow-Up of TB cases
• Registration,Referral & Follow-Up of Leprosy cases
• Malaria Blood Smear collection,presumptive & radical treatment
• Providing ORS
• Recording communicable diseases & follow-up
. Registration,Referral & Follow-Up of disability cases
. Registration,Referral & Follow-Up of Acurate respiratory infection cases
• RTI/STD ases recorded
Different Types of Promotive Services
• Registration & follow-ups of Ante-Natal Care(Follow-up No: 1,2,3)
• TT doses for Mothers( 1,2,booster)
• Initiation & completion of IFA for mothers
• Conducting Deliveries
• Post-Natal Care
£
Different Types of Family Planning Services
The various programs that come under Family Welfare services are as follows:
• Contacting Eligible Couples
• Family Welfare folloe-Up
. Referring for Vasectomy & Tubectomy
• IUD insertion & Removal
. Supply of Condoms & Oral Pills
• Registration & Follow-Up of MTP
Home | Org.Chart | PHC
1 of 1
2/16/00 4:22 PM
Curative & Prevantive Services
http://www.dhskhsdp.coni/phc 1 .htn
Different Types of Curative & Preventive Services
Preventive Services
The various programs that come under preventive services are as follows:
• DPT VaccinationfFirst,Second,Third & Booster doses)
• Polio Vaccination(First,Second,Third & Booster doses)
. BCG Vaccination
• Measles Vaccination
• DT Vaccination(For children below 5 years)
• TT Vaccination(For children of 10 & 16 years of age)
• IFA to chidren(l,2,3
Doses)
• Vitamin 'A' to children(l,2,3
Doses)
Curative Services
The various programs that come under curative services are as follows:
• Registration,Referral & Follow-Up of TB cases
• Registration,Referral & Follow-Up of Leprosy cases
• Malaria Blood Smear collection,presumptive & radical treatment
• Providing ORS
• Recording communicable diseases & follow-up
• Registration,Referral & Follow-Up of disability cases
• Registration,Referral & Follow-Up of Acurate respiratory infection cases
• RTI/STD ases recorded
Different Types of Promotive Services
• Registration & follow-ups of Ante-Natal Care(Follow-up No: 1,2,3)
• TT doses for Mothers( 1,2,booster)
• Initiation & completion of IFA for mothers
. Conducting Deliveries
• Post-Natal Care
£
Different Types of Family Planning Services
The various programs that come under Family Welfare services are as follows:
• Contacting Eligible Couples
• Family Welfare folloe-Up
* Referring for Vasectomy & Tubectomy
• IUD insertion & Removal
• Supply of Condoms & Oral Pills
. Registration & Follow-Up of MTP
Home | Org.Chart | PHC
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http://www.dhskhsdp.com/deptment.htr
K.HSDP - Organisational Chart
<% newsarea = requestf'newsarea") %>
Organizational Structure of the Department of Health & Family Welfare Services
(Govt, of Karnataka)
External
Projects
Department of Health
& Family Welfare
World
Bank
Aided
Directorate of Health
& Family Welfare
O
.
,
System; Development
Project iKHSDP;
India Population
Project (IPPl
Karnataka Family
Welfare (KFW)
E
(p
,,
-“Karnataka Health
Divisional Joint
Director
Tertiary
Hospital
OPEC
O
tu
E
E
co
District Hospital I
Sub-District Hospital
Bed Capacity >100
District Health Officer
tr
Taluk level / Sub-Divisional Hospital
tr
Community Health Center
—
Administrative
Control
Referral &
Tech. Support
tr
tr
Primary Health Cure Center
—
tr t
Sub-Center
1 of 1
2/16/00 4:23 PM
National Programs
http://www.dhskhsdp.com/np.htn
National Programmes From Central Govt.
• National Aids Control Programme
• National Leprosy Eradication Programme
• National Tuberculosis Control Programme
• National Programme for Control of Blindness
• National Malaria Eradication Programme
• National Family Welfare Programme
• National Filaria Control Programme
Home | Org.Chart
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2/16/00 4:24 PM
http://www.dhskhsdp.com/djd.htn
djd
Divisional Joint Directors
The four divisions in Karnataka are:
1.
2.
3.
4.
Bangalore Division
Mysore Division.
