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Indian Public Health Standards (IPHS) For 51 to 100 Bedded Sub-District/Sub-Divisional Hospitals
Directorate General of Health Services Ministry of Health & Family Welfare Government of India
1. Introduction 2. Objectives of IPHS for Sub-District Hospitals 3. Definition of Sub-District Hospital 4. Grading of Sub-District Hospital 5. Functions 6. Essential Services 7. Physical Infrastructure 8. Manpower 9. Equipment 10. Laboratory Services 11. Recommended allocation of bed strength at various levels 12. List of Drugs 13. Capacity Building 14. Quality Assurance in Services 15. Rogi Kalyan Samities / Hospital Management Committee 16. Citizen’s Charter Annexure – I: Guidelines for Bio-Medical Waste Management Annexure – II: Reference Laboratory Networks List of Abbreviations References 3 4 4 4 5 5 26 36 39 52 55 56 67 67 68 68 78 82 87 88
Sub-district (Sub-divisional) hospitals are below the district and above the block level (CHC) hospitals and act as First Referral Units. Specialist services are provided through these sub-district hospitals. These hospitals should play an important referral link between the Community Health Centres, Primary Health Centres and sub-centres. They have an important role to play as First Referral Units in providing emergency obstetrics care and neonatal care and help in bringing down the Maternal Mortality and Infant Mortality. It also saves the travel time for the cases needing emergency care and reduces the workload of the district hospital. In some of the states, each district is subdivided in to two or three sub divisions. A subdivision hospital caters to about 5-6 lakhs people. In bigger districts the sub-district hospitals fills the gap between the block level hospitals and the district hospitals. There are about 1200 such hospitals in the country with a varying strength of number of beds ranging from 50 to 100 beds or more. The Government of India is strongly committed to strengthen the health sector for improving the availability, accessibility of affordable quality health services to the people. In order to improve the quality and accountability of health services a set of standards need to be there for all health service institutions including sub-district hospitals. Standards are a means of describing the level of quality that health care organizations are expected to meet or aspire to. The key aim of standard is to underpin the delivery of quality services which are fair and responsive to client’s needs, which should be provided equitably and which deliver improvements in health and well being of the population. Standards are the main driver for continuous improvements in quality. The performance of Sub-district hospitals can be assessed against a set of standards. There has been effort to set standards for 30 and 100 bedded hospitals by the Bureau of Indian Standards (BIS). However, these standards are considered very resource intensive and lack the process to ensure community involvement, accountability and citizens charter issues that are important for public hospitals. Under the National Rural Health Mission (NRHM), the concept of Indian Public Health Standards (IPHS) for the Health Centres/ Hospitals functioning in the country. IPHS for CHC, PHC and Sub-centres have been finalized available on the ministry’s website www.mohfw.nic.in. The current effort is to prepare Indian Public Health Standards for the Sub-district Hospitals. Reference has been made to the BIS Standard for 100 bedded hospitals; Rationalisation of Service Norms for Secondary Care Hospitals prepared by Govt. of Tamil Nadu; District Health Facilities, Guidelines for Development and Operations, WHO, 1998 and Indian Public Health Standards (IPHS) for Community Health Centres.
Setting standards is a dynamic process. This document contains the standards to bring the Sub-district Hospitals to a minimum acceptable functional grade with scope for further improvement in it. These standards are flexible as per the requirements and resources available to the concerned State/UT Government. The timeframe for implementation and achievement of these Standards could be extended for five years and to be done in phases. Most of the existing hospitals below district level (51-100 Bed category) are located in older buildings in urbanized areas / towns as compared to most Primary Health Centres / Sub-centres. The expansions already done have resulted in construction touching the boundaries walls with no scope of further expansions. As far as possible, States should not dislocate the said hospitals to a new location (in case of dislocating to a new location, the original client group will not be able to have same access to the desired health facilities)
Objectives of Indian Public Health Standards (IPHS) for Sub-District Hospitals:
The overall objective of IPHS is to provide health care that is quality oriented and sensitive to the needs of the people of the district. The specific objectives of IPHS for Sub District Hospitals are: i. ii. iii. To provide comprehensive secondary health care (specialist and referral services) to the community through the Sub District Hospital. To achieve and maintain an acceptable standard of quality of care. To make the services more responsive and sensitive to the needs of the people of the district and act as the First Referral Unit (FRU) for the hospitals/centers from which the cases are referred to the Sub District hospitals Definition of Sub District hospitals
The term Sub District / Sub Divisional Hospital is used here to mean a hospital at the secondary referral level responsible for the Sub District / Sub Division of a defined geographical area containing a defined population. 4. Grading of Sub District hospitals
The size of a sub district hospital is a function of the hospital bed requirement, which in turn is a function of the size of the population it serves. In India the population size of a sub district varies from 1,00,000 to 5,00,000. Based on the assumptions of the annual rate of admission as 1 per 50 populations and average length of stay in a hospital as 5 days, the number of beds required for a sub district having a population of 5 lakhs will be around 100-150 beds. However, as the population of the sub district varies a lot, it would be prudent to prescribe norms by grading the size of the hospitals as per the number of beds.
5. preventive and promotive) for a defined population.Grade I: Sub District hospitals norms for 100 beds or more Grade II: Sub District hospitals norms for 50 beds not exceeding 100 beds The Sub District hospitals having less than 50 beds may follow the IPHS standards prescribed for CHCs. Functions A sub district hospital has the following functions: 1. Function as a referral centre for the public health institutions below the district level such as Sub-divisional Hospitals. Sub District Hospitals having more than 100 beds should follow IPHS for District Hospitals. 2. It provides effective. manpower. equipment norms. have been given. Similarly. with their full participation and in co-operation with agencies in the district that have similar concern. affordable healthcare services (curative including specialist services. Essential Services (Minimum Assured Services) Services include OPD. Secondary level health care services regarding following specialties will be assured at hospital: Consultation services with following specialists: General Medicine General Surgery O&G Paediatrics Emergency/A&E Critical care Anaesthesia Opthalmology ENT Dermatology and Venerology (Skin & VD) RTI/STI Orthopaedics 5 . 6. It covers both urban population (sub divisional headquarter town) and the rural population of the sub division. Community Health Centres. Provide education and training for primary health care staff. indoor. emergency services. diagnostic and investigation facilities. The minimum functional grade of the two different grades of sub district hospitals requiring the physical infrastructure. 3. drugs and other supportive services etc. Primary Health Centres and Sub-centres.
Financial powers of Head of the Institution Medical Superintendent to be authorized to incure and expenditure up to Rs. Following services mix of procedures in medical and surgical specialties would be available: SERVICE MIX OF PROCEDURES IN MEDICAL AND SURGICAL SPECIALITIES MEDICAL 6 . housekeeping and sanitation. No equipment/instruments should remain non-functional for more than 30 days.00 lakhs for repair/upgrading of impaired equipments/instruments with the approval of executive committee of RKS. Manpower and outsourcing work could be done through local tender mechanism. It will amount to suspension of status of IPHS of the concerned institutions for absence period. Blood transfusion and storage. Outsourcing of services like laundry.Dental care AYUSH Diagnostic and other Para clinical services regarding: Lab. Gender and socially sensitive service delivery be assured. ambulance. dietary. and physiotherapy Support services: Following ancillary services shall be ensured: ♦ ♦ ♦ ♦ ♦ ♦ ♦ ♦ Medico legal/postmortem Ambulance services Dietary services Laundry services Security services Housekeeping and sanitation Waste management Office Management (Provision should be made for computerized medical records with anti-virus facilities whereas alternate records should also be maintained) Counseling services for domestic violence. waste disposal etc. etc. ECG. Ultrasound. X-ray. to be arranged by hospital itself. gender violence. Finance* Inventory Management ♦ ♦ ♦ * Financial accounting and auditing be carried out as per the rules along with timely submission of SOEs/UCs. adolescents.15.
OPV.only cradle 2.2 .1 Pleural Aspiration 2 Skin scraping for fungus / AFB 3 Skin Biopsies 4 Abdominal tapping OPD Procedures (Including IPD) 1 Dressing (Small.Incubator 2.10 .1 . DPT. Measles.Electrical Stimulator 7 .Cut down 2.3 .Radiant Heat Warmer 2. DT) 2 Services related to new borne care 2. Medium and Large) 2 Injection (I/M & I/V) 3 Catheterisation 4 Steam Inhalation 5 Cut down (Adult) 6 Enema 7 Stomach Wash 8 Douche 9 Sitz bath 11 Blood Transfusion 12 Hydrotherapy 13 Bowel Wash Skin Procedures 1 Chemical Cautery 2 Electro Cautery 3 Intra Lesional Injection 4 Biopsy Paediatric Procedures 1 Immunization (BCG.2 .Phototherapy 2.12 .1 .Ventilator Cardiology Procedures and Diagnostic Tests 1 ECG 2 Defibrilator Shock 3 Laproscopy (Diagnostic and Therapeutic) Physiotherapy Services 1 With Electrical Equipments 1.Short wave diathermy 1.Gases (oxygen) 2.4 .5 .
I & C of chalazion 1.2 .Tonometry 1.Walking Bars 2.Subconj Injection 1.Epilation 1.3 .Syringing and Probing 1.6 .Conjuctival Resuturing 1.1 .Ultra Sonic Therapy 1.20 .Small Lid Turnour Excision 2.Syringing of Ear 1.10 .7 .Pterygium Excision 1.2 .3 .18 .2 .3 .Retrobular Injection (Alcohol etc.13 .Infra Red Lamp (Therapy) 1.4 .Mechanical Tractions (Lumber & Cervical) 2.Corneal Scarping 1.Foreign Body Removal (Ear and Nose) 1.11 .1 .Shoulder Wheel 2.1 .19 .Conjuctival Cyst ENT Services 1 OPD Procedures 1.2 .Post Polio Exercise Eye Specialist Services (Opthalmology) 1 OPD Procedures Refraction (by using snellen’s chart) 1.5 .Exercycle 2.5 .Uncomplicated Lid Tear 1.1.1 Prescription for glasses using Trial frame.17 .4 .4 .Indirect Opthalmoscopy 1.Foreign Body Removal (Corneal) 1.Syringing & Probing 1.Foreign Body Removal (conjuctival) 1.15 .3 .I & D Lid Abscess 1.12 .5 .Electric Vibrator 2 With Mechanical Gadgets/Exercises 2. 1.16 .) 1.8 .Glaucoma (Trabeculectomy) 2.3 .Retinoscopy 2 IPD Procedures 2.Stye 1.9 .14 .4 .Cauterization (Thermal) 1.Wart Excision 1.Suture Removal 1.Chemical Cauterization (Nose & Ear) 8 .21 .Cataract Extraction 2.
Cautrization (Oral.3 .2 .2 .Septoplasty 3.Stiching of LCW (Nose & Ear) 7.Therapeutic Removal of Granulations (Nasal.5 .Antral Punchure (Unilateral & Bilateral) 3.Hypopharyngoscopy 6.Broncoscopic & F B Removal 7 General ENT Surgery 7.2 . VECC 3 Craniotomy-Dead Fetus/Hydrocephalus 4 Caeserean section 5 Female Sterilisation ( Mini Laparotomy & Laparoscopic) 7 D&C 9 .4 . Aural & nasal) 3 Nose Surgery 3.5 .3 .S M R 3. 2.Direct Laryngoscopy 6.1.1 .Packing (Anterior & Posterior Nasal) 3.6 .1 .Fracture Reduction Nose with Septal Correction 4 Ear Surgery 4.Adenoidectomy 5.4 . Aural.I & D Septal Abscess (Unilateral & Bilateral) 3.1 Oropharynx) 2.Tracheostomy 8 Audiometry 8.7 .1 .Broncoscopic Diagnostic 6.Audiogram (Pure tone and Impedence) Obstetric & Gynecology Specialist Services 1 Episiotomy 2 Forceps delivery.1 .Fracture Reduction Nose 3.Eustachian Tube Function Test 1. Oropharynx.Tonsillectomy 5.Ear Piercing 4.Vestibular Function Test/Caloric Test 2 Minor Procedures .3 .Adenoidectomy + Tonsillectomy 5.Hearing Aid Analysis and Selection 5 Throat Surgery 5.2 .4 .2 .1 .2 .1 .4 .Preauricular Sinus Excision 7.Tongue Tie excision 6 Endoscopic ENT Procedures 6.3 .
