Launched as recommended by the national health policy 2017
To achieve the vision of universal health coverage (UHC).
This initiative has been designed to meet Sustainable Development Goals (SDGs) and its underlining commitment, which is to "leave no one behind.“
The National Health Mission (NHM) encompasses
its two Sub-Missions, the National Rural Health
Mission (NRHM) and the National Urban Health
Mission (NUHM). The main programmatic
components include Health system strengthening
in rural and urban areas, ReproductiveMaternal-Neonatal-Child and Adolescent Health
(RMNCH+A) and Communicable and NonCommunicable Diseases. The NHM envisages
achievement of universal access to equitable,
affordable & quality healthcare services that are
accountable and responsive to people’s needs.
Health Aspect of 12th five year plan in IndiaVikash Keshri
India's 12th Five year plan is widely believed to be Health Plan. Presentation summarizes the major highlights from Health chapter of 12th Plan of India.
Family health services are the central point of health services.
It is an important component of “Health for All” goal.
Health of each individual affects the health of other member of family.
Launched as recommended by the national health policy 2017
To achieve the vision of universal health coverage (UHC).
This initiative has been designed to meet Sustainable Development Goals (SDGs) and its underlining commitment, which is to "leave no one behind.“
The National Health Mission (NHM) encompasses
its two Sub-Missions, the National Rural Health
Mission (NRHM) and the National Urban Health
Mission (NUHM). The main programmatic
components include Health system strengthening
in rural and urban areas, ReproductiveMaternal-Neonatal-Child and Adolescent Health
(RMNCH+A) and Communicable and NonCommunicable Diseases. The NHM envisages
achievement of universal access to equitable,
affordable & quality healthcare services that are
accountable and responsive to people’s needs.
Health Aspect of 12th five year plan in IndiaVikash Keshri
India's 12th Five year plan is widely believed to be Health Plan. Presentation summarizes the major highlights from Health chapter of 12th Plan of India.
Family health services are the central point of health services.
It is an important component of “Health for All” goal.
Health of each individual affects the health of other member of family.
an insight on medical negligence and certain techniques that can be adopted to ensure that such errors or mistakes can be avoided. Deliberately or not we must always ensure that proper healthcare is provided and received.
This presentation explores some of the factors that influence how long a human being lives, what affects the length of our lives, nutrition effects on life span and how to use diet and nutrition to stay healthy and live long.
This ppt contains all the information about Health system in India / Health Administration. It is useful for students of medical field learning Preventive and social medicine, Swasthavritta (Ayurved) and everyone who is interested in in knowing about it.
An acceptable health care delivery sys- tem should have two primary objectives: (1) it must enable all citizens to access health care services, and (2) the services must be cost-effective and meet certain established standards of quality.
India is a union of 29 states and 7 union territories. Under the constitution of India, the states are largely independent in matters relating to the delivery of health care to the people. Each state, therefore, has developed its own system of health care delivery, independent of the central Government. The central responsibility consists mainly of policy making, planning, guiding, assisting, evaluating and coordinating the work of the State Health Ministries, so that health services cover every part of the country, and no State lags behind for want of these services
health care system is community led topic usefull for nursing students and medical students who can improove their knowledge by reading this slide
bhad me ja aur kitna describtion likhu
Psychosocial care of coronavirus disease 2019Nursing Path
The novel Coronavirus (nCoV) epidemic in 2019 -2020 has recently emerged. The route of transmission is not totally known, although it is known that it can spread from person to person, and local health care systems may be ill-equipped to handle a large-scale outbreak.
The blood electrolytes—sodium, potassium, chloride, and bicarbonate—help regulate nerve and muscle function and maintain acid-base balance and water balance. ... Thus, having electrolytes in the right concentrations (called electrolyte balance) is important in maintaining fluid balance among the compartments
Hospital infection control programs can help healthcare organizations monitor and improve practices, identify risks and proactively establish policies to prevent the spread of infections
Outcome-based education (OBE) is an educational theory that bases each part of an educational system around goals (outcomes). By the end of the educational experience, each student should have achieved the goal.
Assessment is part of the everyday activities of nursing professionals. Assessment is the only way by which a teacher can know how successful his teaching was and what areas in teaching need improvement.
