The Health Care Delivery System (HCDS) consists of the governmental (public) and non-governmental (private) health agencies and the facilities they provide for one or more of the three main aspects of comprehensive health care viz., curative, preventive and promotive. The delivery of comprehensive health care in a country like India poses many problems. An adequate network of organisation, particularly governmental, has to be built up. This has to be primarily directed towards delivery of health care in the rural areas with considerable emphasis on preventive and promotive health. Such an organisational set up has to be manned by a large army of personnel with varying types and levels of basic professional education. At present both the know how for practical application of professional knowledge under varying conditions and proper attitude for the same are often inadequate among the health personnel. These can be improved and maintained only on the basis of a long term plan for job training. Permanent facilities should be available so that training of new recruits and staff on promotion/transfer can be taken care of regularly and systematically. Also, refresher courses have to be undertaken regularly to keep the staff abreast of the developments in delivery of health care. At present juncture, Multi Purpose Worker (MPW), community level workers and health assistants in the public sector of HCDS, also require the training.

To make such training more purposeful, it must be emphasised that planning for training has to come well ahead so that implementation of any programme is not unduly delayed due to absence or shortage of properly trained health workers. To illustrate this, the training requirements of the National Tuberculosis Programme (NTP) which is integrated with general health services have been dealt below: Governmental Agency: i)Programme workers who attend patients and community should be trained by the District TB Centre (DTC) key personnel as in service training or on the job training, ii)Programme supporter PHC doctors in addition to being programme workers, DHO, ADHO, ADHS (TB) etc should undergo orientation course for 8 to 9 working days. iii)Trainer Professors and lecturers of preventive & social medicine, tuberculosis and medicine of medical colleges, trainers of central training institute also undergo orientation course for 8-9 days. iv)Research Worker in research methodology for 4 weeks. v)Programme planners & Decision Makers a)Ministers of Health, Secretaries & Directors of Health both at state and central-levels By periodic meetings, personal discussions, participation in Central Council of Health meetings. b)TB Adviser, TB-Officer By periodic meetings, written communication, attending seminars. Similar estimates have to be made for other components of HCDS. Taking all these into consideration, the number of training institutions/facilities which are required to meet all the training needs can be worked out, keeping in view their proper regional or geographic distribution. The next step would be to organise the education and training of private health workers and health consumers. Adequate information for the detailed planning is not available for these two categories. But, a beginning has to be made as quickly as possible.