This is IPHS presentation .hope it is helpful to you. contents are - introduction,origin of iphs, iphs for subcenter,phc, in maharashtra ,summary and references
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.
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.“
An initiative of Ministry of Health & Family Welfare to leverage information technology for ensuring delivery of full spectrum of healthcare and immunization services to pregnant women and children up to 5 years of age.
THIS PPT EXPLAINS SUB CENTER ACTION PLAN IN EASY WAY
Important links- NOTES- https://mynursingstudents.blogspot.com/
youtube channel
https://www.youtube.com/c/MYSTUDENTSU...
CHANEL PLAYLIST-
ANATOMY AND PHYSIOLOGY-https://www.youtube.com/playlist?list...
COMMUNITY HEALTH NURSING- https://www.youtube.com/playlist?list...
CHILD HEALTH NURSING- https://www.youtube.com/playlist?list...
FIRST AID- https://www.youtube.com/playlist?list...
HCM- https://www.youtube.com/playlist?list...
FUNDAMENTALS OF NURSING- https://www.youtube.com/playlist?list...
COMMUNICABLE DISEASES- https://www.youtube.com/playlist?list...
ENVIRONMENTAL HEALTH- https://www.youtube.com/playlist?list...
MSN- https://www.youtube.com/playlist?list...
HINDI ONLY- https://www.youtube.com/playlist?list...
ENGLISH ONLY- https://www.youtube.com/playlist?list...
facebook profile- https://www.facebook.com/suresh.kr.lrhs/
FACEBOOK PAGE- https://www.facebook.com/My-Student-S...
facebook group NURSING NOTES- https://www.facebook.com/groups/24139...
FOR MAKING EASY NOTES YOU CAN ALSO VISIT MY BLOG –
BLOGGER- https://mynursingstudents.blogspot.com/
Instagram- https://www.instagram.com/mystudentsu...
Twitter- https://twitter.com/student_system?s=08
#SUBCENTER,#ACTIONPLAN,#PRIMARY, #SECONDARY,#TERTIARY PREVENTION#Prevention_COMMUNICABLE_DISEASES,#breaking_CHAIN_OF_INFECTION,#PORTAL_OF_EXIT, #PORTAL_OF_ENTRY, #AGENT, #HOST, #CASE, #CARRIER, #NIDDCP,#NATIONALHELATHPROGRAM,S#MYSTUDENTSUPPORTSYSTEM, #rashes,#nursingclasses, #communityhealthnursing,#ANM, #GNM, #BSCNURING,#NURSINGSTUDENTS, #WHO,#NURSINGINSTITUTION,#COLLEGEOFNURSING,#nursingofficer,#COMMUNITYHEALTHOFFICER
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.
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.“
An initiative of Ministry of Health & Family Welfare to leverage information technology for ensuring delivery of full spectrum of healthcare and immunization services to pregnant women and children up to 5 years of age.
THIS PPT EXPLAINS SUB CENTER ACTION PLAN IN EASY WAY
Important links- NOTES- https://mynursingstudents.blogspot.com/
youtube channel
https://www.youtube.com/c/MYSTUDENTSU...
CHANEL PLAYLIST-
ANATOMY AND PHYSIOLOGY-https://www.youtube.com/playlist?list...
COMMUNITY HEALTH NURSING- https://www.youtube.com/playlist?list...
CHILD HEALTH NURSING- https://www.youtube.com/playlist?list...
FIRST AID- https://www.youtube.com/playlist?list...
HCM- https://www.youtube.com/playlist?list...
FUNDAMENTALS OF NURSING- https://www.youtube.com/playlist?list...
COMMUNICABLE DISEASES- https://www.youtube.com/playlist?list...
ENVIRONMENTAL HEALTH- https://www.youtube.com/playlist?list...
MSN- https://www.youtube.com/playlist?list...
HINDI ONLY- https://www.youtube.com/playlist?list...
ENGLISH ONLY- https://www.youtube.com/playlist?list...
facebook profile- https://www.facebook.com/suresh.kr.lrhs/
FACEBOOK PAGE- https://www.facebook.com/My-Student-S...
facebook group NURSING NOTES- https://www.facebook.com/groups/24139...