A mental health disorder characterised by feelings of worry, anxiety or fear that are strong enough to interfere with one's daily activities.
The term "anxiety disorder" refers to specific psychiatric disorders that involve extreme fear or worry, and includes generalized anxiety disorder (GAD), panic disorder and panic attacks, agoraphobia, social anxiety disorder, selective mutism, separation anxiety, and specific phobias.
Selection and organization of learning experienceNursing Path
Curriculum is the educational design of learning experiences for the students. Curricular experiences include course content as well as learning activities. The selection and organization of curricular experiences must also reflect the philosophy of the school. The identifying and organizing of curricular experiences begins with the analysis of curriculum objectives. The most commonly used approach in selecting learning experiences is the logical approach in which the process is treated as content in curriculum development.
Universal health coverage (UHC) means that all people and communities can use the promotive, preventive, curative, rehabilitative and palliative health services they need, of sufficient quality to be effective, while also ensuring that the use of these services does not expose the user to financial hardship.
Pneumonia is an inflammatory condition of the lung affecting primarily the small air sacs known as alveoli. Typically symptoms include some combination of productive or dry cough, chest pain, fever, and trouble breathing.
Swine influenza is an infection caused by any one of several types of swine influenza viruses. Swine influenza virus (SIV) or swine-origin influenza virus (S-OIV) is any strain of the influenza family of viruses that is endemic in pigs
Abortion is the ending of pregnancy by removing an embryo or fetus before it can survive outside the uterus. An abortion that occurs spontaneously is also known as a miscarriage.
The enterobacteriaceae basic properties.ppsx xNursing Path
The Enterobacteriaceae are a large family of Gram-negative bacteria that includes, along with many harmless symbionts, many of the more familiar pathogens, such as Salmonella, Escherichia coli, Yersinia pestis, Klebsiella, and Shigella.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
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Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
1. 1www.drjayeshpatidar.blogspot.com
HEALTH CARE DELIVERY SYSTEM IN INDIA:
Introduction:
India is a union of 28 states and 7 union territories. States are largely independent in
matters relating to the delivery of health care to the people. Each state has developed its own
system of health care delivery, independent of the Central Government.
The Central Government responsibility consists mainly of policy making, planning, guiding,
assisting, evaluating and coordinating the work of the State Health Ministries. The health system
in India has 3 main links
1. Central
2. State and
3. Local or peripheral
(1) At the central
The official “organs” of the health system at the national level consist of
1. Ministry of Health and Family Welfare
2. The Directorate General of Health Services
3. The Central Council of Health and Family Welfare
1. Union Ministry of Health and Family Welfare.
Organization Pattern
Cabinet Minister
↓
Department of Health Department of Family Welfare
↓ ↓
Joint Secretary Additional Secretary
↓ ↓
Deputy Secretary Commissioner
↓ ↓
Administrative staff Joint Secretary
↓
Administrative staff
2. 2www.drjayeshpatidar.blogspot.com
Functions:
(1) Union list
1. International health relations and administration of port quarantine
2. Administration of Central Institutes such as All India Institute of Hygiene and
Public Health, Kolkata.
3. Promotion of research through research centers
4. Regulation and development of medical, pharmaceutical, dental and nursing
Professions
5. Establishment and maintenance of drug standards
6. Census and collection and publication of other statistical data
7. Immigration and emigration
8. Regulation of labor in the working of mines and oil fields
9. Coordination with states and with other ministries for promotion of health
(2) Concurrent list
The functions listed under the concurrent list are the responsibility of both the union and state
governments.
1. Prevention and extension of communicable diseases
2. Prevention of adulteration of food stuffs
3. Control of drugs and poisons
4. Vital statistics
5. Labor welfare
6. Ports other than major
7. Economic and social planning
8. Population control and Family Planning
9. Preparation of health education material for creating health awareness through
Central Health Education Bureau.
10. Collection, compilation, analysis, evaluation and dissemination of information
Through the Central Bureau of Health Intelligence
11. National Medical Library
3. 3www.drjayeshpatidar.blogspot.com
2. Directorate General of Health Services
Organization Pattern
Directorate General of health services
↓
Director General of health services
↓
Additional Director General of health service
↓
Deputy Directorate General of health services
↓
Administrative staff
Functions:
1. International health relations and quarantine of all major ports in country and
International airport
2. Control of drug standards
3. Maintain medical store depots
4. Administration of post graduate training programmes
5. Administration of certain medical colleges in India
6. Conducting medical research through Indian Council of Medical Research
7. Central Government Health Schemes.
8. Implementation of national health programmes
9. Preparation of health education material for creating health awareness through Central Health
Education Bureau.
