HEALTH COMMITTEES

HEALTH COMMITTEES

• The guide-lines for national health planning

were provided by a various committees of
experts have been appointed by the
Government of India from time to time to
review the existing health situation and
recommend measures for further action.
 The important committees are
• Bhore Committee, 1946
• Mudaliar Committee, 1962
• Chadah Committee, 1963
• Mukerji Committee, 1965
• Mukerji Committee, 1966
• Jungalwalla Committee, 1967
• Kartar Singh Committee, 1973
• Shrivastav Committee, 1975
• Rural health scheme, 1977
 Bhore Committee, 1946
• The Government of India in 1943 appointed
the Health Survey and Development
Committee with Sir Joseph Bhore as Chairman
, Popularly known as Bhore Committee
• To survey the then existing position regarding
the health conditions and health organization
in the country, and to make recommendations
for the future development.
• Committee members met regularly for 2 years
and submitted in 1946 its famous report
which runs into 4 volumes.
• The Committee put forward, for the first time,
comprehensive proposals for the
development of a national programme of
health services for the country.
 Recommendations

1. Integration of preventive and curative services

at all administration level
2. Development of Primary health centres in 2
stages.
• In short-term measure
PHC in rural area should include population of
40,000 with a secondary health centre to
serve as a supervisory, coordinating and
referral institution.
 For each PHC,
2 Medical Officer
4 Public Health Nurses
1 Nurse
4 Midwives
4 Trained Dais
2 Sanitary Inspectors
2 Health Assistants
1 Pharmacist
15 Other Class Iv Employees
• long-term programme (also called
the 3 million plan)

Setting up primary health units with 75-bedded

hospitals for each 10,000 to 20,000 population
and secondary units with 650-bedded hospitals,
and district hospitals with 2,500 beds
3 ) Major changes in medical education which
includes 3 month's training in preventive and
social medicine to prepare "social physicians".
 Mudaliar Committee, 1962

• In 1959, the Government of India appointed

another Committee known as "Health Survey
and Planning Committee", popularly known as
the Mudaliar Committee
• Dr. A.L. Mudaliar as Chairman -to survey the
progress made in the field of health since
submission of the Bhore Committee's Report and
to make recommendations for future
development and expansion of health services.
• The Mudaliar Committee found the quality of
services provided by the primary health
centres inadequate,
• Advised strengthening of the existing primary
health centres before new centres were
established.
• It also advised strengthening of subdivisional
and district hospitals - function as referral
centres
 Recommendations
• Consolidate advances : first 2 five year plans
• Strengthen District Hospitals: specialists
• Each PHC not more than 40,000
• Improve quality in PHC
• Integrate medical and health services
• Constitution of All India Health Services
 Chadah Committee, 1963
• In 1963, a Committee was appointed by the
Government of India, under the Chairmanship
of Dr. M.S. Chadah, the then Director General
of health Services to study the arrangements
necessary for the maintenance phase of the
National Malaria Eradication Programme.
 RECOMMENDATIONS

• "Vigilance" operations in respect of the NMEP

should be the responsibility of the general health
services
• “ Malaria Vigilance operations through monthly
home visits should be implemented by basic
health workers.
• One basic health worker per 10,000 population
• BHW to serve as MPHW for family planning
and vital statistics and malaria vigilance.
• FPHA to supervise 3-4 BHW
 Mukerji committee, 1965

 Within a couple of years of implementation

of the Chadah Committee's recommendations
by some states,
 it was realised that the basic health workers
could not function effectively as multipurpose
workers.
 So, malaria operations and family planning
programme suffered
• This subject came up for discussion at a
meeting of the Central Health Council in 1965
• Set up a committee known as "Mukerji
Committee, 1965" under the Chairmanship of
Shri Mukerji, was appointed to review the
strategy for the family planning programme.
 Recommendations
• The Committee recommended separate staff for
the family planning programme.
• The family planning assistants were to undertake
family planning duties only.
• The basic health workers were to be utilized for
purposes other than family planning.
• The Committee also recommended to delink the
malaria activities from family planning
The recommendations were accepted by the
Government of India.
 Mukerji committee, 1966

