HEALTH MANPOWER DEVELOPMENT INSTITUTE

INTRODUCTION

For the socioeconomic development of any nation, it is essential

that people of that country should be kept healthy. For the provision of
health care we require sufficient no of trained personnel fo different
catogories who are equipped, motivated to work as a team in the spirt of
social relevance of that country. The delivery of health services requires
special consideration in developing countries, where, human resources
are in abunclated and other resources are source. For such countries
health man power development is essential.

ORIGIN (1996)

The overall objective of DANIDA Tamilnadu Area Health Care

project (TNAHCP) is to improve the health and family welfare status of
the rural population in the project are especially of the weaker sections
with a view to improving and strengthening the facilities for the delivery
of healthcare and family welfare services in an integrated manner in
accordance with the national health policy. Various external agencies are
providing financial assistance to the Govt. of Tamilnadu DANIDA is a
major bilateral donor in the health sector.

The activities of DANIDA extending to the old districts of Salem,

Namakkal, Cuddalore and Villupuram.

In Tamilnadu two health Manpower Development Institutes

(HMDIs ) in Salem, Villupuram.

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OBJECTIVES FO HEALTH MANPOWER DEVELOPMENT
INSTITUTE

1) To develop an intermediate Center of Health Manpower to deliver

community need based health care to our rural and semirural
population.

2) To produce mid level health manpower for providing community

need based health care to subcentres and other areas.

3) To provide necessary knowledge skill and develop attitudes in the

field of health sciences to enable them to serve the community to
meet their health needs.

4) Orientation : The training programme of health works will have to

be duly oriented towards prevention of diseases, promotion of
health and family welfare programme including maternal and
child health care.

5) To establish a rapport with rural masses and act as an entry point

for providing meaningful and effective services in remaining
categories

6) Course for Community health Adhikari, alternative names could

be medial assistant, Assistant medical practioner, Physician
Assistant Medical Officer or Health Assistant.

7) Course content should lay adequate emphasis on preventive,

promotive and rehabilitative and therapeutic aspects of health
including meternal, child and family welfare programme.

8) The syllabus should be so framed to cover preventive, promotive,

curative and rehabilitative aspects of medical care.

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 9) Training in traditional system of medicine suitable training in
Ayurveda, Homeopathy also to be given.

10) To provide awards : Certificate, diploma licentiate in community

health.

TRAINING

Training is the process of helping people learn to do tasks,

learning new tasks and training others is a familiar part of life. Think
about how you learned to swim or cook or write, health care task can
be learned in much the same way. It is not always necessary to hear a
long lecture or read a text book, it is necessary to practice doing the
task. So that health workers will learn how to do the task of their
jobs.

OBJECTIVES

Describe the Select Plan Conduct Evaluate

Tasks which appropriate training training Training and
Workers Must Training Make Changes
learn to do methods to improve it

CRITERIAS

1) Find out the background and experience of the staff.

2) Determine the learning needs of the staff.
3) Enlist their participation in planning draw up clear and definite
objectives
4) Draw up clear and definite objectives
5) Prepare a programme
6) Plan and carryout a system of evaluation
7) Plan for an adequate followup of the staff.

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THE CONCEPT OF HEALTH MANPOWER DEVELOPMENT
(HMD) STAGES

1) HMD Planning

2) HMD production

3) HMD management

4) HMD monitoring and evaluation.

1) HMD PLANNING

In India there is about 1,50,000 doctors and they were producing

at the rate of 12,000 / year out of these 67% doctors were in urban
areas resulting geographical mat distribution and inadequate health
man power available to the rural areas where 79% of the population
lives. This distribution represent familier inverted pyramid which
does not match the distribution of available manpower to the health
needs of the community.

Further a large no. of rural diseases as compared to ones in urban

areas are such, which are preventable. For handling there problems
we need more trained health works in rural areas but as a result of
these, uneven distribution of doctors, people in rural areas are
deprived of even primary health care. Therefore to meet the basic
needs of rural people the government felt the need for starting a new
scheme of community health volunteers, they established DANIDA
Assisted project is called health manpower development.

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2) HMD PRODUCTION

- Production of more doctors in future.

- For treating various disease, it will be necessary to provide them

with the requisite knowledge and skills in therapy of various diseases,
which are commonly prevalent in rural areas.

CURRICULAM

About 75 percent content should be on preventive, promotive,

rehabilitatives aspects of health including material, child and family
welfare programme twenty five percent may be on therapeutic aspects
of disease.

HMD MANAGEMENT FACULTY :

It may comprise of

Civil surgeon

District health officer

Specialities attached to district hospital and PHC

Consultants

General practioners

Retired teachers.

HMD EVALUATION

- Trainees will be provided with government service in the

rural areas and will not be allowed private practice. They
will have to serve in rural areas.

- Each state government intending to start the course should

assess the need of development of such midlevel health
manpower, only thereafter their course should be started.

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 - It should be made available as cent percent centrally
sponsored scheme.

SHORT TERM MEDICAL COURSES

1) Courses for peripheral workers community health workers

Paramedicals ANM’S, Health Educations, Technicians,

Sanitary Workers, Male and Female Workers

2) Courses for medical man power

Nurses, Pharmacists, Technicians

Better trained paramedical personal may be utilized for

delivery of health care of this level.

Topics about

75%

- Preventive, promotive and rehabilitate aspects

- Maternal and child health

- Family Welfare

25% - Therapeutic aspects of diseases.

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MEDICAL MAN POWER STAFFING PATTERN AND THEIR
FUNCTIONS

Home as Village Sub-Phc Subsidiary PHC Short term course trainees

the unit level PHC Medical and
of health Para medicals

Through CHV Paramedicals Paramedicals

Chapters and multi and medical
on positive purpose short term
health in Health course
text books workers trainees

Sub-divisional District MTBS and postgraduate aided

hospital hospital By paramedicals etc.

