Article thumbnail

Organization of Indian Health Bureaucracy and its Delivery System

By Srinivasan K. and Sharan Raka


The aim of this paper is to probe into the structure and functioning of health bureaucracy in India with specific reference to rural health bureaucracy of Tamil Nadu State. bureaucracy is defined as "a hierarchical division of staff who act on formal assignments" - Gouldner(1954). This definition suggests five specific dimensions of bureaucracy namely (i) hierarchical structure (ii) nature of work and progress (iii) procedural devices (iv) decision making and (v) procedural bottlenecks have been considered in this order to understand the functioning of bureaucracy. These factors are particularly relevant to the understanding of bureaucratic functioning as the previous studies have indicated that the magnitude of these attributes varies from one organization to another (Hall, Peabody, Meyer) 1. The functional complexities of any bureaucratic system largely depend upon the combination of these attributes (Bennis). Health care delivery system is a system in which the services related to health care delivered to the target population. In Health care the higher-level officials do only planning while the local staff do implementation. In India including Tamil Nadu, the implementing agency of health care programmes is at block level known as Primary Health Centers (P.H.C.). In such a kind of setup, whether the centralised approach will be effective? Whether the mechanistic and vertical delivery system will achieve the health care to all sections of society? What are the merits and demerits of mechanistic model? The paper would like to address the above questions in the present context. It also would like to present the health delivery of Non Governmental Organisations. The nature of hierarchy plays an important role in health. The centralised control created problem in managing emergencies. It was also found that the lower level officials need to be part of the planning process as the policies have to be customised.Health Administration, Bureaucracy, Health management, Structure, Organisation, Vertical, Horizontal, Organisational Development, Decision Making, Organisational Behaviour

OAI identifier:

To submit an update or takedown request for this paper, please submit an Update/Correction/Removal Request.

Suggested articles


  1. (1977). A casual model of the health care system: A replication", J.of health and science behaviour, vol.18,
  2. (1956). A theory of group development.
  3. (1968). Beyond Bureaucracy” Pp. 53-76
  4. (1984). Bureaucratic personality and organisation structure, Hants,
  5. (1988). Bureaucratization Without Centralization: Changes in the Organizational System of U.S.
  6. (1972). Changing Organizations. — In:
  7. (1985). Computers and clinical judgments, the role of physician networks, soc sci med, vol.20, no.10,
  8. Dietary beliefs in health and illness among a,
  9. Discovering chronic illness using grounded, Soc sci med,
  10. (1995). Government move to promote Indian Medicine, A Newspaper Report,
  11. (1973). Hospital bureaucracy,
  12. (1988). Inside organizationsUnderstanding the human dimension,
  13. (1977). Institutionalized Organizations: Formal Structure as Myth and Ceremony.”
  14. (1968). Max Weber on Charisma and Institution Building,
  15. (1990). Neikirk Helen J and Hosokama Michael CCollaborative practice and provider styles of delivering health care, soc sci med,
  16. (1983). Organizational Environments: Ritual and Rationality
  17. (1982). Organizations: Structure and Processes.
  18. (1982). Organizations: Structure and Processes. Englewood Cliffs,
  19. (1973). Orientation toward clients in a public welfare agency, from the book, Bureaucracy and the public, Ed. by Katz and Denet,
  20. (1954). Patterns of industrial bureaucracy.
  21. (1962). Perceptions of organizational authority: A comparative analysis'.
  22. Social impact on chronic diseases: A sociological study of Delhi publication.
  23. (1970). Tamil culture and civilization, readings: The classical period,
  24. (1971). The concept of ritual in modern sociological theory, New Delhi, the Academic Journals of India,
  25. The cultural Definition of Illness in Village India,
  26. (1971). The dynamics of bureaucracy, Chicago,
  27. (1986). The of habit,
  28. (1968). The policy-making process. Englewood Cliffs,
  29. (1992). World expansion of mass education,