10. Collection, compilation, analysis, evaluation and dissemination of information through the
Central Bureau of Health Intelligence
11. National Medical Library
4. 4www.drjayeshpatidar.blogspot.com
3. Central Council of Health
Organization Pattern
Chairman
(Union health Minister)
↓
Members
(State health Minister)
Functions
1. To consider and recommend broad outlines of policy regard to matters
Concerning health like environment hygiene, nutrition and health education.
2. To make proposals for legislation relating to medical and public health matters.
3. To make recommendations to the Central Government regarding distribution of
Grants-in-aid
II. At the State level
The health subjects are divided into three groups: federal, concurrent and state. The state list is
the responsibility of the state, including provision of medical care, preventive health services and
pilgrimage within the state.
State health administration
At present there are 28 states in India, each state having its own health administration
Organization Pattern
(1) State Ministry of Health & family welfare
↓
Deputy Minister of Health and Family Welfare
↓
Health Secretary
↓
Deputy Secretaries
↓
Administrative staff
5. 5www.drjayeshpatidar.blogspot.com
(2) State Director of health
↓
Director of Medical Education Director of Health Services
↓ ↓
Dean of medical college Additional Director of Health Services
↓ ↓
State nursing superintendent Deputy Director of Health Services
↓ ↓
Hospital Education Regional Functional
↓ ↓ ↓
Nsg Superintendent Nsg Officer MCH, TB, Leprosy, Immunization
↓ ↓
Ward Incharge Senior tutor
↓ ↓
Nsg Staff Junior tutor
Functions of state health Director:
(1) Studies in depth the health problem and needs in the state and plans scheme to
Solve them
(2) Providing curative &preventive services
(3) Provision for control of milk and food sanitation
(4) Prevention of any outbreak of communicable diseases
(5) Promotion of health education
(6) Promotion of health programmes such as school health, family planning,
Occupational health
(7) Supervision of PHC
(8) Establishing training courses for health personnel
(9) Co-ordination of all health services with other minister of state such as minister
of education, central health minister &voluntary agency
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III. At the district level
T here are 593 ( year 2001 ) districts in India. Within each district, there are 6 types of
administrative areas.
1. Sub –division
2. Tehsils( Taluks )
3. Community Development Blocks
4. Municipalities and Corporations
5. Villages and
6. Panchayats
Most district in India are divided into two or more subdivision, each
incharge of an Assistant Collector or Sub Collector
Each division is again divided into taluks, incharge of a Thasildhar. A taluk
usually comprises between 200 to 600 villages
The community development block comprises approximately 100 villages
and about 80000 to 1,20,000 population, in charge of a Block Development
Officer.
Finally, there are the village panchayats, which are institutions of rural local
self-government.
The urban areas of the district are organized into
Town Area Committees (in areas with population ranging between 5,000 to
10,000
Municipal Boards (in areas with population rangingbetween 10,000 and
2,00,000)
Corporations (with population above 2,00,000)
The Town Area Committees are like panchayats.They provide sanitary
services.
The Municipal Boards are headed by Chairmen /President, elected by
members.
The functions of Municipal Board:
Construction and maintenance of roads
Sanitation and drainage
Street lighting
Water supply
Maintenance of hospitals and dispensaries
Education and
Registration of births and deaths etc
The Corporations are headed by Mayors, elected by councillors, who are elected from
different wards of the city. The executive agency includes the
7. 7www.drjayeshpatidar.blogspot.com
commissioner, the secretary, the engineer and the health officer.
The activities are similar to those of municipalities, on a
much wider scale.
Panchayat Raj -
The panchayat raj is a 3-tier structure of rural local self-government in India linking the village
to the district.It includes
Panchayat (at the village level)
Panchayat Samiti( at the block level)
Zila Parishad(at the district level)
(1) Panchayat (at the village level):
The Panchayat Raj at the village level consists of
The Gram Sabha
The Gram Panchayat
The Gram Sabha:
It is the assembly of all the adults of the village, which meets at least twice a year.The gram
sabha considers proposals for taxation,and elect members of The Gram Panchayat.
