SUSWASTHYA KENDRAS HWC COMPREHENSIVE PRIMARY HEALTH CARE IN

SUSWASTHYA KENDRAS (HWC) COMPREHENSIVE PRIMARY HEALTH CARE IN WEST 1

FUNCTIONING STATUSHWC (S. K) Ø Functioning: 430 ØSC: 162 ØPHC: 262 ØIn FY 2019 -20: , 2148 more would be functional 2

HUMAN RESOURCES ØCHO is the bridge between ANM & MO ØAt S. K. level: ØCHO, Nodal officer ØANM -2 (1 st & 2 nd) ØASHA – 5 to 7 üThe Community Health Officers - selected from regular cadre of Staff Nurses üThe expertise of Staff Nurses in curative services üFixed Incentives üBond Agreement and Fine for dropout 3

BPCCHN TRAINING Ø Org. by WBNC with tech assistance from Health University Ø PSC (Programme study centre) - Nursing Training Schools in attached to Medical Colleges/Dist. /Subdivision hospitals Ø Currently functioning – 28 with a batch size of 60 Ø Batch strength - 1658. Ø Technical Commtt. – multidisciplinary (Subject specialists, Nursing council, Programme officers etc. ) – to review and update course modules 4

SALIENT POINTS ABOUT THE BPCCHN TRAINING The BPCCHN Training is being affiliated under West Bengal Nursing Council. The program will be offered in both January and July cycle of admissions The selection of the candidates eligible for the BPCCHN Training have been stipulated to : 1. GNM/B. Sc (Nursing)/Post Basic B. Sc (Nursing)/M. Sc (Nursing) passed working as Staff Nurse, Gr II under WBNS cadre on regular basis 2. GNM passed ‘Other’ cadre HA(F) The Training is non-residential in nature. No accommodation shall be provided for trainees. Study Materials and Uniform shall be provided and must be maintained properly. Breakfast, Lunch, evening tiffin and tea shall be provided to all trainees.

Duties and Responsibilities of Community Health Officer (CHO) A. ROLES & RESPONSIBILITIES RELATED TO ADMINISTRATION: 1. To perform all the day to day administrative duties at Su-Swasthya Kendra 2. To submit all the reports and returns to the higher level. 3. To supervise and guide Health Assistant (Female), 2 nd ANM, ASHA and other staff at Su. Swasthya Kendra. 4. To participate actively in financial management 5. To maintain the attendance register at Su-Swasthya Kendra for CHO, ANMs and ASHA. 6. To maintain Inventory and ensure supply of essential drugs, logistics, consumables, vaccines with the help of 1 st ANM and under guidance of Sr. PHN.

B. ROLES & RESPONSIBILITIES RELATED TO HEALTH CARE SERVICES: 1. Care in pregnancy (antenatal & post-natal) and child-birth (intra-natal in case of delivery point). 2. Neonatal and infant health care services as a part of post-natal visits 3. Childhood and adolescent health care services 4. Family planning, Contraceptive services and other Reproductive Health Care services 5. Management of Communicable diseases especially vector and water borne diseases 6. Management Outpatient care for acute simple illnesses and minor ailments 7. Screening, Prevention, Control and Management of Non-Communicable diseases 8. Care for Common Ophthalmic and ENT problems 9. Basic Oral Health care 10. Elderly and Palliative Health care services 11. Emergency Medical Services including Burns and Trauma 12. Screening and Basic Management of Mental Health ailments

C. ROLES & RESPONSIBILITIES RELATED TO SUPPORTIVE SUPERVISION • To supervise and guide the HA (F), 2 nd ANM, HA (M) & ASHA in planning & organizing health programme, delivery of health care services to the community. • To carry out supervisory home visit in the area of HA (F)/2 nd ANM/ASHA with respect to their duties under various National Health Programme. • To help the HA (F)/2 nd ANM/ASHA to work as part of the health team. • To coordinate with the stakeholders of other departments like PRI, WCD, PHE, Primary and Secondary Education etc. • To organize and actively participate in VHND, VHSNC and all field and outreach activities. • To engage in social mobilization for health promotion in her community.