FOR MAKING EASY NOTES YOU CAN ALSO VISIT MY BLOG –
BLOGGER- https://mynursingstudents.blogspot.com/
Instagram- https://www.instagram.com/mystudentsu...
Twitter- https://twitter.com/student_system?s=08
#SUBCENTER,#ACTIONPLAN,#PRIMARY, #SECONDARY,#TERTIARY PREVENTION#Prevention_COMMUNICABLE_DISEASES,#breaking_CHAIN_OF_INFECTION,#PORTAL_OF_EXIT, #PORTAL_OF_ENTRY, #AGENT, #HOST, #CASE, #CARRIER, #NIDDCP,#NATIONALHELATHPROGRAM,S#MYSTUDENTSUPPORTSYSTEM, #rashes,#nursingclasses, #communityhealthnursing,#ANM, #GNM, #BSCNURING,#NURSINGSTUDENTS, #WHO,#NURSINGINSTITUTION,#COLLEGEOFNURSING,#nursingofficer,#COMMUNITYHEALTHOFFICER
This presentation deals with Primary Health Care in India. It describes in detail concept & characteristics of PHC. It focuses on structure, service delivery & challanges in front of Primary Health Care in India.
Pneumoconiosis and prevention Dr Muhammad Athar Khan MBBS,DPH,DCPS-HCSM(MP...Dr Athar Khan
Dr Muhammad Athar Khan
MBBS,DPH,DCPS-HCSM(MPH),MBA MCPS,PGD-Statistics,DCPS-HPE
Associate Professor
Department of Community Medicine
Liaquat College of Medicine & Dentistry
Karachi, Pakistan
This presentation deals with advent of NRHM, backdrop of public health scenario prior to NRHM & discusses in details vision & core strategy of NRHM. It focuses on different schemes related to maternal & child health under NRHM with special reference to Maharashtra.
The concept of Primary Health Centre (PHC) is not new to India. The Bhore Committee in 1946 gave the concept of a PHC.
According to K Park,
Primary health center as a basic unit, to provide, as close to the people as possible, an integrated curative and preventive health care to the rural populations with emphasis on preventive and promotive aspects of health care.
The primary health center is the basic structural and functional unit of the public health services in developing countries, to provide accessible affordable and available primary health care to people.
The objectives of IPHS for PHCs are:
To provide comprehensive primary health care to the community through the Primary Health Centers.
To achieve and maintain an acceptable standard of quality of care.
To make the services more responsive and sensitive to the needs of the community.
From Service delivery angle,
PHCs may be of two types, depending upon the delivery case load – Type A and Type B.
Type A PHC: PHC with delivery load of less than 20 deliveries in a month,
Type B PHC: PHC with delivery load of 20 or more deliveries in a month
SERVICES
Medical care
Maternal Child Health care including family planning
MTP
Management of Reproductive tract infections/STDs
Nutrition Services
School Health
Adolescent HealthCare
Promotion of Safe drinking water and Basic Sanitation
Prevention and control of locally endemic diseases
Collection and Reporting of vital events
Other National Health Programmes
Oral Health
Physical Medicine and Rehabilitation
Health Education and Behavior Chang Communication
Referral Services
Training
Basic Laboratory and Diagnostic services
Monitoring and Supervision
Functional Linkage with Sub center
Mainstreaming Of AYUSH
Record and Reports of vital events
Selected surgical procedures
Maternal Death Review
INFRASTRUCTURE
Location
Area
Sign age
Entrance
Disaster Prevention Measures
Waiting Area
OPD
Wards
Operational Theatre
Labor Room
Minor OT/ Dressing Room/Injection Room/ Emergency
All the drugs available at the Sub-Centre level should also be available at the PHC, perhaps in greater quantities, (if required).
Oxygen Inhalation
Diazepam
Acetyl Salicylic Acid
Ibuprofen
Paracetamol
Chlorpheniramine Maleate
Dexchlorpheniramine Maleate
Dexamethasone
Pheniramine Maleate
Promethazine
Ampicillin
Benzylpenicillin
Cloxacillin , etc.
