Literature study that deals with the terminologies concerned to any community health Centre

1. TERMINOLOGIES
COMMUNITY HEALTH CENTER
Community health centres are community-based and patient-directed
organisations that serve populations with limited access to health care.
NOTE – ALL THESE TERMINOLOGIES AND STANDARDS ARE BASED ON THE
IPHS AND DELHI BUILDING BYELAWS GUIIDLINES.

2. DIFFERENT ZONES IN A CHC
1. Entrance Zone
2. Administrative Zone
3. Diagnostic Zone
4. Intermediate Zone (inpatient Nursing units)
5. Critical Zone (Operational Theatre/Labour room)
6. Service Zone
7. Ambulatory Zone

3. DIFFERENT ZONES IN A CHC
1. Entrance Zone
Registration & Record storage,Pharmacy (Issue counter/formulation/drug storage) Public
utilities & circulation space.
ENTRANCE ZONE
RECEPTION AREA ENQUIRY
COUNTER
PHARMACYREGISTRATION
AND RECORD
AREA
PUBLIC
UTILITIES
(WASHROOMS)
CIRCULATION

4. 2. Administrative Zone
General Administration, general-store, public utilities circulation space.
ADMINISTRATIVE ZONE
PUBLIC UTILITIES
(WASHROOMS)
GENERAL
ADMINISTRATION
STAFF LAUNGE

5. 3. Diagnostic Zone
Pathology (Optional) Laboratory, sample collection, bleeding room, washing disinfections
storage, sub waiting. Imaging (radiology, radiography, ultra- sound) Preparation, change,
toilet, control, Dark room-treatment room sub waiting public utilities.
DIAGNOSTIC ZONE
PATHOLOGY LAB SAMPLE
COLLECTION
BLEEDING
ROOM
WASHING AND
DISINFECTION
STORAGE
UTILITIES IMAGING
-CHANGING
ROOM
-TOILETS
RADIOLOGY,
RADIOGRAPHY,
ULTRA SOUND,
DARK ROOM

6. 4. Intermediate Zone (inpatient Nursing units)
Nursing station(Nurse desk,clean utility , treatment room , pantry ,store, sluice room
,trolly bay) patient area(bed space, toilets, Day space, Isolation Space) Ancillary rooms
(Doctor's rest room, Nurses duty room, Public utilities ,circulation space.
INTERMEDIATE ZONE
NURSING STATION PATIENT AREA ANCILLARY ROOMS
nurse desk, clean
utility, pantry,
treatment room,
store, troll bay
bed space, toilet,
day space,
isolation space
doctor rest room,
nurse duty room

7. 5. Critical Zone (Operational Theatre/Labour room)
Patient area (Preparation, Preanaesthesia, post operative resting ) Staff area (Changing
Resting ) Supplies area (trolley bar, equipment storage ,sterile storage) OT/LR area
(Operating /Labour room, scrub, instrument sterilisation, Disposal) public utilities,
circulation space
ENTRANCE ZONE
PATIENT AREA STAFF AREA SUPPLIES AREA OT/LR AREA UTILITIES
toilet, changing
room
preparation,
preanesthesia,
post operative
resting
changing room,
resting room
trolley bar,
equipment
storage,
sterilisation area
operation
theatre,
maternity ward,
nursery,
sterilisation and
disposal

8. 6. Service Zone
SERVICE ZONE
DIETARY CENTRAL STERILE
SERVICES
DEPARTMENT
LAUNDRY WATER SUPPLY,
DRAINAGE AND
SANITATION
Space for other
service like ,gas
store, Telephone
intercom fire
protection , waste
disposal, Mortuary
Dry Store, Day
Store,
Preparation,
Cooking,
Delivery, pot
wash, Utensil
wash, Utensil
store, trolley park
Receipt, wash,
assembly,
sterilisation,
sterile storage
weigh,
sluice/wash,
Hydro extraction,
tumble, calendar,
press
Services like Electrical
engineering
/Mechanical
engineering & civil
engineering can be
privately hired to avoid
permanent space in the
CHC building

9. 7. Ambulatory Zone
Examination & Workup(Examination Room, sub waiting), Consultation(consultation room
Toilets, subwaiting) Nursing station (utility, treatment rooms, Cold Chain, Vaccines and
public utilities, circulation) Nurses desk, clean utility, dirty utility,treatment
rooms,injection & dressing room),Logistics area, ECG (subwaiting,
Casualty/Emergency,space
AMBULATORY ZONE
EXAMINATION
AND WORKUP
ECG CASUALTY/E
MERGENCY
NURSING
STATION
CONSULTATION LOGISTICS
AREA
Examination
Room, sub
waiting
consultation
room, Toilets,
sub-waiting
utility, treatment rooms, Cold Chain,
Vaccines and public utilities,
circulation, Nurses desk, clean utility,
dirty utility, treatment rooms injection
& dressing room

