HEALTH ADMINISTRATION SYSTEM IN INDIA

India is a union of 29 states and 7 union territories. States are largely

independent in matters relating to the delivery of health care to the people. Each
state has developed its own system of health care delivery, independent of the
Central Government. The Central Government responsibility consists mainly of
policy making, planning, guiding, assisting, evaluating and coordinating the
work of the State Health Ministries. The health system in India has 3 main links
1. Central
2. State and
3. Local or peripheral
(1) At the Centre
The official organs of the health system at the national level consist of
1. Ministry of Health and Family Welfare
2. The Directorate General of Health Services
3. The Central Council of Health and Family Welfare
1. Union Ministry of Health and Family Welfare
Organization Pattern
Cabinet Minister
Department of Health
Joint Secretary

Department of Family Welfare

Additional Secretary

Deputy Secretary

Commissioner

Administrative Staff

Joint Secretary
Administrative Staff

Functions:
(1) Union list
1. International health relations and administration of port quarantine
2. Administration of Central Institutes such as All India Institute of
Hygiene and Public Health, Kolkata.
3. Promotion of research through research centers
4. Regulation and development of medical, pharmaceutical, dental and
nursing professions
5. Establishment and maintenance of drug standards
6. Census and collection and publication of other statistical data
7. Immigration and emigration
8. Regulation of labour in the working of mines and oil fields
9. Coordination with states and with other ministries for promotion of
health
(2) Concurrent list
The functions listed under the concurrent list are the responsibility of both the
union and state governments.
1. Prevention and extension of communicable diseases
2. Prevention of adulteration of food stuffs
3. Control of drugs and poisons
4. Vital statistics
5. Labour welfare
6. Ports other than major
7. Economic and social planning
8. Population control and Family Planning

2. Directorate General of Health Services

Organization Pattern
Directorate General of health services

Director General of health services

Additional Director General of health service

Deputy Directorate General of health services

Administrative staff
Functions:
1. International health relations and quarantine of all major ports in country and
International airport
2. Control of drug standards
3. Maintain medical store depots
4. Administration of post graduate training programmes
5. Administration of certain medical colleges in India
6. Conducting medical research through Indian Council of Medical Research
7. Central Government Health Schemes.
8. Implementation of national health programmes
9. Preparation of health education material for creating health awareness
through Central Health Education Bureau.
10. Collection, compilation, analysis, evaluation and dissemination of
information through the Central Bureau of Health Intelligence
11. National Medical Library

3. Central Council of Health

Organization Pattern
Chairman
(Union health Minister)

Members
(State health Minister)
Functions
1. To consider and recommend broad outlines of policy regard to matters
concerning health in all its aspects such as provision of remedial and preventive
care, environment hygiene, nutrition and health education and promotion of
facilities for training and research.
2. To make proposals for legislation relating to medical and public health
matters.
3. To make recommendations to the Central Government regarding distribution
of Grants-in-aid
4. To establish any organisation or organisations invested with appropriate
functions for promoting and maintaining cooperation between the Central and
State Health administrations.

II. At the State level

The health subjects are divided into three groups: federal, concurrent and state.
The state list is the responsibility of the state, including provision of medical
care, preventive health services and pilgrimage within the state.
State health administration
At present there are 29 states in India, each state having its own health
administration. In all the States, the management sector comprises the State
Ministry of Health and a Directorate of Health.

1. State Ministry of Health

The State Ministry of Health is headed by a Minister of Health and Family
Welfare and a Deputy Minister of Health and Family Welfare. In some States,
the Health Minister is also in charge of other portfolios. The Health Secretariat
is the official organ of the State Ministry of Health and is headed by a Secretary
who is assisted by Deputy Secretaries, Under Secretaries and a large
administrative staff. The Secretary is a senior officer of the Indian
Administrative Service.
2. State Health Directorate
For a long time, two separate departments, medical and public health, were
functioning in the States; the heads of these departments were known as
Surgeon General and Inspector General of Civil Hospitals and Director of
Public Health respectively. The Bhore Committee (1946) recommended that the
medical and public health organizations should be integrated at all levels and
therefore, should have a single administrative officer for the curative and
preventive departments of health. West Bengal led the process of integrating
health services at the State level by creating a post of the Director of Health
Services in August 1947; the process was completed by Maharashtra in May
1970.
The Director of Health Services (known in some States as Director of Medical
and Health Services) is the chief technical adviser to the State Government on
all matters relating to medicine and public health. He is also responsible for the
organization and direction of all health activities. With the advent of family
planning as an important programme, the designation of Director of Health
Services has been changed in some States and is now known as Director of
Health and Family Welfare. A recent development in some States is the
appointment of a Director of Medical Education in view of the increasing
number of medical colleges.