EMERGENCY DRUGS
Inj. Adrenaline,
Inj. Hydrocortisone,
Inj. Dexamethasone,
Ambu bag (Paediatric),
Sterile hypodermic syringe for single use with reuse prevention feature 2ml and 5ml syringes, Needles (Size 24, 22, 20).
AYUSH DRUGS
Ayurvedic Medicines for PHCs (Sanjivani Vati, Godanti Mishran)
Unani Medicines for PHCs (Arq-e-Ajeeb,Arq-e-Gulab)
Normal Delivery Kit.
Equipment for assisted vacuum delivery.
Equipment for assisted forceps delivery.
Standard Surgical Set (for minor procedures like episiotomies stitching).
Equipment for Manual Vacuum Aspiration.
Equipment for New Born Care and Neonatal Resuscitation.
IUCD insertion kit.
PHC
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.
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
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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.
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.
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
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
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Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists
Iphs
1. Sub Centers and Primary Health
Centers
-------------- By- Dr.Pallavi Gawande
2. Introduction
Why Standards
Origin of IPHS
IPHS for Sub Center
IPHS for Primary Health Center(PHC)
IPHS in Maharashtra
Summary
References
3. The Indian Public Health Standards (IPHS) for
Sub-centers
Primary Health Centers (PHCs)
Community Health Centers (CHCs)
Sub-District Hospitals
District Hospitals
were published in January/ February, 2007 and have been used
as the reference point for public health care infrastructure
planning and up-gradation in the States and UTs.
4. Conti.....
IPHS describes benchmark for quality expected from various
components of Health Care organizations.
Standards for quality of services, facilities, infrastructure, manpower,
machine and equipment, drugs etc. This is main driving force for
continuous improvement in quality.
Setting standards is a dynamic process, Revision of standards will
occur as and when the facilities achieve
a minimum functional grade.
5. Functioning of Rural health care institutes is not
satisfactory.
The health care system in India has expanded
considerably over the last few decades, however, the
quality of services is not uniform.
Lack of comprehensive and realistic mandatory
standards for public health institutions in Indian
context.
6. Need of IPHS:
Quality management, Quality assurance
Effective, economical and accountable Health care
delivery system.
Optimal level of services
7. Aims to:
Provide accessible , affordable, accountable
quality health care.
Reduce child and maternal deaths.
Stabilize population.
Ensure gender and demographic balance.
8.
9. The Minimum Needs Program (MNP) was introduced in the
country in the first year of the Fifth Five Year Plan (1974–
78) with the objective to provide certain basic minimum
needs.
Most peripheral and first contact point
Services of acceptable standers to the people, through
certain available guidelines.
First step is to lay norms and standards for sub Centers
There are 147069 Sub-centers functioning in the country as
on March 2010 as per Rural Health Statistics Bulletin, 2010.
10. o 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.
o To maintain an acceptable quality of care for these
services.
o To facilitate monitoring and supervision of these facilities.
o To make the services provided more accountable and
responsive to people’s needs.
11. Type A
Type A Sub Centre will provide all recommended services
except that the facilities for conducting delivery will not be
available.
However, the ANMs have been trained in midwifery, they
may conduct normal delivery in case of need.
Sub-centres located in remote, difficult, hilly, desert or tribal
area such situations, ANMs would be required to conduct
deliveries at homes and ANMs of these Sub-centres should
mandatorily be Skilled Birth Attendance (SBA) trained.
12. Type B (MCH Sub-Centre)
Centrally or better located Sub-centers with good
connectivity to catchment areas.
They have good physical infrastructure preferably with
own buildings, adequate space, residential
accommodation and labor room facilities.
They already have good case load of deliveries from
the catchment areas.
There are no nearby higher level delivery facilities.
