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Objectives
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Ayushman bharat what an why ..we must know this programme it is important for all doctors and nurses and others...very important for MBBS students also
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Statement of goals, objectives and targets are inherent in the population policy.
History
National Population Policy 2000
Objectives
National Socio-Demographic Goals
Conclusion
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Hypertension is a chronic condition of concern due to its role in the causation of coronary heart diseases. Hypertension is a worldwide epidemic and important risk factor for coronary artery disease, stroke and renal diseases. Blood pressure is the force exerted by the blood against the walls of the blood vessels and is sufficient to maintain tissue perfusion during activity and rest. Hypertension is sustained elevation of BP. In adults, HTN exists when systolic blood pressure is equal to or greater than 140mmHg or diastolic BP is equal to or greater than 90mmHg. The
Defecation
Normal defecation begins with movement in the left colon, moving stool toward the anus. When stool reaches the rectum, the distention causes relaxation of the internal sphincter and an awareness of the need to defecate. At the time of defecation, the external sphincter relaxes, and abdominal muscles contract, increasing intrarectal pressure and forcing the stool out
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Normal defecation is painless, resulting in passage of soft, formed stool
CONSTIPATION
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IMPACTION
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DIARRHEA
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Stewardship is the act of taking good care of something.
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WHO launched the Global Antimicrobial Resistance and Use Surveillance System (GLASS) in 2015 to fill knowledge gaps and inform strategies at all levels.
ACCORDING TO apic.org,
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
ACCORDING TO pewtrusts.org,
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VISION
Being proactive
Supporting optimal animal and human health
Exploring ways to reduce overall use of antimicrobials
Using the drugs that prevent and treat disease by killing microscopic organisms in a responsible way
GOAL
to prevent the generation and spread of antimicrobial resistance (AMR). Doing so will preserve the effectiveness of these drugs in animals and humans for years to come.
being to preserve human and animal health and the effectiveness of antimicrobial medications.
to implement a multidisciplinary approach in assembling a stewardship team to include an infectious disease physician, a clinical pharmacist with infectious diseases training, infection preventionist, and a close collaboration with the staff in the clinical microbiology laboratory
to prevent antimicrobial overuse, misuse and abuse.
to minimize the developme
One of the most developed cities of India, the city of Chennai is the capital of Tamilnadu and many people from different parts of India come here to earn their bread and butter. Being a metropolitan, the city is filled with towering building and beaches but the sad part as with almost every Indian city
Job responsibilities of health workers ( male & female)
1. 1
SMCH/HCDS/16: Job responsibilities of Health Workers ( Male & Female)
Quadrant-I
Personal Details
Role Name Affiliation
Principal
Investigator
Prof. CP Mishra Department of Community Medicine,
Institute of Medical Sciences, Banaras
Hindu University, Varanasi
Paper Coordinator
Prof. Najam Khalique Department of Community Medicine,
J N Medical College, AMU, Aligarh
Content Writer Dr. Urfi
Assistant Professor
Department of Community Medicine,
J N Medical College, AMU, Aligarh
Content Reviewer Prof. M. Athar Ansari Department of Community Medicine,
J N Medical College, AMU, Aligarh
Description of Module
Items Description of Module
Subject name Social Medicine & Community Health
Paper name Health Care Delivery System
Module name/Title Job responsibilities of Health Workers ( Male & Female)
Module Id SMCH/HCDS/16
Pre-requisites Understanding of organization of health system
Objectives To know the job responsibilities of Health Workers ( Male & Female)
Keywords ASHA, village health guide, vital events.
2. 2
Job responsibilities of health workers male
Introduction
Health worker male is a worker posted at sub enter he plays a significant role in relation to malaria,
TB, Leprosy. School health including nutrition and recording of vital events as well as record keeping
are his major responsibilities.