Flap Trauma including Vehicular Accidents Sub Mucus Fibrosis (SMF) Scaling and Polishing Root Canal Treatment Extractions Light Cure Amalgum Filling (Silver) Sub Luxation and Arthritis of Temporomandibular Joints Pre Cancerous Lesions and Leukoplakias Intra oral X-ray Complicated Extractions (including suturing of gums) SURGICAL 1 Abcess drainage including breast & perianal 2 3 4 5 6 7 Wound Debridement Appendicectomy Fissurotomy or fistulectomy Hemorrohoidectomy Circumcision Hydrocele surgery 10 . Impaction.8 10 11 16 17 18 19 20 21 22 23 24 25 MTP Bartholin Cyst Excision Suturing Perimeal Tears Assisted Breech Delivery Cervical Cautery Nomal Delivery Casserian EUA Midtrimestor Abortion Ectopic Pregnancy Ruptured Retain Placenta Suturing Cervical Tear Assisted Twin Delivery Dental Services 1 Dental Caries/Dental Abcess/Gingivitis Cleaning Periodontitis 2 Surgery 3 4 5 6 7 8 9 10 11 12 13 14 Minor Surgeries.
Rectum and Anus 1 Fistula in ane low level 2 Fistula in ane high level 11 . Abscess/Perigastric Abscess Biliary System 1 Cholecystostomy 2 Cholecystectomy 3 Cholecystectomy and Choledocholithotomy Colon.8 Herniorraphy 9 Suprapubic Cystostomy 10 Diagnostic Laparoscopy 11 Cysts and Benign Tumour of the Palate 12 Excision Submucous Cysts Breast 1 Excision fibroadenoma – Lump Hernia 1 Ingunial Hernia repair reinforcement 2 Ingunial Hernia repair with mesh 3 Femoral Hernia repair 4 Recurrent Ingunial Hernia repair 5 Strangulated Ventral or Incisional Hernia/Ingunial Abdomen 1 Exploratory Laparotomy 2 Gastrostomy or Jejuncstomy 3 Simple Closure of Perforated Ulcer 4 Burst Abdomen Repair Appendix 1 Emergency Appendisectomy 2 Interval Appendisectomy 3 Appendicular Abscess Drainage Small Intestine 1 Resection and Anastomosis 2 Multiple Resection and Anaestomosis 3 Intestinal Performation Liver 1 Open Drainage of liver abscess 2 Drainage of Subdia.
2 Catheters 3 IV Sets 4 Colostomy Bags 3 Perianal Abscess 4 Ischiorectal Abscess 5 Ileostomy or colostomy alone 6 Haemorroidectomy 7 Anal Sphincter Repair after injury 8 Resection anastomosis Penis. Testes. Scrotum 1 Circumcision 2 Partial amputation of Penis 3 Total amputation of Penis 4 Orchidopexy (Unilateral & Bilateral) 5 Orchidectomy (Unilateral & Bilateral) 6 Hydrocele (Unilateral & Bilateral) 7 Excision of Multiple sebaceous cyst of scrotal skin 8 Reduction of Paraphimosis Other Procedures 1 Suture of large laceration 2 Suturing of small wounds 3 Excision of sebaceous cyst 4 Small superficial tumour 5 Repair torn ear lobule each 6 Incision and drainage of abscess 7 Injection Haemorrhoids/Ganglion/Keloids 8 Removal of foreign body (superficial) 9 Removal of foreign body (deep) 10 Excision Multiple Cysts 11 Tongue Tie 12 Debridment of wounds 13 Excision carbuncle 14 Ingroving Toe Nail 15 Diabetic Foot Asnd carbuncle Urology 1 Pyelolithotomy 12 .
large 30% 1 to 60%.2 Nephrolithotomy 3 Simple Nephrostomy 4 Uretrolithotomy 5 Open Prostectomy 6 Cystolithotomy Superopubic 7 Dialatition of stricture urethra under GA 8 Dialation of stricture urethra without anaesthesia 9 Meatotomy 10 Trocar Cystostomy Plastic Surgery Burn Dressing Small. medium (10% to 30%). Bone. Prepuceal Dilatation. B. Meatotomy Orthopaedic Surgery 1 Hip Surgery Femoral Neck nailing with or without plating replacement prosthesis / Upper Femoral Osteotomy. extensive > 60% 2 Ear lobules repair one side (bilateral) 3 Simple wound 4 Complicated wound 5 Simple injury fingers 6 Multiple finger injury 7 Crush injury hand 8 Polio Surgery 9 Surgery concerning disability with Laprosy 10 Surgery concerning with TB Paediatric Surgery 1 Minor Surgery. tibia. I & D. DHS/Richard Screw Plate 3 Synovial or bone biopsy from HIP 4 Girdle stone Arthoplasty 5 Fractures Open reductuin int. Forarm Humerus inter-condylar fracture of humerus and 6 femur and open reduction and int. fixation or femur. Innominate 2 Osteotomy/Open Reduction of Hip disclocation. Fixation bimaleolar fracture and fracture dialocation of ankle montaggia fracture dialocation Medial condyle of humerus fracture lateral condyle of 7 humerus Olecranen fracture. head of radius lower end of 13 .
No 1 2 3 4 5 6 7 8 9 NAME OF THE ILLNESS Bleeding during first trimester Bleeding during second trimester Bleeding during third trimester Normal Delivery Abnormal lablour ( Mal presentation . Wrist.8 9 10 11 12 13 14 15 16 17 18 radius. excision head fibula. Metacarples.Obstructed labour ) PPH Puerperal Spesis Ectopic Pregnancy Hypertentive disorders RECOMMENDED SERVICE MIX (SUGGESTED ACTIONS) Treat Treat Treat Yes Treat / Refer Treat and refer if necessary Treat and refer if necessary Diagnose & refer if necessary Conservative management and follow up servcies 14 . fixation of hand & foot bones Tarsals. medial malleolus patella fracture and fracture of calcaneum talus single forearm. Phalanges carpals.prolonged labour . bone fracture Ext. Leg. Foot bone and cervicle Forearm or Arm. Hip. lower and of Inia Interlocking nailing of long bones Debridement & Secondary closure Percutaneous Fixation (small and long bones) Closed Reduction Hand. Aknle Dislocation elbow. Knee Closed Fixation of hand / foot bone Ingrowing toe-nail RECOMMENDED SERVICE MIX (SUGGESTED ACTIONS) FOR DIFFERENT ILLNESSES CONCERNING DIFFERENT SPECIALITIES: Obstetric & Gynecology S. Metatarsals. shoulder.PROM. Thigh.
first aid and delivery Gynecology 1 2 3 4 5 6 7 8 9 10 RTI / STI DUB Benign disorders ( fibroid. prolapse . No 1 NAME OF THE ILLNESS Fever -a) Short duration (<1 week) Fever -b) Long duration (>1 week) c) Typhoid d) Malaria / Filaria e) Pulmonary Tuberculosis.10 11 12 Septic abortion Medical disorders complicating pregnancy ( heart disease . ILLNESSES : Bronchial Asthma / Pleuraleffusion / Pneumonia / Allergic RECOMMENDED SERVICE MIX (SUGGESTED ACTIONS) Basic investigation and Treatment Investigation and treatment Refer if necessary Treat Treat Treat Treat Refer to Gr-I / G-II District level Refer to Gr-I / G-II District Diagnose and Treat 2 15 . f) Viral Hepatitis g) Leptospirosis / Menningitis and Haemorrhagic fever h) Malignancy COMMON RESP.hepatitis ) Bronchial asthma Treat and refer if necessary Diagnose and refer Diagnose . ovarian masses ) Initial investigation at PHC / Gr III level Breast Tumors Cancer Cervix screening Initial investigation at PHC / Grade III level Cancer cervix /ovarian Initial investigation at PHC / Gr III level Infertility Prevention of MTCT MTP / MVA services Tubectomy Treat Treat and refer if necessary Diagnose and refer Refer Collection of PAP SMEAR and biopsy Diagnose and refer Investigate and refer Refer Treat Yes GENERAL MEDICINE S.diabetes .
diagnose.Ref. To Gr . Treat. To Gr-II / Gr-I District Hospital Treat Ref. ORT Corner Refer if no improvement 2 3 4 Diarrohoeal Diseases Protein Energy Malnutrition and Vitamin Diagnose. refer if no Pyrexia of unknown origin improvement 16 . & Refer Deficiencies Investigate. No 1 NAME OF THE ILLNESS ARI/ Bronchitis Asthmatic RECOMMENDED SERVICE MIX (SUGGESTED ACTIONS) Investigate Diagnose.I / G-II district Basic investigation and Treatment Refer if necessary Stabilise Ref. Nebulizator Treat Refer if no improvement Diagnose Treat (ORS. IVF). treat.I sub district Ref.3 4 a) b) 5 a) b) 6 a) b) c) 7 Bronchitis/COPD COMMON CARDIAC PROBLEMS a) Chest pain (IHD) b) Giddiness (HT) G I TRACT G I Bleed / Portial hypertension / Gallblader disorder AGE / Dysentry / Diarrhoreas NEUROLOGY Chronic Hpeadache Chronic Vertigo/ CVA/TIA/Hemiplegia/ Paraplegia HAEMATOLOGY Anaemia Bleeding disorder Malignancy Communicable Diseases Cholera Measles Mumps Chickenpox Psychological Disorders Acute psychosis / Obsession / Anxiety neurosis Treat and decide further management Diagnose and treat Emergencies . To Gr . To tertiary Ref. emergency care and referral PAEDIATRICS S.I / G-II district Treat 8 Screening. To Gr .
5 6 7 8 9 10 Bleeding Disorders Diseases of Bones and Joints Childhood Malignancies Liver Disorders Paediatric Surgical Emergencies Poisoning. Bites Treat Treat Early Diagnosis and Refer Diagnose and Refer Early Diagnosis and Refer First Aid . Sting.Refer 17 .
ARI 13 Dangerously ill baby 14 Feeding Problems 15 Neonatal Diarrhoea 16 Birth injury 17 Neonatal Meningitis 18 Renal problems/Congenital heart ndisease/Surgical emergencies 19 HIV/AIDS 20 Hypocalcemia 18 .D. major -refer Manage and Refer Refer Follow up and refer to ART Center Manage NEONATALOGY 1 2 3 4 5 6 7 8 9 Attention at birth (to prevent illness) Hypothermia Birth asphyxia Hypoglycemia Meconium aspiration syndrome Convulsions (seizures) Neonatal Sepsis LBW Neonatal Jaundice 10 Preterm 11 Congenital malformations 12 R. kangaroo care Examine and refer Manage and Refer Identify and manage Identify and manage Diagnosis and manage Minor -manage.S. feeding. No NAME OF THE ILLNESS RECOMMENDED SERVICE MIX (SUGGESTED ACTIONS) 5 cleans warm chain Warm chain Resuscitation And Treatment Treat Treat Treat and Refer Treat 1800-1500 gms treat with kangaroo care below that refer Treat Warm chain.S.
Mycosis Subcut . LGV.Mycetoma d) Parasitic Infestation Scabies / Pediculosis/Larva Migrans e)Spirochaetes Syphilis Papulosquamous Psoriasis (classical)uncomplicated/Lichen Planus Pigmentary Disorder Vitiligo Keratinisation Disorder Ichthyosis/Traumatic Fissures Autoimmune Collagen Vascular DLE. HIV b) Bacteria Pyoderma Chancroid Gonorrhea.Verrucca Molluscum Contagiosa Pityriasis Rosea.Keratosis.21 22 23 24 25 26 27 Metabolic Disorders Hyaline Membrane diseases Neonatal Malaria Blood disorders Developmental Delays UTIs Failure to Thrive Identify & Refer diagnose and refer Manage Manage CBR Manage &refer Manage & Refer DERMATOLOGY S.HIV . Leprosy & Tuberculosis c) Fungal Sup. No 1 NAME OF THE ILLNESS Infections a) Viral . Seb. Soft RECOMMENDED SERVICE MIX (SUGGESTED ACTIONS) Treat Treat Treat Treat Identify / Treat and refer Treat Diagnosis and Treat Treat Treat / Refer Refer / Treat Treat / Refer Treat 2 3 4 5 6 19 . Morphea Skin Tumors.