13. Type of sub-
centre
Sub-centre A Sub-centre B
(MCH Sub-centre)
Staff Essential Desirable Essential Desirable
ANM/Health
Worker (Female)
1 +1 2
Health Worker
(Male)
1 1
Staff Nurse (or
ANM, if Staff Nurse
is not available)
1**
Safai-Karamchari 1
(Parttime)
1
(Fulltime)
** if number of deliveries at the Sub-centre is 20 or more in a month
14. Not too close to an existing sub center/PHC
As far as possible, no person travels more than 3 km to
reach the sub-centre
In the field of rural health, the objective was to
establish: one Sub-centre for a population 5000 people
in the plains and for 3000 in tribal and hilly areas,
15. Elementary drugs for minor ailments such as
ARI
Diarrhea
Fever
Worm infestation
List of drugs given in Annexure 6
16. Sub-centers are expected to provide promotive, preventive and
few curative primary health care services.
Both types of Sub-centers should provided Non-Communicable
Diseases related services.
site of service delivery may be at following places:
In the village: Village Health and Nutrition Day/Immunization
session.
During house visits.
During house to house surveys.
During meetings and events with the community.
At the facility premises.
17. It is desirable, minimum of six of hours of routine OPD services in
a day for six days in a week
Type A: Shall provide all services as envisaged for the Sub-centre
except the facilities for conducting delivery will not be available
here.
Type B: They will provide all recommended services including
facilities for conducting deliveries at the Sub-centre itself. This
Sub-centre will act as Maternal and Child Health (MCH) centre
with basic facilities for conducting deliveries and Newborn Care
at the Sub-centre.
the facilities for attending to home deliveries shall remain
available at both types of Sub-centres.
18. Every sub-center has to provide the following services
which have been indicated as Essential and Desirable.
Maternal Health
Antenatal care:
Minimum 4 ANC check ups including Registration
associated services.
Recording tobacco use by all antenatal mothers.
Minimum laboratory investigations like Urine Test for pregnancy
confirmation, hemoglobin estimation, urine for albumin and sugar
and linkages with PHC for other required tests
19. Intra-natal care:
Promotion of institutional deliveries
Skilled attendance at home deliveries when called.
Appropriate and Timely referral of high risk cases which are
beyond her capacity of management.
20. Essential for Type B Sub-centre
Managing labour using Partograph.
Identification and management of danger signs during labor.
Proficient in identification and basic fist aid treatment for PPH,
Eclampsia, Sepsis and prompt referral of such cases as per
Antenatal Care and Skilled Birth Attendance at Birth or SBA
Guidelines.
Minimum 24 hours of stay of mother and baby after delivery at
Sub-centre.
The environment at the Sub-centre should be clean and safe for
both mother and baby.
21. Postnatal 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 42nd 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 28th days.
Counseling on diet & rest, hygiene, contraception, essential
newborn care, immunization, infant and young child feeding,
STI/RTI and HIV/AIDS.
Name based tracking of missed and left out PNC cases.
22. Child Health
Newborn Care Corner In The Labour Room to provide Essential
Newborn Care (Essential If the Deliveries take Place at the Type B
Sub-centre)
Counseling on IYCF ( Infant and young child Feeding)
Full Immunization and Vitamin A prophylaxis to the children as
per National guidelines.
23. Family Planning and Contraception
••Education, Motivation and counselling to adopt appropriate
Family planning methods.
••Provision of contraceptives.
School Health Services
••Screening, treatment of minor ailments, immunization, de-
worming, prevention and management of Vitamin A and
nutritional deficiency anemia and referral services through fixed
day visit of school by existing ANM/MPW
••Staff of Sub-centre shall provide assistance to school health
services as a member of team
24. Control of Local Endemic Diseases
••Assisting in detection, Control and reporting of local endemic
diseases such as malaria, Kala Azar, Japanese encephalitis,
Filariasis, Dengue etc.
••Assistance in control of epidemic outbreaks as per programme
guidelines.
Disease Surveillance, Integrated Disease Surveillance Project
(IDSP)
Immediate reporting of any cluster/outbreak based on syndromic
surveillance.
Weekly submission of report to PHC in ’S’ Form as per IDSP
guidelines.
25. National Health Programmes
Communicable Disease Programme
National Vector Borne Disease Control Programme
(NVBDCP)
National AIDS Control Programme (NACP)
National Leprosy Eradication Programme (NLEP)
Revised National Tuberculosis Control Programme
(RNTCP)
26. 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.
