1. PRESENTED BY :
MRS. VRUTI PATEL,
LECTURER,
SUMANDEEP NURSING COLLEGE

2. CONCEPT OF HEALTH
• Health is evolved over the centuries as a
concept from individual concern to world
wide social goal and encompasses the whole
quality of life. Changing concept of health till
now are:
– Biomedical concept
– Ecological concept
– Psychosocial concept
– Holistic concept
2

3. CONCEPT OF HEALTH
BIO MEDICAL CONCEPT
ECOLOGICAL CONCEPT
PSYCHOSOCIAL CONCEPT
HOLISTIC CONCEPT

4. BIOMEDICAL CONCEPT
• Traditionally, health has been viewed as an
“absence of disease”, and if one was free
from disease, then the person was
considered healthy.
• This concept has the basis in the “germ
theory of disease”.
• The medical profession viewed the human
body as a machine, disease as a
consequence of the breakdown of the
machine and one of the doctor’s task as
repair of the machine.
4

5. ECOLOGICAL CONCEPT
• Form ecological point of view; health is
viewed as a dynamic equilibrium between
human being and environment, and disease a
maladjustment of the human organism to
environment.
• According to Dubos “Health implies the
relative absence of pain and discomfort and a
continuous adaptation and adjustment to the
environment to ensure optimal function.”
• The ecological concept raises two issues, viz.
imperfect man and imperfect environment.
5

6. PSYCHOSOCIAL CONCEPT
• According to psychosocial concept “health is
not only biomedical phenomenon, but is
influenced by social, psychological, cultural,
economic and political factors of the people
concerned.”
6

7. HOLISTIC CONCEPT
• This concept is the synthesis of all the
above concepts.
• It recognizes the strength of social,
economic, political and environmental
influences on health.
• It described health as a unified or multi
dimensional process involving the
wellbeing of whole person in context of his
environment .
7

8. DIMENSIONS OF HEALTH
• Health is multidimensional.
• World Health Organization explained
health in three dimensional perspectives:
physical, mental, social and spiritual.
• Besides these many more may be cited,
e.g. emotional, vocational, political,
philosophical, cultural, socioeconomic,
environmental, educational, nutritional,
curative and preventive..
8

9. PHYSICAL DIMENSION
• Physical dimension views health form
physiological perspective.
• It conceptualizes health that as
biologically a state in which each and
every organ even a cell is functioning at
their optimum capacity and in perfect
harmony with the rest of body.
• Physical health can be assessed at
community level by the measurement
of morbidity and mortality rates. 9

10. MENTAL DIMENSION
• Ability to think clearly and coherently. This
deals with sound socialization in
communities.
• Mental health is a state of balance between
the individual and the surrounding world, a
state of harmony between oneself and
others, coexistence between the relatives of
the self and that of other people and that of
the environment.
• Mental health is not merely an absence of
mental illness.
10

11. Features of mentally healthy person
• Free from internal conflicts.
• Well – adjusted in the external environment.
• Searches for one’s identity.
• Strong sense of self-esteem.
• Knows himself: his mind, problems and goal.
• Have good self-controls-balances.
• Faces problems and tries to solve them
intellectually.
11

12. SOCIAL DIMENSION
• It refers the ability to make and maintain
relationships with other people or
communities.
• It states that harmony and integration
within and between each individuals and
other members of the society.
• Social dimension of health includes the
level of social skills one possesses, social
functioning and the ability to see oneself
as a member of a larger society. 12

13. SPIRITUAL DIMENSION
• Spiritual health is connected with religious beliefs
and practices. It also deals with personal creeds,
principles of behavior and ways of achieving
peace of mind and being at peace with oneself.
• It is intangible “something” that transcends
physiology and psychology.
• It includes integrity, principle and ethics, the
purpose of life, commitment to some higher
being, belief in the concepts that are not subject
to “state of art” explanation.
13

14. INDICATORS OF HEALTH
• A variable which helps to measure
changes , directly or indirectly
(WHO,1981).
• The health indicators are defined as
those variables which measures the
health status of an individual and
community.
14

