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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).
Mrs. Jagrutiben PandyaAssistant ProfessorDepartment of Public Administration
K.S.K.V. Kachchh University, Bhuj.
Research by.Suresh R Makwana(MPA SEM IV)
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.
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
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
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.
Mrs. Jagrutiben Pandya
No. Indicator Page No.
Personnel health structure
Health scenario in Gujarat
Health scenario in Kachchh
02. Research Methodology
Review of literature
03. Profile of Study Region
Kachchh Dist. profile
04. Data Analysis, Interpretation
Review of Government Health Scheme
Primary Data Analysis
Secondary Data Analysis
05. Finding, Observation, Suggestion, Conclusion 106-112
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
CHAPTER : 01
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
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