EMF / SJS / TENPsoriasis/Collagen Vascular/Auto immune Disorders c) Deep Mycosis.Tumors / Cysts.Resistant/ Complications / reaction Allergy . PFT Treatment PFT.7 Fibroma. Miliaria. X-ray 20 .Toxin induced b) Leprosy . Appendageal Tumors Miscellaneous a. Alopecia. STD Complications d) Genetically Determined Disorders Treat Treat / Refer Treat / Refer Refer CHEST DISEASES S. X ray treatment Treatment. Benign Surface. Nail disorder. No 1 2 3 4 5 6 Fever Cough with Expectoration / Blood Stained Hemoptysis Chest Pain Wheezing Breathlessness NAME OF THE ILLNESS RECOMMENDED SERVICE MIX (SUGGESTED ACTIONS) Investigation and Treatment Treatment Investigation and Treatment ECG.) Acne Vulgaris.
PSYCHIATRY RECOMMENDED SERVICE MIX (SUGGESTED ACTIONS) Follow up Follow up Follow up Follow up Follow up Follow up Follow up Follow up S. No 1 2 3 4 5 6 Name of the Illness Screening for Diabetes Gestational Diabetes/DM with Pregnancy DM with HT Nephropathy/Retinopathy Neuropathy with Foot Care Emergency :i) Hypoglycemia ii)Ketosis iii)Coma RECOMMENDED SERVICE MIX (SUGGESTED ACTIONS) Diagnose and Treat Diagnose and Treat Diagnose and Treat Diagnose and Refer Diagnose & Treat Diagnose and Treat 21 . No 1 2 3 4 5 6 7 8 NAME OF THE ILLNESS Schizophrenia Depression Mania Anxiety Disorders Mental Retardation Other Childhood Disorders Alcohol and Drug Abuse Dementia DIABETOLOGY Sl.
Follow-up First Aid.A. Infections Trauma Chronic headache Chronic Progressive Neurological disorder RECOMMENDED SERVICE MIX (SUGGESTED ACTIONS) First Aid.Children/ Acute Nephritis Nephrotic Syndrome . Follow-up Investigations and Treatment complicated Refer Treat simple injuries Refer complicated cases Referral Referral 22 . Referal for investigation.V. No 1 2 3 4 5 6 NAME OF THE ILLNESS Epilepsy C. DM Asymptomatic Urinary Abnormalities Nephrolithiasis RECOMMENDED SERVICE MIX (SUGGESTED ACTIONS) Treat Treat Refer to tertiary Treat Refer to the District Refer to District Hospital Suspect / Acute renal Failure/ Chronic Renal Failure Refer to District level Tumors Refer to Tertiary NEURO MEDICINE AND NEURO SURGERY S. Referal for investigation.Adults HT.NEPHROLOGY S. No 1 2 3 4 5 6 7 8 NAME OF THE ILLNESS Uncomplicated UTI Nephrotic Syndrome .
Swelling Diagnosis / Treatment 2 3 a. Genitourinary tract Hydrocele.GENERAL SURGERY Major S. Diagnose & refer Malignant Prostate.Hernia. Supra Treat pubic cysostomy.Testis) Diseases Others Burns Thyroid. c) Rape AR Entry / Treat 23 . Gastrointestinal disorder Appendicitis/Anorectal Treat abcesses/Rectalprolapse/Liver abscess/Haemorrhoids/Fistula Assault injuries/Bowel injuries/Head Emergency injuries/Stab injuries/Multiple Treat surgeries injuries/Perforation/Intestinal obstruction Benign/ Breast/Oral/GItract/Genitourinary (Penis. Lymphnodes. Breast Lumps. Elective Surgeries b. Seb-Cyst / Dermoid / Ear Lobe Basic Techniques Repair / Circumcision b. Minor Cases under LA Abcess I&D/Suturing. No Classification NAME OF THE ILLNESS RECOMMENDED SERVICE MIX (SUGGESTED ACTIONS) 1 a. FNAC Thyroid. b) Poisonings.Varicose veins Burns < 15% >15% d) Postmortem Treat Treat Treat Done 4 5 6 7 Medico legal a) Assualt / RTA.Biopsy / Excision of Lipoma / Ganglion / Lymph Treat Node.Circumcision.
INJ.OPTHALMOLOGY S.Leucoma)/ Oculoplasty 9 Malignancy/Retina Disease 10 Paediatric Opthalmology EAR. NOSE. No NAME OF THE ILLNESS RECOMMENDED SERVICE MIX (SUGGESTED ACTIONS) Treatment with drugs Treat Treat Treat Treat Treat Treat Refer Refer Refer 1 Superficial Infection 2 Deep Infections 3 Refractive Error 4 Glaucoma Eye problems following systemic disorders 6 Cataract 5 7 Foreign Body and Injuries Squint and Amblyopia/Corneal 8 Blindness(INF. THROAT S. No 1 2 3 4 5 1 2 3 4 NAME OF THE ILLNESS ASOM/SOM/CSOM Otitis External / Wax Ears Polyps Mastoiditis Unsafe Ear EAR RECOMMENDED SERVICE MIX (SUGGESTED ACTIONS) Treat Treat Diagnose and Refer Treatment (Medical) Diagnose and Refer Treat Diagnose and Refer Diagnose and Refer Diagnose and Refer THROAT Tonsillitis/Pharyngitis/Laryngitis Quinsy Malignancy Larynx Foreign Body Esophagus 24 .
No 1 Epistaxis Name of the Illness NOSE RECOMMENDED SERVICE MIX (SUGGESTED ACTIONS) First aid & Refer Treat (Removal) and refer if needed Refer Treat (Medical) Treat (Symptomatic) 2 Foreign Body 3 Polyps 4 Sinusitis 5 Septal Deviation ORTHOPADICS S.S. NAME OF THE ILLNESS RECOMMENDED SERVICE MIX (SUGGESTED ACTIONS) Diagnose and refer Diagnose and refer Diagnose and refer Diagnose and refer Urethral Catheter Insertion Referral Diagnose and refer Diagnose and refer Diagnose and refer Diagnose and refer Diagnose and refer CHILDREN 1 Hydronephrosis 2 Urinary Tract Injuries 3 PUV/ Posterior Urethral Valve 4 Cystic Kidney 5 Urinary Obstruction 6 Undesended Testis 7 Hypospadias and Epispadias 8 Mega Ureter 9 Extrophy 10 Tumours .Urinary Tact 25 . No. No 1 2 3 4 Name of the Illness Osteomyelitis Rickets /Nutritional Defeciencies Poliomyelitis with residual Deformities/JRA/RA RTA/Polytrauma RECOMMENDED SERVICE MIX (SUGGESTED ACTIONS) Treat Detection Manage Corrective Surgery / Physiotherapy Manage UROLOGY S.
Urinary and Genital 3 Tract 4 Trauma Urinary Tact 5 GUTB OLD AGE Prostate Enlargement and Urinary 1 Retention 2 Stricture Urethra 3 Stone Cancer 4 (Kidney. Flap Malocclusion Prosthodontia (Prosthetic Treatment) Trauma Maxillo Facial Surgeries Neoplasms RECOMMENDED SERVICE MIX (SUGGESTED ACTIONS) Treat Treat 3 4 5 6 7 8 Cleaning Treat Surgery if necessary and refer Refer Treat with appliances Treat Refer Refer 26 .Periodontitis . Testis. Penis and Urethra) 5 Trauma Urinary Tract DENTAL SURGERY S.Surgery Minor Surgeries. Prostate. No 1 NAME OF THE ILLNESS Dental Caries/Dental Abcess/Gingivitis Cleaning: 2 . Bladder. ADULT 1 2 NAME OF THE ILLNESS RECOMMENDED SERVICE MIX (SUGGESTED ACTIONS) Diagnose and refer Diagnose and refer Diagnose and refer Diagnose and refer Diagnose and refer Urethral Catheter Insertion Referral Diagnose and refer Diagnose and refer Diagnose and refer Diagnose and refer All above and Stricture Urethra Stone Diseases Cancer . Impaction. No.S.
including air. Local agency Guidelines and By-laws should strictly be followed. In India the population size of a district varies from 50. Physical infrastructure 7.7. For the purpose of convenience the average size of the district is taken in this document as one million populations. railway station. 27 . 7. ♦ It should be free from dangers of flooding. Hospital Management Policy should emphasize on quake proof. Based on the assumptions of the annual rate of admission as 1 per 50 populations. and horticulture services including herbal garden. land used in adjoining areas. therefore. nearest city. Provision should be made for water harvesting. noise. solar energy / power back-up. etc.4.000 to 15.00. water and land pollution. be sited at the lowest point of the district. gas and telephone. generating back-up. topography. airport. The area will include the service areas such as waiting space. ♦ Necessary environmental clearance will be taken. seeds etc will be made available.000.2. rain fall and data on weather and climate. Site information: Physical description of the area which should include bearings. Size of the hospital: the size of a district hospital is a function of the hospital bed requirement which in turn is a function of the size of the population serve. Infrastructure should be eco-friendly and disabled (physically and visually handicapped) friendly. ♦ Too old building may be demolished and new construction done in its place. Area of the hospital: An area of 65-85 m2 per bed has been considered to be reasonable.000 x 1/50 = 20.3. sewage and storm-water disposal. 7. In areas where such utilities are not available. surface area. flexibility in altering the area be kept. Factors to be considered in locating a district hospital ♦ The location may be near the residential area. ♦ It should be in an area free of pollution of any kind.1.00. major bus stand. maps of vicinity and landmarks or centers.000 x 5 = 100. electricity. entrance hall. generators for electricity and radio communication for telephone. And average length of stay in a hospital as 5 days. ♦ It must be serviced by public utilities: water. it must not. A room for horticulture to store garden implements. In case of specific requirement of a hospital. boundaries. The number of beds required for a district having a population of 10 lakhs will be as follows: The total number of admissions per year = 10. fire proof and flood proof buildings. registration counter. limitation of the site that would affect planning. existing utilities. port. ♦ Disability Act will be followed. substitutes must be found.000 Total number of beds required when occupancy is 100% = 100000/365 = 275 Total number of beds required when occupancy is 80% = 100000/365 x 80/100 7.000 Bed days per year = 20. such as a deep well for water.
5. laundry. in the hospital should not be more than 55% of the total floor area of the building. Circulation Areas Circulation areas like corridors. and planners arid architects are confronted with the job of assessing whether apiece of land is suitable for building a hospital. store or workshop or for any other use of the district hospital. Floor Height The room height should not be less than approximately 3. Site selection criteria A rational. could they be converted to a motor pool. natural features and limitations. utilities available.6 m measured at any point from floor to floor height. toilets. And new construction should be put in place. Entrance Area Physical Facilities Ambulatory Care Area (OPD) Waiting Spaces 28 . In some cases. 7.6 In the already existing structures of a district hospital ♦ It should be examined whether they fit into the design of the recommended structure and if the existing parts can be converted into functional spaces to fit in to the recommended standards. soil conditions. ♦ If the existing structures are too old to become part of the new hospital. drainage.7. step-by-step process of site selection occurs only in ideal circumstances. In the case of either site selection or evaluation of adaptability. 7. the following items must be. considered: size. ramps. ♦ If they are too old and dilapidated then they must be demolished. lifts. topography. staircase and other common spaces etc.7. Building and Space Requirements Administrative Block: Administrative block attached to main hospital along with provision of MS Office and other staff will be provided. the availability of a site outweighs other rational reasons for its selection.