15. INDICATORS OF HEALTH
• Mortality Indicators: Crude Death rate, Life
Expectancy, Infant mortality rate, Child
mortality rate, Under five mortality rate,
Maternal mortality ratio, Disease specific
mortality, proportional mortality rate etc.
• Morbidity Indicators: Incidence and
prevalence rate, disease notification rate,
OPD attendance rate, Admission,
readmission and discharge rate, duration of
stay in hospital and spells of sickness or
absence from work or school. 15

16. INDICATORS OF HEALTH
• Nutritional Status Indicators:
Anthropometric measurement of preschool
children, Prevalence of low birth weight etc.
• Health Care Delivery Indicators: Doctor-
population ratio, Bed-nurse ratio, Population-
bed ration, Population per health facility etc.
• Utilization Rates: immunization coverage,
ANC coverage, % of Hospital Delivery,
Contraceptives prevalence rate, Bed
occupancy rate, average length of stay in
hospital and bed turnover rate etc.
16

17. INDICATORS OF HEALTH
• Indicators of social and mental health: Rates
of suicides, homicides, violence, crimes, RTAs,
drug abuse, smoking and alcohol consumption
etc.
• Environmental indicators: proportion of
population having access to safe drinking
water and improved sanitation facility, level of
air pollution, water pollution, noise pollution
etc.
• Socio Economic Indicators: rate of population
increase, Per capita GNP, Dependency ratio,
Level of unemployment, literacy rate, family
size etc.
17

18. INDICATORS OF HEALTH
• Health policy Indicators: proportion of
GNP spent on health services, proportion
of GNP spent on health related activities
including safe water supply, sanitation,
housing, nutrition etc. and proportion of
total health resources devoted to primary
health care.
• Indicators of Quality of Life: PQLI, IMR,
Literacy rate, Life Expectancy at age one
etc.
18

19. CONCEPT OF WELLBEING
• Wellbeing of an individual or group of
individuals have several components and has
been expressed in various ways, such as
‘standard of living’ or ‘level of living’ and
‘quality of live’.
19

20. STANDARD OF LIVING
• Income and occupation, standards of
housing, sanitation and nutrition, the
level of provision of health,
educational, recreational and other
services all be used individually as
measures of socioeconomic status, and
collectively as an index of the standard
of living.
20

21. LEVEL OF LIVING
• It consists of nine components : health,
food consumption, education, occupation
and working conditions, housing, social
security, clothing, recreation and leisure
human rights.
• These objective characteristics are
believed to influence human wellbeing. It is
considered that health is the most
important component of the level of living
because its impairment always means
impairment of the level of living.
21

22. CONCEPT OF DISEASE
• Ecological point of view disease is defined
as “a maladjustment of the human
organism to the environment.”
• The simplest definition is that disease is
just the opposite of health: i.e. any
deviation from normal functioning or state
of complete physical or mental well-being.
22

23. Distinction between Disease,
Illness and Sickness
• The term disease literally means “without
ease” (uneasiness), when something is
wrong with bodily function.
• Illness refers to the presence of a specific
disease, and also to the individual’s
perceptions and behavior in response to
the disease, as well as the impact of that
disease on the psychosocial environment.
• Sickness refers to a state of social
dysfunction. 23

24. Distinction between Disease,
Illness and Sickness
• Disease is a physiological/psychological
dysfunction.
• Illness is a subjective state of the person
who feels aware of not being well.
• Sickness is a state of social dysfunction i.e.
a role that the individual assumes when ill
(sickness role).
24

25. HEALTH ILLNESS CONTINUUM
• According to Newman (1990) "Health on a continuum
is the degree of client wellness that exists at any point
in time, ranging from an optimal wellness condition
with available energy at its maximum to death, which
represents total energy depletion.“
• According to Health-illness continuum model, 'Health
is a dynamic state that continuously alters as a
person adapts to changes in the internal and external
environments to maintain a state of physical,
emotional, intellectual, social, developmental and
spiritual well-being. Illness is a process in which the
functioning of a person is diminished or impaired in
one or more dimensions when compared with the
person's previous condition'.

