Shrivastava Committee, officially known as “Group on Medical Education and Support Manpower,” was established by Government of India in November 1974.
Under chairmanship of Dr. J.B. Shrivastava, then Director General of Health Services, committee was tasked with reviewing health services and medical education system of country. Its report, submitted in 1975, laid conceptual foundation for modern community-based healthcare in India.
Objectives
Committee was formed to address disconnect between urban-centric medical education and actual needs of India’s rural population. Its primary goals included:
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Shifting focus from purely curative, hospital-based training to preventive and community health.
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Developing a curriculum for Health Assistants to bridge gap between doctors and field-level workers.
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Community Involvement: Creating a system where health care is “placed in hands of the people.”
Recommendations
Shrivastava Committee is known for introducing concept of Village Health Guide and three-tier healthcare delivery system.
1. Village Health Guides (VHGs)
Committee recommended creating a band of paraprofessional and semiprofessional health workers from within community itself.
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Workers like school teachers, postmasters, and gram sevaks were to be trained.
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To provide simple promotive, preventive, and basic curative services at the village level.
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This concept eventually evolved intoAccredited Social Health Activist (ASHA) program used today.
2. Three-Tier System
To streamline path from village to hospital, committee proposed a clear hierarchy:
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Tier 1: Village level (Community Health Volunteers/Guides).
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Tier 2: Sub-center and Primary Health Center (PHC) level (Multipurpose Workers and Health Assistants).
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Tier 3: Referral level (Specialized hospitals and medical colleges).
3. Referral Services
Committee suggested that medical colleges should not exist in isolation. Instead, they should be linked with PHCs and district hospitals to form a National Referral Services, ensuring that rural patients could access specialist care when needed.
4. Medical and Health Education Commission
It recommended establishment of a dedicated commission (similar to University Grants Commission) to plan and implement reforms in medical and health education specifically for Indian context.
Impact
Following committee’s report, Government of India launched Rural Health Scheme in 1977.
While not all recommendations were implemented perfectly—for instance, the “Health Guide” scheme faced funding and administrative hurdles in various states. It successfully shifted national dialogue from “doctors in cities” to “health workers in villages,” a move that remains vital for achieving Universal Health Coverage in India.