EXPANDED BASKET OF SERVICES 1. Care in pregnancy and child-birth. 2. Neonatal and infant health care services. 3. Childhood and adolescent health care services. 4. Family planning, Contraceptive services and other Reproductive Health Care services. 5. Management of Communicable diseases including National Health Programmes. 6. Management of Common Communicable Diseases and Outpatient care for acute simple illnesses and minor ailments. 7. Screening, Prevention, Control and Management of Non. Communicable diseases. 9

EXPANDED BASKET OF SERVICES (CONTD. ). . 7. Care for Common Ophthalmic and ENT problems. 8. Basic Oral health care. 9. Elderly and Palliative health care services. 10. First-aid & emergency Medical Services. 11. Screening and Basic management of Mental health ailments. Newer services to be rolled out in phases 10

INFRASTRUCTURE üState specific branding and nomenclature üMaintaining Quality Assurance protocols üDisplay of Job-aids 11

LAYOUT DESIGN OF S. K 12

INFRASTRUCTURE COMPONENTS q. Building & Branding q. Clinic room, Store, Lab corner, waiting area, toilet (M & F) q. Water, sanitation & electricity with power back up (preferably inverter) q. Approach path with directional signage at main roadway q. Main signage and citizen’s charter q. Grievance box q. Waste disposal system (pit) 13

DRUGS & DIAGNOSTICS ØList of EDL already available – being updated including essential NCD drugs Ø 55 drugs ØNCD, RMNCH, CD ØAs per free drug policy – all drugs & diagnostic services are free 14

ESSENTIAL DRUGS NCD üAntihypertensives • A - ACE inhibitors (Lisinopril, Ramipril) & ARB – Angiotensine receptor blocker (Losartan, Telmisartan) • B - B blocker (Metoprolol, Atenolol, Carvedilol) • C - CCB (Amlodipine, S-amlodipine) • D – Diuretics (Thiazide, Frusemide) ü Statins (Atorvastatin, Rosuvastatin) ü Anti-platelet (Aspirin, Clopidogrel) ü Antidiabetics • • Insulin Biguanides (metformin) Sulphonylurea (Gliclazide, Glibenclamide) DPP 4 (Dipeptidyl peptidase 4) inhibitors (Vildagliptin) ü Vasodilators (Isosorbide dinitrate, Nitroglycerine) 15

ESSENTIAL DRUGS - NCD Sl. No. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 Name of Drugs Tab. Aspirin (75/150 mg) Tab. Atenolol (25/50/100 mg) Tab. Metoprolol (25/50 mg) Tab. Amlodipine (5/10 mg) Tab. Hydrochlrothiazide (12. 5/25 mg) Tab. Enalapril Maleate (2. 5/5 mg) Tab. Captopril (12. 5/25 mg) Tab. Nifedipine (5/ 10 mg) Tab. Telmisartan (40/80 mg) Tab. Atorvastatin (10/40 mg) Tab. Frusemide Tab. Isosorbide Dinitrate Tab. Digoxine (0. 25 mg) Tab. Metformin HCL (500/750/1000 mg) Tab. Gliclazide 40 mg Tab. Glimepiride (1/ 2 mg) Tab. Etophylline + Theophylline Tab. Propanolol (10/40 mg) Tab. Follic Acid Tab. Amiodarone (100 mg) Tab. Clopidogrel Tab. Frusemide 20 mg + Spironolactone - 50 mg Tab. Glyceryl Trinitrate (2. 6 / 6. 4 mg) Tab. Diazepam Tab. Alprazolam (0. 25/0. 5 mg) Tab. Verapamil (40 mg) Tab. Potassium IP Type of facility where to be at least made Point of Care available OPD OPD OPD OPD OPD OPD Both Sub-centre & PHC Suswasthya Kendra OPD OPD OPD Only PHC-Suswasthya Kendra 16