10. BASIC TERMS RELATED TO CHC
Outpatient
a patient who attends a hospital for treatment without staying there overnight.
Inpatient
a patient who is residing in the hospital where he is being treated
Unit
A a department of an institution, especially a hospital, that has a particular purpose
Ward
a large room in a hospital with beds for people to stay in
ICU
an intensive care unit in a hospital

11. Nursery
an area in a hospital where new babies are looked after until they go home
Housekeeping
the department of a hotel or hospital that is responsible for cleaning rooms
Dispensary/Pharmacy
a place in a hospital where you can get medicines and drugs
Hospital pharmacy is the organization or department of the hospital to manage the
procurement, storage, preservation, packaging, sterilisation, compounding, preparation,
dispensing or distribution of medicine in the hospital.

12. Different rooms/wards in a CHC
OUTPATIENT DEPARTMENT (OPD)
An OPD is a hospital department designed to be a first contact point between the patient
and the hospital staff. A Patient who goes first time to the hospital, he directly goes to
OPD and then the OPD decides to which department a patient should go.
Consulting room
a room where a doctor examines a patient and discusses their medical problems with them
OPERATION THEATRE
An operating theatre is a special room in a hospital where surgeons carry out medical
operations.
High Dependency Unit
the department of a hospital for people who are very ill or badly injured, but need less
care than people in intensive care

13. Nursing Station
The nursing station shall be centered such that it serves all the clinics from that place.
The nursing station should be spacious enough to accommodate a medicine chest / a
work counter (for preparing dressings, medicines), hand washing facilities, sinks, dressing
tables with screen in between and colour coded bins , (As per standard biomedical waste
disposal guidelines) to hold soiled material. It should have provision for Needle cutter
and syringe destroyers
Emergency Room/ Casualty/A&E Department
an emergency department (ED), also known as an accident & emergency department (A&E),
emergency room (ER), emergency ward (EW) or casualty department, is a medical treatment
facility specializing in emergency medicine, the acute care of patients who present without
prior appointment; either by their own means or by that of an ambulance. It is
recommended to have a separate earmarked emergency area to be located near the
entrance of hospital preferalbly having 4 rooms (one for doctor, one for minor OT, one for
plaster/dressing) and one for patient observation (At least 4 beds).

14. X ray room
The radiology department may also be called the X-ray or imaging department. It is the
facility in the hospital where radiological examinations of patients are carried out
Labour room/Maternity Ward
The labor room is one of the most versatile rooms in a hospital. It is called a labor, delivery,
and recovery room (LDR). This is the type of room that some hospitals and almost all birth
centers use for their care. Once you are placed in a room, this is the room that you will use
for your labor and birth, including the initial hours of recovery.
Blood storage
The blood storage centres are designed to ensure rapid and safe delivery of whole blood in
an emergency. The detail of storage of packed cells, fresh frozen plasma and platelets
concentrate, are therefore not given in these guidelines.

15. FROM
DELHI BUILDING BYELAWS
While designing the COMMUNITY HEALTH CENTRE, we need to follow some standards and norms
which are mentioned in the DELHI BULDING BYELAWS, some of those are as follows :-
1.BASEMENT
❖ Basement(s) up to setback line maximum equivalent to parking and services requirement, such as Air
Conditioning Plant, water storage, electric Sub-station, mechanical services and firefighting equipments etc.
are not counted in FAR. However, the area provided for services should not exceed 30% of the basement
area.
❖ The mezzanine floor and service floor wherever provided shall be considered as a part of the total FAR.
❖ The height of Service floor in the building shall be limited to 1.8m.
❖ In case of provision of stack-parking in stilt floor or basement, minimum height should be 2.5m.
❖ If the building is constructed with stilt area of non-habitable height (2.4mts) and is proposed to be used for
parking, landscaping, etc. the stilt floor need not be included in FAR.
❖ The ESS, firefighting installations and underground water tank shall neither be counted in ground coverage
nor in FAR.

16. 2. PARKING
• In existing buildings having plot area of more than 2000sqm; an extra ground
coverage of 5% shall be permissible for construction of automated multi-level
parking to provide dedicated parking structures for additional needs.
• SPACES REQUIRED FOR CAR PARKING :-
NOTE – These spaces include movement and rotation space for the vehicles.