26. MODEL OF HEALTH AND ILLNESS

27. Spectrum of Health:
• -Positive Health, Better Health
• -Unrecognized sickness,
• -Mild sickness,
• -Severe sickness,
• -Death.
• The spectrum indicates that health of a person is
not a static condition, there arc always continuous
changes that come in the health status and it is not
possible to attain health once and for all.

28. • The literature supports the view that health and its
attainment is a central concept and a goal of nursing
practice.
1. A nurse can determine a client's level of health at any
point on health illness continuum. A client's risk factors
(variables) are important in identifying level of health.
Risk factors include genetic and physiological variables.
2 As a person progresses through the developmental
stages, certain risk factors are common than others, e.g.
Body image changes and self-concept.
3. To help clients set goals to reach an optimal level of
health, the nurse helps them identify their positions on
the health-illness continuum

29. 1. How many concepts of health?
a. 1 b. 2 c.3 d. 4
2. What is bio-medical concept?
a. germ theory b. environment c. all of above d. none
of above
3. What are ecological concepts?
a. environment b. air c. water d. all
4. What is psychological concept?
a. germ theory b. environment c. psychology d. all
5. What is holistic concept?
a. all of concept b. environment c. diseases d. none
of above

30. Answer keys:-
1. (D)
2. (a)
3. (a)
4. (c)
5. (a)

31. 1. Howmany dimension are there?
a. 1 b. 4 c. 5 d. 3
2. What is physical dimension?
a. physical well-being b. environment
c. air d. none of above
3. What is mental dimension?
a. healthy b. mental condition c. air d. all of
above
4. What is vocational dimension?
a. related to air b. related to job
c. related to water d. none of above
5. Other dimension include?
a. cultural dimension b. educational dimension
c. socio-economic dimension d. all of above

32. • Answer keys:-
1. (d)
2. (a)
3. (b)
4. (a)
5. (d)

34. LEVELS OF PREVENTION
Primordial Prevention :
• Prevention from Risk Factors.
• Prevention of emergence or development of
Risk Factors.
• Discouraging harmful life styles.
• Encouraging or promoting healthy eating
habits.
34

35. LEVELS OF PREVENTION
Primary Prevention:
• Pre-pathogenesis Phase of a disease.
• Action taken prior to the onset of the disease:
• Immunization & Chemo-prophylaxis
35

36. LEVELS OF PREVENTION
Secondary Prevention:
• Halt the progress of a disease at its incipient
phase.
• Early diagnosis & Adequate medical
treatment.
Tertiary Prevention:
• Intervention in the late Pathogenesis Phase.
• Reduce impairments, minimize disabilities &
suffering.
36

37. MODES OF INTERVENTION
• Intervention is any attempt to intervene or
interrupt the usual sequence in the development
of disease. Five modes of intervention
corresponding to the natural history of any disease
are:
–Health Promotion
–Specific Protection
–Early Diagnosis and Adquate Treatment
–Disability Limitation
–Rehabilitation
37

38. HEALTH PROMOTION
• It is the process of enabling people to increase
control over diseases, and to improve their
health. It is not directed against any particular
disease but is intended to strengthen the host
through a variety of approaches(interventions):
–Health Education
–Environmental Modifications
–Nutritional Interventions
–Lifestyle and Behavioral Change
38

39. SPECIFIC PROTECTION
• Some of the currently available interventions
aimed at specific protection are:
– Immunization
– Use of specific Nutrients
– Chemoprophylaxis
– Protection against Occupational Hazards
– Avoidance of Allergens
– Control of specific hazards in general
environment
– Control of Consumer Product Quality & Safety
39

40. EARLY DIAGNOSIS & TREATMENT
• Though not as effective and economical as ‘Primary
Prevention’, early detection and treatment are the
main interventions of disease control, besides being
critically important in reducing the high morbidity
and mortality in certain diseases like hypertension,
cancer cervix, and breast cancer.
• The earlier the disease is diagnosed and treated the
better it is from the point of view of prognosis and
preventing the occurrence of further cases
(secondary cases) or any long term disability.
40