27. Laboratory
Electricity
Water
Telephone
Assured Referral linkages
Toilet
Waste Disposal: Guidelines for Health Care Workers for
Waste Management and Infection Control in Sub Centers to be
followed.
28. Monitoring Mechanism
1. Internal mechanism
2. External mechanism
A check list for monitoring of internal mechanism of Sub-centers is
given at Annexure 9.
A simpler check list for monitoring of external mechanism that can
be used by PRI/NGO is given in Annexure 9A.
Quality Assurance and Accountability
In order to ensure quality of services and patient satisfaction, it is
essential to encourage community participation.
To ensure accountability, the Citizens’ Charter should be available
in all Sub-centers (Annexure 11).
29. Annexure 1: National Immunization Schedule for Infants, Children and
Pregnant Women.
Annexure 2: Job Functions of Health Worker Female/ANM, Staff Nurse,
Health Worker Male .
Annexure 3: Layout of Sub-Centre
Annexure 4: List of Furniture, Other Fittings and Sundry Articles
Annexure 5: Equipment and Consumables
Annexure 5A: Newborn Corner in Labour Room
Annexure 6: Suggested List of Drugs
Annexure 7: Standards for Deep Burial Pit; Bio-Medical Waste
(Management and Handling) Rules, 1998
Annexure 8: Records and Reports.
Annexure 8A: Register
Annexure 8B: IDSP Format
Annexure 9: Checklist
Annexure 9A: A simpler checklist that can be used by non-governmental
organization/Panchayati Raj Institutions/Self Help Groups
Annexure 10: Proforma for Facility Survey of Sub-Centers on IPHS
Annexure 11: Model Citizen’s Charter for Sub-Centers
Annexure 12: List of Abbreviations
30.
31. In order to provide optimal level of quality health care, a set
of standards called Indian Public Health Standards (IPHS)
were recommended for PHC in early 2007.
PHC is the cornerstone of rural health services- a first port
of call to a qualified doctor of the public sector in rural
areas for curative, preventive and promotive health care.
It acts as a referral unit for 6 Sub-Centers and refer out
cases to CHC (30 bedded hospital) and higher order public
hospitals.
There are 23673 PHCs functioning in the country as on
March 2010 as per Rural Health Statistics Bulletin, 2010.
32. To provide comprehensive primary health care to the
community through the Primary Health Centers.
To achieve and maintain an acceptable standard of
quality of care.
To make the services more responsive and sensitive to
the needs of the community.
33. From Service delivery angle, PHCs may be of two
types, depending upon the delivery case load – Type A
and Type B.
Type A PHC Type B PHC
PHC with delivery load of less than
20 deliveries in a month.
PHC with delivery load of 20 or more
deliveries in a month
34. Medical care
OPD services: A total of 6 hours of OPD services it is
desirable that MO PHC shall spend at least two hours
per day twice in a week for field duties and monitoring.
24 hours emergency services.
Referral services.
••In-patient services (6 beds)
35. Maternal and Child Health Care Including Family
Planning
Antenatal care
Early registration and Minimum 4 antenatal checkups
and provision of complete package of services.
Identification and management of high risk.
Timely referral of such identified cases.
36. Intra-natal care (24-hour delivery services both normal
and assisted)
Promotion of institutional deliveries.
Assisted vaginal deliveries including forceps/ vacuum
delivery whenever required.
Manual removal of placenta.
Pre-referral management (Obstetric first-aid) in Obstetric
emergencies that need expert assistance (Training of staff
for emergency management to be ensured).
37. Proficient in identification and basic first aid treatment for PPH,
Eclampsia, Sepsis and prompt referral: As per ‘Antenatal Care and
Skilled Birth Attendance at Birth’ Guidelines
Postnatal Care
Ensure post- natal care for 0 & 3rd day and ensuring 7th & 42nd
day post-natal home visits by ANM.
Initiation of early breast-feeding within one hour of birth.