Belgaum Division.
Gulbarga Division.
Home | Org.Chart
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Brief Introduction About District Health Office:
http://www.dhskhsdp.com/dho.htrr
Brief Introduction About District Health Office:
The District Health Officer is the head for an District Health Office the following are the activities that
are performed in a District Health Office:
• Supervise taluka medical activities
• Co-Ordinating PHC activities
• Monitoring referral systems.
• Quality Assurance.
• Surveillance of Communicable Diseases.
Organizational set-up in Districts:
•
9
Organisational set-up in the District there is one Divisional Joint Director in-charge of each of the four
Revenue Divisions and report to DHS. In each district, there is a District Surgeon to manage the district
hospital and a District Health Officer (DHO) to manage primary health care,all hoapitals other than
those under the District Surgeon,and programmes to control diseases.The activities managed by DHO
fall under the jurisdiction of the Zilla Panchayat.Consequently ,he reports to the Chief Executive
Officer(CEO) of the Zilla Panchayat .who is an IAS officer.The DHOs are under the administrative
control of the DHS in so far as evaluation of their performance,promotions and transfers are
concemed.The organisational set-up under the DHO is almost similar to that under DHS
The Zilla Panchayats receive grants from the State Government to meet expenditure on health care.Such
grants and actual express are reflected in the Health Budget of the State,under the District Sector
component.
The Karanataka panchayat Raj act, 1993which is now in force in the state,specifies the functions to be
performed by the zilla panchayats,taluka panchayats,and the grama panchayats.The matter to be dealt
with by the zilla panchayat,in respect of health and family welfare,at the district level,are: 1 .management
of hospitals and dispensaries excluding the district hospital and other hospitals under the direct
management of Government (above 50 beds).2.Implementation of maternity and child health
programmes;3.Implementation of family welfare programmes;(4)Implementation of immunisation and
vaccination programmes.The taluka panchayats deal with; 1.Promotion of health and family welfare
programmers ;2.promotion of immunisation and vaccinatoin programmes at the taluka level ,3.health
and and sanitaton of fairs and festivals .At the village level the grama panchayats deal with
implementation of family welfare programmes,preventive measures againest epidemics,regulation of
sale of food articles.partucipation in immunisation programmers,licensing of eating establishments and
regulation of offensive and dangerous trades.apart from operating the district sectorbudget,the zilla
panchayats also
Implement such state sector schemes as are entrusted to them by government.
Home | Org.Chart
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Brief Introduction About District Hospital:
http://www.dhskhsdp.com/dh.htn
Brief Introduction About District Hospital:
The District hospitals are located in the district headquarters of each of the 27 districts & cater to the
health needs of 2 million population on an average. The District Surgeon is the Head for a District
Hospital & the following are the service facilities that are offered in a District Hospital. :
1.
2.
3.
4.
5.
General & speciality outpatient care.
Emergency/Casuality services.
General & speciality in patient care.
General & special diagnostic & therapeutic facilities.
Post Mortem facilities.
The district surgeon, in addition to overall supervision of patient care in the district
hospital, ia also responsible for the following areas.
. Maintenance of Equipment.
• Waste Management.
. Training of Technical Staff.
• Monitoring referral systems.
• Quality Assurance.
• Surveillance of Communicable Diseases.
. User Fees.
• Medical supervisory powers to lower level hospitals like training,equipment repairs
etc.(Implemented by KHSDP)
Organizational set-up in Districts:
Organisational set-up in the District there is one Divisional Joint Director in-charge of each of the four
Revenue Divisions and report to DHS. In each district, there is a District Surgeon to manage the district
hospital and a District Health Officer (DHO) to manage primary health care,all hoapitals other than
those under the District Surgeon,and programmes to control diseases.The activities managed by DHO
fall under the jurisdiction of the Zilla Panchayat.Consequently ,he reports to the Chief Executive
Officer(CEO) of the Zilla Panchayat .who is an IAS officer.The DHOs are under the administrative
control of the DHS in so far as evaluation of their performance,promotions and transfers are
concemed.The organisational set-up under the DHO is almost similar to that under DHS
The Zilla Panchayats receive grants from the State Government to meet expenditure on health care.Such
grants and actual express are reflected in the Health Budget of the State,under the District Sector
component.
