The document outlines the structure and standards of district health management services in healthcare, detailing the services provided at primary, secondary, and tertiary care levels. It emphasizes the Minimum Service Delivery Standards (MSDS) to ensure quality healthcare, covering access, patient care, medication management, patient rights, and infection control. Additionally, it discusses the role of a district health information system (DHIS) in data collection, analysis, and quality improvement for effective healthcare delivery.

1. DISTRICT HEALTH MANAGEMENT
1. Healthcare Services Delivered at Different Tiers of District
Health Management Services {Minimum Service Delivery
Standards}
2. Health Information System at District Level.

2. Healthcare Services Delivered at Different Tiers
of District Health Management Services
Levels of Health Care :
• Primary (BHU, RHC, LHWS ) 60-80 per district
• Secondary (THQ, DHQ hospitals) 1-4 per district
• Tertiary (Teaching hospitals) 1-3 per division

3. Primary Healthcare (PHC) Level:
• Basic Health Services:
Primary healthcare is the foundation of the healthcare
system and includes services such as preventive care,
health education, maternal and child health services,
family planning, immunizations, and treatment for
common illnesses.
• Routine Medical Care:
Basic medical care for common ailments like colds, fevers,
minor injuries, etc.

4. Primary Healthcare (PHC) Level:
• Immunization Programs:
Administering vaccines to prevent communicable
diseases.
• Antenatal and Postnatal Care:
Providing care to pregnant women before and after
childbirth.
• Family Planning Services:
Offering contraceptive methods and counseling.

5. Secondary Healthcare Level:
• Specialist Consultations:
Services provided by specialists such as gynecologists,
pediatricians, surgeons, etc.
• Diagnostic Services:
Advanced diagnostic tests like X-rays, ultrasounds, CT
scans, blood tests, etc.

6. Secondary Healthcare Level:
• Minor Surgical Procedures:
Surgeries that are relatively simple and don't require
highly specialized facilities.
• Rehabilitation Services:
Physiotherapy and rehabilitation programs for patients
recovering from injuries or surgeries.

7. Tertiary Healthcare Level:
• Highly Specialized Medical Care:
Treatment for complex and rare diseases provided by
specialized hospitals and medical centers.
• Intensive Care Units (ICUs):
Critical care units for patients with life-threatening
conditions.

8. Tertiary Healthcare Level:
• Organ Transplant Services:
Facilities for organ transplantation including kidney, liver,
heart, etc.
• Medical Research and Teaching Institutions:
Centers focused on medical research, training healthcare
professionals, and developing new treatments and
technologies.

9. Minimum Service Delivery Standards
• The Minimum Service Delivery Standards (MSDS) define a
set of the benchmarks for minimum level of mandatory
services that a healthcare establishment (HCE) is
responsible to achieve and patients have a right to
expect.
• It's a set of important standards for all kinds of healthcare
facilities. These guidelines cover everything involved in
healthcare, like medicine, nursing, and more. The main
goal is to make sure that everyone gets good quality
healthcare services.

10. Minimum Service Delivery
Standards
Minimum Service Delivery Standards are like a set of rules or guidelines
that healthcare providers follow to make sure they're giving good care
to patients
• Minimum: This means the smallest or least amount needed. So, these
are the basic things that must be done to provide good care.
• Service Delivery: This refers to how healthcare services are provided to
patients. It includes things like seeing a doctor, getting medicine, or
receiving treatment.
• Standards: These are like rules or expectations. They set a level of
quality that healthcare providers should meet.
It's kind of like having a checklist of things they need to do to make
sure everyone gets the care they need.

11. Minimum Service Delivery Standards
The standards prescribed in the MSDS cover the following
functional areas for assuring quality healthcare services
delivery:
• Access, Assessment and Continuity of Care (AAC)
• Care of Patients (COP)
• Management of Medication (MOM)
• Patient Rights and Education (PRE)
• Hospital Infection Control (HIC)

12. Access, Assessment and
Continuity of Care (AAC)
Access, Assessment, and Continuity of Care (AAC) are essential
principles in healthcare that ensure patients can easily get the care they
need, that their healthcare needs are properly evaluated, and that their
care is coordinated and consistent over time.
• Access: This is about how easily people can get healthcare when they
need it.
• Assessment: This means understanding what's wrong with someone's
health and how to help them.
• Continuity of Care: It's about keeping healthcare consistent and
organized over time, so people get the right care at the right times.