Clinics The clinics should include general. orthopaedic and social service department. in remote corner. assistance and enquiry counter facility be made available in all the clinics. etc. However.Registration. The clinics for infectious and communicable diseases should be located in isolation. Separate Reporting Room for doctors should be there. provided with independent access. ophthalmic. Main entrance. adequate space be made available. Diagnostic Services Imaging Role of imaging department should be radio-diagnosis and ultrasound along with hire facilities depending on the bed strength. The room should have a sub-waiting area with toilet facility and a change room facility. neonatology. Nursing Services Various clinics under Ambulatory Care Area require nursing facilities in common which include dressing room. psychiatry. if required. Out of these half will be for acute patients and chronic patients. preferably. surgical. The department should be located at a place which is accessible to both OPD and wards and also to operation theatre department. social service and treatment rooms. unloading. developing and processing of X-ray films. paediatrics. ENT. dermatology and venereology. Film developing and processing (dark room) shall be provided in the department for loading. side laboratory. dental. general waiting and subsidiary waiting spaces are required adjacent to each consultation and treatment room in all the clinics. obsetetric and gynaecology. it should be ensured that nursing station caters to about 40-45 beds. The size of the room should depend on the type of instrument installed. medical. injection room. Clinical Laboratory 29 . one nursing station per ward will be provided. For National Health Programme. Nursing Station: On an average.
appropriate beds may be allowed for private facility. Separate Reporting Room for doctors should be there. Intermediate Care Area (Inpatient Nursing Units) General Nursing care should fall under following categories: General Wards: Male / Female Private Wards Wards for Specialities Depending upon the requirement of the hospital and catchment area. treatment room. 10% of the total bed strength is recommended as private wards beds. Ward Unit The basic aim in planning a ward unit should be to minimize the work of the nursing staff and provide basic amenities to the patients within the unit. Separate Reporting Room for doctors should be there. a small sample collection room facility shall be provided. Ward unit will include nursing station. etc. On an average one nursing station per ward will be provided. Location Location of the ward should be such to ensure quietness and to control number of visitors. It should be ensure that nursing 30 . The distances to be traveled by a nurse from bed areas to treatment room. Blood Bank should follow all existing guidelines and fulfill all requirements as per the various Acts pertaining to setting up of the Blood Bank.. should be kept to the minimum. intensive care units and emergency and accident department. pantry. Blood Bank Blood bank shall be in close proximity to pathology department and at an accessible distance to operation theatre department. urine. pantry etc. nursing store along with wards and toilets as per the norms. doctors’ duty room.For quick diagnosis of blood. isolation room.
Out of these. 31 . X-ray and pathology so that the staff and ancillaries could be shared. out of which half will be for acute patients and chronic patients. critically ill patients requiring highly skilled life saving medical aid and nursing care are concentrated. This unit will also need all the specialized services. in a 500-bedded hospital. heating. For example. severe haemorrhage. The unit shall not have less than 4 beds nor more than 12 beds. The size should be adequate to contain 5 percent of the total clinical visits to the OPD in one session. 13 may be ICU beds and 12 will be allocated for High Dependency Wards. Location This unit should be located close to operation theatre department and other essential departments. Pharmacy (Dispensary) The pharmacy should be located in an area conveniently accessible from all clinics. However. Easy and convenient access from emergency and accident department is also essential. acute coronary occlusion. head injuries. These should include major surgical and medical cases. Intensive Care Unit and High Dependency Wards General In this unit. It should be the ultimate medicare the hospital can provide with highly specialized staff and equipment. poisoning etc. kidney and respiratory catastrophe.station caters to above 40-45 beds. such as. Private ward: Depending upon the requirement of the hospital and catchment area appropriate beds may be allocated for private facilities. Number of beds will be restricted to 5% of the total bed strength. piped suction and medical gases. total of 25 beds will be for Critical Care. The number of patients requiring intensive care may be about 2 to 5 percent total medical and surgical patients in a hospital. Pharmacy should have component of medical store facility for indoor patients and separate pharmacy with accessibility for OPD patients. Out of these. 10% of the total bed strength is recommended as private wards beds. such as. Changing room should be provided for. they can be equally divided among ICU and High Dependency Wards. uninterrupted electric supply.
Facilities Nurses Station Clean Utility Area Equipment Room Critical Care Area (Emergency Services) It should preferably have a distinct entry independent of OPD main entry so that a very minimum time is lost in giving immediate treatment to casualities arriving in the hospital. All these should be properly channelized. piped suction and medical gases. The location of Operation theatre should be in a quite environment. ventilation and efficient life service. Out of these. total of 25 beds will be for critical care. nurses and sometime pathologist and radiologist operate upon or care for the patients. Aspectic or Sterile Zone and Disposal or Dirty Zone. Number of beds for both the units will be restricted to 5% of the total bed strength. electric supply. Pre-operative Room and Post Operative Resting Room. namely. free from noise and other disturbances. airconditioning. staff and supplies. For example. Protective Zone. blood bank and CSSD. There should be an easy ambulance approach with adequate space for free passage of vehicles and covered area for alighting patients. such as. This unit also need constant specialized services. Operating room should be made dust-proof and moisture proof. Out of these 13 may be ICU beds and 12 will be allocated for high dependency wards. maximum protection from solar radiation and convenient relationship with surgical ward.ventilation. if the theatres are located on upper floors. radiology. An Operation Theatre should also have Preparation Room. Clean Zone. intensive care unit. Zoning should be done to keep the theatres free from micro organisms. central air conditioning and efficient life services. Normally there are three types of traffic flow. pathology. heating. There should also be 32 . in a 500 bedded hospital. patients. A good natural light and pleasant environment would also be of great help to the patients and staff as well. There may be four well defined zones of varying degree of cleanliness namely. they can be equally divided among ICU and High Dependency Wards. Therapeutic Services Operation Theatre Operation theatre usually have a team of surgeons anesthetists. free from contamination and possible cross infection.
slop sink.a Scrub-up room where operating team washes and scrub-up their hands and arms. It should have a single leaf door with self closing device and viewing window to communicate with the operation theatre. The room should be provided with sink. The department is more frequently visited by out-patients but should be located at a place which may be at convenient access to both outdoor and indoor patients with privacy. Operation Theatre should also have a SubSterilizing unit attached to the operation theatre limiting its role to operating instruments on an emergency basis only. office. Laminar flow of air be maintained in operation theatre. gymnasium. Delivery Suite Unit The delivery suit unit be located near to operation theatre. Non-disposable instruments after initial wash are given back to instrument sterilization and rest of the disposable items are disposed off and destroyed. dirty linen. The delivery Suit Unit should include the facilities of accommodation for various facilities as given below: Reception and admission Examination and Preparation Room Labour Room (clean and a septic room) Delivery Room Neo-natal Room Sterilizing Rooms Sterile Store Room Scrubbing Room Dirty Utility Physiotherapy The physiotherapy department provides treatment facilities to patients suffering from crippling diseases and disabililties. such as. Normative standards will be followed. A pair of surgeon’s sinks and elbow or knee operated taps are essential. The theatre should have sink / photo sensors for water facility. put on their sterile gown. Hospital Services 33 . store and toilets separate for male and female. work bench and draining boards. gloves and other covers before entering the operation theatre. Theatre refuse. It should have a central air conditioning facility. Dirty linen is sent to laundry through a separate exit. used instruments and other disposable / non disposable items should be removed to a room after each operation. It should also have a physical and electro-therapy rooms.
It should have a provision of hot water supply. it is recommended to locate the department at a position of easy access to operation theatre department. Mortuary It provides facilities for keeping of dead bodies and conducting autopsy. It should easily be accessible from outside along with vehicular accessibility and separate room for dietician and special diet. Engineering Services Electric Engineering Sub Station and Generation Electric sub station and standby generator room should be provided. Illumination 34 . It should be located such that the noise and cooking odours emanating from the department do not cause any inconvenience to the other departments. Medical and General Stores There are of medical and general store should have vehicular accessibility and ventilation.Hospital Kitchen (Dietary Service) The dietary service of a hospital is an important therapeutic tool. pressing and storage of soiled and cleaned linens. security and fire fighting arrangements. At the same time location should involve the shortest possible time in delivering food to the wards. Hospital Laundry It should be provided with necessary facilities for drying. It should be so located that the dead bodies can be transported unnoticed by the general public and patients. Central Sterile and Supply Department (CSSD) As the operation theatre department is the major consumer of this service.
Emergency portable light units should be provided in the wards and departments. Ventilation The ventilation in the hospital may be achieved by either natural supply or by mechanical exhaust of air. Call Bells Call bells with switches for all beds should be provided in all types of wards with indicator lights and location indicator situated in the nurses duty room of the wards. Separate provision for fire fighting and water softening plants be made available. Air coolers or hot air convectors may be provided for the comfort of patients and staff depending on the local needs. Public Health Engineering Water Supply Arrangement should be made for round the clock piped water supply along with an overhead water storage tank with pumping and boosting arrangements. surface water. Drainage and Sanitation The construction and maintenance of drainage and sanitation system for waste water. sub-soil water and sewerage 35 . Emergency Lighting Shadow less light in operation theatre and delivery rooms should be provided.The illumination and lightning in the hospital should be done as per the prescribed standards. Mechanical Engineering Air-conditioning and Room Heating in operation theatre and neonatal units should be provided. Approximately 10000 litres of potable water per day is required for a 100 beded hospital. Hospital should be provided with water coolers and refrigerator in wards and departments depending upon the local needs.
Prescribed standards and local guidelines shall be followed. trainings with associated furniture. Waste Disposal System National guidelines on Bio-Medical Waste Management and a Notification of Environment and Forests are at Annexure . 36 .shall be in accordance with the prescribed standards. Residential Quarters All the essential medical and para-medical staff will be provided with residential accommodation.I Trauma Centre Guidelines to be followed Fire Protection Telephone and Intercom Medical Gas Cooking Gas: Liquefied petroleum gas (LPG) Laboratory Gas: Liquefied petroleum gas (LPG) and other specified gases. Building Maintenance: Provision for building maintenance staff and an office-cum store will be provided to handle day to day maintenance work Parking: Sufficient parking place as per the norms will be provided Administrative Services: Two sections (i) General section to deal with overall upkeep of the hospital and welfare of its staff and patients (ii) Medical Records section. Committee Room: A meeting or a committee room for conferences.
MANPOWER MAN POWER – DOCTORS S. No 1 2 3 4
Hospital Superintendent Medical Specialist Surgery Specialists O&G specialist Dermatologist / 5 1 Venereologist 6 Paediatrician 2 Anesthetist (Regular / 7 2 trained) 8 ENT Surgeon 1 9 Opthalmologist 1 10 Orthopedician 1 11 Radiologist 2 Casualty Doctors / General 9 (at least 4 female doctors 12 Duty Doctors from allopathy) 13 Dental Surgeon 1 1 14 Public Health Manager 1 15 Forensic Expert 1 16 AYUSH Physician2 2 Pathologist with DCP / MD 17 (Micro) / MD (Patho) / MD 1 (Biochemestry) Total 31 1 May be a Public Health Specialist or management specialist trained in public health 2 Provided there is no AYUSH hospital / dispensary in the district headquarter
51-100 bedded Sub District Hospital 1 2 2 2
8.2. S. No 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
MAN POWER – PARA MEDICAL Staff Staff Nurse Attendant Ophthalmic Assistant / Refractionist ECG Technician Audiometry Technician Laboratory Technician ( Lab + Blood storage) Laboratory Attendant (Hospital Worker) Radiographer Pharmacist Matron (including assistant matron) Physiotherapist Statistical Assistant Medical Records Officer / Technician Electrician Plumber Total 51-100 bedded Sub District Hospital 50 (including 5 ward incharge) 1 1 1 1 5 3 3 5 2 1 1 1 1 1 77
Manpower- Administrative Staff Sub District Hospital 51-100 bedded
S. No. 1 2 3 4 5 6
Item Junior Administrative Officer Accountant Computer Operator Driver Peon Security Staff*
1 2 6 2 2 2
Total 15 Note : Drivers post will be in the ratio of 1 Driver per 1 vehicle. Driver will not be required if outsourced * The number would vary as per requirement and to be outsourced. 8.4. Man Power – Operation Theatre Sub District Headquarters Hospital 51-100 Bedded Emergenc y / FW OT General OT 1 2 1 4 Staff
S l. No 1 2 3
Staff Nurse OT Assistant Safai Karamchari Total
4 4 2 10
Man Power – Blood Storage S. No. 1 2 3 4 5 Item Staff Nurse MNA / FNA Blood Bank/Storage Technician Safai Karamchari Attendant Blood Storage 1 1 5 3 2
X-ray machine 1 60 M.A. X-ray machine 1 100 M.ray dark room 2 Cassettes X.These items will be provided depending upon the need and availability of skilled personnel Sl. Scan Mammography Unit * Echocardiogram* * .A.9. 1 2 3 4 5 6 7 II X Ray Room Accessories 51-100 bedded Sub District Name of the Equipment Hospital X.ray developing tank 1 Safe light X.T. department should be having a separate ultra-sound machine of its own) 1+1 C.A.ray 10 X.A. No.ray lobby Multiple Lead Apron 1 Intensifying screen X-ray 1 41 . 1 2 3 4 5 6 7 8 9 10 S.ray lobby single 4 X. X-ray machine* 300 M. Equipment I Imaging Equipment 51-100 bedded Sub Name of the Equipment District Hospital 500 M. X-ray machine (Mobile) 1 C arm with accessories * Dental X ray machine 1 Ultra Sonogram (Obs & Gyne. No.