Learning Outcomes
Upon completion this module, the reader should be able to:
State responsibilities of Health Worker Male (MPW) in Malaria, TB and Leprosy
Mention role of MPW(Male) in Preventive Health Care
Mention role of MPW(Male) in School Health including Nutrition
State role of MPW in UIP & RCH
Enumerate role of MPW in Vital Events and Record Keeping
Main Text
Job responsibilities of health worker (male)/multipurpose worker
Based on the Indian Public Health Standards (IPHS) guidelines; MPHW (Male) will mainly focus on
activities which are related to disease control programs, detection and control of epidemic outbreaks,
environmental sanitation, safe drinking water, first aid in emergencies like accidents, injuries, burns
etc., treatment of common/ minor illnesses, communication and counselling, life style diseases and
logistics and supply management at sub-centre. In addition he will also facilitate ANM in MCH,
Family Welfare, and Nutrition related activities .
The broad areas of job responsibilities of MPHW (Male) would broadly include the following –
1.Responsibilities of Health Worker Male (MPW) in Malaria, TB and Leprosy
1.1 Malaria
a. Conduct domiciliary house-to-house visits covering all the assigned population as per the schedules
approved by the PHC Medical Officer. During his visits, he shall enquire about fever cases in each
family and verify the cases diagnosed positive after the last visit.
b. Collect blood smears and perform RDT from suspected fever cases and appropriately maintain
records in M-1.
c. Ensure immediate dispatch of collected blood smears for laboratory investigations and provide
treatment to positive cases as per the guidelines
Advise all seriously ill cases to visit PHC for immediate treatment and refer all fever cases with
altered sensorium to the PHC / hospital and arrange funds for transportation of such cases from
NRHM/ other funds.
e. Undertake necessary measures to contain the spread of disease as advised by PHC Medical officer.
3. 3
f. Liaison with ASHA / Village Health Guide / Anganwadi Worker for early detection of malaria,
replenish the stocks of microscopy slides, RDKs and / or drugs.
g. Ensure treatment for all diagnosed cases as per the instructions by the PHC medical officer and also
take prompt actions for adverse reactions reported.
h. Intimate each house hold in advance regarding date of spraying and other public health activities as
well as duly explain the benefits of such activities to the community.
i. Supervise the spraying operations and deploy the two squads in adjoining areas for adequate
supervision. Ensure the quality of spraying operations for uniformity in coverage of all the surfaces as
well as due precautions regarding water sources and personal hygiene as per the guidelines.
j. Maintain the records of domiciliary visits, blood smears collected, patients given anti-malarials,
details of spraying operations etc in the prescribed formats.
1.2 Tuberculosis (RNTCP)
a. Identify all cases of fever for over two weeks with prolonged cough or spitting of blood and refer to
PHC for further investigation. Verify the TB patients self reporting at health facilities.
b. Function as DOTS provider to ensure that all confirmed cases are on regular treatment and motivate
defaulters for regular treatment.
c. Improve community awareness on signs and symptoms of tuberculosis and guide the suspected TB
cases for referral to the designated microscopy centres and facilitate sputum examinations.
d. Assist and supervise the ASHAs / Anganwadi Workers / Village Health Guides / local health
volunteers to function effectively as DOTS providers by ensuring regularity of DOTS, schedule the
DOTS as per patient’s convenience and collection of empty blister packs.
e. Ensure that follow up smear examinations of sputum are carried out as per the schedules.
f. Maintain the treatment cards and transmit the data weekly to the PHC.
g. Maintain the records of domiciliary visits, records of patients on treatment, sputum examinations
etc.
1.3 Leprosy
a. Identify Leprosy suspected cases of skin patches with loss of sensation and refer to PHC.
b. Provide Multi Drug Treatment (MDT) to confirmed cases and ensure completion of treatment
including retrieval of defaulters.
c. Guide leprosy patients with deformities for management at appropriate health facilities.
d. Assist and supervise the ASHAs / Anganwadi Workers / Village Health Guides / local health
volunteers for early detection of Leprosy cases and treatment.
e. Improve community awareness on signs and symptoms of Leprosy for early detection.
f. Maintain the treatment cards and transmit the data to the PHC.
g. Maintain the records of domiciliary visits and records of patients on treatment.