The Director of Health and Family Welfare is assisted by a suitable number of

deputies and assistants. The Deputy and Assistant Directors of Health may be of
two types - regional and functional. The Regional Directors inspect all the
branches of public health within their jurisdiction, irrespective of their
speciality. The Functional Directors are usually specialists in a particular branch
of public health such as mother and child health, family planning, nutrition,
tuberculosis, leprosy, health education etc.

III. At the district level

There are 688(year 2016) districts in India. Within each district, there are 6
types of administrative areas.
1. Sub division
2. Tehsils (Talukas)
3. Community Development Blocks
4. Municipalities and Corporations
5. Villages and
6. Panchayats
Most district in India are divided into two or more subdivision, each incharge
of an Assistant Collector or Sub Collector.
Each division is again divided into taluks, incharge of a Thasildhar. A taluk
usually comprises between 200 to 600 villages.
The community development block comprises approximately 100 villages and
about 80, 000 to 1, 20,000 population, in charge of a Block Development
Officer.
Finally, there are the village panchayats, which are institutions of rural local
self-government.
The urban areas of the district are organized into

 Town Area Committees (in areas with population ranging between 5,000
and 10,000)
Municipal Boards (in areas with population ranging between 10,000 and
2,00,000)
Corporations (with population above 2,00,000)
The Town Area Committees are like panchayats.They provides sanitary
services.
The Municipal Boards are headed by Chairmen /President, elected by members.
The functions of Municipal Board:
Construction and maintenance of roads
Sanitation and drainage
Street lighting
Water supply
Maintenance of hospitals and dispensaries
Education and
Registration of births and deaths etc
The Corporations are headed by Mayors, elected by Councillors, who are
elected from different wards of the city. The executive agency includes the
Commissioner, the Secretary, the Engineer and the Health Officer. The activities
are similar to those of the municipalities, but on a much wider scale.
Panchayat Raj
The panchayat Raj is a 3-tier structure of rural local self-government in India
linking the village to the district. It includes
Panchayat (at the village level)
Panchayat Samiti( at the block level)
Zilla Parishad(at the district level)
(1) Panchayat (at the village level):

The Panchayat Raj at the village level consists of

The Gram Sabha
The Gram Panchayat
The Gram Sabha:
It is the assembly of all the adults of the village, which meets at least twice a
year. The gram sabha considers proposals for taxation, and elect members of
The Gram Panchayat.
The Gram Panchayat
It is the executive organ of the gram sabha and an agency for planning and
development at the village level. The population covered varies from 5000 to
15000 or more. The members of panchayat hold offices for a period of 3to4
years. Every panchayat has an elected president (Sarpanch or Sabhapati or
Mukhia), a vice president and panchayat secretary. It covers the civic
administration including sanitation and public health and work for the social
and economic development of the village
(2) Panchayat Samiti (at the block level):
The block consists of about 100 villages and a population of about 80,000 to
1,20,000. The panchayat samiti consists of Sarpanch, MLAs, MPs residing in
block area, representative of women, SC, ST and cooperative societies. The
primary function of the Panchayat Samiti is the execution of the community
development programme in the block. The Block development Officer and his
staff give technical assistance and guidance in development work.
(3) Zila Parishad (at the district level):
The Zila Parishad is the agency of rural local self government at the district
level. The members of Zila parishad include all heads of panchayat samiti in the
district, MPs, MLAs, representative of SC, ST and women and 2 persons of
experience in administration, public life or rural development. Its functions and
powers vary from state to state.

Rajiv Yeravdekar et al reported that the effectiveness of a health care system is

also affected by the ability of community itself to participate in designing and
implementing delivery of services. They mentioned that the opportunity to
design and manage such delivery provides empowerment to the community as
well as better access, accountability and transparency. In essence, the health
care delivery must be made more consultative and inclusive. They suggested
that this can be achieved through a three dimensional approach of strengthening
Panchayat Raj Institutes through improved devolution and capacity building for
designing

and

management,

increasing

users

participation

through

institutionalized audits of health care service delivery for better accountability

and biannual evaluation of this process by empowered agencies of civil society
organizations for greater transparency. They also mentioned that methodologies
based on community based monitoring health care provision by the organized
private sector is virtually absent at the primary level, which highlights the need
for providing adequate resources to build a public sector health system.