The document outlines the role and structure of sub-centres, now known as Health and Wellness Centres (HWCs), serving as the primary contact point for health services in rural India, catering to populations of 5,000 in plain areas and 3,000 in hilly areas. It discusses their objectives, types, infrastructure requirements, essential equipment, and services provided, including maternal and child health, family planning, and immunization. Additionally, the document highlights budgetary provisions and monitoring mechanisms to ensure quality health care and proper waste management in these centres.

2. PRESENTEDBY
Ms. ANSHUYADAV
Nursing instractor

4.  Introduction
 Definition
 Background
 Objectives
 Purposes
 Category/types
 Types of kits available at sub-centre
 Physical infrastructure
 manpower
 Services provide at sub-centre
 Equipments
 Drugs

5.  Budgeting
 Registration and total register at sub-centre
 Monitoring mechanism
 Quality assurance
 Waste disposal
 Record and report
 Importance
 Summary
 Conclusion
 Bibliography

6. Sub-centre is the first point of contact between primary
health system and community peoples. it is the first unit
of health system for village peoples. It provides the
primary health services to the community peoples. Now it
is known as health and wellness centre (HWCs).

7. It covers the population of 5000 in plain area
and 3000 in hilly or tribal areas.
According to 7 February 2020 report , Total
1602 health and wellness centres functioning
in UP .
India has passed a notable landmark 1,50,000
Ayushman Bharat health and wellness centres
have been operationalised before 31
December.

8. “Sub-centre is the lowest referral pyramid of
health facilities in which provide adequate
primary health services to the peoples.”
OR
“Sub-centre is the first contact between
community peoples and services for
promoting the health of the peoples.”

9.  National rural health mission (NRHM) is strengthen the
sub-centre to the level of Indian public health standards
which were first prescribed in early 2007.
 September 2010 , total 1,47,069 sub-centre functioning
in the country.
 In February 2018, the government of India announced
the creation of 1,50,000 health and wellness centres by
transforming existing sub-centres and PHC as the base
of pillar of Ayushman Bharat.

10. o To provide basic primary health care to the
community.
o To achieve and maintain acceptable standards of
quality of care.
o To make the services more responsive and sensitive to
the needs of the community.
o To facilitate supervision and monitoring of health
services.

11. Promotion
of health
Preventive
services
Curative
services

12. Types of sub-centre
Type A sub-
centre
Type B sub-
centre

13.  Total kits-16
 Sub- centre kits
 Kit A
 Kit B
 Kit C (Midwifery kit)

14. • Sub-centre should have its own building.
• Location of the centre- it should be located
within the village and no person has to travel
more than 3km to reach sub-centre.
• Building and layout- type B sub-centre
should have 4 to 5 rooms ,1 waiting room,1
labor room,1store room,1room for
office,1toilet facility , newborn corner and
ward room , one room have only 2 or 4 beds.

15.  Building structure should be made disaster
proof especially earthquake.
 It should not be located in low lying area.
 Fire extinguishers should available.
 Signage and furniture should also available.
 Health staff should be trained about
management and prevention of disaster.

17. Maternal and child health(JSY,JSSK)
Family planning and contraception
Adolescent health care
School health services
Control of endemic diseases
Safe abortion services(MTP)
Water quality monitoring

18. Promotion of medical herbs
Immunization
Record of vital events
National health programme
Under five clinics
Nutritional programme
National rural health mission

19.  Examination table
 24 hour water supply and electricity
 Refrigrator
 Room heater/cooler
 Plastic sheet
 Ice pack pox
 Cheatle forcep
 Chair, stool, jug , torch
 Screen , lamp, bed with mattress
 Clock , fan ,light

20.  Kidney tray , vaccine carrier
 Tooth forceps
 Vitals tray , depressor
 Cannula , seizure , tape
 Ambu bag , mucus extractor
 Cotton , bandage
 Suction machine , hemoglobin meter scale
 Oxygen administration equipments
 Catheter , IV stand , PPE
 Specimen bottle , incubator

21.  Disposable delivery kit , partograph
 Pregnancy kit(strip for urine test)
 Dressing tray
 Plastic sheets
 Uterine forceps vulsellum
 Vaginal spaculum
 Cord cutting scissors
 Suture needle
 Weighing scale ,
 Nasal cannula , infantometer

22. (1)Drug kit for type a sub-centre
 oral rehydration salt
 vitamin a solution and tablet
 Iron and folic acid tablet
 PCM syrup
 eye drops

23. (2) Drug kit for type b sub-centre
 inj. And tab . Methylergometrine
 inj . Oxytocin
 tablet and inj. Diclofenac
 inj. Magnesium sulphate , gentamycin
 tab. Mebendazle
 cap. Ampicillin , absorbent cotton, Savlon

24. 3) Vaccines
- BCG,DPT,OPV,MEASLES,TD
- JE, Hepatitis B
4) Contraceptive methods
- condom
- oral pills
- copper t(380-A)s
- emergency contraceptive pills
- counseling

25.  NRHM providing fund 10,000 to each sub-
centre .
 Fund to be kept under joint bank /post office.
 1000 fund also for maintenance of sub-centre
building.
 This fund also improve village level and
community level activities.
 Transporting emergencies available for
referral centres.

26.  Eligible couples
 MCH( antenatal visit , intranatal visit ,
postnatal visit)
 Under five children(immunization , growth
monitoring)
 Birth and death register
 Drug expiry register
 HIV/STD/RTI infections

27.  Total register at sub-centre – 18
 birth and death register
 Eligible couples
 Male and female sterilization cases
 IUD
 Condom distribution
 MTP cases
 Distribution DDT
 Daily report
 Mahila mandal meeting
 OPD Register etc.

28. Internal mechanism – record checking by
periodic intervals by the male and female
health supervisors from PHC (at least once a
week) MO of the PHC (at least once in
month).
External mechanism – it will be under the
oversight of gram panch.

29.  This can be ensured through regular skill
development training / continuing medical
education(at least one training a year ) as per
guideline of NRHM.

30.  Infection management and environment plan
guidelines (1998) for health care workers for
waste management and infection control in
sub-centre of ministry of health and family
welfare , government of India are to be
followed.
 Deep burial pit methods

31.  Proper maintenance of records of services
provided at sub-centre.
 morbidity and mortality data recording is
necessary.

32.  Sub-centre are assigned tasks related to
interpersonal communication in order to bring
about behavioral change.
 Provided equally all primary health services to
all the community peoples.

33. 1. Saxena R . P. Prof. textbook of community
health nursing . 3rd ed. Punjab : lotus
publisher.pp78-81.
2. GM Veerbhadrappa . The short textbook of
CHN . Vol 2nd.new Delhi ; the health sciences
publishers . Pp31-33.