4. 4
2.Role of MPW(Male) in Preventive Health Care
a. Surveillance for unusually high incidence of cases of diarrhoeas, dysentery, fever, jaundice,
diphtheria, whooping cough, tetanus and other communicable disease and notify PHC.
b. Ensure regular chlorination of all the drinking water sources. Collect water samples regularly, send
for testing at sub- distt & distt hospitals and undertake appropriate actions for provision of safe
drinking water supplies.
c. Generate community awareness regarding safe drinking water, sanitation, waste disposal and
personal hygiene and ensure safe disposal of liquid/ solid wastes.
d. Assist and coordinate with the VHSC and SHC / PHC Committees as well community leaders for
health awareness and preventive health care activities.
3.Role of MPW(Male) in School Health including Nutrition
a. Visit all the schools in the assigned area and advocate personal hygiene, nutrition, safe drinking
water and sanitation and other public health measures.
b. Undertake awareness generation of national health programmes (Malaria, TB, Leprosy etc) for
early detection of communicable and non-communicable diseases.
c. Ensure completion of immunisation schedules including Inj. TT as per guidelines.
d. Assist Ophthalmic Assistant for eye screening of children for detection of visual defects.
e. Identify cases of malnutrition in school children and refer cases to PHC Medical Officer. Guide
teachers and parents on nutrition and anaemia. Educate the community about nutritious diet for
mothers and children from locally available foods.
4. Role of MPW(Male) in UIP & RCH
4.1. Universal Immunization Programme
a. Administer DPT vaccines, oral Poliomyelitis vaccine, measles vaccine, hep B vaccine and BCG
vaccine to all infants and children in his area in collaboration with health worker female.
b. Assist the health worker female in administration of tetanus toxiod to all pregnant women.
c. Assist the health supervisor male/health supervisor female in the school health programme
d. Educate the people in the community about the importance of immunisation against the various
communicable diseases.
4.2. Reproductive And Child Health Programme (RCH)
a. Utilize the information from the eligible couple and child register for the family planning
Programme.
b. Spread the message of family planning to the couples and motivate them for family planning
individually and in groups.
5. 5
c. Distribute conventional contraceptives and oral contraceptives to the couples.
d. Help prospective acceptors of sterilization in obtaining the services, if necessary by accompanying
them or arranging for ASHA or dai to accompany them to the PHC/Hospital.
e. Provide follow up services to male family planning acceptors, and refer those cases that need
attention by the physician to PHC/Hospital.
f. Build rapport with satisfied acceptors, village leaders, ASHA, Dais and others and utilize them for
promoting family welfare programme.
g. Assist the health supervisor male in training the leaders in the community and in educating and
involving the community in Family Welfare Programme.
h. Identify the women requiring help for medical termination of pregnancy, refer them to the nearest
approved institution and inform the health worker female.
i. Educate the community on the availability of service for Medical Termination of Pregnancy.
j. Educate community on home management of diarrhoea and ORS.
k. Report any outbreak of diarrhoea disease.
5. Role of MPW(Male) in Vital Events and Record Keeping
5.1. Vital Events
a. Enquire about births and deaths occurring in his area, record them in the births and deaths register
and report them to the Health Supervisor Male/ ANM.
b. Educate the community on the importance of registration of births and deaths.
5.2. Record Keeping
a. Survey all the facilities in his area and prepare/maintain maps and charts for the village.
b. Prepare maintain utilize family and village records.
c. Assist the Health Worker Female/ ANM to prepare the eligible couple and child register and
maintaining it up to date.
d. Maintain a record of cases in his area as to who are under treatment for tuberculosis and leprosy.
e. Prepare and submit the prescribed monthly reports in time to the Health Supervisor male.
f. While maintaining passive surveillance register for malaria cases, he will record:
No. of fever cases
No. of blood slides prepared
No. of malaria positive cases reported
No. of cases given treatment
6. 6
Job responsibilities of health worker (Female)/Auxillary Nurse Midwife (ANM)
Introduction
Health worker female is staff posted at sub-centre . she is the key worker for reproductive and child
health
Learning Outcomes
Upon completion this module, the reader should be able to:
State responsibilities of Health Worker Female (ANM) in MCH, FP and MTP.
Mention role of ANM in UIP & Nutrition
Enumerate role of ANM in Dai training
Mention role of ANM in Communicable Diseases
Mention role of MPW in Vital Events and Record Keeping
Identify role of ANM in treatment of minor ailments
State role of ANM in team activity
Main Text
1.Responsibilities of Health Worker Female (ANM) in MCH, FP and MTP
1.1. Maternal and Child Health: Based on the Indian Public Health Standards (IPHS) guidelines
Register and provide care to pregnant women throughout the period of pregnancy.
