Public Health Cadre and Services in Maharashtra

The public health cadre in Maharashtra, led by Dr. Satish Pawar, focuses on improving the health and wellbeing of populations through interdisciplinary partnerships. The Directorate of Health Services oversees the selection and appointment of medical officers in different cadres. Various specialties within the cadre provide primary, secondary, and tertiary healthcare services under the guidance of Deputy Director of Circles.

• Public Health
• Maharashtra
• Medical Officers
• Health Services
• Directorate of Health

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1. PUBLIC HEALTH CADRE OF MAHARASHTRA DR SATISH PAWAR DHS MAHARASHTRA

2. Public Health Speciality Public Health and Preventive medicine is branch of medicine similar to other clinical specialties and is concerned with health of populations Through interdisciplinary and intersectoral partnerships PHS measures health needs of populations and develop strategies for improving health and wellbeing through health promotion, disease prevention and health protection The PHS are trained in leadership skills, development of public policy, designing, implementation and evaluation of health programs and applies them to broad range of public health issues. PHS works in collaboration with other disciplines in prevention of disease and injury and promotion of healthy behavior.

3. Directorate of Health Services Maharashtra Selection and appointment of doctors as Medical Officer, their posting based on educational qualifications. (2011) MO Promoted in three cadres as per qualifications District Health Officer (Public Health ) Cadre Civil Surgeon Cadre Senior Clinician cadre Common seniority of DHO/CS/Clinician cadres for promotion to Deputy Director and higher posts

4. DIRECTORTE OF HEALTH SERVICES MAHARASHTRA, SIMPLE ORGANOGRAM Director of Health Services Additional Director Joint Director of Health Services Deputy Director of Health Services District Health Officer Cadre Civil Surgeon Cadre Clinician Class I Cadre Medical Officer with MD (PSM) /DPH/MPH Degree Medical Officer with Clinical Deg Medical Officer with Clinical Diploma /Degree

5. Responsibilities of Specialities Primary Health Care services including FW, disease surveillance, epidemic control, DCPs etc provided by Primary Health Centers and Sub Centers under Public Health Cadre Secondary health care services provided by Hospitals under Civil Surgeon Cadre Tertiary health care services provided by clinicians under particular speciality All these levels work under Deputy Director of Circles

6. DEPUTY DIRECTOR OF HEALTH SERVICES SECONDARY HEALTH CARE SERVICES TERTIARY HEALTH CARE SERVICES PRIMARY HEALTH CARE SERVICES DIST HEALTH OFFICER CIVIL SURGEON MS OF HOSPITAL PHC DISTRICT HOSPITAL RRH/MH/TB HOSP/LEP HOSP PHU RH/SDH/GH/ WH SUB-CENTER

7. Milestones : Public Health Cadre in Maharashtra State 1961 :Maharashtra State decided to entrust Primary Health Care and Communicable disease control to local Self Governments 1962 : District Health Officer cadre was established to provide Primary Health Care and to control epidemics 1971 : Diploma in Public Health or MD in PSM introduced as required qualification for Public Health cadre 1983 : Posts of Assistant Directors of PH Cadre created in all offices from Deputy Directors to Director office. 2014 : Public Health Specialist posted as one speciality in District Hospitals.

8. Structure of Public Health Cadre Level 1 (Facility level) : PHS in Medical Officers cadre posted as THO, MO DTC, MO in Hospitals, MO in DCPs Level -2 (District Level) : PHS promoted in DHO (PH) cadre posted as DHO, Add DHO, DRCHO, etc. Level 3 (Regional level) : PHS from DHO (PH) cadre also posted as Asst Director (CD), Principal HFWTC at Regional level Level 4 (State level) : PHS from DHO (PH) Cadre also posted as Assistant Director in JDHS, Add DHS and DHS offices

9. FACILITY AND DISTRICT LEVEL CIVIL SURGEON DHO DTO/DLO RMO (O) ADHO DRCHO ACS MO DH MO DTT MO DCP MO DCP THO

10. REGIONAL LEVEL POSTING OF PUBLIC HEALTH SPECIALIST DEPUTY DIRECTOR (CIRCLE) PRINCIPAL HFWTC ADHS (M) ADHS (CD)

11. STATE LEVEL POSTING OF PUBLIC HEALTH SPECIALIST DHS PHS PHS PHS PHS PHS PHS JDHS JDHS PHS PHS PHS PHS Add DHS PHS PHS PHS PHS PHS PHS

