Organization of Indian Health Bureaucracy and its Delivery System

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

Organization of Indian Health Bureaucracy and its Delivery System

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

SOCIAL NETWORKS AND HEALTH DECISIONS: A CASE OF TWO VILLAGES OF TAMIL NADU

A common question always had been of interest to understand as to how people make decisions. It is well known that decisions are not made in isolation but they are the products of influence and confluence of social correlates. Studies of some Sociologists report that often decisions are made in consultation with their community members. This understanding shifts the focus from individuals ‘choice’ to socially constructed patterns of decisions, including the consultation with others (Pescosolido, 1992). Therefore, one can conclude that even health issues have been decided in consultation with the community members. Community is an interactive agency and it is a part of social network. Social networks provide the mechanism through which individuals learn to hand their problematic issues. Therefore, it will be of interest to understand the extent of social network influence on health issues of rural population of Tamil Nadu. In this paper our a presentation of field information on the processes involved in the health care decisions of rural population of Tamil Nadu is presented

Religiosity and Health

There are studies showing linkages between religious beliefs and health. The importance of religion on health has been examined by studies (Vaux 1976), the dietary beliefs in health and illness (Chan Ho 1985), the role of religion in morbidity and mortalitiy (Jarvis and North Cott 1987), the Religion and other factors influencing health status (Idler and Kasl 1992). In India studies showing the role of caste and religion in terms of specific behaviour of individual groups in the power structure and related this to their healthculture (Banerji 1982), and the role of magic and other beliefs among a south Indian caste in health (Dumont 1986). Based on the concurrency in the issue the present paper focuses its attention on the various aspects of religiosity and health It is observed by various researches that the rural population of India, is very much influenced by religious beliefs. For example cultural formation of individuals closely inter linked with performance of individual's daily routine. Therefore, let us first examine the impact of religious practices and rituals as aspects of religiosity on health with specific reference to rural individuals of Indi

SOCIAL NETWORKS AND HEALTH DECISIONS: A CASE OF TWO VILLAGES OF TAMIL NADU

A common question always had been of interest to understand as to how people make decisions. It is well known that decisions are not made in isolation but they are the products of influence and confluence of social correlates. Studies of some Sociologists report that often decisions are made in consultation with their community members. This understanding shifts the focus from individuals ‘choice’ to socially constructed patterns of decisions, including the consultation with others (Pescosolido, 1992). Therefore, one can conclude that even health issues have been decided in consultation with the community members. Community is an interactive agency and it is a part of social network. Social networks provide the mechanism through which individuals learn to hand their problematic issues. Therefore, it will be of interest to understand the extent of social network influence on health issues of rural population of Tamil Nadu. In this paper our a presentation of field information on the processes involved in the health care decisions of rural population of Tamil Nadu is presented

Religiosity and Health

There are studies showing linkages between religious beliefs and health. The importance of religion on health has been examined by studies (Vaux 1976), the dietary beliefs in health and illness (Chan Ho 1985), the role of religion in morbidity and mortalitiy (Jarvis and North Cott 1987), the Religion and other factors influencing health status (Idler and Kasl 1992). In India studies showing the role of caste and religion in terms of specific behaviour of individual groups in the power structure and related this to their healthculture (Banerji 1982), and the role of magic and other beliefs among a south Indian caste in health (Dumont 1986). Based on the concurrency in the issue the present paper focuses its attention on the various aspects of religiosity and health It is observed by various researches that the rural population of India, is very much influenced by religious beliefs. For example cultural formation of individuals closely inter linked with performance of individual's daily routine. Therefore, let us first examine the impact of religious practices and rituals as aspects of religiosity on health with specific reference to rural individuals of Indi

Organization of Indian Health Bureaucracy and its Delivery System

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