ESSENTIAL DRUGS – OTHER SERVICES Tab Diclofenac (50 mg) Tab Paracetamol (500/650/1000 mg) Tab Levo-Cetirizine (5/10 mg) Tab Chlorpheniramin Tab. Albendazole (400 mg) Tab. Diethylcarbamazin (Antifilarial) (50/100 mg) Tab Ciprofloxacin (250/ 500 mg) Inj. Gentamicin (10 / 40 mg/ml) Tab Metronidazole (200/400 mg) Tab/ Cap Amoxicillin (250/500 mg) Syr. Amoxicillin (250 mg/5 ml) Tab Fluconazole 100 mg Tab Chloroquin (150 mg) & Primaquin (2. 5/7. 5/15 mg) Tab Artesunate (A) + Sulphadoxine – Pyrimethamine (B). Combi pack (A+B) Tab IFA (child & adult) Cap Mefenamic acid (250/500 mg) Lotio. Gamma benzene hexa-chloride/ Benzyl Benzoate (anti-scabies) Tab Folic acid (5 mg) Oint Clotrimazole Soln. Methylrosanilinium chloride (Gentian Violet) Oint Povidone iodine Oint Silver sulphadiazine Lotio Povidone Iodine (4 -10%) Tab Famotidine (20/40 mg) Tab Domperidone (10 mg) Tab Dicyclomine (10 mg) Oral rehydration salts (low osmolar) Zinc sulphate (10/20 mg) Normal Saline nasal drops : sodium chloride Xylometazoline nasal drops Wax-solvent ear drops : benzocaine, chlorbutol, paradichlorobenzene, turpentine oil Tab Ibuprofen (200/400 mg) Tab. IFA (100 mg elemental Iron + 400 mcg Folic acid) Tab. Ca+D 3 (Calcium-500 mg+D 3 -250 I. U) 17

ESSENTIAL EQUIPMENTCONSUMABLES FOR CHO APART FROM EXISTING SC SERVICES Weighing Scale, Adult 125 kg/280 lb Measuring Tape (MUAC) Weighing Scale, Infant (10 Kg) Steam Sterilizer (big) Sphygmomanometer Aneroid 300 mm with cuff IS: 7652 Cusco’s/Graves Speculum vaginal bi-valve medium Stitch Cutting Scissor Tooth Forceps Needle Holder Suture needle straight -10 Suture needle curved Foreign body hook (ENT) Artery Forceps, straight, 160 mm Stainless steel Digital Thermometer (Infra-red variety) Stethoscope Digital Foetal doppler Measuring Tape (WC) Dental Probe with mirror set Examination Lamp Tongue Depressor Mouth Gag Snellen vision chart Near vision chart Colour vision chart Stadiometer Nebulizer Gauze Cutting Scissors Straight Tuning fork IV cannula and Intravenous set Glucometer with Testing 18

DIAGNOSTIC FACILITIES AT S. K ü Hemoglobin ü Human chorionic gonadotropin (HCG) (Urine test for pregnancy) ü Urine test for glucose, protein ü Blood sugar ü Malaria test (Smear & RDT) ü HIV (Antibodies to HIV 1&2) ü Test for iodine in salt (used for food) ü Water testing for fecal contamination and chlorination (H 2 S) ü Hematology – Slide preparation for blood smear ü Filariasis (endemic areas only) –FST ü Visual Inspection – Acetic Acid* ü Rapid Test Kit for Syphilis –RDT* 19

CPHC ACTIVITIES Mother’s Picnic Saturday Review Meetings 20

SATURDAY REVIEW MEETINGS Ø 1 st Sat: Block MIS meeting agenda Fixed CME Ø 2 nd Sat: Block PH & ASHA orientation meeting Ø 3 rd Sat: Convergence meeting with ICDS Ø 4 th Sat: GP Meeting with PRIs (CHCMI – Community healthcare management initiative) Ø 5 th Sat: Misc agenda discussion at PHCs 21

CPHC ACTIVITIES Screening of Common NCDs March - Aug 2019 80000 70000 60000 50000 40000 30000 20000 10000 0 74656 55274 Hypertension Diabetes 10026 6770 Oral Cancer Breast Cancer 22

MONITORING & SUPERVISION ØDistrict CPHC cell with Dy. CMOH-III (Nodal officer), Dy. CMOH-I, II, DPHNO, A. E, DPC, DAF ØBlock CPHC cell with BMOH (Nodal Off), BPHN/PHN, BAM, BAF 23

EXPANDED SERVICES 24

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