Short Notes: WHO, UNICEF, and International Red Cross

1. WORLD HEALTH ORGANIZATION (WHO)

Origin / Birth of WHO

• Originated at the San Francisco Conference (April 1945) when Brazil and China proposed forming an international health organization.
• The Constitution was drafted by the "Technical Preparatory Committee" under chairmanship of Rene Sand and approved in 1946 by an International Health Conference of 51 nations in New York.
• The Constitution came into force on 7th April 1948 - this date is now celebrated as World Health Day.
• WHO is a specialized, non-political health agency of the United Nations, with headquarters at Geneva, Switzerland.

Objectives

Membership

• Original membership was 55; now over 190 member states.
• India was among the founding members in 1948.

Structure (Three-Tier)

Six Regional Organizations

Functions / Work of WHO

1. Communicable diseases
2. Non-communicable diseases
3. Health statistics and informatics
4. Environmental health
5. Public information and health education
6. Mental health
7. Family health
8. Health manpower development
9. Strengthening of health services
10. Diagnostic, therapeutic and rehabilitative technology
11. Budget and finance

2. UNICEF (United Nations Children's Fund)

Establishment

• UNICEF stands for United Nations International Children's Emergency Fund.
• Established in 1946 by the United Nations General Assembly to deal with rehabilitation of children in war-ravaged countries after World War II.
• In 1953, when emergency functions were over, the General Assembly gave it a new name - "U.N. Children's Fund" - but retained the initials UNICEF.

Structure

• Headquarters: United Nations, New York
• Governed by a 36-nation Executive Board (as of 2010)
• Regional office for South/Central Asia: Kathmandu, Nepal
• South Central Asian Region covers: Afghanistan, Sri Lanka, India, Maldives, Pakistan, Bhutan, Bangladesh, and Nepal

Activities

• Maternal and Child Health (MCH)
• Nutrition - combating malnutrition, supplementary feeding programs
• Environmental sanitation - especially rural water supplies
• Health centres and health education
• Immunization - supporting national vaccination programmes (EPI)
• Primary Health Care - after the Alma Ata Declaration (1978), UNICEF aligned with PHC
• GOBI-FFF programme - Growth monitoring, Oral rehydration therapy, Breastfeeding, Immunization, Female education, Family spacing, Food supplementation

Significance for India

3. INTERNATIONAL RED CROSS

Founder and Origin

• Founded by Henry Dunant, a young Swiss businessman.
• In 1859, while travelling through North Italy, Dunant witnessed the Battle of Solferino - one of the most savage battles of history. Appalled by the neglect of thousands of wounded soldiers, he recruited volunteers to relieve their suffering.
• Later, in his book "Un Souvenir de Solferino", Dunant urged that voluntary national societies be founded to render aid to the wounded without distinction of nationality.
• He proposed a protective emblem, trained workers, and international treaty protection.

Establishment

• Dunant's plea led to the First Geneva Convention in 1864, signing a treaty for relief of wounded and sick soldiers.
• This gave birth to the International Committee of the Red Cross (ICRC) - an independent, neutral institution and the founder organization of the Red Cross.
• In 1919, the League of Red Cross Societies was created, with headquarters in Geneva, to coordinate the work of national societies (now numbering more than 90).
• The modern entity is the International Federation of Red Cross and Red Crescent Societies (IFRC).

Emblem

• Red Cross on white background (in Muslim countries: Red Crescent; in Israel: Red Star of David)

Role of Red Cross

• Service to armed forces
• Service to war veterans
• Disaster relief (natural disasters)
• First aid and nursing
• Health education
• Maternity and child welfare services

Indian Red Cross

• Established by an Act of the Indian Legislature in 1920
• Three objectives:
  1. Improvement of health
  2. Prevention of disease
  3. Mitigation of suffering
• Provides amenities to military hospitals in peacetime
• Disaster services: distributes milk, medicines, vitamins during floods and famines
• Junior Red Cross: active youth section providing opportunities to boys and girls in service and health education
• Has done pioneering work in maternity and child welfare as an auxiliary of the country's health services

Quick Comparison Table

SHORT NOTES — EXAM FORMAT

A. WORLD HEALTH ORGANIZATION (WHO)

• Origin: San Francisco Conference, April 1945 (proposed by Brazil and China)
• Constitution drafted in New York, 1946 (by 51 nations; Technical Preparatory Committee under Rene Sand)
• Came into force: 7th April 1948 → celebrated as World Health Day

"A state of complete physical, mental and social well-being, and not merely the absence of disease or infirmity."

Exam tip: India is in SEARO. SEARO has 11 member countries.