The Gram Panchayat
It is the executive organ of the gram sabha and an agency for planning and development at the
village level. The population covered varies from 5000 to 15000 or more.The members of
panchayat hold offices for a period of 3to4 years. Every panchayat has an elected president
(Sarpanch or Sabhapati or Mukhia), a vice president and panchayat secretary. It covers the civic
administration including sanitation and public health and work for the social and economic
development of the village
(2) Panchayat Samiti (at the block level):
The block consists of about 100 villages and a population of about 80,000 to 1,20,000. The
panchayat samiti consists of Sarpanch, MLAs, MPs residing in block area, representative of
women, SC, ST and cooperative socities. The primary function ofThe Panchayat Samiti is the
execute the community development programme in the block. The Block development Officer
and his staff give technical assistance and guidance in development work.
(3) Zila Parishad (at the district level):
8. 8www.drjayeshpatidar.blogspot.com
The Zila Parishad is the agency of rural local self governmen at the district level . The members
of Zila parishad include all heads of panchayat samiti in the district,MPs, MLAs, representative
of SC, ST and women and 2 persons of experience in administration,public life or rural
development. Its functions and powers vary from state to state.
Health care system:
(1) At village level
(2) At sub center level
(3) At PHC level
(4) At CHC level
(1) At village level:
At the village level, elementary services are rendered by
(a) Village health guides
(b) Local dais
(c) Anganwadi workers
(d) ASHA
(a) Village health guides:
Village health guide is a person with an aptitude for social service and is not full time govt.
functionary. Village health guides scheme was introduced on 2nd
oct. 1977.
Guidelines for their selection:
(1) They should be permanent resident of the local community, preferably women
(2) They should be able to read and write, having minimum formal education at
least up to the VI std.
(3) They should be acceptable to all sections of community
(4) They should be able spare at least 2 to 3 hours every day for community health work.
After selection the health guide undergo a short training in primary health care. The
training is arranged in the nearest PHC, subcenter or other suitable place for the duration of 200
hours, spread over a period of 3 months. During the training period they receive a stipend of Rs.
200 per month.
Functions of Village health guides:
(1) Provide treatment for common minor ailments
(2) First aid during accidents and emergency
(3) MCH care
(4) Family planning
(5) Health education
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(2) Local dais:
Most deliveries in rural areas are handled by untrained dais. Th e training for dais given for 30
working days. Each dai is paid stipend of Rs. 300 during the training period.The training is given
at PHC,subcenters or MCH center for 2 days in a week and on the remaining four days of the
week they accompany the health worker(female) to the village. During her training each dai is
required to conduct at least 2 deliveries under the supervision and guidance of health worker
(female), ANM,health assistant (female).
Functions of dais:
(1) MCH care
(2) Family planning
(3) Immunization
(4) Education about health
(5) Referral services
(6) Safe water and basic sanitation
(7) Nutrition
(3) Anganwadi worker:
Under the ICDS scheme there is an anganwadi worker for a population of 1000.There are about
100 such workers in each ICDS project. The anganwadi worker is selected from the community
and she undergoes training in various aspect of health, nutrition and child development for 4
months. She is a part time worker and paid an honorarium of Rs.200-250 per month for the
services.
Functions of anganwadi worker:
(1) MCH care
(2) Family planning
(3) Immunization
(4) Education about health
(5) Referral services
(6) Safe water and basic sanitation
(7) Supplementary nutrition
(8) Nonformal education of children
Accredited Social Health Activist (ASHA)
One of the key components of the National Rural Health Mission is to provide every village in
the country with a trained female community health activist – ‘ASHA’ or Accredited Social
Health Activist. Selected from the village itself and accountable to it, the ASHA will be trained to
10. 10www.drjayeshpatidar.blogspot.com
work as an interface between the community and the public health system. Following are the
key components of ASHA:
SELECTION OF ASHA
The general norm will be ‘One ASHA per 1000 population’. In tribal, hilly, desert areas the
norm could be relaxed to one ASHA per habitation, dependant on workload etc.
The States will also need to work out the district and block-wise coverage/phasing for
selection of ASHAs.