The Karanataka panchayat Raj act, 1993which is now in force in the state,specifies the functions to be
performed by the zilla panchayats,taluka panchayats,and the grama panchayats.The matter to be dealt
with by the zilla panchayat,in respect of health and family welfare,at the district level,are: 1.management
of hospitals and dispensaries excluding the district hospital and other hospitals under the direct
management of Government (above 50 beds).2.Implementation of maternity and child health
programmes;3.Implementation of family welfare programmes;(4)Implementation of immunisation and
vaccination programmes.The taluka panchayats deal with; 1.Promotion of health and family welfare
programmers ;2.promotion of immunisation and vaccinatoin programmes at the taluka level ,3.health
and and sanitaton of fairs and festivals .At the village level the grama panchayats deal with
implementation of family welfare programmes,preventive measures againest epidemics,regulation of
sale of food articles.partucipation in immunisation programmers,licensing of eating establishments and
regulation of offensive and dangerous trades.apart from operating the district sectorbudget,the zilla
panchayats also
Implement such state sector schemes as are entrusted to them by government.
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Brief Introduction About District Hospital:
http://www.dhskhsdp.com/dh.htn
Home | Qrg.Chart
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Community Health Centre
http://www.dhskhsdp.com/chc.htn
Community Health Centres
Details of Community' Health Centres
1. Members'.
o Surgeon
o Gynaecologist
o Physcician
o Paediatrician
o 21 Paramedical Staff + Other Staff
2. Number ofBeds:3G
3. Population:
o Plain Area: 120000
o Hilly/Tribal Area:80000
4. Facilities
o Operation Theatre
o Labour Room
o Laboratory
Home | Org.Chart | Job Responsibilities Manual
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KHSDP Sub-Centre's
http://www.dhskhsdp.com/scentre.htn
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Sub-Centre's
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Organisation
home
Details of Sub-Centres
1. Members:
o Multi-Purpose Female workers
(Females are also called Auxiliary Nursing
Midwives {ANMs})
o Multi-Purpose Male workers
2. Population:
° Plain Area:5000
o Hilly/Tribal Area:3000
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Ill
http://www.clhskhsdp.com/opec.htn
OPEC Project
The super speciality hospital at an estimated cost of Rs. 29.25 crores at Raichur is assisted by OPEC.
This super speciality hospital will cater to the needs of the people of the districts of Gulbarga Division.
There are two phases in this project.
* The improvements and repairs along with upgradation to the existing 250 beded district hospital
to be developed as Women & Children Hospital. The total estimated cost of is Rs. 2.86 crores.
* Construction of 350 beded super speciality hospital at a total project cost of 26.3 crores. For this
work, the tenders are already issued and expected that the construction activity will start in the
month of April/May 1997.
Even though the project agreement was signed in 1991, due to various constrains, the project could not
take of till 1995-96. Now the project activities have been started and it expected that the project will be
completed by 1998 as agreed to.
Home | Org.Chart
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http://www.dhskhsdp.com/gallery.htm
Photo Gallery
Photographs taken at District Hospital - Tumkur
Tumkur situated 70 Kms from Bangalore has a District Hospital with 330 beds. The hospital has bed
occupancy rate of more then 85%. The civil works of the District Hospital is almost being completed. The
hospital has all infrastructure viz., Major OT, Radiology Block with Ultrasound room, endoscopy room,
IPP OT labour theatre, an upgraded causality department and outpatient department of various specialties
The maternity section has been provided with a foetal monitor for the improvisation of the obstetric work.
Home
The Female Ward
Operation Theatre
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Photo gallery
http://www.dhskhsdp.com/gallery.htrr
Jail Ward
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OPEN
http://www.dhskhsdp.com/manual/cover.html
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covet
http://www.dhskhsdp.com/manual/COVER 1 .HTMI
Job Responsibilities of Staff of the
Primary Health Centre
Rural Health Division
MINISTRY OF HEALTH & FAMILY WELFARE
Government of India
New Delhi
1991
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ack ,
http://www.dhskhsdp.com/manual/ack.HTMI
ACKNOWLEDGEMENT
This booklet is ttui revised version ol earlier published 'Job Responsibilities of Staff
of Primary Health Centro' brought out in 198B. The revised responsibilities incorporate the
policy changes which have taken place in National l l.-alth Programmes during the past 5
years. Maternal & Child Health Programmes have u.en brought info sharper focus because
of the priority attached to these programmes by Government ol India. An attempt nas baun
made to define the duties of Health Providers In the programmes like ARI, Diarrhoeal
diseases and Maternal Health Care.