S.P.P* Infusion pump 1 B. No. No. 1 2 3 4 5 6 7 8 9 10 11 12 13 III Cardiac Equipments 51-100 bedded Sub District Name of the Equipment Hospital ECG machine computerized ECG machine ordinary 1 12 Channel stress ECG test equipments Tread Mill * Cardiac Monitor 2 Cardiac Monitor with defibrillator 2 Ventilators (Adult) Ventilators (Paediatrics) Pulse Oximeter 2 Pulse Oximeter with NIB. Name of the Equipment Hospital 1 Baby Incubators 1 2 Phototherapy Unit 1 3 Emergency Resuscitation Kit-Baby* 2 4 Radiant Warmer 1 5 Room Warmer 2 6 Foetal Doppler 1 7 CTG Monitor 1 8 Delivery Kit 2 9 Episiotomy kit 2 10 Forceps Delivery Kit 1 11 Crainotomy 1 12 Vacuum extractor metal 1 13 Silastic vacuum extractor 1 14 Pulse Oximeter baby & adult 1 15 Cardiac monitor baby 1 16 Nebulizer baby 1 17 Weighing machine adult 2 18 Weighing machine infant 2 42 .apparatus stand model 5 Stethoscope 5 * To be provided as per need.P.apparatus table model 8 B. IV Labour ward & Neo Natal Equipments 51-100 bedded Sub District S.
Tonsils Mastoid Set Micro Ear Set myringoplasty* Stapedotomy Set* Stapeidoplasty* ENT Nasal Set (SMR. DNS. No. Rhinoplasty)* Laryngoscope fibreoptic ENT * Laryngoscope indirect Otoscope Oesophagoscope Adult* Oesophagoscope Child * Head Light (cold light) Tracheostomy Set Tuning fork Name of the Equipment 51-100 bedded Sub District Hospital 1 1 1 1 1 1 1 1 1 * To be provided as per need. No.V Ear Nose Throat Equipments S. Septoplasty. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 Audiometer Operating Microscope (ENT)* Head light (ordinary) (Boyle Davis) ENT Operation set including headlight.Direct Slit Lamp Retino scope Perimeter IOL Operation set Laser Photocoagulometer* * . Polypetcomy. 1 2 3 4 5 6 7 VI Eye Equipments Name of the Equipment Cryo Surgery Unit Opthalmoscope .to be supplied by Blindness Control Society 51-100 bedded Sub District Hospital 1 1 1 2 43 . Sl.
Medium* 19 Diathermy Machine (Electric Cautery) 20 Suction Apparatus . No. No. S.big* 18 Bowl steriliser . 1 2 3 4 5 VII Dental Equipments Name of the Equipment Air Rotor Dental Unit with motor for dental OP Dental Chair Dental Lab Dental Kit 51-100 bedded Sub District Hospital 1 1 1 1 Name of the Equipment Auto Clave HP Horizontal Auto Clave HP Vertical (2 bin) Operation Table Ordinary Paediatric* Operation Table Hydraulic Major Operation table Hydraulic Minor Operating table non-hydraulic field 6 type 7 Operating table Orthopedic * 8 Autoclave with Burners 2 bin* 9 Autoclave vertical single bin 10 Shadowless lamp ceiling type major* 11 Shadowless lamp ceiling type minor* 12 Shadowless Lamp stand model 13 Focus lamp Ordinary 14 Sterilizer big (Instrument) 15 Sterilizer Medium (Instrument) 16 Steriliser Small (Instruments) 17 Bowl Steriliser . 1 2 3 4 5 VIII Operation Theatre Equipment 51-100 bedded Sub District Hospital 2 1 2 1 1 1 1 1 2 2 3 3 1 1 3 2 2 44 .Foot operated 22 Dehumidifier* 23 Ultra violet lamp philips model 4 feet 24 Ethylene Oxide sterilizer* 25 Microwave sterilizer* * To be provided as per need.Sl.Electrical 21 Suction Apparatus .
S. S. No. 1 2 3 4 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 22 23 24 25 26 27 34 35 36 37 38 IX Laboratory Equipments Name of the Equipment Binocular Microscope Balance (Electrical Monopan) Simple balance Electric Colorimeter Semi auto analyser Micro pipettes of different volume range Water bath Hot Air oven* Lab Incubator* Distilled water plant Electricentrifuge Table Top Cell Counter Electronic* Hot plates Rotor / Shaker Counting chamber PH meter Paediatric Glucometer / Bilirubinometer* Glucometer Haemoglobinometer TCDC count apparatus ESR stand with tubes Test tube stands * Test tube rack * Test tube holders* Spirit lamp* Timer stop watch Alarm clock Lab Autoclaves Refrigerators Bio-safety Cabinet (Class-I) 51-100 bedded Sub District Hospital 4 1 1 1 1 4 1 1 1 2 2 1 2 1 2 1 1 1 1 3 5 5 5 6 2 1 2 2 1 * To be provided as per need. Set MTP Set Biopsy Cervical Set* S. No. X Surgical Equipment Sets Name of the Equipment P. 1 2 3 51-100 bedded Sub District Hospital 1 1 1 45 .
U.P. Kit LSCS set MVA Kit Vaginal Hysterectomy Proctoscopy Set* P.C. No.Tray* Uretheral Dilator Set TURP resectoscope * Haemodialysis Machine * Amputation set Name of the Equipment 51-100 bedded Sub District Hospital 1 1 1 2 1 1 1 1 1 2 6 1 2 1 1 4 3 1 1 5 1 2 2 3 2 1 46 . Fistula.V.D. Hydrocele* Varicosevein etc* Gynaec Electric Cautery Vaginal Examination set* Suturing Set* MTP suction apparatus Thoracotomy set Neuro Surgery Craniotomy Set I M Nailing Kit SP Nailing Compression Plating Kit* AM Prosthesis* Dislocation Hip Screw Fixation* Fixation Fracture Hip Spinal Column Back Operation Set Thomas Splint Paediatric Surgery Set Mini Surgery Set* Urology Kit Surgical Package for Cholecystectomy* Surgical package for Thyroid GI Operation Set* Appendicectomy set * L. Fissure* Knee hammer Hernia.S. Tray* Abdominal Hysterectomy set Laparotomy Set Formaline dispenser Kick Bucket General Surgical Instrument Set Piles. 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 X Surgical Equipment Sets D & C Set I.
No.T 5 Tubes connecting for ETT 4 Air way female* 4 Air way male* 10 47 .to be provided as per need Sl. 1 2 3 4 5 6 7 XII Endoscopy Equipments 51-100 bedded Sub District Name of the Equipment Hospital Endoscope fibre Optic (OGD) * Arthroscope Laparoscope operating major with accessories * Laparoscope diagnostic and for sterilisation * 1 Colonoscope and sigmoidoscope* Hysteroscope * 1 Colposcope * 1 * . 45 46 47 X Surgical Equipment Sets Name of the Equipment Universal Bone Drill Crammer wire splints Heamo dialysis machine 51-100 bedded Sub District Hospital 8 * To be provided as per need.S. No. No. No.T. 1 2 3 4 5 6 7 XIII Anaesthesia Equipments 51-100 bedded Sub District Name of the Equipment Hospital Anaesthetic .laryngoscope magills with four blades 2 Endo tracheal tubes sets 1 Magills forceps (two sizes) 5 Connector set of six for E. 1 2 3 XI Physiotherapy Equipments Name of the Equipment Skeleton traction set Interferential therapy unit Short Wave Diathermy 51-100 bedded Sub District Hospital 1 1 1 S. S.
D. s Lab etc.R.Requirements (record room use) * 1 Paediatric cots with railings 5 Cradle* 3 Fowler' cot s 0 Ortho Facture Table* 0 Hospital Cots (ISI Model ) 100 Hospital Cots Paediatric (ISI Model ) 10 Wooden Blocks (Set)* 2 Back rest* 4 Dressing Trolley (SS) 4 48 . Blood Bank. 20 Doctor' Table s 6 Duty Table for Nurses 5 Table for Sterilisation use (medium) 6 Long Benches(6 1/2' 1 1/2' x ) 20 Stool Wooden 15 Stools Revolving 8 Steel Cup-board 15 Wooden Cup Board 6 Racks -Steel – Wooden 7 Patients Waiting Chairs (Moulded) * 10 Attendants Cots * 4 Office Chairs 4 Office Table 4 Foot Stools * 12 Filing Cabinets (for records) * 6 M.8 9 11 12 13 14 15 16 Mouth prop* Tongue depressors* O2 cylyinder for Boyles N2O Cylinder for Boyles CO2 cylinder for laparoscope* PFT machine Boyles Apparatus with Fluotec and circle absorber Exchange Transfusion Sets* * . 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 XIV Furniture & Hospital Accessories 51-100 bedded Sub District Name of the Equipment Hospital Doctor' chair for OP Ward.to be provided as per need 6 8 8 8 1 1 S. No.
No. Tumblers* Waste Disposal . 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 XIV Furniture & Hospital Accessories 51-100 bedded Sub District Name of the Equipment Hospital Medicine Almairah 2 Bin racks (wooden or steel)* 5 ICCU Cots 4 Bed Side Screen (SS-Godrej Model) 4 Medicine Trolley(SS) 4 Case Sheet Holders with clip(S.Trolley (SS) 1 Linen Almirah 3 Stores Almirah 3 Arm Board Adult* 10 Arm Board Child* 10 SS Bucket with Lid 6 Bucket Plastic* 8 Ambu bags 5 O2 Cylinder with spanner ward type 12 49 .Assorted 30 Basin Assorted (SS) 30 Basin Stand Assorted (SS) (2 basin type ) 4 ( 1 basin type) 8 Delivery Table (SS Full) 6 Blood Donar Table* 1 O2 Cylinder Trolley(SS) 8 Saline Stand (SS) 15 Waste Bucket (SS)* 25 Dispensing Table Wooden 1 Bed Pan (SS)* 20 Urinal Male and Female 20 Name Board for cubicals* 1 Kitchen Utensils* Containers for kitchen* Plate.Bin / drums 8 Waste Disposal .)* 60 Bed Side Lockers (SS)* 0 Examination Couch (SS) 2 Instrument Trolley (SS) 6 Instrument Trolley Mayos (SS) 4 Surgical Bin Assorted 25 Wheel Chair (SS) 4 Stretcher / Patience Trolley (SS) 3 each Instrument Tray (SS) Assorted 30 Kidney Tray (SS) .S.S.
1 2 3 4 5 6 7 8 9 XV PM equipments Name of the Equipment Mortuary table (Stainless steel) * P. No. 66 67 68 69 70 71 72 73 74 75 76 77 XIV Furniture & Hospital Accessories 51-100 bedded Sub District Name of the Equipment Hospital Diet trolley . No. ^ . S.to be provided as per need $ .equipments (list) Weighing machines (Organs) Measuring glasses(liquids) Aprons* PM gloves ( Pairs )* Rubber sheets* Lens Spot lights * .S.One fan per four beds in the ward.stainless steel 1 Needle cutter and melter 15 Thermometer clinical * 20 Thermometer Rectal* 3 Torch light* 10 Cheatles forceps assortted* 8 Stomach wash equipment* 2 Infra Red lamp* 3 Wax bath* 1 Emergency Resuscitation Kit-Adult* 2 Enema Set* 6 Ceiling Fan$ As per requirement Bed Side Screen (SS-Godrej Model)^ As per requirement * . No.to be provided as per need 100 bedded Sub District Hospital 2 3 1 2 10 10 1 2 XVI Linen S. Name of the Equipment 1 Bed sheets 51-100 bedded Sub District Hospital 400 50 .M.At least one screen per five beds except female wards.