• As the states were finding it difficult to take

over the whole burden of the maintenance
phase of malaria.
• Other mass programmes like family planning,
smallpox, leprosy, trachoma, etc. due to
paucity of funds,
• This matter came up for discussion at a
meeting of the Central Council of Health held
in Bangalore in 1966.
• The Council recommended that these and
related questions may be examined by a
committee of Health Secretaries, under the
Chairmanship, Shri Mukerji.
• The Committee worked out the details of the
BASIC HEALTH SERVICE
• Recommended basic health service at PHC
Level
 Jungalwalla committee, 1967
• The Central Council of Health at its meeting held
in Srinagar in 1964.
• Taking note of the importance and urgency of
integration of health services, and elimination
of private practice by government doctors,
appointed a Committee known as the
"Committee on Integration of Health Services“
under the Chairmanship of Dr. N. Jungalwalla,
 To examine the various problems including those
of service conditions and submit a report to the
Central Government in the light of these
considerations.
The report was submitted in 1967.
• The Committee defined "integrated health
services" as:
(i) a service with a unified approach for all
problems instead of a segmented approach for
different problems; and
(ii) medical care of the sick and conventional
public health programmes functioning under a
single administrator
• The Committee recommended integration
from the highest to the lowest level in the
services, organization and personnel.
 RECOMMENDATIONS

 Unified cadre
Common seniority
Recognize extra qualifications
Equal pay for equal work
Special pay for specialized work
No private practice and good service condition
 Kartar Singh committee, 1973

• The Government of India constituted a

Committee in 1972 known as "The Committee
on Multipurpose Workers under Health and
Family Planning" under the Chairmanship of
Kartar Singh,
 To study and make recommendation on :
(a) the structure for integrated services at the
peripheral and supervisory levels;
(b) the feasibility of having multipurpose, bi-
purpose workers in the field:
(c) the training requirements for such workers;
and
(d) the utilization of mobile service units set up
under family planning programme
The Committee submitted its report in
September 1973.
 Recommendations
• (a)Present Auxiliary Nurse Midwives to be
replaced by the newly designated "Female
Health Workers", and the present-day Basic
Health Workers, Malaria Surveillance
Workers, Vaccinators, Health Education
Assistants and the Family Planning Health
Assistants to be replaced by "Male Health
Workers".
• (b) The Programme for having multipurpose
workers to be first introduced in areas where
malaria is in maintenance phase and
smallpox has been controlled.
• (c) For proper coverage, there should be one
primary health centre for a population of
50,000
• (d) Each primary health centre should be
divided into 16 sub-centres each having a
population of about 3,000 to 3,500.
• (e) Each sub-centre to be staffed by a team of
one male and one female health worker
• (f) There should be a male health supervisor to
supervise the work of 3 to 4 male health
workers; and a female health supervisor to
supervise the work of 4 female health workers
• (g) The present-day lady health visitors to be
designated as female health supervisors and
• (h) The doctor in charge of a primary health
centre should have the overall charge of all the
supervisors and health workers in his area.
• The recommendations of the Kartar Singh
Committee were accepted by the Government
of India to be implemented during the Fifth
Five year Plan.(1974 -1979)
 Shrivastav committee, 1975
• The Government of India in the Ministry of
Health and Family Planning in November
1974 set up a 'Group on Medical Education
and Support Manpower' popularly known as
the Shrivastav Committee.
(1) to devise a suitable curriculum for training a
cadre of health assistants
(2) to suggest steps for improving the existing
medical educational processes
• The Group submitted its report in April 1975.
 RECOMMENDATIONS
• ( 1) Creation of bands of para-professional and
semi-professional health workers from within
the community itself (e.g., school teachers,
postmasters, gram sevaks) to provide simple,
promotive, preventive and curative health
services.
• (2) Establishment of 2 cadres of health workers,
namely - multipurpose health workers and
health assistants between the community level
workers and doctors at the PHC;
• (3) Development of a 'Referral Services
Complex.
• (4) Establishment of a Medical and Health
Education Commission for planning and
implementing the reforms needed in health
and medical education
 Rural health scheme, 1977

• The most important recommendation of the

Shrivastav Committee was that primary health
care should be provided within the
community itself through specially trained
workers
• The basic recommendations of the Committee
were accepted by the Government in 1977
• which led to the launching of the Rural Health
Scheme
• The programme of training of community
health workers was initiated during 1977-78.
• Steps were also initiated
• (a) involvement of medical colleges in the total
health care of selected PHCs with the objective
of reorienting medical education to the needs of
rural people; and
(b) reorientation training of multipurpose
workers engaged in the control of various
communicable disease programmes.