I am grateful to all the National Health Programme Officers for the changes suggested
tor each category of Health Providers to meet lhe needs of their programmes which have
tried to incorporate.
I am also thankful to Dr. (Mrs.) T. Bhasln. Assistant Comm!sskmers(RHS}. who has
taken keen Interest In the revision ol this booklet Without her efforto, it was not possible
to update litis document.
<"7^
New Delhi
6th May, 1991
1 of 1
Dr. (Miss) A. Bhardwaj 3
Deputy Director General (RHS)
Next-**
2/16/00 4:31 PM
contents
http://www.dhskhsdp.com/manual/Contents.HTMI.
Contents
1.
2
Duties of Medical Officer, Primary Health Centre
1 - 6
Job Responsibilities of Community Health Officer'
7 - fl
3.
Job Description of Block Extentsion Educator
10-11
4.
Job Responsibilities of Health Assistant Male
12 - 15
5.
Job Responsibilities cf Health Assistant Female
16 - 19
6.
Job Responsibilities of Health Worker Male
20 - 24
7.
Job Responsibilities of Health Worker Female
25 - 28
8.
Job Responsibilities of Laboratory Technician
29 - 30
9.
Job Responsibilities of Computer
31 — 32
[Next
1 of 1
2/22/00 6:15 PM
. The Paily Star: Features
http://www.dailystarnews.com/199807/04/n8070409.htir
Whe Jtatly Star
Prepared by Onirban
Features
Volume 1 Number 312
July 04, 1998
[News Highlights | Front Page || Editorial || Politics || Sports || Business [| Metropolitan || Regional |
| Foreign Relations || Features || General || Letters to the Editor || Stock Report || International News |
| Supplements || Star Archives || Advertising on Star || Advertisments |
Seeking Options for Better Land Use
The Labyrinth Must End
Potential Area for Intervention
Bidi sells Good in LA
CHITTAGONG HILL TRACTS
Seeking Options for Better Land Use
by Zulfiqar AU
THE area of Chittagong Hill Tracts, comprising the three hill districts Rangamati, Khagrachhari and Bandarban - is 13181 sq. kilometres. The area is
composed of hills, valleys, ravines and cliffs. The land is uneven.
In the year 1961 the then government of Pakistan engaged a Canadian company
- Forestal International - to survey the soil and topography of Chittagong Hill
Tracts. The survey conducted by them revealed that most of the soil of the area
is very poor. The Forestal report had graded only 3.2 per cent of the land as
category A - suitable for cultivation. It may be mentioned here that currently,
only 2,90,000 acres are under cultivation in the three hill districts.
The B grade land accounted for 2.9 per cent as suitable for terraced agriculture.
They graded 15.5 per cent of land as category C which were found to be
suitable mostly for horticulture and partially for afforestation. The next
category C-D accounted fore only 1-4 per cent. Finally category D which was
about 7 per cent of the area and might be used only for afforestation.
Many of the educated people of the country think that in CHT vast cultivable
land is lying vacant and kept fallow unnecessarily. This reflects their ignorance
about the area. From the above information one may conclude that the arable
land is scarce. The scarcity of land, when taxed by the settlement of
plainlanders during late 70s and early 80s, became more acute. Scarcity of land
was thus the basic cause of conflict which continued in Chittagong Hill Tracts
for more than two decades.
Jhum cultivation is an integral part of the way of life and culture of the tribal
people. Because of the land pattern there is no other alternative than to adopt
Jhum cultivation in most of the areas in Chittagong Hill Tracts, though there
are also constrains of Jhum cultivation. Apart from soil erosion, the same land
cannot be cultivated twice in succession without a normal cycle of 5 to 10
years. The increase in population has increased the pressure on land thereby
reducing the Jhum cycle from 5-10 years to 2-3 years, which aggravates the
situation with the decrease in fertility of soil.