It is envisaged that the selection and training process of ASHA will be given due attention by
the concerned State to ensure that at least 40 percent of the ASHAs in the State are selected and
given induction training in the first year as per the norms given in the guidelines. Rest of the
ASHAs can subsequently be selected and trained during second and third year.
Criteria for Selection
ASHA must be primarily a woman resident of the village ‘Married/Widow/Divorced’ and
preferably in the age group of 25 to 45 yrs.
ASHA should have effective communication skills, leadership qualities and be able to reach
out to the community. She should be a literate woman with formal education up to Eighth Class.
This may be relaxed only if no suitable person with this qualification is available.
Adequate representation from disadvantaged population groups should be ensured to serve
such groups better.
Roles and responsibilities of ASHA:
ASHA will take steps to create awareness and provide information to the community on
determinants of health such as nutrition, basic sanitation & hygienic practices, healthy living and
working conditions, information on existing health services and the need for timely utilization of
health & family welfare services.
She will counsel women on birth preparedness, importance of safe delivery, breast- feeding
and complementary feeding, immunization, contraception and prevention of common infections
including Reproductive Tract Infection/Sexually Transmitted Infection (RTIs/STIs) and care of
the young child.
ASHA will mobilize the community and facilitate them in accessing health and health related
services available at the village/sub-center/primary health centers, such as Immunization, Ante
Natal Check-up (ANC), Post Natal Check-up (PNC), ICDS, sanitation and other services being
provided by the government.
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She will work with the Village Health & Sanitation Committee of the Gram Panchayat to
develop a comprehensive village health plan.
She will arrange escort/accompany pregnant women & children requiring treatment/ admission
to the nearest pre-identified health facility i.e. Primary Health Centre/ Community Health Centre/
First Referral Unit (PHC/CHC /FRU).
ASHA will provide primary medical care for minor ailments such as diarrhea, fevers, and first
aid for minor injuries. She will be a provider of Directly Observed Treatment Short-course
(DOTS) under Revised National Tuberculosis Control Programmed.
She will also act as a depot holder for essential provisions being made available to every
habitation like Oral Rehydration Therapy (ORS), Iron Folic Acid Tablet (IFA), chloroquine,
Disposable Delivery Kits (DDK), Oral Pills & Condoms, etc. A Drug Kit will be provided to
each ASHA. Contents of the kit will be based on the recommendations of the expert/technical
advisory group set up by the Government of India.
Her role as a provider can be enhanced subsequently. States can explore the possibility of
graded training to her for providing newborn care and management of a range of common
ailments particularly childhood illnesses.
She will inform about the births and deaths in her village and any unusual
health problems/disease outbreaks in the community to the Sub-Centers/Primary Health Centre.
She will promote construction of household toilets under Total Sanitation Campaign.
Fulfillment of all these roles by ASHA is envisaged through continuous training and up-
gradation of her skills, spread over two years or more
Comparison of health care delivery system in Rajasthan and Maharashtra:
(1) Subcenter:
Topics Maharashtra Rajasthan
(1) Population covered
(2) Functions
5000 in general
3000 in tribal & hilly areas
(1) MCH care
(2) Family planning
(3) Immunization
(4) Education about health
(5) Referral services
3600 in general
2800 in tribal & hilly areas
(1) MCH care
(2) Family planning
(3) Immunization
(4) Education about health
(5) Safe water and basic
sanitation
(6) Prevention and control of
locally endemic diseases
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Designation Maharashtra Rajasthan
(3) Staffing pattern Health worker female 1
Health worker male 1
Voluntary worker 1
(paid Rs 100 per month as
Honorarium
Health worker female 1
Health worker male 1
ANM 1
(2) Primary health center:
Designation Maharashtra Rajasthan
(1) Population covered
(2) Functions
(3) Staffing pattern
30,000 rural population in plains
20,000 population in hilly, tribal
(1) MCH care
(2) Family planning
(3) Immunization
(4) Education about health
(5) Referral services
(6) Safe water and basic sanitation
(7) Prevention and control of
locally endemic diseases
(8) Collection and reporting of vital
statistics
(9) National health programmes
(10) Training of health guides, health
workers, local dais and health
assistant
(11) Basic laboratory services
Medical officer 2
Pharmacist 1
Nurse midwife 1
Health worker female 1
Block extension educator 1
Health assistant (female) 1
Health assistant male 1
U.D.C 1
48000 population in plains
30000 population in tribal and
hilly
(1) MCH care
(2) Family planning
(3) Immunization
(4) Education about health
(5) Referral services
(6) Safe water and basic
sanitation
(7) Prevention and control of
locally endemic diseases
(8) Collection and report in
Of vital statistics
(9) National health
programmes
(10) Training of health guides,
health workers, local
dais and health assistant
(11) Basic laboratory services
Medical officer 1
Pharmacist 1
Nurse midwife 1
Health worker female 1
Health worker male 1
Block extension educator 1
Health assistant (female) 1
Health assistant male 1
U.D.C 1
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L.D.C 1
Driver 1
ClassIV 4
L.D.C 1
Driver 1
ClassIV 2
(3) Community health center:
Designation Maharashtra Rajasthan
(1) Population covered
(2) Bed capacity
(3) Specialty
(3) Functions
80,000 to 1.20 lakhs
30 Beds
Surgery, medicine, obstetrics and
gynecologist and pediatrics with X-ray and
lab facilities.
