It is the small topic from the 3rd unit of Bsc nursing, delivery of community health nursing , in which u will come to know about organization, staffing and functions of rural health services provided by Govt.

1. KIDWAI COLLEGE OF NURSING
Sub: Community Health Nursing
Unit: Delivery Of Community Health Services
Topic: Organization, Staffing & Functions of Rural Health
Services Provided by Govt.
Submitted By:
Amrutha P
4th year BSc Nursing,
Kidwai college of nursing,
Bangalore.

2. INTRODUCTION
• In 1977, the Government of India launched a Rural Health Scheme,
based on the principle of “placing people’s health in people’s hands”.
• It is a three tier system of health care delivery in rural areas based on the
recommendation of the Shrivastav Committee in 1975.
• Close on the heels of these Recommendations an International
conference at Alma-Ata in 1978, set the goal of an acceptable level of
Health for All the people of the world by the year 2000 through primary
health care approach.

3. State Level
District
Level
CHC
PHC
Sub centre
Village Level
Central Level
Organization of Health Services In India

4. Village Level:
At village level, Elementary services are:
Village health guides
Local dais
Anganwadi workers
ASHA

5. Functions of Village health guides:
1.Provide treatment for common minor aliments
2.First aid during accidents and emergency
3.MCH care
4.Family planning
5.Health education

6. Sub Centre
• The sub-centre is the peripheral outpost of the existing health delivery
system in rural areas.
• They are being established on the basis of one sub-centre for every
5000 population in general and one for every 3000 population in hilly,
tribal and backward areas.
• As of March 2008, 146,036 sub-centres were established in the
country.

7. Currently, a sub-centre is staffed by
• One Female Health Worker known as Auxiliary Nurse Midwife (ANM) and
• One Male Health Worker known as Multi Purpose Worker (Male),
• One, Health Assistant (Female) known as Lady Health Visitor (LHV) and
• One Health Assistant (Male) located at the PHC level are entrusted with the
task of supervision of six sub-centres under a PHC.
Staffing:

8. • Maternal and child health
• Family planning
• Immunization
• Nutritional services
• Control over communicable
diseases
• Records of vital statistics
Functions:

9. Primary health centre
• The concept of primary health centre is not new to India.
• The Bhore committee in 1946 gave the concept of a primary health centre as
a basic health unit, to provide, as close to the people as possible,
• an integrated curative and preventive health care to the rural population
with emphasis on preventive and promotive aspects of health care.
• The Bhore Committee aimed at having a health centre to serve a population
of 10,000 to 20,000 with 6 medical officers, 6 public health nurses and other
supporting staff.
• But in view of the limited resources, the Bhore Committee's
recommendations could not be fully implemented, even after a lapse of 60
years.

10. Staffing:
Personnel Strength
Medical Officer 01
Pharmacist 01
Nursing Officer 01
Health worker / ANM 01
Block extension educator 01
Health assistant Male 01
Health assistant female 01
Upper division clerk 01
Lower division clerk 01
Lab technician 01
Diver 01
Class 4 04
Total 15

11. 1. Medical care
2. MCH including family planning
3. Safe water supply and basic sanitation
4. Prevention and control of locally endemic diseases
5. Collection and reporting of vital statistics
6. Education about health
7. National Health Programmes – as relevant
8. Referral services
9. Training of health guides, health workers, local dais and Health assistants
10. Basic laboratory services
Functions

12. COMMUNITY HEALTH CENTRE
• As on 31st March 2008, 4276 community health centres Were established by upgrading the
primary health centres.
• Each community health centre covering a population of 80,000 to 1.20 lakh with 30 beds and
specialists in surgery, medicine, obstetrics and gynaecology, and paediatrics with X-ray and
laboratory facilities.
• For strengthening preventive and promotive aspects of health care, a new non-medical post
called community health officer has been created at each community health centre.
• The community health officer is selected from amongst the supervisory category of staff at the
PHC and district level with minimum of 7 years experience in rural health programmes.
• Some states have not accepted this scheme and have opted for a second medical officer .

13. The specialists at the community health centre may refer a
patient directly to the State level hospital or the nearest/
appropriate Medical College Hospital, as may be necessary,
without the patient having to go first to the sub-divisional or
District Hospital.

14. Personnel Strength
Nursing Officer 19
Medical Officer 4
Public Health Nurse 1
Pharmacist 3
Health worker / ANM 1
Lab. Technician 3
Ophthalmic Assistant 1
Ward boys 5
Sweepers 5
Chowkidar 5
Dhobi 1
Mali 1
STAFFING

15. Aya 5
Peon 2
OPD attendant 1
Registration Clerk 2
Data entry operator 2
Accountant 1
OT Technician 1
Total 64

16. • Routine and emergency care in surgery, medicine, obstetrics and gynecology, and pediatrics,
in addition to services for the National Health Programmes.
• To provide specialist services and referral services to four PHCS area.
• 24 hour delivery services.
• Full range of family planning services.
• RTI/STI services and ICTC for HIV/AIDS.
• MTP services
• School health services and Adolescent health service.
• Referral transport services
• Cold chain maintenance for vaccines.
FUNCTIONS:

17. • Designated microscopy centre for TB.
• Essential laboratory and X-ray services.
• In-patient services.
• Dental health services.
• Blood storage facility.
• Training and continuing education of health teams.
• To elicit community participation.
• To enhance public private partnership
• To organize behaviour change communication activities.

18. district hospital
The term District Hospital is used here to mean a
hospital at the secondary referral level responsible
for a district of a defined geograpfical area
containing a defined population.

19. There are proposals to convert the district hospital into District Health Centre .
A hospital differs from a health centre in the following respects
• In a hospital, services provided are mostly curative;
• In a health centre, the services are preventive, promotive and curative all integrated
• A hospital has no catchment area, i.e., it has no definite area of responsibility. Patients may be
drawn from any part of the country.
• A health centre, on the other hand, is responsible for a definite area and population
• The team consists of only the curative staff, i.e., doctors, compounders, nurses, etc.
FUNCTIONS