Primary Health Care Dr Pracheth R Subcentre level

Primary Health Care Dr. Pracheth R.

Sub-centre level • Every 5000, 3000: difficult areas • Link with grass root level • Female Health Worker: ANM • Male Health Worker: MPW • One health assistant (female): LHV, health assistant (male): supervize

Roles and responsibilities ANM • Register, antenatal care • Ensure: women: 4 antenatal visits • Identify high-risk cases • Refer abnormal cases • Conduct deliveries/supervise: dais • Refer: difficult deliveries

Roles and responsibilities ANM • Identify: beneficiaries-JSY • Make: at least 2 postnatal visits • Assess growth: infant • Essential newborn care • Immunization, breast feeding promotion • Treat childhood ailments

Roles and responsibilities ANM • Utilize : eligible couple register-family planning programme • Distribute: OCP/conventional contraceptives • Follow up services: side-effects • Establish female depot holders-continuous supply • Identify, refer those: needing MTP

Registers maintained-ANM • Report vital events-health authorities • Register: pregnant, infants, women: 15 -49 years • Eligible couple, child register • Pre-natal, maternity, child care records • Records: contraceptive used, couples sterilized, IUD inserted.

ASHA+ ANM • Weekly /fortnightly meeting: discuss activities • Resource persons • Update eligible couple register • Motivate pregnant women: TT, IFA • Orient ASHA: OCPs • Danger signs: pregnancy

M-health

IPHS for sub-centres • Maternal Health care: üAntenatal care üIntranatal care üPostnatal care üChild health care üFamily planning üServices: MTP

Continued…. • Adolescent health care • Water quality monitoring • Promote sanitation • Field visits: health workers • Train Dais • Treat minor ailments

National Health Programmes • NACP: IEC, counsel, referral, condom, link-ART • NVBDCP: IEC, blood smears, supply drugs • NLEP: refer suspect cases, provide MDT, follow up • RNTCP: refer, provide DOTS • NBCP: IEC, refer suspect cataract • IDSP: report weekly • NCD, cancer control: screening

Primary Health Centres (PHCs) • Population: 30, 000 • Functions: üMedical care, MCH üWater+ sanitation üPrevention, control: endemic diseases üCollect, report vital statistics üHealth education üNational Health Programmes üReferral, laboratory

IPHS for PHCs Why ? ? • Comprehensive health care • Acceptable standard • Sensitive: needs of people

Standards • Medical care • Maternal and child care üAntenatal üIntranatal üPostnatal üNewborn care üCare of child

Continued…. • Full range: family planning • MTP : trained personnel • Health education: STI/RTI • Nutrition services: diagnose anaemia, vitamin A deficiency • School health services • Adolescent health • Control epidemics

Continued…. • Collect, report vital events • Test water quality, disinfection • National Health Programmes: üRNTCP üNPCB üNVBDCP üNACP

Continued…. • Prompt referral • Training • Basic laboratory services • Monitor activities • Selected surgeries • Mainstream AYUSH

Staffing pattern • Medical Officer: 1 - 3 • AYUSH: nil-1 • Account manager: nil- 1 • Pharmacist: 1 -2 • Nurse: 1 -5 • Health workers (F): 1 -1 • Health educators: 1 -1 • Health assts: 2 -2

Continued…. • Clerks: 2 -2 • Lab technician: 1 -2 • Driver: 1 - Outsource • Class IV: 4 -4

Community Health Centres (CHCs) • Population: 80, 000 to 1 lakh • 30 beds; specialists: surgery, medicine, OBG, paediatrics-X ray, lab facilities • New non-medical post: Community Health Officer • Refer: Nearest Medical College/State level hospital

IPHS standards • Routine , emergency cases: üI&D, hernia , hyrocoele, appendicitis üIntestinal obstruction, haemorrhages • Medicine cases: routine +emergencies • 24 hour delivery services • Caesarean • Family planning • Safe abortion • New born care

Continued…. • National Health Programmes: üRNTCP üNACP üNVBDCP üNLEP üNBDCP üIDSP • Blood storage facilities

Medical Officer • Captain: health team, morning: OPD, supervisor • Plan and implement UIP • Proper implementation: IMNCI • School visits • Training: ASHAs, AWWs, Dais • National Health Programmes: guidelines • Visit sub-centres: fixed days • Once a month: staff meeting • Team leadership: success

Female Health Worker • Maternal and Child Health • Family planning • MTP • Nutrition • UIP • Dai training • Communicable diseases • Vital events

Continued…. • Record keeping • Treat minor ailments • Team activities

Health worker male • Record keeping • NVBDCP: üMalaria üKala azar: fever 15 days, suspect : PHCs üJE üFilariasis: lymphoedema • Identify skin patches • RNTCP

Continued… • NBCP • RCH programme • Communicable diseases • Environmental sanitation • Health education • Record maintenance

Health assistant (Female) • Covers: 30, 000 population (20, 000: hilly) • Supervision, guidance • Team work • Supplies, equipment, maintenance: sub-centres • Records, reports: scrutiny • Kala azar, JE, fliariasis: endemic- 10% houses verify • Train ASHAs/Dais

Continued… • MCH clinics: Sub-centres, respond to calls from Dais • Family welfare clinics • Inform: services-MTP • Identify: malnutrition cases • IFA, Vitamin A • Supervise immunization • Early diagnosis: ARI • Help MO: school health services

Health assistant (male) • Malaria: supervise MHW, minimum 10% house check, radical treatment , supervise spray insecticides • Communicable disease: outbreak investigation • Leprosy: ensure proper treatment • TB: ensure complete treatment • Environmental sanitation • Nutrition: identify, IFA, Vitamin A • Blindness: case referral • Conduct immunization : school going children

Summary

Thanks