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A

Dissertation on

Government Public Health Administration in PHC- Primary Health Center Role

To be submitted to the department of Public Administration

K.S.K.V.Kachchh University, Bhuj (Kachchh) in the partfullment of the

requirement for the degree of Master of Public Administration (MPA).

Guide:

Mrs. Jagrutiben PandyaAssistant ProfessorDepartment of Public Administration

K.S.K.V. Kachchh University, Bhuj.

Research by.Suresh R Makwana(MPA SEM IV)

Year: 2012-2013Acknowledgement

At the outset, I wish to thank Almighty GOD for his guidance and blessings in every

steps of my life. It is an immense pleasure for me on the occasion, to convey my gratitude and

regards to all the personalities to whom I owe a lot.

My family has played an important role in the completion of the Dissertation. Throughout

the years, my parents and Brother encouraged me to do my very best in everything I have

undertaken. I am eternally grateful for all the support they have given me.

I wish offer my sincere gratitude and deep appreciation to my research guide Mrs. Jagrutiben Pandya who anabled me in designing the whole research work for the study. It was because of

his timely advice and expert guidance and suggestion. I was able to complete my research.

I would also like to thank our Faculty member Dr. Tushar Hati and Mrs. Jagrutiben Pandya for their kindsupport.

I am thankful to all medical staff members; respondents who spared their valuable time

for filling up the questionnaires and provided authentic information about health services.

Finally, I must say that getting involved in this dissertation has been a matter of immense

pleasure & satisfaction for me.

Suresh R Makwana.

ABBREVIATIONS

ANM Auxiliary Nurse Midwife

API Annual Parasite Incidence

ARSH Adolescent Reproductive and Sexual Health

ASHA Accredited Social health Activist

AWW Aanganwadi Worker

AYUSH Ayurvedic, Yoga, Unani, Siddha & Homeopathic

BHO Block Health Office/Officer

BPL Below Poverty Line

CBR Crude Birth Rate

CDHO Chief District Health Officer

CDR Crude Death Rate

CHC Community Health Centre

CHCU Comprehensive Health Care Unit

CMR Child Mortality Rate

DH District Hospital

DHAP District Health Action Plan

DMO District Malaria Officer

DRCHO District Reproductive and Child Health Officer

FHW Female Health Worker

FRU First Referral Unit

HQ Headquarter

H&FW Health and Family Welfare

IMR Infant Mortality Rate

JSY Janani Suraksha Yojana

MDT Multi Drug Therapy

MMR Maternal Mortality Ratio

MPW Multi-purpose Worker

MTP Medical Termination of Pregnancy

NGO Non Government Organization

NRHM National Rural Health Mission

OPD Outdoor Patient Desk

PHC Primary Health Centre

PNC Post Natal Check up

RCH Reproductive & Child Health

SHC Sub Health Centre

SWOT Strength, Weakness, Opportunity & Threats

TFR Total Fertility Rate

Statement by Student

I Mr. Suresh R Makwan am bonafide students of Sem-IV (MPA). I have

prepared dissertation on Effectiveness and utility value of Primary Health Center as partial

fulfillment of the requirement for the degree of MPA. I here by declare that this is my own and

original work. I have not submitted such work to this or any other university for any other degree

or diploma.

Place : Bhuj Name :

Date : Suresh R MakwanaStatement by Guide

This is to certify that Mr. Suresh Raymalbhai Makwana is bonafide student of Sem

IV (MPA). This dissertation on Effectiveness and utility value of Primary Health Center is his

original work. He has not submitted such work to this or any other degree or diploma.

Date:

Mrs. Jagrutiben Pandya

CONTENTS

No. Indicator Page No.

