Health care in India

coolbrat

New member
Hi all
this thread focusses on health care delivery system in India and various concerned issues. The current topic deals with the Indian Public Health standards at most peripheral level.

Public health care delivery system Indian Public health standards - for subcentres.
In the public sector, a Sub-health Centre (Sub-centre) is the most
peripheral and first contact point between the primary health care system and the community. As per the population norms, one Sub-centre is established for every 5000 population in plain areas and for every 3000 population in hilly/tribal/desert areas.
There is a felt need for quality management and quality assurance in
health care delivery system so as to make the same more effective, economical
and accountable. No concerted effort has been made so far to prepare
comprehensive standards for the Sub-centres. The launching of NRHM has
provided the opportunity for framing Indian Public Health Standards.

The overall objective of IPHS is to provide health care that is quality oriented
and sensitive to the needs of the community.

Service Delivery:
♦ All “Assured Services” as envisaged in the Sub-centres should be available,
which includes routine, preventive, promotive, few curative and referral
services in addition to all the national health programmes as applicable.
♦ All the support services to fulfil the above objectives will be strengthened at
the Sub-centres level.

Minimum Requirement (Assured Services) to be provided in a Subcentre:

1.Maternal and Child Health:
(i) Antenatal care:
(ii)Intranatal care
(iii) Postnatal care

2.Child health

3.Family Planning and Contraception

4.Counseling and appropriate referral for safe abortion services (MTP)
for those in need.
5.Adolescent health care
6.Assistance to school health services.
7.Control of local endemic diseases such as Malaria, Kala azar,
Japanese Encephalitis, Filariasis, Dengue etc and control of Epidemics
8. Disease surveillance
9. Water Quality Monitoring

10. Promotion of sanitation including use of toilets and appropriate
garbage disposal.
11. Field visits
12. Community needs assessment
13. Curative Services:
3.12.1 Provide treatment for minor ailments including fever, Diarrhea, ARI, worm
infestation and First Aid
3.12.2 Appropriate and prompt referral
3.12.3 Organizing Health Day at Anganwadi centres at least once in a month with
the help of Medical Officer of PHC, ASHA, AWW, PRI, self help groups
etc.
14. Training, Coordination and Monitoring:
3.13.1Training of Traditional Birth Attendants and ASHA/Community Health
Volunteers
3.13.2 Monitoring of water quality in the villages
3.13.3 Keeping watch over unusual health events
3.13.4 Coordinated services with AWWs, ASHA, Village Health and Sanitation
Committee, PRI etc.
11
15. National Health Programmes:
1 National AIDS Control Programme (NACP)
:
• IEC activities to enhance awareness and preventive measures about STIs
and HIV/AIDS, PPTCT services and HIV-TB coordination.
• Counseling and referral of persons practicing high risk behaviour in relation
to HIV/AIDS and STD
• Linkage with Microscopy Centre for HIV-TB coordination.
• Condom Promotion & distribution of condoms to the high risk groups.
• Help and guide patients with HIV/AIDS receiving ART with focus on
adherence.

2 National Vector Borne Disease Control Programme (NVBDCP):
Prevention of breeding places of vectors through IEC, community mobilisation,
collection of blood smears from all fever cases, supply of anti malarial drugs and
follow-up of patients on treatment are the activities that are required at the subcentre
level. Rapid test kits for malaria may be used in sub-centres wherever
such provision has been made. Assistance to integrated vector control activities
in relation to Malaria, Filaria, JE, Dengue, Kala-Azar etc. as prevalent in specific
areas and record keeping and reporting of the same. The disease specific
guidelines issued by NVBDC are to be followed.
3 National Leprosy Eradication Programme (NLEP):
Refer the suspect cases of leprosy (patients with skin patches with loss of
sensation) to PHC, provision of MDT to diagnosed patients of leprosy at subcentre,
accompanied with documentation & follow-up. Help in defaulter retrieval.
Facility for potable drinking water should be ensured for patients taking
supervised treatment. Educating public about sign, symptoms & complication of
leprosy and availability of MDT at Government Institutions.
4 Integrated Disease Surveillance Projects (IDSP):
• Weekly reporting of information for Syndromic Surveillance in prescribed
format to be reported to Primary Health Centres on every Monday.
• High level of alertness for any unusual health event and appropriate action.
5 Revised National Tuberculosis Control Programme (RNTCP):
• Referral of suspected symptomatic cases to the PHC/Microscopy centre
• Provision of DOTS at subcentre and proper documentation and follow-up.
Care should be taken to ensure compliance and completion of treatment in all
cases. Adequate drinking water should be ensured for taking the tablets.
6 National Blindness Control Programme (NBCP):
IEC is the major activity to help identify cases of blindness and refer suspected
cataract cases to the PHC/CHC.
7 Non-communicable Disease (NCD) and Cancer Control Programmes:
IEC to sensitise the community about prevention of cancers and other NCDs,
early detection through awareness regarding warning signs and appropriate and
prompt referral of suspect cases.

16. Record of Vital Events
3.15.1 Recording and reporting of vital events including births and deaths,
particularly of mothers and infants to the health authorities.
3.15.2 Maintenance of all the relevant records concerning mother, child and
eligible couples in the area.
 
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