1. Direction and coordination of international health work
2. Assistance to governments in strengthening health services
3. Technical assistance and emergency aid on request
4. Promotion of maternal and child health
5. Promotion of mental health
6. Stimulation of research and setting of international standards
7. Revision of International Pharmacopoeia
8. Collection and dissemination of health statistics

B. UNICEF (United Nations Children's Fund)

• Founded: 1946 by UN General Assembly
• Purpose: Rehabilitation of children in war-ravaged countries post-WWII
• 1953: Renamed "UN Children's Fund" but initials UNICEF retained

1. Maternal and Child Health (MCH) services
2. Nutrition programs - combating malnutrition
3. Environmental sanitation - rural water supply
4. Health education
5. Immunization (supports EPI programs)
6. Support to Primary Health Care (after Alma Ata, 1978)

• G - Growth monitoring
• O - Oral Rehydration Therapy (ORT)
• B - Breastfeeding promotion
• I - Immunization
• F - Female education
• F - Family spacing
• F - Food supplementation

Nobel Prize: UNICEF was awarded the Nobel Peace Prize in 1965

C. INTERNATIONAL RED CROSS

• 1859: Dunant witnessed the Battle of Solferino (North Italy) - was appalled by neglect of wounded soldiers
• He wrote the book "Un Souvenir de Solferino" urging voluntary national societies
• Proposed: (a) Voluntary national societies, (b) protective emblem, (c) trained workers, (d) protection by international treaty

• First Geneva Convention, 1864 - treaty signed for relief of wounded soldiers
• ICRC (International Committee of Red Cross) formed - independent, neutral, founder organization
• 1919: League of Red Cross Societies created (HQ Geneva) - coordinates national societies (now >90)
• Modern form: IFRC - International Federation of Red Cross and Red Crescent Societies

• Red Cross on white background
• Red Crescent (Muslim countries)
• Red Star of David (Israel)

1. Humanitarian service to war victims (original role)
2. Disaster relief - natural disasters
3. Service to armed forces and war veterans
4. First aid and nursing services
5. Health education
6. Maternity and child welfare

• Established by Indian Legislature Act, 1920
• Three objectives:
  1. Improvement of health
  2. Prevention of disease
  3. Mitigation of suffering
• Activities: peacetime military hospital amenities, disaster relief (milk, medicines, vitamins), MCH services
• Junior Red Cross - active youth wing

Nobel Prize: Henry Dunant was awarded the first Nobel Peace Prize in 1901

HIGH-YIELD EXAM POINTS AT A GLANCE

Exam writing tip: For a 5-mark short note, write: 1 line definition + establishment + structure/governance + functions (4-5 points) + one high-yield fact. Tables save space and score well. For a 10-mark long answer, expand each function with examples and add comparison table at the end.

PANCHAYATI RAJ

SHORT NOTE — EXAM FORMAT (PSM / Community Medicine, 3rd Year MBBS)

DEFINITION

HISTORICAL BACKGROUND

Exam tip: The Balwant Rai Mehta Committee (1957) is credited with recommending the 3-tier Panchayati Raj structure. The 73rd Amendment Act 1992 gave it constitutional status and made it mandatory for all states.

3-TIER STRUCTURE

DISTRICT LEVEL   →   Zilla Parishad / Zilla Panchayat
BLOCK LEVEL      →   Panchayat Samiti / Janpada Panchayat
VILLAGE LEVEL    →   Gram Panchayat / Gram Sabha

TIER 1 - VILLAGE LEVEL

(a) Gram Sabha

• Assembly of all adult members of the village
• Meets at least twice a year
• Functions: considers proposals for taxation, discusses annual programmes, elects members of the Gram Panchayat

(b) Gram Panchayat

• Executive organ of the Gram Sabha
• Agency for planning and development at the village level
• Strength: 15 to 30 members; population covered: 5,000 to 15,000 or more
• Members hold office for 3 to 4 years
• Has an elected President (Sarpanch / Sabhapati / Mukhiya), Vice-President, and Panchayat Secretary
• Functions of Panchayat Secretary cover the entire field of civic administration including sanitation, public health, and social and economic development

(c) Nyaya Panchayat

• Judicial arm at village level
• Deals with minor civil and criminal disputes of the village

TIER 2 - BLOCK LEVEL

• Agency: Panchayat Samiti (also called Janpada Panchayat)
• A block consists of approximately 100 villages and a population of 80,000 to 1,20,000

• All Sarpanchas (heads) of village panchayats in the block
• MLAs and MPs residing in the block area
• Representatives of women, Scheduled Castes, Scheduled Tribes, and cooperative societies
• Block Development Officer (BDO) - ex-officio secretary

TIER 3 - DISTRICT LEVEL

• Agency: Zilla Parishad / Zilla Panchayat
• Rural local self-government at the district level

• All heads of Panchayat Samitis in the district
• MPs and MLAs of the district
• Representatives of SCs, STs, and women
• 2 persons with experience in administration/public life/rural development
• Collector of the district - non-voting member
• Membership: 40 to 70 members