41. DISABILITY LIMITATIONS
• The Objective is to prevent or halt the
transition of the disease process from
impairment to handicap.
Sequence of events leading to disability &
handicap:
• Disease → Impairment → Disability→ Handicap
41

42. DISABILITY LIMITATIONS
• Impairment: Loss or abnormality of
psychological, physiological/anatomical
structure or function.
• Disability: Any restriction or lack of ability to
perform an activity in a manner considered
normal for one’s age, sex, etc.
• Handicap: Any disadvantage that prevents one
from fulfilling his role considered normal.
42

43. REHABILITATION
• Rehabilitation has been defined as the
‘combined and coordinated use of medical,
social, educational and vocational measures for
training and retraining the individual to the
highest possible level of functional ability”
• Areas of concern in rehabilitation:
– Medical Rehabilitation
– Vocational Rehabilitation
– Social Rehabilitation
– Psychological Rehabilitation
43

44. CONCEPT OF CONTROL
• DISEASE CONTROL: The term disease control
refers ongoing operation aimed at reducing:
– The incidence of disease.
– The duration of disease and the consequently
the risk of transmission.
– The effect of infection including physical and
psychological complication.
– The financial burden to the community.
44

45. CONCEPT OF CONTROL
• In disease control, the disease agent is
permitted to persist in the community at a
level where it ceases to be a public health
problem according to the tolerance of local
community. For example Malaria control
programme. Disease control activities focus on
primary prevention
45

46. CONCEPT OF CONTROL
ELIMINATION: Reduction of case transmission to
a predetermined very low level or interruption
in transmission. E.g. measles, polio, leprosy from
the large geographic region or area.
ERADICATION: Termination of all transmission of
infection by extermination of the infectious
agent through surveillance and containment.
“All or none phenomenon”. E.g. Small pox
46

47. CONCEPT OF CONTROL
• MONITORING: Defined as “the performance
and analysis of routine measurement aimed at
detecting changes in the environment or health
status of population.” e.g. growth monitoring of
child, Monitoring of air pollution, monitoring of
water quality etc.
• SURVEILLANCE: Defined as “the continuous
scrutiny of the factors that determine the
occurrence and distribution of disease and
other conditions of ill health.” E.g. Poliomyelitis
surveillance programme of WHO.
47

48. BODY DEFENCE: IMMUNITY
The Body Defence Against Infection
 The first line of defense against infection to the body
is the normal flora/non specific defense, which helps
to keep harmful bacteria from invading the body.
 Eg. Mechanical and Chemical Barriers:- It involves the
skin and mucous membrane. In these membranes,
there are densely packed cells that protect the
internal environment from the invasion by foreign
cells. Substances such as sebum, mucus, HCI in gastric
mucosa act as non-specific defences.

49. BODY DEFENCE: IMMUNITY
The Immune Response
Involves nonspecific reactions in the body as it
responds to an invading foreign protein such
as bacteria, and in some cases, the body’s
own bacteria.
 A complex mechanism that swing into action
as the body attempts to protect and defend
its self.
Antigen – the foreign body and the body
responds to the antigen by producing an
antibody.

50. BODY DEFENCE: IMMUNITY
The inflammatory response
The inflammatory response is a
protective mechanism that eliminates
the invading pathogen and allow tissue
to repair by neutralising, controlling or
eliminating the harmful agent and
prepares the site for repair.

51. BODY DEFENCE: IMMUNITY
Types of Immunity
1. Innate immunity : the natural defence
against infectious agent.
2. Active immunity : Acquired naturally after
exposure to infection or it could be
artificially acquired immunity resulting from
administration of vaccine.
3. Passive immunity : naturally transferred
from mother to fetus or could be by the
artificial transfer of antibodies by parenteral
administration.