01 Introduction

Personnel health structure

Health scenario in Gujarat

Health scenario in Kachchh

12-25

02. Research Methodology

Research Problem

Objectives

Universe

Significant

Limitation

Review of literature

26-34

03. Profile of Study Region

Kachchh Dist. profile

35-44

04. Data Analysis, Interpretation

Review of Government Health Scheme

Primary Data Analysis

Secondary Data Analysis

45-105

05. Finding, Observation, Suggestion, Conclusion 106-112

06. Appendix

Bibliography

Questionnaire

113-120List of Tables

No. Name of Table

1 SEX OF RESPONDENTS

2 PROFESSION OF RESPONDENTS

3 EDUCATION OF RESPONDENTS

4 CASTE CATEGORY

5 Classification of Respondents in respect of BPL

6 When you go to PHC for treatment, Doctor or Midwife present at there?

7 Is delivery facility available in PHC ?

8 Are PHC medical staffs trained in primary health staff?

9 Is an emergency Ambulance facility available in PHC?

10 Are you satisfied with the treatment given by the doctor and midwife?

11 If yes, what kind of treatment was given by the doctor and midwife?

12 How is Electricity facility in PHC ?

13 How is water and sanitation system in PHC ?

14 Indoor treatment available in PHC?

15 Is there 24x7 service available in Primary Health Center ?

16 Respondents opinion for available of treatment off the time period

17 Do you get free treatment from PHC ?

18 Regularity of vaccination facility at PHC

19 Respondents regarding beneficiaries of CHIRANJEEVI Scheme

20 Respondents reflections regarding the benefit of Janani Suraksha Yojana

21 If yes, How many rupees did you get from above scheme ?

22 Is medicine facility available at PHC ?

23 Reasons for visiting PHC

24 Respondents reflections regarding regular visit of ASHA worker

25 Reflections regarding PHCs approach for preventive care

26 Type of preventive program offered by PHC

27 Respondents reflections regarding environment preservation of PHC

28 How is preservation of environment in PHC ?

29 Do you get information on awareness of female health?

30 If yes, who gives the guidance?

CHAPTER : 01

INTRODUCTION

CHAPTER : 01

INTRODUCTION

After independent in 1947 India decided to expand and improve health services of the

country as one of a comprehensive package programmes to raise the standard of living of the

people. Indian constitution does not list health as a fundamental right. The recommendatory

directive principles of state policy enjoin the state to raise nutrition level and improve public

health (Article-47) but many court rulings have interpreted the fundamental right protection of

right of life and liberty (Article-21). So we can say that perticurly right to health is included.

India has achieved relatively a good health during the last 60 years. Before independent there

was very poor system and situation of health in India.

In India health care system- Allopathic, Ayurveda, Homeopathy, Unani and various types

of ownership patterns- Public (Central and State government, Municipal and panchayat local

government), Private (for profit and non profit).

1.1 Central Government health policy goal to be achieved by 2000-2015

1. Eradicated Polio and yaws-2005

2. Eliminate leprosy-2005

3. Eliminate Kala Azar-2010

4. Eliminate Lymphatic Filariasis-2015

5. Achieve Zero level growth of HIV/AIDS- 2007

6. Reduce Morality by 50% on account of malaria and other water Bo diseases- 2010

7. Reduce Prevalence of Blindness to 0.5% - 2010

8. Reduce IMR to 30/1000 and MMR 100/lakh- 2010

9. Increase utilization of public health facility from current Level of 75 % -2010

10. Establish an integrated system surveillance, National Health Accounts a statistics- 2005

11. Increase health expenditure.

12. Government as a % of GDP from existing 0.9 % to 2.0 % -2010

13. Increase share of Central grants Constitute at least 25 % of total head spending -2010

14. Increase state Sector Health spending for 2005 5.5 % of the budget Further increase to 8

%- 2010.

1.2 PUBLIC HOSPITAL

Public hospitals are owned and operated by federal, state or city governments. Many have

a continuing tradition of caring for the poor. They are usually located in the inner cities and are

often in precarious financial situations because many of their patients are unable to pay for

services. These hospitals depend heavily on Medicaid payments supplied by local, state and

federal agencies or on grants from local governments. Medicaid is a program run by both the

state and federal government for the provision of health care insurance to persons younger than

sixty-five years of age who cannot afford to pay for private health insurance. The federal

government matches the states contribution to provide a certain minimal level of available

coverage, and the states may offer additional services at their own expense. There are many

types of government public hospitals District hospital (district level), Municipality hospital

(urban level), Community Health Center, Primary Health Center (Taluka level). In India central

government is not direct

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