Counseling on nutrition, hygiene, contraception, essential new
born care (As per Guidelines of GOI on Essential new-born care)
and immunization.
Others: Provision of facilities under Janani Suraksha Yojana
(JSY).
Tracking of missed and left out PNC
38. New Born care
Facilities for Essential New Born Care (ENBC) and
Resuscitation (Newborn Care Corner in Labour
Room/OT, Details given in Annexure 3A).
Care of the child
Routine and Emergency care of sick children including
Integrated Management of Neonatal and Childhood
Illnesses (IMNCI) strategy and inpatient care.
Full Immunization and vitamin A prophylaxis of all
child
Tracking of vaccination dropouts
39. Family Welfare
Education, Motivation and Counseling to adopt
appropriate Family planning methods.
Permanent methods like Tubal ligation and
vasectomy/NSV, where trained personnel and facility
exist.
Medical Termination of Pregnancies
Counseling and appropriate referral for safe abortion
services (MTP) for those in need.
40. Nutrition Services (coordinated with ICDS)
• Diagnosis of and nutrition advice to malnourished children,
pregnant women and others.
• Diagnosis and management of anaemia and vitamin A
deficiency.
• Coordination with ICDS.
School Health
Health service provision:
• Screening, health care and referral.
• Immunization.
• Micronutrient (Vitamin A & IFA) management.
• De-worming.
• Monitoring & Evaluation.
• Mid Day Meal.
41. Prevention and control of locally endemic diseases like malaria,
Kala Azar, Japanese Encephalitis etc.
Collection and reporting of vital events.
Health Education and Behavior Change Communication (BCC).
Other National Health Programmes.
Revised National Tuberculosis Control Programme (RNTCP)
National Leprosy Eradication Programme
Integrated Disease Surveillance Project (IDSP)
National Programme for Control of Blindness (NPCB)
42. National Programme for Prevention and Control of
Deafness (NPPCD)
National Vector Borne Disease Control Programme
(NVBDCP)
National AIDS Control Programme
National Mental Health Programme (NMHP)
National Tobacco Control Programme (NTCP)
National Programme for Prevention and Control of Cancer,
Diabetes, CVD and Stroke (NPCDCS)
National Programme for Prevention and Control of
Fluorosis (NPPCF) (In affected (Endemic Districts)
National Iodine Deficiency Disorders Control Programme
(NIDDCP)
43. Revised National Tuberculosis Control Programme
(RNTCP)
Essential
All PHCs to function as DOTS Centres to deliver
treatment as per RNTCP treatment guidelines
through DOTS providers and treatment of
common complications of TB and side effects of
drugs, record and report on RNTCP activities as
per guidelines.
Facility for Collection and transport of sputum
samples should be available as per the RNTCP
guidelines.
44. National Leprosy Eradication Programme
Essential
Health education to community regarding
Leprosy.
Diagnosis and management of Leprosy and its
complications including reactions.
Training of leprosy patients having ulcers for
self-care.
Counseling for leprosy patients for regularity/
completion of treatment and prevention of
disability.
45. Other NCD Diseases
Health Promotion Services to modify individual, group and
community behaviour especially through
Promotion of Healthy Dietary Habits.
Increase physical activity.
Avoidance of tobacco and alcohol.
Stress Management.
Early detection, management and referral of Diabetes Mellitus,
Hypertension and other Cardiovascular diseases and Stroke
through simple measures like history, measuring blood pressure,
checking for blood, urine sugar and ECG.
46. Training
Orientation training of male and female health workers in
various National Health Programmes including RCH,
Adolescent health services and immunization
Skill based training to ASHAs.
Initial and periodic Training of paramedics in treatment of
minor ailments.
Periodic training of Doctors and para medics through
Continuing Medical Education, conferences, skill
development trainings.
All health staff of PHC must be trained in IMEP.????
47. Basic Laboratory and Diagnostic Services
Essential Laboratory services including
Routine urine, stool and blood tests.
Diagnosis of RTI/STDs with wet mounting, Grams stain, etc.
Sputum testing for mycobacterium (as per guidelines of RNTCP).
Blood smear examination malarial.