52. BODY DEFENCE: IMMUNIZATION
• Immunization is the process by which an
individual immune system becomes fortified
against an agent.
• When the system is exposed to molecules that
are foreign to the body, an immune response is
set off, and the body develops the ability to
quickly respond to a subsequent encounter
because of immunological immunity that has
been acquired.
• T cells, B cells and antibodies are improved by
immunisation.

53. • Vaccination
• Introduction of Foreign
molecules in to the
body
• Body generate imm.
Active
• Presynthesised
elements of immune
system
• Antibodies
Passive

54. IMMUNIZATION
• BCG (TB) – At Birth
• OPV - At Birth, 6 wks, 10 wks, 14 wks till 5 years
• HBV – At birth, 6 wks, 10 wks, 14 wks
• Pentovalent - 6 wks, 10 wks, 14 wks
• Measles – 9 months
• MMR – 15 months
• Typhoid vaccine – 2 yrs.
• TT – 10+ 15 Yrs.

55. HEALTH CARE TEAM :-
• Definition:- The health team consists of a
group of people who coordinate their
particular skills in order to assist a patient
or his family. The personnel, who comprise
a particular team, will depend upon the
needs of the patient.
• The personnel commonly included In the
health team are:

56. • 1. The Physician: - In hospital setting, the
physician is responsible for the medical
diagnosis and for determining the therapy
required by a person who is ill or injured. A
physician is a person who is legally authorized
to practice medicine in particular jurisdiction.
• 2. The Nurse: - A number of nursing personnel
may be involved in health team and may have
their own nursing team. A 'nursing team'
composed of personnel who provide nursing
services to a patient or his family. The team
leader 'head nurse' is responsible for
delegation of duties to members of her team
and care given to the patients.

57. • 3. The Dietitian or Nutritionist: - When dietary
and nutritional services are required, dietitian
or' nutritionist may also be a member of
health team. Dietitians design special duties
and they supervise the preparation of meals
according to doctor's prescription. The
nutritionist in a community setting
recommends healthy diets for people and is
frequently involved in broad advisory services
in regard to purchase and preparation of food.
• 4. The Physiotherapist:-The physiotherapist
provides assistance to a patient who has
problem related to his musculoskeletal
system.

58. Functions of Physiotherapist are:

59. 5. The Social Worker:-
• The patient and his/her family are assisted by social
worker with such problems as finances, rest home
accommodation, counseling or marital problems,
adoption of children.
6. The Occupational therapist:-
• The occupational therapist assists patients with
some impairment of function to gain skills as they
are related to Activities of Daily Living (ADL) and
help with a skill that is therapeutic.
• It provides some satisfaction ego Teaching a man
who has severe arroyos, in his arms and hands how
to adjust kitchen utensils so that he can continue to
cook.

60. 7. The Paramedical Technologist;
-It includes laboratory technologists, radiologic
technologists.
• • Laboratory technologists:-Examine and study
specimens such as urine, faeces, blood and
discharges from wound.
• • Radiologic technologist:-Assists with wide variety
of x-ray procedures, from simple chest radiograph
to more complex fluoroscopy. Through use of
radioactive materials, nuclear medicine technologist
can provide diagnostic information about
functioning of a patient's liver etc.
8. The Pharmacist:-The pharmacist prepares and
dispenses pharmaceuticals in hospital and community
settings. The role of pharmacist in monitoring and
evaluating the actions and effects of medications on
patients is becoming increasingly prominent.

61. • 9. The Inhalation Therapist: - The inhalation
therapist or respiratory technologist is skilled
in therapeutic measures used in care of
patients with respiratory problems. These
therapists are knowledgeable about oxygen
therapy devices, intermittent positive pressure
breathing respirators, artificial mechanical
ventilators, accessory devices used for
inhalation therapy.

62. India is a union of 28 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.

63. • The Central Government responsibility
consists mainly
• of policy making , planning , guiding,
assisting, evaluating and
• coordinating the work of the State
Health Ministries.

