Gram Panchayat - Community Medicine Notes

What is Panchayati Raj?

Key Fact: The 73rd Constitutional Amendment Act, 1992 gave constitutional status to Panchayati Raj Institutions (PRIs), making them mandatory across India, with 29 subjects under their purview including health, sanitation, primary health care, family welfare, and women & child development.

Village-Level Structure (What You Will See on Your Visit)

1. Gram Sabha

• The assembly of all adults of the village
• Meets at least twice a year
• Considers proposals for taxation
• Discusses the annual programme
• Elects members of the Gram Panchayat

2. Gram Panchayat

• The executive organ of the Gram Sabha
• Acts as the agency for planning and development at village level
• Strength: 9 to 30 elected members (varies by state)
• Population covered: 5,000 to 15,000 or more
• Members hold office for 3 to 4 years
• Key elected officials:
  • President (called Sarpanch / Sabhpati / Mukhiya)
  • Vice-President
  • Panchayat Secretary (appointed; very wide powers covering entire civic administration)

3. Nyaya Panchayat

• Village court for speedy dispensation of justice

Health Functions of Gram Panchayat

1. Sanitation - maintenance of village cleanliness, drainage
2. Safe drinking water supply
3. Medical relief - overseeing access to health services
4. Mother and Child Health (MCH) programmes
5. Nutrition programmes
6. Maintenance of village roads and streets, tanks
7. Agricultural production and rural industries
8. Primary health centres and local schools (control envisaged)
9. Working with ASHA - the ASHA works with the Village Health and Sanitation Committee of the Gram Panchayat to develop a comprehensive village health plan

Village Health and Sanitation Committee (VHSC)

• A sub-committee of the Gram Panchayat focused on health
• Receives an annual untied grant of Rs. 10,000 for local health action
• Works alongside ASHA for local health planning
• Responsible for health awareness and access to health services

Block Level - Panchayat Samiti

• Covers about 100 villages with a population of 80,000 to 1,20,000
• Consists of all Sarpanchas (village heads) in the block, plus MLAs, MPs, representatives of women, SC/ST communities, and cooperative societies
• Block Development Officer (BDO) is the ex-officio secretary
• Primary function: execution of community development programmes
• Provides technical assistance to village panchayats

District Level - Zilla Parishad

• Supervisory and coordinating body
• Membership of 40 to 70 members
• District Collector is a non-voting member
• In some states (e.g., Gujarat), District Health Officer and District Family Planning/MCH Officers are under the control of the Zilla Parishad

Key Committees That Shaped Panchayati Raj

What to Observe / Document During Your Visit

1. Infrastructure - Panchayat office, notice boards, records
2. Membership & elections - Who is the Sarpanch, when were elections held
3. VHSC existence and functioning - Is there an active health/sanitation committee?
4. ASHA linkage - Does ASHA report to/coordinate with the panchayat?
5. Health activities undertaken - immunization drives, sanitation campaigns, Swachh Bharat initiatives
6. Drinking water facilities - handpumps, piped water, quality monitoring
7. Sanitation - open defecation free (ODF) status, toilet coverage
8. Anganwadi centre - nutrition and ICDS programmes under panchayat oversight
9. Records maintained - birth/death registrations, BPL lists
10. Funds received - untied grants, MGNREGA utilization, health funds

Challenges (Important for Exam/Discussion)

• 3 Fs Deficit: Insufficient Funds, Functions, and Functionaries (classic mnemonic)
• Inadequate financial autonomy
• Limited technical capacity
• Political interference
• Poor inter-sectoral coordination with the health system
• Low community awareness and participation