Blood for grouping and Rh typing.
RDK for Pf malaria in endemic districts.
Rapid tests for pregnancy.
RPR test for Syphilis/YAWS surveillance (endemic districts).
Rapid test kit for fecal contamination of water.
Estimation of chlorine level of water using orthotoludine reagent.
Blood Sugar.
Desirable
Blood Cholesterol.
ECG.
48. Monitoring and Supervision
Monitoring and supervision of activities of Sub- Centre through
regular meetings/periodic visits, by LHV, Health Assistant Male
and Medical Officer etc..
Monitoring of all National Health Programmes by Medical
Officer with support of LHV, Health Assistant Male and Health
educator.
Monitoring activities of ASHAs by LHV and ANM (in her Sub
centre area).
Health educator will monitor all IEC and BCC activities
Health Assistants Male and LHV should visit Sub- Centers once a
week.
Timely payment of JSY beneficiaries.
Timely payment of TA/DA to ASHAs.
49. PHC Building
It should be centrally located in an easily accessible area.
PHC should be away from garbage collection cattle shed,
water logging area, etc. PHC shall have proper boundary
wall and gate.
Prominent display boards in local language providing
information regarding the services available/user
charges/fee and the timings of the centre.
Barrier free access environment for easy access to
nonambulant (wheel-chair, stretcher), semi-ambulant,
visually disabled and elderly persons as per guidelines of
GOI.
50. The outpatient room should have separate areas for
consultation and examination.
All PHCs should have Disaster Management Plan in
line with the District Disaster management Plan.
The area for examination should have sufficient
privacy.
One room for Immunization/Family Planning/
Counseling.
51.
52. All the drugs available in the Sub-Centre should also
be available in the PHC. All the drugs as per state/UT
essential drug list shall be available.
In addition, all the drugs required for the National
Health Programmes and emergency management
should be available.
Drugs of that discipline of AYUSH to be made
available for which the doctor is present.
The list of suggested drugs is given in Annexure 4.
53. The Transport Facilities with Assured Referral
Linkages
Waste Management at PHC Level Guidelines for
Health Care Workers for Waste Management and
Infection Control in Primary Health Centres are to be
followed.
55. Sr. No Type of
Institution
Total no.
in state
No of Institutes
selected for IPHS
(2013-14)
Upgraded
24*7/ FRU
upto May
2013
%
Upgradation
1 PHC 1816 704 409 58.10
2 RH/SDH 455 200 107 53.05
3 DH/RRH 23 23 23 100.00
4 GH/WH 14 14 14 100.00
Total 12887 941 409/144 58.10/60.75
Status of up gradation of Health Institutions as per IPHS standard
Source-http://www.nrhm.maharashtra.gov.in/iphsmonitor.htm
56. Ministry of Health and Family Welfare,
Government of India. Indian Public Health
Standards (IPHS) For Sub Centers:
Guidelines. New Delhi; Revised 2012
Ministry of Health and Family Welfare,
Government of India. Indian Public Health
Standards (IPHS) For Primary Health
Center: Guidelines. New Delhi; Revised
2012
57. Park K., Park's Text Book of Preventive and
Social Medicine,19th Edition,
Jabalpur(India):M/s.Banarasidas Bhanot
Publishers,2009
National Rural Health Mission 2005-2012 –
Reference Material (2005),Ministry of Health
& Family Welfare, Government of India.
State Health Society Maharashtra, IPHS in
Maharashtra; 2009 Dec.
Sunderlal .Text book of community medicine
3rd edition.New delhi. Cbs publication 2011
Editor's Notes
The health care system in India has expanded considerably over the last few decades, however, the quality of services is not uniform (due to various reasons like non availability of manpower, problems of access, acceptability, lack of community involvement, etc. )
OPD services: A total of 6 hours of OPD services out of which 4 hours in the morning and 2 hours in the afternoon for six days in a week.
24 hours emergency services: appropriate management of injuries and accident, First Aid, stitching of wounds, incision and drainage of
abscess, stabilisation of the condition of the patient before referral, Dog bite/snake bite/scorpion bite cases, and other emergency conditions.