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Iphs for subcentre

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IPHS Standard for Undergraduates Class

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Iphs for subcentre

  1. 1. Indian Public Health Standards (IPHS) Guidelines for Sub-Centres Revised 2012 Dr Deepak Upadhyay MBBS, MD, MBA(HCSM) Department of Community Medicine Rohilkhand Medical College & Hospital
  2. 2. Background • One of the important components of National Rural Health Mission(NRHM) is to strengthen the Sub-centres to the level of Indian Public Health Standards (IPHS), which were first prescribed in early 2007 • September 2005, a total of 1,46,027 sub- centres are functional in the country • There are 1,47,069 Sub-centers functioning in the country as on March 2010 as per Rural Health Statistics Bulletin, 2010.
  3. 3. Objectives of IPHS • To specify the minimum assured (essential) services that Sub-centre is expected to provide and the desirable services which the states/UT s should aspire to provide through this facility • To maintain an acceptable quality of care for these services • To facilitate monitoring and supervision of these facilities • To make the services provided more accountable and responsive to people’s needs
  4. 4. Categorization of Sub-Centres • Type A: Provide all recommended services except that the facilities for conducting delivery will not be available. • Type B: Provide all recommended services including facilities for conducting deliveries at the Sub-centre itself. – They will be expected to conduct around 20 deliveries in a month. – They should be provided with all labour room facilities and equipment including Newborn care corner
  5. 5. Manpower requirement (2012 guideline)
  6. 6. Manpower requirement (2007 guideline)
  7. 7. Services to be Provided 1.Maternal Health: Antenatal care: • Early registration of all pregnancies, within first trimester (before 12 week of Pregnancy) • Minimum 4 ANC including Registration • Recording tobacco use by all antenatal mothers. • Urine Test for pregnancy confirmation and linkages with PHC for other required tests. • Name based tracking of all pregnant women for assured service delivery.
  8. 8. • Provide information about provisions under current schemes and programmes like Janani Suraksha Yojana. • Identification & basic management of STI/RTI. • Counselling & referral for HIV/AIDS Intra natal care: • Essential for Type B Sub-centre • Managing labour using Partograph. • Identification and management of danger signs during labour. • Proficient in identification and basic fist aid treatment for PPH, Eclampsia, Sepsis and prompt referral
  9. 9. Post natal care: • Ensure post- natal home visits on 0,3,7 and 42nd day for deliveries at home and sub- centre ( both for mother & baby). • Ensure 3, 7 and 42 day visit for institutional delivery (both for mother & baby) cases • In case of Low Birth weight Baby (less than 2500 gm), additional visits are to be made on 14, 21 and 28 days • Tracking of missed and left out PNC
  10. 10. 2.Child Health • Newborn Care Corner In The Labour Room to provide Essential Newborn Care( essential in type B) • Promotion of exclusive breast-feeding for 6 months. Appropriate and adequate complementary feeding from 6 months of age while continuing breastfeeding. • Assess the growth and development of the infants and under 5 children and make timely referral. • Immunization Services • Identification and follow up, referral and reporting of Adverse Events Following Immunization (AEFI).
  11. 11. 3. Family Planning and Contraception 4. Safe abortion services (MTP) 5. Curative Services – Essential • Provide treatment for minor ailments including fever, diarrhea, ARI, worm infestation and first aid to animal bite cases, care of the wound assessment and referral). – Desirable • Once a month clinic by the PHC medical officer
  12. 12. 6. Adolescent Health Care 7. School Health Services: – Screening – Treatment of minor ailments – Immunization – De-worming – Prevention and management of Vitamin A and nutritional deficiency anemia – Referral services through fixed day visit of school by existing ANM/MPW 8. Control of Local Endemic Diseases
  13. 13. 9. Disease Surveillance, Integrated Disease Surveillance Project (IDSP) 10.Water and Sanitation Desirable : o Disinfection of drinking water sources o Testing of water quality using Rapid Test (Bacteriological) o Promotion of sanitation including use of toilets and appropriate garbage disposal
  14. 14. 11.Out reach/Field Services • VHND should be organised at least once in a month in each village • Home Visits: – Essential :To check out on disease incidences reported to HW. Notify the M.O PHC immediately about any abnormal increase in cases of diarrhoea/dysentery, fever with rigors, fever with rash, flaccid paralysis of acute onset in a child <15 years (AFP), Tetanus, fever with jaundice or fever with unconsciousness, minor and serious AEFIs which she comes across during her home visits – Desirable :Visits to houses of eligible couples who need contraceptive services, but are not currently using them
  15. 15. • House-house survey: done once annually, preferably in April. The Male multipurpose worker would take the lead and be accountable for the organization of these surveys and the subsequent preparation of lists and referrals 12.Coordination and Monitoring: • Coordinated services with AWWs, ASHAs, Village Health Sanitation and Nutrition Committee PRI etc
  16. 16. National programmes • Communicable disease programmes – National AIDS Control Programme (NACP) – National Vector Borne Disease Control Programme (NVBDCP) – National Leprosy Eradication Programme (NLEP) – Revised National Tuberculosis Control Programme (RNTCP)
  17. 17. National programmes Non-communicable Disease (NCD) Programmes • National Programme for Control of Blindness (NPCB) • National Programme for Prevention and Control of Deafness (NPPCD) • National Mental Health Programme • National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke • National Iodine Deficiency Disorders Control Programme • National Tobacco Control Programme • National Programme for Health Care of Elderly
  18. 18. logistics • Two drug kits – A & B SNo Kit A Kit B 1 ORS powder Methylergometrine tablets 2 IFA tablets (Large) Methylergometrine Injections 3 IFA tablets (Small) Paracetamol tablets 4 IFA Syrup Albendazole tablets 5 Folic acid tablets Dicyclomine tablets 6 Cotrimoxazole (Pediatric) tablet Chloramphenicol Eye Ointment 7 Zinc Tablets Povidone Iodine Ointment 8 Vitamin A Syrup Cotton bandage 9 GV Crystals (Methylrosanilinium Chloride) Absorbent Cotton
  19. 19. Other Drugs & vaccines • BCG, DPT, OPV, Measles, TT, Hepatitis B, JE and any other vaccines as per Immunization Schedule • Syrup Cotrimoxazole • Tab. Cotrimoxazole 80+400 mg (for adults) • Syrup Paracetamol • Tab. Albendazole 400 mg • Adhesive tape (leucoplast & Micropore) • Savlon solution (Anti-septic Solution) • Betadine solution (Povidone Iodine solution 5%) • Clove oil • Gum paints
  20. 20. Registers at Sub centre 1. Eligible Couple Register including Contraception 2. Maternal and Child Health Register I. Antenatal, intra-natal, postnatal II. under-five register I. Immunization II. Growth monitoring III.Above Five Child immunization IV. Number of HIV/STI screening and referral 3. Births and Deaths Register 4. Drug Register
  21. 21. 5. Equipment Furniture and other accessories Register 6. Communicable diseases / Epidemic Register / Register for Syndromic Surveillance 7. Passive surveillance register for malaria cases 8. Register for records pertaining to Janani Suraksha Yojana 9. Register for maintenance of accounts including untied funds. 10. Register for water quality and sanitation 11. Minor ailments Register 12. Records/registers as per various National Health Programme guidelines (NLEP, RNTCP, NVBDCP, etc.)

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