12. Special features of Public Health Cadre in Maharashtra State Public Health is identified as specility from entry point i.e. Medical officers to Highest post Public Health is only speciality with presence at all levels Public Health as separate speciality in District Hospitals Presence of PHS at regional and state level offices where the i/c officer could be from Clinical or Public Health Speciality Presence in all units where planning, monitoring and evaluation of health programs takes place PH considered as preferred qualification in nomination for Joint Director and higher posts.

13. Benefits of Public Health cadre Implementation of Primary Health Care is responsibility of PHS, so strong Primary Health Care System in State Health MIS, MDR, CDR with PHS so appropriate measures are introduced Disease Surveillance, epidemic control, control of emerging and re-emerging disease with PHS so always prompt response PHS posted in all Bureaus so systematic planning monitoring and evaluation of all health programs PH Experts assist senior officials at all levels so inputs of PHS is available at all levels Trainings implemented by PHS so robust and effective training infrastructure in State

14. POST GRADUATE COURSES IN PUBLIC HEALTH DEPARTMENT HOSPITALS IN MAHARASHTRA

15. SPECIALISTS STATUS IN MAHARASHTRA Maharashtra state has identified required speciality in each type of hospitals in the State. We get specialists from three sources In service PG (25% of State quota) Selection board Bonded candidate (For one year) Almost all bonded specialist do not continue beyond one year Requirement of specialists in State is 2891 and vacancy is 1529 (53%)

16. Specialist Availability in Maharashtra Years to fill up the vacancy 13 9 25 15 11 10 11 2 3 15 Approve d posts Filled in VacancyYearly Sr Speciality intake 1 Paediatrics 2 OBGY 3 Anaesthesia 4 PSM 5 Gen. Medicine 6 Gen Surgery 7 Radiology 8 Ophthalmology 9 Orthopaedics 10 Psychiatry Total 548 571 619 479 159 153 78 109 118 57 2891 303 363 214 158 60 61 14 86 91 13 1363 245 208 405 321 99 92 64 23 27 45 1529 19 23 16 21 9 9 6 12 11 3 129

17. Way out Short term Posting of Specialists by Counselling Starting CPS Courses in District Hospitals, Women Hospitals, Mental Hospitals, RRH and PHI Nagpur Centralised posting for bonded specialists Long term Appointment of MO with PG Degree as Honorary Assistant Professors in Medical Colleges (For DNB courses after 5 years) Increasing quota for in-service PG courses

18. CPS Courses College of Physicians and Surgeons established in Mumbai in 1912 by then Surgeon General Sir H. W. Stevenson CPS empowered to confer qualifications by Indian Medical Degrees Act 1916 Govt of Maharashtra recognises CPS courses under Maharashtra Medical Council Act 1965 Any Specialist with PG degree and 10 years clinical experience can become PG teacher under CPS courses. Intake will be 40:60 (In-service : Fresh) Fees will be charged to fresh candidates from which the course expenditure will be met 5 years bond for all candidates to serve in rural areas.

19. Hospitals included for CPS Courses No. in State Included for CPS courses Sr Type of Hospital 1 District Hospitals 2 Women Hospitals 3 Mental Hospitals 4 RRH 5 PHI Total 23 11 4 2 1 41 18 5 3 2 1 29

20. Effect of CPS Courses on Specialist Availability Years to fill up the vacancy Yearly intake Vacan cy Sr Speciality Regul ar 19 With CPS Wt CPS CPS Total 245 38 57 4 13 1 Paediatrics 208 23 44 67 3 9 2 OBGY 405 16 38 54 7 25 3 Anaesthesia 321 21 2 23 14 15 4 PSM 45 3 6 9 5 15 5 Psychiatry 1224 82 128 210 Total

21. Benefits Hospitals will get specialists for secondary health care services The years required to get specialists will be shortened by 66% District Hospitals will get more manpower as PG students to provide services to patients. Quality improvement in services Our medical officers will remain in our own hospitals

22. Thank you