By the end of last century, the then British government had started encouraging
plough cultivation. To this end the government provided loans to the plough
cultivators. The initiative was partially successful. A portion of the flat land
came under plough cultivation, though the cultivators were the plainlanders
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. The Daily Star: Features
http://www.dailystamews.com/199807/04/n8070409.htrr
from the neighbouring Chittagong. But it failed to make any headway at that
time in the way of life of the tribal people because of their love for a free style
sort of life. The plough cultivation had aimed at settling the tribals at a
particular place to facilitate collection of revenue. The hill men are not
nomadic in the true sense of the term. They generally move within the mouza
they use to reside in.
The survey conducted by Forestal International, among others, had
recommended to undertake orchard plantation in Chittagong Hill Tracts. The
government initiative to develop horticulture during late 60s was successful as
far as fruit gardens were concerned, but the government efforts ultimately did
not succeed due to bad communication system, lack of credit, storage and
marketing facilities. Over the years the communication system in the area has
developed to a satisfactory level which coupled with credit and marketing
facilities may open a new horizon for the development of the people as well as
the area. As the arable land available is very scarce, for the best use of the land
large scale afforestation and orchard may be undertaken. But before doing that
arboureal survey may be conducted in the area.
The Chittagong Hill Tracts Regulations of 1900 and the rules made under
Regulation 18 were and still are the guiding principles relating to land
administration and land revenue. The three circle chiefs and the mouza
headmen are the main instruments in the field of land management in the
Chittagong Hill Tracts.
The question of conducting cadastral survey of the area did not arise earlier
because of its status as a non regulation district and the existence of a different
pattern of life style of the hill people. Due to the system prevailing there the
hill people, in general, were not required to take lease of land by name.
According to the Chittagong Hill Tracts Regulation of 1900 and the rules
framed there under it, the hill people used to enjoy a kind of customary and
community right on land, although the land belongs to the state. A hillman can
settle to a place of his choice within the mouza he used to reside with an
intimation to the mouza headman. The mouza headman keeps record of land
settled in favour of a person. So most of the hill people did not require
documents relating to settlement or ownership of land. Certain amendments,
relating to land management incorporated in the regulation, made during the
British, Pakistan and post independence period, as the hill men feel, have
infringed the customary and community right on land. The increase in
population has increased the pressure on land which has since not only changed
the relationship between the hillmen and the non-hillmen but also indirectly
curtailed their customary right on land.
The three circle chiefs - the Chakma chief, the Bohmong chief and the Mong
chief - used to collect land revenue on behalf of the government from the
mouza headmen appointed by the Deputy Commissioner in consultation with
the respective circle chief. The mouza headmen used to collect land revenue
from within his mouza and maintain records of land, land settled and
transferred. There are no Tahsildars in the three hill districts. The two
traditional offices in Chittagong Hill Tracts - the circle chief and mouza
headman - may be strengthened for the purpose of land administration and
collection of land revenue. The headmen with the basic training on land
matters, may efficiently perform the functions of Tahsildar.
[Top][Home][Qnirban Online]
2 of 6
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• The Daily Star: Features
http://www.dailystarnews.com/199807/04/n8070409.htn-
In Oil and Gas
The Labyrinth Must End
by Md. Shah Jahan
AT the end of the dark tunnel of our national life, since independence, we
sighted a flicker of hope when we were told that our country was "floating on
oil and gas." We had thought our dark nights of poverty were over. We
dreamed of a bright morning which would give real meaning to our
independence. But what we see and hear now all around is totally
disheartening. It is alleged that deep conspiracies are underway to grab our
natural resources through lobbying by the local agents, which was totally
prohibited in the 70s.
In the absence of transparency in awarding Production Sharing Contracts to
foreign companies and dealing with the bidding process there exists a total
chaos and confusion. Baseless, motivated and contriving figures of gas reserve
have been doled out by the multinational companies. Goaded by these figures
our former Energy Minister remarked that Bangladesh had a gas reserve of 80
TCF to 100 TCF. But national experts say our gas reserve is 10.5 TCF. The
potentiality of gas reserve in our country said Dr. Badrul Imam, Chairman of
the Geology Department, Dhaka University, can be around 25 TCF.