Registration of a pregnant woman for ANC should take place as soon as the pregnancy is
suspected ideally in the first tri-master (before or at 12th week of pregnancy). However, even
if a woman comes late in her pregnancy for registration, she should be registered, and care
given to her according to gestational age.
Ensure that every pregnant woman makes at least 3 (three) visits for Ante Natal Check-up.
First visit to the antenatal clinic as soon as pregnancy is suspected / between the 4th and 6th
month (before 26 weeks), 2nd visit at8th month (around 32 weeks) and 3rd visit at 9th month
(around 36 weeks).Provide ante natal check-ups and associated services such as IFA tablets,
TT immunization etc.
Test urine of pregnant women for albumin and sugar. Estimate haemoglobin level.
Refer all pregnant women to PHC for RPR test for syphilis.
Refer cases of abnormal pregnancy and cases with medical and gynaecological problems to
Health Assistant Female (LHV) or the Primary Health Centre.
Conduct deliveries in her area when called for.
Supervise deliveries conducted by Dais and assist them whenever called in.
Refer cases of difficult labour and newborns with abnormalities, help them to get
institutional care and provide follow up to the patients referred to or discharged from
hospital.
ANM will identify the ultimate beneficiaries, complete necessary formalities and obtain
necessary approvals of the competent authority before disbursement to the beneficiaries
under Janani Suraksha Yojana (JSY)and by 7th day of each month will submit accounts of
the previous month in the prescribed format to be designed by the State. ANM will prepare a
monthly work schedule in the meeting of all accredited workers to be held on every 3rd
Friday of every month, which is mandatory. The guideline under JSY is to be followed.
7. 7
Make at least two post-natal visits for each delivery happened in her areas and render advice
regarding care of the mother and care and feed of the newborn.
Assess the growth and development of the infant and take necessary action required to
rectify the defect.
Educate mothers individually and in groups in better family health including maternal and
child health, family planning, nutrition, immunization, control of communicable diseases,
personal and environmental hygiene.
Assist Medical Officer and Health Assistant Female in conducting antenatal and postnatal
clinics at the sub-centre.
1.2. Family Planning:
Utilise the information from the eligible couple and child register for the family Planning
programme. She will be squarely responsible for maintaining eligible couple registers and
updating at all times.
Spread the message of family planning to the couples and motivate them for family planning
individually and in groups.
Distribute conventional contraceptives and oral contraceptives to the couples, provide
facilities and to help prospective accept to family planning services, if necessary, by
accompanying them or arranging for the Dai/ASHA to accompany them to hospital.
Provide follow-up services to female family planning acceptors, identify side effects, give
treatment on the spot for side effects and minor complaints and refer those cases that
need attention by the physician to the PHC/Hospital.
Establish female depot holders, help the Health Assistant Female in training them, and
provide a continuous supply of conventional contraceptives to the depot holders.
Build rapport with acceptors, village leaders, ASHA, Dais and others and utilize them for
promoting Family Welfare Programme.
Identify women leaders and help the Health Assistant Female to train them.
Participate in Mahila Mandal meetings and utilize such gatherings for educating women in
Family Welfare Programme.
1.3. Medical Termination of Pregnancy
Identify the women requiring help for medical termination of pregnancy and refer them to
nearest approved institution.
Educate the community of the consequences of septic abortion and inform them about the
availability of services for medical termination of pregnancy.
2. Role of ANM in UIP & Nutrition
2.1. Nutrition
Identify cases of malnutrition among infants and young children (zero to five years) give the
necessary treatment and advice and refer serious cases to the Primary Health Centre
Distribute Iron and Folic Acid tablets rs in getting as prescribed to pregnant nursing mothers,
and young children (up to five years) as per the guidelines
Administer Vitamin A solution to children as per the guidelines.
Educate the community about nutritious diet for mothers and children.
Coordinate with Anganwadi Workers.
8. 8
2.2. Universal Programme on Immunization (UIP)
Immunize pregnant women with tetanus toxoid.