17. 3. EXIT
• All exists shall be free of obstructions.
• Exits shall be clearly visible and the routes to reach
exits shall be clearly marked and signs posted to guide
the occupants of floor concerned.
• Firefighting equipment where provided along exits
shall be suitably located and clearly marked but must
not obstruct the exit way and there should be clear
indication about its location from either side of the
exit way.
• Alarm devices shall be installed to ensure prompt
evacuation of the occupants concerned through the
exits, wherever required.
• All exits shall provide continuous means of egress to
the exterior of a building or to an exterior open space
leading to a street.
TYPES OF EXITS
HORIZONTAL VERTICAL
❑ Lifts/escalators and revolving doors
shall not be considered as exits.
❑ Exits shall be so located so that the
travel distance on the floor shall not
exceed 22.50 m, for residential,
educational, institutional and hazardous
occupancies and 30.0 m.

18. 4. STAIRCASE
• There shall be minimum of two staircases and one of them shall be enclosed stairway and the other shall be on
the external walls of building and shall open directly to the exterior, interior open space or to any open place of
safety.
• Interior stairs shall be constructed of non-combustible material throughout.
• Interior stairs shall be constructed as a self-contained unit with at least one side adjacent to an external wall and
shall be completely enclosed.
• A staircase shall not be arranged round a lift shaft for buildings 15.0 m. and above height.
• Handrails shall be provided with a minimum height of 100 cm. from the centre of the tread.
• The minimum headroom in a passage under the landing of a staircase and under the staircase shall be 2.2 m.
• Minimum Width Provisions for Passageway/Corridors is 2.4m.
• Minimum Width Provisions for Stairways is 2.0m.
• Ramp shall be provided to enter the building.
• Minimum width of ramp shall be 1800 mm.
• Maximum gradient 1:12.
• Length of ramp shall not exceed 9.0 m having 900 mm high hand rail on both
sides extending 300 mm on both sides of ramps.
➢ RAMP

19. 5. DOORWAYS
• No exit doorways shall be less than l00 cm in width and
150 cm in case of hospital and ward block. Doorways
shall not be less than 200 cm in height.
• Exit doorways shall open outwards, that is away front
the room but shall not obstruct the travel along any
exit.
• No door when opened shall reduce the required width
of stairway or landing to less than 100 cm.
• Overhead or sliding door shall not be installed.
• Exit door shall not open immediately upon a flight of
stairs. A landing equal to at least, the width of the door
shall be provided in the stairway at each doorway. Level
of landings shall be the same as that of the floor, which
it serves.
• Exit doorways shall be openable from both the side,
which they serve without the use of a key.
• Revolving doors shall not be allowed.

20. 6. TOILETS
• The minimum size of W.C.
shall be 1075 x 1650 mm
with a minimum depth of
1450 mm from entry door
900 mm.
• Long handrail on the side
closer to W.C. with a clear
width between the
handrails shall be 900 mm
and height of handrails shall
be 800 mm from floor level.
• Minimum size of the clear
door opening shall be 780
mm.
For Toilets Designed for Non-
Ambulant Disabled Small Wheel
Chair :-
• The minimum size of W.C. shall be
1350 x 1500 mm with a minimum
depth of 1500 mm from entry door.
• 900 mm long handrail on the side
closer to W.C. shall be provided.
• To provide movement space for
wheel chair, W.C. seat shall be fixed
towards one side to the opposite
adjacent wall.
• The centerline of W.C. from the
adjacent wall shall be 400 mm and
minimum 950 mm from the other
wall.
• Minimum size of the clear door
opening shall be 780 mm.
• The minimum size of W.C. shall be
1500 X 1750 with a minimum depth
of 1750 mm for entry door.
• 900 mm long handrail on the side
wall closer to W.C. shall be
provided.
• To provided movement space for
wheel chair, W.C. seat shall be fixed
towards one side of the opposite
wall.
• The centerline of the W.C. from the
adjacent wall shall be 400 mm and a
minimum of 1100 mm from the
other wall.
• Min. size of clear door opening shall
be 860 mm.
For Toilets Designed for
Ambulant Disabled :-
For Toilets Designed for Non-
Ambulant Disabled Using Large
Wheel Chair:-

21. • Sanitation Requirements for Institutional (Medical) Occupancy- Hospital
• Sanitation Requirements for Institutional (Medical) Occupancy- (staff quarters and Hostels)