64. The health system in India has 3 main links
Central
• 1. Ministry of
Health and
Family Welfare
• 2. The
Directorate
General of
Health
Services
• 3. The Central
Council of
Health and
Family Welfare
State Local
• 1.Sub –division
• 2. Tehsils(Talukas
)
• 3. Community
Development
Blocks
• 4. Municipalities
and Corporations
• 5. Villages and
• 6. Panchayats

65. DISTRICT COLLECTOR
SUBDIVISION 2-3 ASST./SUBCOLLECTOR
TALUKAS 200-600 VILLAGE TEHSILDAR
COMMUNITY DEVELOPMENT BLOCK BLOCKDEV.OFFICER
800000-120000 population
MUNICIPAL BOARDS MUNICIPAL COMISSIONER
CORPORATION (ABOVE 200000)

66. Panchayat Raj -The panchayat raj
is a 3-tier structure of rural local self-
government in India,
linking the village to the district
Ø Panchayat (at the village level)
Ø Panchayat Samiti( at the block level)
Ø Zila Parishad(at the district level)

67. PANCHAYAT (AT THE VILLAGE LEVEL):
 The Panchayat Raj at the village
level consists of
The Gram Sabha
The Gram Panchayat

68. The Gram Sabha considers proposals
for taxation,and elects members of The
Gram Panchayat.
The Gram Panchayat covers the
civicl administration including sanitation
and public health and work for the social
and economic development
of the village.

69. PANCHAYAT SAMITI (AT THE BLOCK
LEVEL):
Ø The Panchayat Samiti execute the community
development programme in the block. The
Block Development Officer and his staff give
technical assistance and guidance in
development work.

70. ZILA PARISHAD (AT THE DISTRICT LEVEL:
Ø The Zila Parishad is the agency of rural local
self government at the district level .
Its functions and
powers vary from state to state.

71. HEALTH CARE AGENCIES
• The health care system is intended to deliver
the health care services. It is represented by
five major sectors or agencies which differ
from each other by the health technology
applied and by the source of funds for
operation. These are :
1) PUBLIC HEALTH SECTOR :
• (a) Primary Health care
Primary Health centers
sub-centers

72. (b) Hospitals/Health centers
community health centers
Rural hospital
District Hospitals
Specialist Hospitals
Teaching Hospital
(c) Health Insurance Schemes
Employees state Insurance
Central Govt. Health Scheme
(d) Other agencies
Defense services
Railways

73. 2) PRIVATE SECTOR
(a)Private hospitals, polyclinics , Nursing
homes , and dispensaries
(b) General practitioners and clinics
3) INDIGENOUS SYSTEMS OF MEDICINE
Ayurveda and siddha
Unani and Tibbi
Homoeopathy
Unregistered practitioners
4) VOLUNTARY HEALTH AGENCIES
5)NATIONAL HEALTH PROGRAMMES

74. PRIMARY HEALTH CARE
• Definition:
“Primary health care is essential health care
based on practical, scientifically sound and socially
acceptance method and technology made
universally accessible to individual’s families in the
community through their full participation and cost
which the community and country can afford to
maintain at every stage of their development.”
- Alma ata declaration.

75. ELEMENTS OF PRIMARY HEALTH CARE
1. Education concerning prevailing health problems
and the methods of preventing and controlling
them.
2. Promotion of food supply and proper nutrition.
3. Maternal and child health care, including family
planning.
4. Adequate safe water supply and basic sanitation.
5. Immunization against major infectious diseases.
6. Prevention and control of local endemic diseases.
7. Appropriate treatment of common diseases.
8. Provision of essential basic household drugs for
the community.

76. PRINCIPLES OF PRIMARY HEALTH CARE
COMMUNITY
PARTICIPATION
EQUITABLE
DISTRIBUTION
PHC
MULTI
SECTORIAL
APPROACH
APPROPRIATE
HEALTH
TECHNOLOGY
FOCUS ON
PREVENTION

77. • EQUITBLE DISTRIBUTION:-
It means that health service must
shared equally by all people irrespective of
their ability to pay, and all the people rich
or poor, rural or urban must have access to
health services because the distribution of
health & family welfare services, & also
other related services, i.e. educative
income.