Administer DPT vaccine, oral poliomyelitis vaccine, measles vaccine and BCG vaccine to all
infants and children, (Hepatitis-B in pilot areas) as per immunization schedule
Ensure injection safety.
3. Role of ANM in Dai training
List Dais in her area and involve them in promoting Family Welfare.
Help the Health Assistant Female / LHV in the training programme of Dais.
4. Communicable Diseases
Notify the M.O. PHC immediately about any abnormal increase in cases of
diarrhoea/dysentery, fever with rigors, fever with rash, fever with jaundice or fever with
unconsciousness which she comes across during her home visits, take the necessary
measures to prevent their spread, and inform the Health Worker Male to enable him to
take further action.
If she comes across a case of fever during her home visits she will take blood smear,
administer presumptive treatment and inform Health Worker female for further
action.
Identify cases of skin patches, especially if accompanied by loss of sensation, which she
comes across during her homes visits and bring them to the notice of the Health Worker
Male/MO (PHC).
Assist the Health Worker Male in maintaining a record of cases in her area, who are
under treatment for malaria, tuberculosis and leprosy, and check whether they are
taking regular treatment, motivate defaulters to take regular treatment and bring
these cases to the notice of health worker Male or Health Assistant Male.
Give Oral Rehydration Solution (ORS) to all cases of diarrhoea/dysentery/vomiting.
Identify and refer all cases of blindness including suspected cases of cataract to M.O.
PHC.
Education, Counselling, referral, follow-up of cases STI/RTI, HIV/AIDS.
Where Filaria is endemic:
Identification of cases of lymphoedema / elephantitis and hydrocele and their
referrals to PHC/CHC for appropriate management.
Training of patients with lymphoedema / elephantitis about care of feet and with
home based management remedies.
Identification and training of drug distributors for mass drug distribution of
DEC on National Filaria Day.
5.Role of MPW(Female)in Vital Events and Record Keeping
5.1. Vital Events
Record and report to the health authority of vital events including births and deaths,
particularly of mothers and infants to the health authorities in her area.
Maintenance of all the relevant records concerning mother, child and eligible couples in
the area.
5.2. Record Keeping
9. 9
Register (a) pregnant women from three months of pregnancy onward (b)infants zero to
one year of age; and (c) women aged 15 to 44 years.
Maintain the pre-natal and maternity records and child care records.
Prepare the eligible couple and child register and maintaining it up-to-date
Maintain the records of contraceptive distribution, IUD insertion. Couples sterilized,
clinics held at the sub-centre and supplies received and issued.
Prepare and submit the prescribed weekly / monthly reports in time to the Health
Assistant Female.
While maintaining passive surveillance register for malaria cases, she will record:
No. of fever cases
No. of blood slides prepared
No. of malaria positive cases reported
No. of cases given radical treatment
6. Treatment of minor ailments
Provide treatment for minor ailments, provide first-aid for accidents and emergencies and refer cases
beyond her competence to the Primary Health Centre/Community Health Centre or nearest hospital.
7. Team Activities
Attend and participate in staff meetings at Primary Health Centre/Community Development
Block or both.
Coordinate her activities with the Health Worker Male and other health workers including
the Health volunteers/ASHA and Dais.
Coordinate with the PRI and Village Health and Sanitation Committee.
Meet the Health Assistant Female each week and seek her advice and guidance whenever
necessary.
Maintain the cleanliness of the sub-centre.
Dispose medical waste as per the guidelines.
Participate as a member of the team in camps and campaigns.
Summary
The responsibility of MPHW (Male) mainly focuses activities are related to disease control programs,
detection and control of epidemic outbreaks, environmental sanitation, safe drinking water, first aid in
emergencies like accidents, injuries, burns etc., treatment of common/ minor illnesses, communication
and counselling, life style diseases and logistics and supply management at sub-centre and in addition
also facilitate ANM in MCH, Family Welfare, and Nutrition related activities .
The ANM focus is mainly on the MCH related activities, in addition she also performs the function of
maintenance of records through various registers, vital events registration etc. She also acts as a
resource person for the training of ASHA.
Reference:
1. IPHS guidelines for sub-centre, 2012.