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Under the constitution, Health is a State subject and Karnataka developed its own Health care delivery system based on the guidelines issued by the Government of India from time to time. By and large the health care delivery system is developed based on the various committees constituted at the Central Government level. The recommendations of the Bhore Committee, Mudaliar Committee and other Committees have been taken into consideration in providing comprehensive health care at the door steps of the community. During the previous Five Year Plan periods a large net work of Primary Health Care infrastructure institutions covering the entire State has been established. Wide range of Communicable diseases namely Malaria, Filaria, Tuberculosis, Cholera and several other vaccine preventable diseases like Tuberculosis, Diphtheria, Pertusis, Tetanus, Polio, Measles and Hepatitis B & C are given due importance for under the IDSP, NCD risk factor survey in urban and rural areas is an important component. Several important non-communicable diseases like Iodine Deficiency Disorder, Blindness, Cancer, Diabetes are also given due importance.
Periodical meetings at the State Level, Divisional Level, District Level and Primary Health Centre Level to keep informed of the several activities of the department from time to time and review of progress achieved under various programmes has given impetus to the Department in successfully implementing Health Care System in the State.
Major initiatives were taken to reach the goal of Health for all by 2000 A D on the lines of the policy directives issued from the Government 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 vulnerable group i.e. Mother and Children and Adolescents and also to focus attention on the under privileged segments of population in Tribal areas.
The State Government keeping in mind all the above priorities has created the Department of Health and Family Welfare under the leadership of Hon'ble Minister for Health and Family Welfare and a separate Minister for Medical Education to fulfill the needs of the Department.
Next in order to reach all the activities of the Department of Health and Family Welfare, separate Departments as stated below, are established.
The Health Secretariat is the official organ of the Health and Family Welfare Department. The Principal Secretary to the Government and other officers of the Secretariat are monitoring different activities of the department and also fulfilling the needs of the Department.
DIRECTORATE OF HEALTH AND FAMILY WELFARE SERVICES
Directorate of Health and Family Welfare Services is strengthened from time to time establishing various divisions such as Health Man Power, Planning, Integrated Diseases Surveillance Project and Communicable Diseases Control, Malaria, RCH, Tuberculosis, Development of Medical Institutions (Karnataka Health Systems Development Project), National Rural Health Mission and other Welfare Schemes including Mental Health, School Health and Cancer control Programme are also implemented.
The Head Office of the Directorate of Health & Family Welfare Services is located in the State Head Quarters, which has got Director of Health and Family Welfare Services as the Head of the Department and assisted by several Additional Directors, Joint and Deputy Directors to implement and monitor several Centrally sponsored & State sponsored Health Programmes. There is a separate Project Director to implement & monitor the activities of National AIDS Control Organization (NACO).
There are Joint Directors for Health & Planning, Public Health Institute, Communicable Diseases, Health Education & Training, IEC,RCH,Ophthalmology, Tuberculosis,Leprosy, Malaria & Filaria, Joint Director(Medical) . These Joint Directors are assisted by respective Deputy Directors.
State Institute of Health & Family Welfare
There is a separate State Institute of Health & Family Welfare was created under IPP( IX) (K) to modernize training activities of the Department. There is Director for this Institute with a Joint Director and 10 Deputy Directors. The purpose of this Institute is to design training activities for the different professionals of the Department. Induction Training, In-service Training, outside deputations for Training and skill based Training are planned by this Institute. Preparation of Training Modules, Training Schedules and Pre and Post Training evaluation are also under taken by the Institute. There is a proposal to upgrade the Institute to the National & International level to impart Post Graduate Training & Degree and Diploma Courses which are useful for the day to day activities of the Department. Negotiations are being held to affiliate this Institute to Rajiv Gandhi University of Health Sciences and present teaching infrastructure would be upgraded accordingly.
The Department has Four Divisional Deputy Directors at the respective Revenue Divisions of Bangalore, Mysore, Belgaum, and Gulbarga to implement and monitor control programmes for vectorborne disease like Malaria, Filaria, JE and Chikungunya at District Level. District Health & F.W.Officers, and District Surgeons would take care of Health & Clinical requirements of Districts. The District Health & FW Officer is the over all head of the District for all the Health related activities of District excluding District Hospital / Civil Hospital which is headed by District Surgeon.