78. COMMUNITY PARTICIPATION:-
 It is the process by which individual,
families & communities assume responsibilities
in promoting their own health & welfare.
 For the success of primary health care,
community involvement & participation will be
most vital. Community involvement concerned
with the levels of community resident
participation in health decision making.
 To promote the development of the community
& the community’s self reliance, resident
themselves need to participate in decision
about health of the community. Resident &
health providers need to work together in
partnership to seek solution to the complex
problem facing community today.

79. APPROPRIATE HEALTH TECHNOLOGY:-
• Appropriate technology refers to health care that
is relevant to people’s needs & concerns as well as
being acceptable to them.
• It includes issues of costs & affordability of resources
as the number & type of health professionals & other
worker, equipment & their pattern of distribution
throughout the community.
• In other words “ appropriate technology means those
which are decentralized, require low capital
investment, conserve natural resources, are managed
by their users, & are in harmony with the
environment.
• Thus appropriate technology is the technology which
is scientifically or technically sound, adaptable to local
needs, culturally acceptable & financially feasible.

80. MULTI SECTORIAL APPROACH:-
• Health & family welfare programmes cannot
stand on its own in an isolated manner.
• it is recognized that health of a community cannot
be improved by intervention within just health
sector; other sectors are equally important in
promoting the communities health & self reliance.
• These are agriculture, irrigation, animal husbandry,
education, housing, public works, rural
development, co-operatives, industries, and
panchayats.
• Therefore, these sectors need to work together in a
multi sectorial approach to co-ordinate their goal,
plans & activities to ensure conflicting or
duplicating efforts.

81. COMPONENTS OF PRIMARY HEALTH CARE
PRIMARY
HEALTH
CARE
IMMUNIZATION HEALTH
EDUCATION MCH CARE
SANITATION ADEQUATE
NUTRITION
PRAMOTION OF
MENTAL HEALTH
PREVENTION
OF ILLNESS
PROVISION OF
DRUGS

82. • Population coverage of health centers
HEALTH CENTERS Coverage of population
living in plain area
Coverage of population
living in hilly/tribal area
Sub centers 5000 3000
Primary health center 30000 20,000
Community health
center
1,20,000 80,000

83. ROLE OF NURSE IN PHC
Direct care
provider
Teacher &
Educator
Supervisor
& Manager
Researcher Evaluator

84. HOSPITAL
According to WHO :- A hospital is an integral part
of a social and medical organization, the function
of which is to provide for the population, the
complete health care, both curative and preventive
and whose outpatient services reach out to the
family and its home environment. The hospital is
also a Centre for the training of health worker and
for bio-social research.

85. Classification of Hospitals
The most commonly accepted criteria for
classification of modern hospital are according
to:-
• Length of stay of patient (Long term, Short
term)
• Clinical basis
• Ownership/control basis
• Objectives
• Size
• Management
• System of medicine

86. • Classification according to length of stay of patient :-
A patient stays for a short time in hospital for
treatment of disease that is acute in nature, such as
pneumonia, peptic ulcer etc. A patient may stay for a
long term in a hospital for treatment of diseases that
are chronic in nature such as TB, Leprosy, cancer etc.
The hospitals according to long term and short term
are also known as chronic care hospitals and acute
care hospitals.
• Classification according to Clinical Basis :- These are
the licensed hospitals and are considered as general
hospitals, treat all kinds of diseases, major focus on
treating condition such as heart diseases, cancer etc.

87. Classification according to ownership/
control
• On the basis of ownership/Control,
hospitals can be divided into four
categories:
• Public hospitals.
• Voluntary hospitals.
• Private!/charitable hospitals/ nursing
houses,
• Corporate hospitals,

88. CLASSIFICATION ACCORDING TO
OBJECTIVES:-
• TEACHING CUM REASEARCH HOSPITAL - It is a hospital to
which a college is attached for medical/nursing/
dental/pharmacy education, the main objective of these
hospitals is teaching based on research and the provision of
health care is secondary. e.g.:- f IMS, PCIMER, Chandigarh.
• GENERAL HOSPITAL ;-Are those which provide treatment for
common diseases and conditions. The main objectives of
these hospitals are to provide medical care to the people.
e.g.:- All distinct and taluses or PHC or rural hospitals belong
to this type.
• SPCIALIZED HOSPITAL: are those that provide medical and
nursing care primarily for only one discipline on a specific
disease or condition of one system such as TB, ENT, Leprosy,
STD's etc.
• ISOLATION HOSPITAL:- are those hospitals in which the
persons suffering from infectious/ communicable diseases
require isolation. e.g.:- Epidemic disease hospital, Bangalore .