1 XVIII Administration Name of the Equipment Computer with Modem with UPS. 1 2 3 4 5 6 7 8 9 XVII Teaching Equipments 51-100 bedded Sub District Name of the Equipment Hospital Slide Projector 1 O. Printer with 51-100 bedded Sub District Hospital 1 51 .H. No.2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 Bedspreads Blankets Red and blue Patna towels Table cloth Draw sheet Doctor' overcoat s Hospital worker OT coat Patients house coat (for female) Patients Pyjama (for male) Shirt Over shoes pairs Pillows Pillows covers Mattress (foam) Adult Paediatric Mattress Abdominal sheets for OT Pereneal sheets for OT Leggings Curtain cloth windows and doors Uniform / Apron Mortuary sheet Mats (Nylon) Mackin tosh sheet (in meters) Apron for cook 600 30 150 50 75 30 200 300 200 60 150 300 100 16 50 50 80 30 50 150 S.to be provided as per need S. No.P 1 Screen 1 White / colour boards 1 Television colour 1 Tape Recorder* ( 2 in 1 ) 1 VCD Player 1 Radio 1 LCD Projectors * .
5 KV 1 Solar Water heater * Incinerator* Central supply of 02. No. N20. Vacuum * Cold storage for mortuary * * .2 3 4 5 6 7 8 9 10 Internet Connection Xerox Machine Typewriter (Electronic )* Intercom (15 lines)* Intercom (40 lines)* Fax Machine Telephone Paging System* Public Address System* Library facility* * . 1 2 3 4 5 6 7 8 XXI Hospital Fittings & Necessities 52 .to be provided as per need 1 1 1 1 1 S. No. 1 2 3 4 5 6 7 XIX Refrigeration & AC Name of the Equipment Refrigerator 165 litres Blood Bank Refrigerato ILR Deep Freezer Coolers* Air conditioners Central A/C for OT 100 bedded Sub District Hospital 3 1 1 1 As per requirement 4 * One cooler per 8 beds in the wards. XX Hospital Plants 51-100 bedded Sub District Name of the Equipment Hospital Generator 40 / 50 KV Generator 75 KV 1 Generator 125 KV Portable 2.to be provided as per need S.
to be provided as per need 51-100 bedded Sub District Hospital 30 8 1 2 1 1 2 1 1 50 2 S.S. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 Name of the Equipment Ceiling Fans* Exhaust Fan* Pedestal Fan* Wall Fan* Hotwater geiser* Fire extinguishers* Sewing Machine* Lawn Mover* Vaccum cleaner* Aqua guard* Solar water heater * Neon sign for hospital* Garden equipment* Borewell motor OHT * Water dispenser / Water cooler* Laundry (steam) * Emergency lamp Emergency trauma set* Tube lights* Drinking Water Fountain* * . 1 2 3 4 5 6 7 8 9 10 XXII Transport 51-100 bedded Sub District Name of the Equipment Hospital Ambulance 2 Van (Family Welfare) Pickup vehicles Maruti (Omni) Mortuary Van 1 Administrative vehicle (Car) Minidor 3 wheeler Bicycle Camp Bus Progamme vehicle Motorcycle 53 . No. No.
10. acetone. Sputum Morphology. Urine Analysis c. Bleeding time Clotting time Prothrombin time Peripheral Blood Smear Malaria/Filaria Parasite Platelet count Packed Cell volume Blood grouping Rh typing Blood Cross matching Diagnostic Services / Tests Urine for Albumin. Aspirated fluids II. a list of National Reference Laboratories has been provided as annexure: S. Haematology Diagnostic Services / Tests Haemoglobin estimation Total Leucocyte count Differential Leucocyte count Absolute Eosinophil count Reticulocyte count Total RBC count E.bile salts. No. Cell count etc Cell count cytology Sputum cytology 54 . bile pigments. I.Cholera Occultblood S. Sugar. Reaction (pH) Stool for Ovacyst (Eh) Hanging drop for V. Speciality CLINICAL PATHOLOGY a. No. Speciality b.R. for advanced diagnostic tests. specific gravity. PATHOLOGY b. Stool Analysis d. CSF Analysis f. Laboratory Services: Following services will be ensured. Deposits.S. count Analysis. Semen Analysis e.
VI. Speciality CARDIAC INVESTIGATIONS a) ECG OPHTHALMOLOGY Diagnostic Services / Tests a) Refraction by using Snellen' chart s Retinoscopy Tonometry Biometry 55 .S. sputum etc. RPR Card Test for Syphillis Pregnancy test (Urine gravindex) WIDAL test Rapid test for HIV. HBs Ag. sugar S. No. blood cholesterol Liver function tests Kidney function tests Stocking of OT test for residual chlorine in water. SEROLOGY S. HCV Stocking of rapid H2S based test for bacteriological examination of water III. MICROBIOLOGY IV. KLB (Diphtheria Bacilli) Grams Stain for Meningococci KOH study for fungus Grams Stain for Throat swab. Speciality BIOCHEMISTRY Diagnostic Services / Tests Blood Sugar Blood urea. CSF for protein. Speciality Diagnostic Services / Tests Smear for AFB (Acid Fast Bacilli). V. VII. No. No.
Ophthalmoscopy VIII. Speciality ENDOSCOPY Laparoscopy (Diagnostic) PHYSIOLOGY Pulmonary function tests Diagnostic Services / Tests 56 . bones e) Dental X-ray f) Ultrasonography with colour doppler Sl. IX. Skull. Spine. Abdomen. ENT RADIOLOGY Audiometry a) X-ray for Chest. No. X XI.
11. 57 . No 1 2 3 4 Item Elective OT-Major AE OT* Emergency OT/FW OT Ophthalmology /ENT OT* 1 Sub District Hospital 51-100 bedded 1 * To be provided as per need. Sl. No 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 RECOMMENDED ALLOCATION OF BED STRENGTH AT VARIOUS LEVELS Item Type Beds (M+F) Beds Beds Beds Beds Beds Beds Beds (M+F) Yes Beds (M+F) Beds (M+F) Beds Boards Beds Boards Beds Beds Beds Beds Beds Beds 8+8 10*+8 3 Sub District Hospital 51-100 bedded 8+8 3 5 6 5 4 General Medicine New born ward Mothers room with dining and toilets Paediatrics ward Critical care ward – IMCU Isolation Ward Dialysis unit (as per specifications) Thoracic medicine ward with room for pulmonary function test Blood bank General surgery ward (incl. ENT) Post – Operative Ward Accident and Trauma ward Labour room Labour room (Eclampsia) Septic Labour room Ante-natal ward Post-natal ward Postpartum ward Post operative ward Ophthalmology ward Burns Ward 6 6 10 - REQUIREMENTS FOR OPERATION THEATRE Sl. Urology.
Cefodroxyl 250mg Inj.Aspirin 300mg Tab.Ibuprofen Chemotherapeutics Inj.Ciprofloxacin 100ml Tab.Ampicillin 250mg Cap.Amikacin sulphate 500mg Inj.Ciprofloxacin 500mg Inj.Amoxycillin 500mg Anti Diarrhoeal Tab. LIST OF MEDICINES / INSTRUMENTS / EQUIPMENTS /LAB REAGENTS / OTHER CONSUMABLES AND DISPOSABLES FOR DISTRICT HOSPITALS Sr.Ofloxacin 200mg Inj.Crystalline penicillin 5 lac unit Inj.Metronidazole 200mg 58 .Paracetamol 500mg Inj.Norfloxacin 200mg Tab.Ampicillin 500mg Inj.crystalline penicillin 10 lac unit Cap.Diclofenac sodium Tab.Fortified procaine pen 4 lac Inj.Cefoperazone 1Gm Inj.Erythromycin 250mg Tab.Trimethoprim+Sulphamethazol ss Tab.Diclofenac sod Tab. No A) 1 2 3 4 5 6 B) 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 C) 32 Name of the Drugs Analgesics/Antipyretics/Anti Inflamatory Tab.12.Ciprofloxacin 250mg Tab.Gentamycin 40mg/2ml vial Inj.cefotaxime 500mg Tab.Amikacin sulphate 100mg Cap.Vionocef(Ceffixime)250mg Inj.Tetracycline 250mg Tab.Erythromycin 500mg Syrup Cotrimoxazole 50ml Syrup Ampicillin 125mg/5ml 60ml Inj.Norfloxacin 400mg Tab.Dolonex DT 20mg Tab.
Normal saline (Sod chloride) 500ml Inj.Diolaxanide Fuzate Tab.Metronidazole Tab.V.Metronidazole 400mg Syrup.P 500gm Net P.Plasma Substitute 500ml bot Inj.P Bandage a) 10cm b)15cm Framycetin skin oint 100 G tube Silver Sulphadiazene Oint 500gm jar Antiseptic lotion containing : a)Dichlorometxylenol 100ml bot b)Haffkinol 5litre jar Sterilium lotion Bacillocid lotion Infusion fluids Inj.O.Water for 10ml amp Inj.Dextrose 10% 500ml bottle Inj.Dextrose in Normal saline 500ml bt Inj.Metronidazole 100ml Inj.Ringer lactate 500ml Inj.5cm x 5mtr Absorbent cotton I.Mannitol 20% 300ml Inj.Tinidazole 300mg Dressing Material/Antiseptic lotion Povidone Iodine solution 500ml Phenyl 5litr jar(Black Phenyl) Benzalkonium chloride 500ml bottle Rolled Bandage a)6cm b)10cm c)15cm Bandage cloth(100cmx20mm) in Than Surgical Guaze(50cmx18m) in Than Adhesive plaster 7.Water for 5ml amp Inj.Lomodex Other Drugs & Material All Glass Syringes 2ml 5ml 59 .Furazolidone 100mg Tab.dextrose 5% 500ml Inj.33 34 35 36 37 D) 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 F) 65 Tab.Dextrose 25%100ml bot I.
1/2" c)7" d)7.2/0 Prolene X Ray film 50 film packet(in Pkt) size a)6.23 f)No. c)1-0 No d)2-0 N0 e)8-0 Vicryl No.22 e)No.1/0.Complex NFI Therapeutic Tab.24 g)No. b)2 No.19 b)No.2.26 Scalp vein sets no a)19 b)20 c)21 d)22 e)23 f)24 g)25 h)26 Gelco all numbers Tab.20 c)No.Vitamin B Complex 10ml Inj.B12 Folic acid Surgical Gloves a)6 " b)6.21 d)No.1/2" b)8"x10" c)10"x12' 60 .Polyvitamin NFI Therapeutic Inj.B.Dexamethasone 2mg/ml vial Inj.5" Catgut Chromic a)1 No.25 h)No.1/2x8.1 Sutupak 1.66 67 68 69 70 71 72 73 74 75 76 77 78 79 10ml 20ml Hypodermic Needle (Pkt of 10 needle) a)No.
lignocaine 2% Inj.Rabipur Inj.Streptokinase 15lac vial Inj.Lignocaine 5% Inj.MethylErgometrine 0.5lac vial Inj.Ranitidine Tab.Streptokinase 7.Marcaine Inj.2mg/amp Inj.5g Ether Anaesthetic 500ml Halothane Eye Drops Sulphacetamide eye drops 10% 5ml Framycetin with steroid eye drops 5ml Framycetin eye drops 5ml Ciprofloxacin eye drops Gentamycin eye drops Other Material Rubber Mackintosch Sheet in mtr Sterile Infusion sets(Plastic) Antisera I) A 5ml II)B 5ml III)D 5ml IV)AB 5ml Inj.Antacid ARS Syp.80 81 82 83 84 85 86 87 G) 88 89 90 91 92 H) 93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 112 113 114 d)12"x15" Fixer Developer CT Scan film Ultrasound scan film Dental film Oral Rehydration powder 27.Lignocaine 1% Inj.Ranitidine 2ML Tab.Diazepam 61 .Antacid Inj.Omeprazole Cough syrup 5litre Jar Cough syrup with Noscapine 100ml Coir Mattress Inj.PAM Tab.