It is alleged that the Government has no regard for the 1995 Energy Policy and
also did not formulate a clear national strategy identifying national priorities to
optimise the benefit from gas for present and future generations. It is pursuing
an aimless policy in the energy sector. People are in the labyrinth of numerous
questions: What is the extent of exact gas reserve we have in the country?
Should we lease out all the blocks at a time to foreign companies? If we do so
what will be the consequences?
Do we have enough expertise to supervise activities of foreign companies?
How best we can use our gas reserve? What potentiality we have for alternative
energy in case of exhaustion of our gas reserves?
Though Petrobangla, directly and through its subsidiaries like BAPEX, Titas,
Bakhrabad Gas and others, has made significant contributions in discovery of
oil and gas, in developing technological expertise in exploration, production
and distribution and management of oil and gas sector, but today it has been
cornered and many of its senior experts have left it, causing serious vacuum in
Petrobangla.
Since 1989 BAPEX alone made five exploratory wells out of which four were
discovery well and one was dry wells in addition to its having done
development and appraisal work, and work-overs of many producing wells.
But it is alleged that systematically this national organisation is made crippled
with the pretext of lack of fund - BAPEX is not being awarded contracts and
has rather been kept in the process of total elimination.
As a national petroleum organisation BAPEX should be properly equipped so
that it can play important role in developing and harnessing natural resources
and also can transcend national boundary and earn money for the country.
Under the Production Sharing Contracts all costs in the name of development
are recoverable by the contractor. It is alleged that contractors are recovering
expenditure even for the "drinks consumed by their men" under cost recovery
heading. BAPEX should be entrusted with the responsibilities of supervising
activities of multinational companies operating under PSCs in various blocks.
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.The Daily Star: Features
http://www.dailystarnews.com/199807/04/n8070409.htrr
To strengthen BAPEX the lucrative blocks 9,10 and 11 should be kept reserved
for it instead of putting forward motivated argument of lack of fund. It can be
argued that if we could provide fund while our economy was still under the
rubbles of war in 1974 then why we cannot provide such funds today? BAPEX
is made disable at the very labour room by assigning to it only the
responsibilities of exploration which means it will only incur costs but no
profit. Government should allow BAPEX to work freely and to try to arrange
its own funds by floating shares in national and international markets.
[Top] [Home] [Onirban Online!
Cropland Agro-forestry
Potential Area for Intervention
by Arifa S Sharmin
ONE of the major challenges facing all countries of the South Asian Region is
to find means of producing enough food to feed rapidly increasing population
and, at the same time, combat poverty and increasing rate of deterioration of
their natural resources. Forestry is one of such important sectors where the rate
of deforestation has reached an alarming position.
In Bangladesh, forest lands constitute only 15 per cent of the total land area and
the actual green coverage is hardly 6 per cent. On the other hand, the current
annual rate of deforestation is about 3 per cent, against a much lower
deforestation rate in South Asia (0.6 per cent) as a whole during 1981-1993
(FMP, 1993).
As a result of increasing population, demand for tree products like timber, fuel
wood, fodder, fruit etc. is increasing, whereas supply of such products is
decreasing as a result of declining supply sources.
Different studies revealed that, present demand for wood is estimated at 476.75
million cubic feet per annum. Forest Department of the Bangladesh
Government could only meet 24 per cent of the demand and village forestry
sources meet 70 per cent of the increasing demand for timber. Besides, 90 per
cent fuel wood and bamboo supply come from village forestry.
With this in mind, in 1987, Village and Farm Forestry Programme (VFFP) of
Swiss Agency for Development and Co-operation (SDC) intervened as an
innovative pilot research project in the north western district of Bangladesh.
Considering the scope and reality, VFFP try to introduce tree in the existing
crop field and woodlot in the degraded land and intensify homestead tree
plantation in a way that will restore many of the benefits of the villagers along
with solving problems of land degradation and storage of fuel wood, poles and
fodder.
In the primary stage, VFFP concentrated its work under some selected areas of
the northern districts of Bangladesh. The main focus of the programme is to
promote private planting on private land. VFFP concentrated to introduce tree
in the existing crop field and woodlot, in the marginal land and intensify
homestead tree plantation with view to solve problems of timber, fuel wood,
fodder and fruits which will ultimately contribute towards mitigating the
increasing cash problem of villagers.
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