Care of routine and emergency
cases in surgery
Care of routine and emergency
cases in medicine
24 hours delivery services
including normal and assisted
deliveries
Essential and emergency obstetric
care including caesarean sections
and other Medical interventions.
Full range of family planning
services including laparoscopic
services
Safe abortion service
Newborn care
Routine and emergency care of
children
Other management including
74,000 to 1.5 lakhs
24 Beds
Surgery, medicine,
obstetrics and
gynecologist and
pediatrics with X-ray and
lab facilities.
(1) MCH care
(2) Family planning
(3) Immunization
(4) Education about
health
(5) Referral services
(6) Safe water and basic
sanitation
(7) Prevention and
control of locally
endemic diseases
(8) Collection and
report in of vital
statistics
(9) 24 hours delivery
services including
normal and assisted
deliveries
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(4) Staffing pattern
Nasal
packing,tracheostomy,foreign
body removal
(10) All national
health programmes
delivered through
CHC
Other services
(a) Blood storage
facility
(b) Essential lab.
Services
(c ) Referral
(transport) services
Existing clinical manpower
General surgeon 1
Physician 1
Obstetrics/ gynecologist 1
Pediatrician 1
Proposed clinical man
power
Anesthetics 1
Eye surgeon 1
Public health programme 1
manager
Existing support manpower
Nurse midwife 9
Dresser 1
Pharmacist 1
Lab. Technician 1
Radiographer 1
Ophthalmic 1
Ward boy 2
Sweeper 3
Chowkidar 1
OPD attendant 1
Statistical assistant 1
OT attendant 1
Registration clerk 1
(10) Essential and emergency
obstetric care including
caesarean sections and other
Medical interventions.
(11) Full range of family
planning services including
laparoscopic services
(12) Safe abortion service
(13) Newborn care
(14) Routine and emergency
care of children’s.
(15) ) All national health
programmes delivered through
CHC
Existing clinical manpower
General surgeon 1
Physician 1
Obstetrics/ gynecologist 1
Pediatrician 1
Proposed clinical man
power
Anesthetic 1
Public health programme 1
manager
Existing support manpower
Nurse midwife 12
Dresser 1
Pharmacist 2
Lab. Technician 1
Radiographer 1
Ophthalmic 1
Ward boy 2
Sweeper 3
Chowkidar 2
OPD attendant 1
Statistical assistant 1
OT attendant 1
Registration clerk 2
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Job description of the members of the health team:
(1) Medical officer:
He is the captain of the health team at the primary health center.
He devotes the morning hours attending to patients in the out-door,in the afternoon and
supervises the field work.
He visits each subcenter regularly on fixed days and hours and provides guidance,
supervision and leadership to the health team.
He spends one day in each month organizing staff meetings at PHC to discuss the
problems and review the progress of health activities.
He ensures that national health programmes are being implemented in in his area
properly
The success of PHC depends largely on the team leadership which the medical officer is
able to provide.
The medical officer must be a planner, the promoter, the director, the supervisior, the
coordinator as well as the evaluator.