Valdecoxib 20mg Tab.Perinorm 23 syrup.Quinine 4 Tab.Ethambutol 400mg 10 Tab.Cyclopam 20 Tab.Gattifloxacin 400mg Tab.Isoniazid 100mg 9 Tab.Perinorm 22 Inj.Piperazine citrate 26 Tab.Bisacodyl 21 Tab.Benzathine penicillin 12lac J) Antihistaminics/anti-allergic 13 Inj.Pefloxacin 400mg Tab.Prochlorperazine(Stemetil) 25 Tab.Cefuroxime 250/750 Tab.Salbactum+Cefoperazone2Gm Inj.Rifampicin 8 Tab.Diphenhydramine (eqv.Pheniramine maleate 14 Tab.Amoxycillin with clavutanite acid 600mg Cap.Protein(Provita) Antibiotics and Chemotherapeutics 1 Tab.Mebendazole 100mg I) 62 .Atrovastatin 10mg Sy.Furazolidone 24 Inj.Diethylcarbamazin K) Drugs acting on Digestive system 18 Tab.Benadryl) 15 Tab.Isoniazid+Thiacetazone 11 Cap.Erythromycine Esteararte 250mg 5 Syp.Neomycin 12 Inj.Chlorpheniramine maleate 4mg 17 Tab.115 116 117 118 119 120 121 122 123 124 Inj.Cetrizine 16 Tab.Amoxycillin250+cloxacillin 250 Inj.Phenoxymethyl Penicillin125mg 7 Cap.Chloroquine phosphate 3 Inj.Himalt-X Sy.Erythromycine 6 Tab.Chloroquine phosphate 250mg 2 Inj.Cyclopam 19 Inj.
Enalepril2.Mephentine Tab.Pyrantel Pamoate Tab.Verapamil(Isoptin) tab.Pentazocine (Fortwin) Inj.Isosorbide Dinitrate(Sorbitrate) Tab.Propranolol Tab.Phenobarbitone 60mg 63 .Haloperidol Tab.Piperazine Citrate Sy.Phenobarbitone 30mg Tab.atropine sulphate Inj.Atenolol Tab.Haloperidol Inj.Chlorpromazine 25mg(like Largactil) Inj.Belladona Drugs related to Hoemopoetic system Tab.Isoxuprine Inj.Promethazine Hcl Phenergan inj.Digoxine Tab.Pethidine Inj.Diazepam 5mg Tab.Ferrous sulphate200mg Inj.27 28 29 30 L) 31 32 M) 33 34 35 36 37 38 N) 39 40 41 42 43 44 45 46 47 48 49 50 51 O) 52 53 54 55 56 57 58 59 60 61 62 Syp.adrenaline Inj.Mebendazole Sy.Methyldopa Tab.Iron Dextran/Iron sorbitol Eye oint Chloramphenicol eye oint & applicaps Chloramphenicol + Dexamethsone oint Gentamycin eye/ear drops Dexamethasone eye drops Drosyn eye drops Atropine eye oint Drugs acting on Cardiac vascular system Inj.Diazepam 5mg Tab.Duvadilan Tab.Digoxine Inj.Pavlon 2ml amp Inj.5/5mg Drugs acting on Central/peripheral Nervous system Inj.
Deriphylline Tab.Salbutamol Antiseptic Ointment Furacin skin oint Framycetin skin oint Drugs acting on UroGenital system Tab.Cry Insulin 64 .Aminophylline Tab.Methyl Ergometrine Tab.Largactil 25mg Tab. Mesoprostol Tab.Ethacredin lact(Emcredyl) Hormonal Preparation Inj.Primolut-N Haymycin vaginal tab Inj Magnesium Sulphate Inj.Frusemide Drugs acting on Uterus and Female Genital Tracts Inj.Salbutamol 2mg Syrup Tedral Syrup.Insulin Rapid Insulin lente Besal Inj.Pacitane Tab.Deriphylline Tab.Phenergan Syrup Paracetamol Ethyl chloride spray Lignocaine oint Gentamycin eye/ear drops Betnesol-N/Efcorlin Nasal drops Drugs acting on Respiratory system Inj.Pyridicil Inj.Aminophylline Inj.Surmontil Syrup.KCL Liquid KCL Tab.63 64 65 66 67 68 69 70 71 P) 72 73 74 75 76 77 78 Q) 79 80 R) 81 82 83 84 85 S) 86 87 88 89 90 91 92 93 94 T) 95 96 97 Tab.Frusemide 40mg Inj.Duvadilan Tab.Prostodin Tab.Pitocin Inj.
Cyclophosphamide Inj.Theophylline 65 .Iodine Tr.AntiDiphtheria Serum Inj.Vit K Tab.Calcium lactate Tr.Ascorbic acid Inj.Betamethasone Vitamins Inj.Vit "A" & "D" Tab.Calcium Gluconate Tab.Benzoin Glcial acetic caid Benedict solution Caster oil Liquid paraffin Glycerine Glycerine Suppositories Turpentine oil Potassium Permangnate Formaldehyde Dextrose Powder Methylated spirit Cotrimazole lotion Cotrimazole cream Tab.Prednisolone 5mg Tab.Tolbutamide 500mg Tab.Pyridoxin 50mg Inj.Antisnake venom Inj.Ascorbic acid 100mg Other drugs Inj.Glibenclamide Tab.Sodabicarb Inj.Biguanide Tab.Chlorpropamide 100mg Tab.98 99 100 101 102 103 104 105 106 U) 107 108 109 110 111 112 113 V) 114 115 116 117 118 119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 Inj.Cholcalciferol16lac Inj.Vit "A" Inj.Antirabies vaccine Inj.Testesterone plain 25mg Testesterone Depot 50mg Tab.Mixtard Inj.
Amitryptilline Tab. Gasex Syp. Pilex Rumalaya Gel Pinku Pedratic Cough Syp. Cystone Tab.Liv52 Syrup Liv52 Cap.Tetglobe 66 .Folic acid Inj.Himobin APDYL Cough &Noscopin Tab. Mentat Oint.stilboesteral Inj.Doxycycline 100mg Inj.Pyridoxine Hydrogen peroxide Inj.Metaclopramide Tab.Nitrofurantine Inj.Taxim Inj.Cephalexin 250mg Tab.Heparin sod.Nor adrenaline Betadine lotion Tab.1000IU Tab.trifluoperazine(1mg) Tab.Dopamine Tab.137 138 139 140 141 142 143 144 145 146 147 148 (W) 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 28 ECG Roll Burnion Oint Flemigel APC Ointment Syp.Isolyte-P Inj. Others Tab. Septilin Tab.Dipyridamol(Like Persentine) Inj.Isolyte-M Inj.magnesium sulphate Benzyl Benzoate GammaBenzene Hexachloride Inj.Isolyte-G Cap.Valethemide Bromide(Epidosyn) Inj.Lignocaine Hcl 2% Inj.Glyceryl Trinitrate Tab.
Thyroxine sod 0.5%.Calcium pantothernate Inj.29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 Inj.5% 1 Bacitrium powder 10mg botts Bleaching Powder 5 Kg Pkts(ISI Mark) Ether Solvent Sodium Hypochloride Sod.Phenobarbitone 30mg Tab. Nebasuef .Pyridoxin 10mg Tab.V Inj.Multivitamin I.Orciprenaline Suturing needles (RB. Methyl Prednisolon 500mg vial Inj.Xylocaine 4% 30 ml Halothane Mixture Alkaline Inj.1mg Warfarin sod 5mg Tab.Tetanus Toxoid 5ml vial Inj.U Inj.25mg Tab. Gas gangrene Antitoxin(AGGS)10000 Inj. Hydroxy Progesterone500mg/2ml Inj.Paracetamol Pilocarpine eye drops 1% Sy.Phenobarbitone 60mg Tab.Griseofulvin125mg Tab. 1.Alprazolam 0.Amlodipine 5mg 67 .Quinine Dihydrochloride Tetanus Antitoxin 10000 I.Cutting) Inj.Ferrous sulphate 300mg Tab.U Inj.Theophylline Etophylline Inj.Ferrous sulphate200mg+Folic acid Tab.Vitamin A Tab.Potassium chloride Inj. Diphthoria antition ADS)10000I. Soframycin Pow Magnasium Sulphate Powder Furacin Cream Xylocaine jelly Formaldehyde Lotion Cetrimide 100ml bott 3. B12 (Cynacobalamine) Neosporin. Phenabarbitone 200mg Inj. 5 ltrs/1 ltrs Inj.
Complex Vit D-3 Granules Opthalmic & ear drops Glycerine Mag sulphate ear drops Pilocarpine eye drops 4% Oint Acyclovir 3% 5gm tube Benzyl Benzoate emulsion 50ml bot Oint.Amlodipine 10mg Tab.Norfloxacin Phenylepinephrine eye drops Pilocarpine eye drops 2% Syp.Furazolidone Oint.Nefidipine 20mg Tab.isoniazid 100mg/5ml 100ml bot Liquid paraffin Linctus codein 500ml bot Cream Miconozole 2% 15gm tube Syp.Nefidipine 30mg Tab.70 71 72 73 74 75 76 77 78 79 79A 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 Tab.Theophylline 100ml Syp.Riboflavin 10mg Syp.Gamabenzene hexachloride1% bt Glycerine Suppository USP 3gm bott/10 Cream Nitrofurazone 0.Salbutamol 100ml bot Syp.Ferrous Gluconate 100ml bottle Cream Fluconozole 15gm tube Sus.Betamethasone Cream Clotrimazole skin 1% 15gm Oint Dexamethasone 1%+ Framycetin oint contain clotrimazole+Genta+Flucon Oint Flucanazole 10 mg Cream Framyctin 1% 20gm tube/100gm Lot.2% jar of 500g Oint Silversulpadiazene 1% 25g AIDS Protective kit 68 .Nalidixic acid syp.Primaquine Suspension Pyrantel pamoate Sus Rifampicin Syp.Pottassium chloride 400ml bot Syp.Hydrocortisone acetate Syp.Vitamin B.
Monitoring of Accessibility and equity issues. information exchange. 14. Monitoring of laboratory Internal Quality Assessment Scheme External Quality Assessment Scheme Record Maintenance 69 . All the efforts that are being made to improve hardware i. Standard treatment protocols for locally common diseases and diseases covered under all national programmes should be made available at all sub district hospitals. Financial Audit. human resources are necessary but not sufficient. Quality Assurance in Service Delivery Quality of service should be maintained at all levels. Disaster Preparedness Audit. Capacity Building Training of all cadres of workers at periodic intervals is an essential component of the IPHS for sub district hospitals. infrastructure and software i. Sub District hospitals also should provide the opportunity for the training of medical and paramedical staff working in the institutions below sub district level such as skill birth attendant training and other skill development / management training.13. These need to be guided by standard treatment protocols and Quality Assurance in Service Delivery Quality Control Internal Monitoring Social audit through Rogi Kalyan Samities / Panchayati Raj Institutions Medical Audit.e.e. External Monitoring Monitoring by PRI / Rogi Kalyan Samities Service / performance evaluation by independent agencies District Monitoring Committees formed under NRHM shall monitor the upgradation of Hospitals to IPHS. Annual Jansamvad may also be held as a mechanism of monitoring. Both medical and paramedical staff should undergo continuing medical education (CME) at intervals. Technical Audit.