SIGNIFICANCE / FUNCTIONS OF PANCHAYATI RAJ

1. Democratic decentralization - power to the people at grassroots
2. All development programmes are channelled through these bodies
3. Strengthens democracy at its roots
4. Ensures effective people's participation in governance
5. Supervision of public health, sanitation, and rural development
6. Implementation of health programmes - MCH, immunization, environmental sanitation
7. Maintenance of vital statistics at village level
8. Coordination with Primary Health Centres

73rd CONSTITUTIONAL AMENDMENT ACT, 1992 (KEY EXAM POINT)

• Gave constitutional status to Panchayati Raj institutions
• Made it mandatory for all states to establish 3-tier Panchayati Raj
• Provided for reservation of seats for SCs, STs, and women (not less than 1/3 seats)
• Fixed 5-year term for Panchayat bodies
• Established State Finance Commission and State Election Commission
• Added 11th Schedule to the Constitution listing 29 subjects under Panchayat jurisdiction (including health and sanitation)

ROLE OF PANCHAYATI RAJ IN HEALTH

HIGH-YIELD EXAM FACTS AT A GLANCE

Exam writing tip: For a 5-mark short note - Definition + 3-tier structure (one line each) + brief role in health + one key fact (73rd Amendment / Balwant Rai Mehta). For a 10-mark answer - expand each tier fully with composition and functions, add the historical background, 73rd Amendment details, and role in health as a separate section.

PREVENTION OF MENTAL HEALTH DISORDERS

SHORT NOTE — EXAM FORMAT (PSM / Community Medicine, 3rd Year MBBS)

DEFINITION (WHO)

1. Feels comfortable about himself (self-respect, realistic self-assessment)
2. Feels right towards others (able to love, form friendships, take responsibility)
3. Is able to meet the demands of life (takes decisions, shoulders responsibilities, not overwhelmed by emotions)

BURDEN OF MENTAL DISORDERS (Key Statistics - Exam Favorite)

• Mental, neurological, and substance use disorders account for 13% of total global burden of disease
• Depression alone accounts for 4.3% of global burden and causes 11% of all years lived with disability worldwide
• Cumulative global economic impact estimated at US$ 16.3 trillion between 2011 and 2030

CAUSES OF MENTAL ILL-HEALTH (Epidemiological Triad)

PREVENTION - LEVELS (Leavell and Clark)

I. PRIMARY PREVENTION

• Mental health education in schools, colleges, and workplaces
• Life skills education - stress management, coping skills, resilience building
• Promotion of healthy family environment and parent-child relationships
• Improvement of socioeconomic conditions (poverty, unemployment reduction)
• Reduction of stigma around mental illness

• Preventing exposure to neurotoxins (lead, mercury)
• Prevention of alcohol and drug abuse
• Safe working environments (occupational mental health)

II. SECONDARY PREVENTION

1. Early diagnosis - case detection through OPDs, screening, community surveys
2. Prompt treatment - pharmacological (psychoactive drugs) and non-pharmacological
3. Group and individual psychotherapy
4. Mental health education to reduce health-seeking delay
5. Community mental health services close to patient's home
6. OPD and indoor psychiatric services at district level

Key fact: Since 95% of psychiatric cases can be treated with or without hospitalization close to their homes, integration of psychiatric services with general health services is the current trend.

III. TERTIARY PREVENTION

1. Rehabilitation - social, vocational, psychological
2. After-care services - follow-up, day care centers, halfway homes
3. Foster home placement and home visiting
4. Occupational therapy and reintegration into society
5. Community Mental Health Programme - includes:
   • In-patient and out-patient services
   • Partial hospitalization
   • Emergency services
   • Diagnostic services
   • Pre-care and after-care services
   • Education, training, research and evaluation

NATIONAL MENTAL HEALTH PROGRAMME (NMHP)

1. Availability and accessibility of minimum mental health care - especially for vulnerable/underprivileged
2. Encourage application in general health and social development
3. Promote community participation and self-help

1. Integration of mental health with Primary Health Care
2. Provision of tertiary care institutions
3. Eradicating stigma; protecting rights via Central/State Mental Health Authorities

• School mental health services - life skills education, counselling
• College counselling services - through trained teachers/counsellors
• Workplace stress management - formal and informal sectors
• Suicide prevention services - counselling centres, helplines, sensitization workshops

WHO COMPREHENSIVE MENTAL HEALTH ACTION PLAN 2013-2020

1. Strengthen leadership and governance
2. Provide comprehensive community-based mental health services
3. Implement strategies for promotion and prevention
4. Strengthen information systems, evidence and research

HIGH-YIELD EXAM POINTS AT A GLANCE

Exam writing tip: For a 5-mark short note - define, write the three levels of prevention (2-3 points each), mention NMHP year (1982) and one national/global fact. For a 10-mark long answer - add the full epidemiological causes, detailed lifecycle-based primary prevention, full NMHP objectives and strategies, and DMHP components as a separate section.