The District Health & FW Officer is attached to Zilla Panchayath who administratively comes within the Zilla Panchayath establishment. He is responsible for implementing National Health Programmes and other Health Care & promotive activities. He is the administrative head of all Medical/ Health Institution in the District excepting District Head Quarters Hospital and other Hospitals having bed strength 100 and above. The Medical Colleges and the Medical Institutions attached to these colleges are separately monitored by the respective colleges and by the Director of Medical Education.
Ayurveda, Yoga, Unani, Siddha, Homeopathy (AYUSH) Institutions are separately monitored by the Director of Indian Systems of Medicines & Homeopathy through his Deputy Directors.
District Surveillance Officers will monitor the activities of District Health Laboratories & they report to the District Health & FW Officers for all administrative matters. They are duty bound to implement technical guidelines issued by Project Director (IDSP).
District Health & FW Officers are further assisted by respective Programme Officers for Malaria,RCH, Leprosy, TB, and Mental Health. There are Taluk Health Officers in each revenue Taluk who is administratively responsible to implement the Health Programmes. He is assisted by the Medical Officers of the Primary Health Centers(PHCs) and Primary Health Units(PHU). At the Head Quarters of the District, excepting Bangalore and Mysore there are Districts Head Quarters Hospitals exclusively for curative purposes. Each District Hospital is headed by District Surgeon with other specialists of different specialities.
The Community Health Centers (CHCs) are established by upgrading one out of every four PHCs covering population of 1.2 Lakhs. The CHCs of 30 beds containing three specialties namely Medicine, Surgery, and Gynaecology. Dental faculty is an additional speciality now introduced in the CHCs. At the Sub Division level there are CHCs of 50 beds covering five specialities namely Medicine,Surgery,Paediatrics,Gynacology and Dental Surgery. Some of these CHCs are being upgraded further into 100 beded Hospitals. The Government of Karnataka is contemplating to upgrade all Taluk level Hospitals /CHCs in to One Hundred beds.
Primary Health Centres are established covering population of 30,000 in plain areas & 20,000 in hilly & tribal areas. Community Health Centers are upgraded from PHCs to cover Primary and Curative Services. They also acts as the First Referral Units to the surrounding PHCs.
By strengthening Primary Health Centers, a health care delivery activity in the areas as per the Government of India pattern is adopted. Primary Health Centers provide primary health care in the areas through the network of sub-centers and other Para Medical Staff. Primary Health Care includes preventive services, curative services, environmental sanitation, health education, family welfare services and recording of health statistics of various National Health Programmes which are in force from time to time and also implementing through a network of Primary Health Centers.
It is already stated that one out of four Primary Health Centers, has been upgraded into Community Health Centers, which contains curative Services in addition to preventive services.
In addition to above institutions there are General Hospitals and Civil Hospitals in the State. These Hospitals were existing earlier to re-organisation. The Government is considering to rationalize nomenclature of these Institution.
The sub centers are established to cover rural population of five thousand in plain and maiden areas and three thousand in Hilly, Tribal and Inaccessible and remote areas. Each sub centers is managed by a Junior Health Assistant(Female)and complemented by Junior Health Assistant (Male), who cover the area allotted to them.
Public Health qualification is proposed to manage the posts of District Health and Family Welfare Officers at the District level and Programme Officers for all National Health Programmes at the District & State Level, where curative elements are not Institutionalised. The public health qualification proposed, are Diploma or Degree in Public Health. Now even in Public Health, further specialization is becoming more common and common. Several public health qualifications are emerging even in the sub specialties also . A few are named as follows:
(Diploma in Industrial Hygiene(DIH), Diploma in Maternity & Child Welfare(DMCW) Diploma in tropical Medicine & Health(DTM&H) Diploma in Epidemiology(DE),Diploma in Public Health Administration(DPHA), Diploma in Tuberculosis and Chest Diseases (DT&CD) and several others.