Postgraduates
Medical Regional Super specialities
colleges institute Aided by para medicals

Apex Organisation
MBBS Postgraduate
Postgraduate Aided by
Aided by Para medicals etc.
Para medicals etc.
Highly developed specialties
and super specialties
Aided by paramedical

ASSESSMENT OF MANPOWER REQUIREMENTS

It was generally agreed that the projected assessment of manpower

requirements were realistic it was emphasized that to fulfil there
requirements greater emphasis should be placed towards attempt to
enhance the functional efficiency of existing manpower involved in
various national health programme.

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1) In order to optimally utilize the available manpower, it was
recommended that the practitioner of the indigenous system of
medicines as well as of homeopathy, who are rendering
commendable services to the rural community, should also
effectively involved in the health care delivery system of this
country.

2) Training of the health personnel, include nurses pharmacists,

health assistant, multipurpose health workers etc. need to be
strengthened and reinforce.

3) It was emphasized that the acquisition of appropriate knowledge,

competence and skill including social responsiveness, at the level
of these workers was an essential pre requisiteness to the success
of the proposed health care delivery system.

4) To conduct such meaningful training programme there was a felt

need to have a reorientation of the trainers in order to ensure a
better appreciation of the objectives of such training programmes
as well as an awareness of the available methods in educational
technology that could be used in the implementation of these
programme.

LINKS WITH GENERAL EDCUATION

1) Health Education should form an integral component of general

education at all stages including primary, middle, secondary and
finally the plus two stage, with additional emphasis on family
planning at the level of primary level.

2) Training of the future teacher in basic sciences in the medical

institutions, the latter is likely to produce appropriate manpower
for public health and related services

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REORIENTATION OF MEDICAL EDUCATION

There is a near unanimity regarding incorporation of appropriate

changes in the system undergraduate medical education, so as to
make it not only academically rewarding but also socially relevant.

DOPE (disease oriented professional education) to

HOPE (health oriented professional education)

The teaching of humanities including social and behavioural

sciences as well as greater emphasis on infections and communicable
diseases commonly prevalent in community settings. Ministry of
health and family welfare provided appropriate educational milieu in
the rural and community setting, that would make the graduating
physician respond with sensitivity and greater understanding to the
needs of the community.

CAREER PROSPECTS

Career development for all categories of health personnel, other

avenues of academic progress and career promotion within the same
preofessional categorization should also be developed. Eg. M.Sc.,
Degree in nursing with emphasis on specialization like, paediatric
nursing including maternal and child health.

INTEGRATION OF DIFFERENT SYSTEMS OF MEDICINE

There is a unanimous view approving the development of an

integrated system of medicine by combining in any proportion, the
ingredients of different system of medicines being practiced in this
country. There is happy co-existence and co0ordination of different
systems of medicines.

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 Short term courses workshops or refreshers courses, which may
provide ackquate learning experience to the practioners of one system
of medicine regarding the principles and practice another system of
medicine.

HEALTH MANPOWER DEVELOPMENT INSTITUTE,

DANIDA, PROJECT, SALEM

Curriculum for Training

1) Training in maternal and child health (Post programme)

2) Training on HIV /AIDS (present programme)

1) TRAINING IN MATERNAL AND CHILD HEALTH

1) Antenatal Care

2) Intranatal care for safe delivery

3) Postnatal care of the women.

4) Prevention of unwanted pregnancy

5) Provision of appropriate contraception

6) Appropriate services for management of unwanted pregnancy

7) Diagnosis and management of RTI / STD’S Human Immuno

Deficiency Virus (HIV) AIDS (Acquired immuno Deficiency
Syndrome)

8) New born care at birth.

9) High risk new born care

10) Nutrition.

11) Immunization

12) Diarrhea

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13) Acute respiratory infection

14) Child development

15) Adolescent health

16) Sick child and emergencies

TRAINING ON HIV/AIDS PRESENT TRAINING

PROGRAMME

The HIV/AIDS epidemic represent the most serious public health

problem in India. The prevence of the infection in all parts of the
country highlights the spread from urban to rural areas and from high
risk to the general population.

NATIONAL AIDS CONTROL PROGRAMME

The national AIDS control programme was launched in India in 1987.

OBJECTIVE

1) To slow the spread of HIV

2) To decrease morbidity and mortality associated with HIV

infection.

3) To minimize socio-economic impact resulting from HIV infection.

TRAINING ON

 Epidemiology of HIV / AIDS

 HIV / AIDS surveillance in India

 National AIDS control programme

 National history and clinical manifestation.

 Laboratory diagnosis

 Tuberculosis and HIV infection.

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  Spectrum of appretunistic infection, in AIDS

 Anti retroviral therapy

 Women and HIV infection including mother to child

transmission.

 Children and HIV / AIDS

 Blood safety programme

 HIV counseling

 Prevention and control of HIV infection.

SUMMARY

Health is a positive attribute of life which is characterized by a

study of the complete, physical mental and social well being of an
individual and not merely the absence of disease. The maximum
attainable and acceptable level of health for all people should be a goal.
It can be achieved by development and strengthening of health
manpower in all the health care institutions.

BIBLIOGRAPHY

1) Governmetn of India, Ministry of Health and Family Welfare

(Dept. of Health) “National Conference on Medical and Health
Education” 1979 New Delhi.

2) World Health Organisation “Supervisory Skills Training”

3) Health Manpower Development Institute Tamilnadu AIDS Control

Society “Training Manual on HIV/AIDS

4) www.google.com

5) www.thhealth.org.com

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