(2) Health worker male and female:
Under the multipurpose worker scheme, one health worker female and one male are posted
to each sub-centers and are expected to cover 5000 of population (3000 in tribal and hilly areas)
health worker female limits her activities among 350-500 families.
Health worker female:
She will register pregnant women from three months of pregnancies onwards.
Maintain maternity record, register of antenatal cases, eligible couple register, children
register up to date.
She will provide care to pregnant women especially registered mother throughout the
period of pregnancy;
Give advice on nutrition to expectant and nursing mothers about storage, preparation and
distribution of food.
Immunize pregnant mothers with tetanus toxoid.
Conduct about 50% of total deliveries at home.
Supervise deliveries conducted by Dais and whenever call in.
Spread the message of family planning to the couples; motivate them for family planning
individually and in groups.
Distribute conventional contraceptives to the couples.
Assess the growth and development of the infant and take necessary action.
Records and reports births and deaths in her area.
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Test urine for albumin and sugar and do Hb during her home visit.
Arrange and help M.O and health assistant in conducting MCH and family planning
clinics at subcenters.
Maintain the cleanliness of subcenter.
Attend staff meetings at PHC, CD block or both.
Health worker male:
He will survey all the families in his area and collect all the information about each
village/ locality in his area.
Identify the cases of communicable diseases and notify the health assistant male and M.O
PHC immediately.
Educate the community about importance of control and preventive measures against
communicable diseases.
Assist the village health guide in undertaking the activities under TB programme
properly.
Educate community on the method of liquid and solid waste, home sanitation, advantage
and use of sanitary latrines.
Assist the health assistant male in the school health programme.
Utilize the information from the eligible couple and child register for the family planning
programme.
Spread the message of family planning to the couples; motivate them for family planning
individually and in groups.
Distribute conventional contraceptives to the couples.
Provide follow-up services to male family planning acceptors.
Health assistant male and female:
Health assistant male and female will supervise 4 health workers each of the corresponding
category.
Health assistant female:
Supervise and guide the health workers in the delivery of health care services to the
community.
Carry out supervisory home visiting.
Guide the health workers (female) in Distribution of conventional contraceptives to the
couples.
Visit each of the 4 subcenters at least once in a week on fixed days.
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Respond to urgent calls from the health workers and trained dais and render necessary
help.
Organize and utilize the mahila mandal, teachers etc., in the family welfare programme.
Provide information on the availability of services for MTPs and refer suitable cases to
the approved institution.
Supervise the immunization of all pregnant women and children (0-5 years)
Collect and compile the the weekly reports of births and deaths occurring in his area.
Educate the community regarding the need of registration of vital events. .
Health assistant male:
Supervise the work of Health worker male during concurrent visit.
Check minimum 10% of houses in village.
Supervise the spraying of insecticides during local spraying along with the health worker
(male).
Conduct immunization of all school going children with the help of health worker (male).
Supervise the immunization of all children’s (0-5 years).
Assist M.O.PHC in organization of family planning camps and drives. .
Provide information on the availability of services for MTPs and refer suitable cases to
the approved institution.
Ensures follow-up of all cases of vasectomy, tubectomy IUD and other family planning
acceptors.
Ensure that all the cases of malnutrition infants and young childrens (0-5years) are given
the necessary treatment and advice and refer serious cases to PHC.
Ensure that Iron and folic acid and Vitamin A are distributed to the beneficiaries.
Conduct MCH and family planning clinics and carry out educational activities.
Organize and conduct training for dais women leaders with the help of health workers
Collect and compile the the weekly reports of births and deaths occurring in his area.
Educate the community regarding the need of registration of vital events.
REFERENCES
(1) k. Park, Text book of preventive and social medicine, Bhanot publication, 18th
edition, Page
no.674-699.
(2) B.T.Basvanthappa, Community health nursing, Jaypee, Publication, 6th
edition, Page no.584-
605.
(3) K.K. Gulani, Community health nursing, Kumar Publication, 3rd
edition, Page no.591-593.
(4) Dr. Sr. Mary Lucita, Public health and Community Health, Nursing, B.I. publication, 1st
edition, Page no.25-34.
(5) John M. Cookfair, Nursing care in the community, Mosby, Publication, 2nd
edition, Page no.
65-81.
(6) www.google. com.