13. Care of Patients (COP)
It Includes that patients receive safe, satisfying, and effective care
during their healthcare journey.
• Patient Safety: This measures how well healthcare providers keep
patients safe from harm during treatment, like avoiding mistakes in
medication or preventing falls.
• Patient Satisfaction: This checks if patients are happy with the care
they receive, like whether they feel listened to by their doctors or if they
understand their treatment plans.

14. Management of Medication
(MOM)
It includes that medications are prescribed accurately, used safely, and
that patients understand how to take them correctly for better health
outcomes.
• Prescription Accuracy: This checks if prescriptions are written correctly,
with the right medication, dosage, and instructions.
• Adherence Monitoring: This tracks if patients are taking their
medications as prescribed, which helps ensure they get the full benefits
of treatment.
• Patient Education: This assesses if patients understand how to take
their medications properly

15. Patient Rights and Education (PRE)
Patient Rights indicators ensure fair treatment and privacy, while
Patient Education indicators measure how well patients understand
their health and treatment options.
• Patient Rights: These indicators focus on making sure patients are
treated fairly and respectfully. They measure things like whether
patients have the right to make decisions about their own healthcare
and whether their privacy and confidentiality are protected.
• Patient Education: These indicators look at how well patients
understand their health conditions and treatments.

16. Hospital Infection Control (HIC)
Hospital Infection Control (HIC) indicators are simple measures that
show how well hospitals are preventing the spread of infections among
patients, staff, and visitors.
• Hand Hygiene Compliance: Checking if healthcare workers are
washing their hands properly and regularly to stop germs from
spreading.
• Surface Cleaning Frequency: Monitoring how often hospital surfaces
and equipment are cleaned and disinfected to reduce the risk of
spreading germs.
• Staff Vaccination Rates: Checking how many hospital staff members
have received vaccinations against infectious diseases like the flu, which
can help protect both staff and patients.

17. Health Information System at District Level.
Introduction :
A District Health Information System (DHIS) is a
computerized system designed to collect, manage,
analyze, and disseminate health-related data specific to a
district-level healthcare setting.

18. Role of District HIS
• Data Collection:
HIS gathers comprehensive health data from various
sources, including patient records, diagnostic tests, and
population health surveys.
• Storage:
It stores health data securely in electronic formats,
replacing traditional paper-based systems and enabling
easy access and retrieval.

19. Role of District HIS
• Analysis:
Utilizes data analysis tools to identify trends and insights,
aiding in decision-making and resource allocation.
• Dissemination:
Facilitates sharing of health information through
standardized reports and communication channels
among stakeholders.

20. Role of District HIS
• Decision Support:
Offers real-time access to patient information , assisting
healthcare professionals in delivering optimal care.
• Quality Improvement:
District HIS facilitates continuous quality improvement
initiatives by tracking performance indicators and
outcomes.

21. Importance of Health Information
System (HIS) at District Level
• Improved healthcare service delivery
• Enhanced decision-making
• Effective resource allocation
• Monitoring health trends and disease outbreaks
• Improved Health Outcomes

22. Capacity Building
• Implementation of education and training to
continuously improve knowledge and skills at all levels
• Implement capacity building programs to enhance IT
skills among healthcare staff.

23. Future direction for district HIS
• Mobile health (mHealth):
Expanding access to healthcare services in remote areas
through mobile technology.
• Telemedicine:
Improving healthcare accessibility with remote
consultations and diagnosis via telemedicine platforms.

24. Flow chart of Health Information system from
FLW to District level
Front line
workers
(LHW & CHW)
Facility Staff
(BHU & RHC)
Data entry
operators
IT Support Staff
District Health
Officers
Health
Information
Management
Staff
Monitoring
Team
Capacity
Building Staff