89. CLASSIFICATION ACCORDING TO SIZE
1. Teaching hospital - 500 (bed to be increased
according to !lumber of students).
2. District Hospital 200 (bed to be increased
upto 300 depending upon population).
3. Taluka Hospital - 50 (May be raised
depending upon population to be served).
4. Primary Health centers - 6 (May be
increased upto 10).

90. CLASSIFICATION ACCORDING TO
MANAGEMENT
• UNION GOVERNMENT/GOVERNMENT OF INDIA:- All
hospitals administered by the government of India. e.g:-
Hospitals run by Railways, military/ defense etc.
• STATE GOVERNMENT: - Hospitals administered by state/
union territory including police, prison, irrigation department
etc
• LOCAL BODIES:- Hospitals are administered by local bodies
i.e,muncipal corporation, zila prishad, panchayat etc. e.g:- co-
operation maternity houses.
• AUTONOMUS BODIES: - All hospitals established under
special act of parliament or state legislation and founded by
the central/ state government e.g. AIlMS, PCI etc.
• PRIVATE:-All private hospitals are owned by an individual or
by private Organization e.g.: MAHC Manipal, Hinduja
Hospital.
• Voluntary agency: - All hospitals are operated by a voluntary
body/ a trust/charitable society etc. It includes hospitals run
by missionary bodies and co-operations. e.g: CMC, Vellore

91. CLASSIFICATION ACCORDING TO
SYSTEM
• Allopathic hospitals,
• Ayurveda hospitals
• Homeopathic hospitals,
• Unani hospitals,
• Hospitals of other systems of
medicine.

92. FUNCTIONS OF HOSPITAL
• Care of sick and Injured:- Hospital is an medical institution
where client suffering from some disease/health problem
is getting treated and cared. Comprehensive care is
provided to the sick/injured client by health care team.
Clients are treated according to priority or needs. For
example: Emergency care is provided to client with Heart
attack than the client came with general weakness.
• prevention of disease:-. Prevention of disease is
accomplished by early screening, detection of risk prone
cases. Maintaining aseptic technique, following the
principles of medical care can prevent the occurrence of
certain complications. For example: Immunization
schedule for children, tetanus injection during pregnancy.
• promotion of health:- A client who is maintaining his
health can accomplish higher level of health. In hospital
setting, various aspects of health promotion are taken. For
example: Health education, supplementation, regular
checkup.
.

93. • Diagnosis and treatment of diseases:- As soon as
client approaches the health care team, a complete
assessment is done. Afterward medical diagnosis is
made And treatment is started.
• Scientific Application Of Mental Hygiene And
Mental Therapy:-Mental health is an important
aspect of a healthy person. Client suffering from
stress, mental health 28 problems are getting treated
if'. h0spitals. Counseling is also done in the hospital
setting.
• Rehabilitation: Rehabilitation is the process where
an individual is reeducated, particularly where an
individual has been ill/injured to enable them for
becoming capable of useful activity. For example:
Rehabilitation care is given to client who underwent
for mastectomy, amputation etc.

94. • Medical Education: Hospital attached with
medical colleges/nursing colleges are
providing education to the students. They
are taught how to care for a client. How to
provide individualized medical care, how to
tackle emergency cases. With this, they are
gaining clinical skill as well as knowledge.
• Research: incidence prevalence rate,
mortality rate etc. are calculated from the
hospital settings. Prevalence of disease is
done by conducting research. Etc. in the
hospital.