15. Locations: It is located on ………. and a grievance redressal system. These RKS should be registered bodies with an account for itself in the local bank. The RKS / HMC will have authority to raise their own resources by charging user fees and by any other means and utilized the same for the improvement of service rendered by the Sub District Hospital. It provides medical care to all patients who come to the hospital. 70 . Standards are influenced by patients load and availability of resources. The means through which complaints regarding denial or poor quality of services will be redressed. OUR MOTTO .Computers have to be used for accurate record maintenance and with connectivity to the District Health Systems. State and National Level. Citizen’s Charter Each Sub District hospital should display a citizen’s charter for the sub district hospital indicating the services available. road in front of ………… This hospital hasDoctors: ………………… (including residents ………). user fees charged. if any. The quality of services they are entitled to. A modal citizen’s charter is given as under. Sub-district/divisional hospital. 16.SERVICE WITH SMILE CITIZENS CHARTER This charter seeks to provide a framework which enables our users to know: • • • What services are available in this hospital. Standards of Service: • • • • This is a District. Rogi Kalyan Samities (RKS) / Hospital Management Committee (HMC) Each sub district hospital should have a Rogi Kalyan Samiti / Hospital Management Committee with involvement of PRIs and other stakeholders as per the guidelines issued by the Government of India. Yet we insist that all our users receive courteous and prompt attention.
Location guide maps have been put up at various places in this hospital. treatment/management gets priority over paper work like registration and medico-legal requirements. The decision rests with the treating doctor. Colour coded guidelines and directional signboards are fixed at strategic points for guidance. OPD Services: Various outpatient services available in the hospital are detailed below (as available): OPD Place Time of Registration Time of OPD 71 . Telephone enquiries can be made over telephone numbers: ……………………. Beds: …………………….Nurses: …………………... In serious cases. Doctors wear white aprons and nurses are in uniform. Maternity OT Orthopaedic Emergency OT Burns and plastic OT Main OT for Neurosurgery cases Emergency Operation Theatre is functioned round the clock. Emergency Operations are done in- OT located on …………. • • • • Duty Doctor is available round the clock. General Information Enquiry. Specialist doctors are available on call from resident doctors. Casualty & Emergency Services: All Casualty Services are available round the clock. & ……………………. Emergency services are available for all specialities as listed in the OPD Services. (including supervisory staff). Fax: ………………………. Reception and Registration Services: This counter is functioning round the clock.. floor of ………… building. All Staff member wear identity cards.
72 .General Medicine Paediatrics General Surgery Paediatric Surgery Neuro Surgery Cardiac Surgery Obstetric & Gynec. Eye ENT Skin Urology Cardiology Psychiatry Radiotherapy Neurology Orthopaedics Burns & plastics Dental OPD ISM Services: Homeopathic Ayurvedic Any other In OPDs specialists are available for consultation.
On Saturdays. ………………………. Medical Facilities Not Available: Organ Transplantation ………………………..OPD services are available on all working days excluding Sundays and Gazetted Holidays. the hospital functions from …………….. PM.. ……………………… Some specialities do not have indoor patients services: Psychiatry D-addiction Dental Nuclear Medicine Genetic Counselling Endochronology Geriatrics Laboratory Services: Routine: Laboratory Services are provided in the field of (as available): • • • • • • Bio-chemistry Microbiology Haematology Cytology Histopathology including FNAC Clinical Pathology There is a Central Collection Centre for receiving and collecting various specimens for testing. The timings for receiving specimens are 9:00 AM to 11:30 AM. 73 . AM to …………….
CAT Scan services are also available round the clock. Radio Diagnostic Services: Routine: These services include: X-Rays Ultrasound and CAT Scan Routine X-Rays are done from 9:00 AM to 1:00 PM. 9:00 AM to 4:00 PM.bedded Intensive Coronary Care Unit takes care of heart patients requiring intensive treatment.Emergency: Emergency Laboratory Services are available 24 hours for limited tests relating to clinical pathology and bio-chemistry. Ultrasound examination is done from 9:00 AM to 4:00 PM. 74 . Emergency ward B admits emergency cases for surgical problems.bedded Intensive Care Unit for care of seriously ill patients. Wards providing free indoor patient care.labour rooms for conducting deliveries round the clock. Registration is done from 9:00 AM to 11:30 AM. There are --------------. -----------------. Indoor Patient Services: There are total of ………. There is a ------------. In the Burns Department. A --------------. All indoor patients receive treatment under the guidance and supervision during office hours i. Emergency ward A admits emergency cases for medical problems.bedded Intensive Care Unit to treat seriously injured burns patients. Emergency: Emergency X-Ray services are also available round the clock.e.nurseries provide necessary care to the newborns – normal as well those born with disease. there are ----------.
Admitted patients should contact the Staff Nurse for any medical assistance they need. Visitors are allowed only between 5:00 PM to 7:00 PM. Other Facilities: Other facilities available include: Cold Drinking Water Wheel chairs and trolleys are available in the OPD and casualty. In case of emergency CMO (on duty) may waive off these charges. ----------. are charged for as per Government approved rates. 75 . Canteen for patients and their attendants is available. Free diet is provided to all patients in the General Wards.D. Investigations like CAT Scan. ECHO. Public Telephone Booths are provided at various locations.Outside office hours. Adequate toilet Facilities for use of patients and their attendants are available. TMT etc.O. these charges can be waived partially or fully on the recommendation of the H. For poor patients. Barium-meal. Stand-by Electricity Generators have been provided. Lifts are available for access to higher floors. Chemist Shops are available outside the hospital. Ultra Sound. by the Additional Medical Superintendent. treatment is given by doctor on duty and specialists are available on call. Mortuary Van is available on payment between 9:00 AM to 4:00 PM. Every patient is given one attendant pass. A Staff Nurse is on duty round the clock in the ward.Ambulances are available to pick up patients from their places (on payment of nominal charges) and also for discharged patients.
Name. Dr. Please use the facilities of this hospital with care. Every grievance will be duly acknowledged. Please refrain from demanding undue favours from the staff and officials as it encourages corruption. Please try to appreciate the various constraints under which the hospital is functioning. It will only help us serve you better. Meeting Hours…………… to …………………… Responsibilities of the Users: The success of this charter depends on the support we receive from our uses. Please do not hesitate to register your complaints. (M)………………….lacs patients attend the OPD annually and more than -----------. we will explain the reasons and the time we will take to resolve. If we cannot. Please provide useful feedback & constructed suggestions. ……………………. Please help us in keeping the hospital and its surroundings neat and clean.. designation and telephone number of the nodal officer concerned is duly displayed at the Reception. The Hospital is a “No Smoking Zone” and smoking is a Punishable Offence.. On an average more than --------. Beware of Touts. Please do not inconvenience other patients. These may be addressed to the Medical Superintendent of the Hospital. Tele (O)……………… (R)………………….lacs patients are attended annually in the casualty and emergency wards. Designation……………. 76 . We aim to settle your genuine complaints within 10 working days of its receipt.Complaints & Grievances: There will be occasions when our services will not be upto your expectations. Suggestions/Complaint boxes are also provided at various locations in the hospital.
♦ “No Smoking Please” ♦ Don’t split here & there ♦ Use Dustbin ♦ Keep Hospital Clean ♦ Give regards to Ladies and Senior Citizens 77 .
It is. In accordance with the rules (Rule 4). In connection with the implementation of the Rules. 1998” in July. No untreated bio-medical waste shall be kept stored beyond a period of 48 hours (Rules 5 & 6). i. a person who has the control over the institution and/or its premises. Training 5. required to set in place the biological waste treatment facilities. 3. protective gears. Schedule VI of the rules also provides the time limits by which the waste treatment facilities are required to be in place. where required. 78 . animal house. etc. pathological lab. 1998 (Annexure). microwave system for the treatment of waste. IEC activities.e. 1998. it is incumbent on the occupier to ensure that the waste is treated within a period of 48 hours. Civil and electrical works to house and operate the waste treatment facilities. clinic. The hospitals. Other equipments including colour coded bags and puncture proof containers. dispensary. are. 4. However. etc. therefore. Purchase of equipments such as: a) Incinerator b) Microwave c) Autoclave d) Shredder 2. shall set up requisite biomedical waste treatment facilities like incinerator. The rules also envisage that common facility or any other facilities can be used for waste treatment. Hospital Waste Management System must be established in accordance with the BioMedical Waste (Management & Handling) Rules. to take all steps to ensure that the waste generated is handled without any adverse effect to human health and environment. The Rules further state that every Occupier.Annexure – I Guidelines for the Project providing financial support to the selected Government Hospitals for Hospital Waste Management. nursing homes. autoclave. or ensure requisite treatment of waste at a common treatment facility or any other treatment facility. The Ministry of Environment & Forests notified the “Bio-Medical Waste (Management & Handling) Rules. not incumbent that every institution has to have its own waste treatment facilities. AIM: The aim of the scheme is to implement pilot projects to have a demonstration effect by providing financial assistance to identified hospitals/institutions under Central/State Governments for: 1. however. it has been decided to take up pilot projects in selected Government hospitals – Central and State. it is the duty of every “Occupier”.
As 80-85% of waste generated in hospitals is non-hazardous or general waste. 2. 6. 1998 and must meet the guidelines developed by Central Pollution Control Board for design and construction of bio-medical waste incinerator (circulated to all States/UTs vide letter no. 1998. 1998. remain secure during transportation. Shredder: Shredding will cause a reduction in the volume of waste and will also effectively prevent its re-use. 4. 1998. Needle and Syringe Destroyer: These units can be used for needles and syringes at the point of use. 3. does not have sharp edges and is easy to clean and disinfect. 5. installation of incinerators by individual hospitals may not be encouraged and such waste should be transported to the common facility for proper treatment. trolleys or carts should be used to transport the bins or plastic bags to the site of storage/treatment. These options can be selected for waste categories 3. segregation will reduce the quantum of waste that needs special treatment to only 15-20% of the total waste.28015/50/2003-H. Transportation of Waste: Within the hospital in dedicated wheeled containers. 5. Wherever common facilities for treatment and disposal of bio-medical waste are available. 1998. 3. 1998. 2. The various options for treatment of waste can be selected according to feasibility and type of waste as given in the Schedule – I. These will destroy the used needles reducing it to ashes and cut the syringe effectively preventing the re-use. Waste category. 1.Segregation must be done at the source of generation of waste. dated 18. The equipment for autoclaving or microwaving waste should conform to these standards.11. 7 of Schedule – I of the Bio-Medical Waste (Management & Handling) Rules. The wheeled container should be designed so that waste can be easily loaded. It is required for waste category 4 and 7 of the Schedule – I of the Bio-Medical Waste (Management & Handling) Rules. The correct colour bag should be used for the particular treatment option. & 6 as stated in the Schedule – I of the bio-Medical Waste (Management & Handling) Rules. it should be ensured that waste is disinfected by chemicals/microwaving/autoclaving before shredding. The assistance will be given direct to the hospital/institute for purchase of equipments for waste treatment facilities/installation of equipment and civil/electrical works to 79 . Autoclaving/Microwaving: Standards for autoclaving and microwaving are provided in the Bio-Medical Waste (Management & Handling) Rules. Z. The categories for segregation of waste and colour coding and type of container should be as in Schedule 1 and 2 of the Bio-Medical Waste (Management & Handling) Rules. 4. The various options are: 1. Incineration: The incinerator installed must meet the specification and emission standards as given in the Bio-Medical Waste (Management & Handling) Rules.2003) – a certificate may be taken from the State Pollution Control Board.
50 lakhs Rs.00 lakhs Rs. training. for Disposal of hospital wastes = Rs. by way of complementary equipments supported by estimates of concerned authorities.5.1. trolleys./hour) 3. The grant will be subject to the condition that the State Government/UT Administration/Hospital will give an undertaking that they will provide the required trained manpower for running of the equipments and their maintenance for proper treatment and disposal for the bio-medical waste. 80 . of Rs. The proposal for additionalities. as far as possible.00 lakhs The following eligibility conditions have to be fulfilled for availing of financial assistance: i.30.50.50 crore per State/UT. The funds sanctioned will be utilized for the purpose for which it is sanctioned.2. Waste transportation: Onsite-wheel barrow/wheeled= container or similar carriage 5.2. protective gears for staff etc. pamphlets. 1015 litrs) = = = Rs. ii. Cap.00 Rs. Literature/IEC/Training of Staff = = 7.00 lakhs Upto max.00 lakhs 4.house the waste treatment facilities. v. The estimated costs are as under:1. Procurement of equipments like needle shredder puncture proof containers for sharps. The grant will be subject to the condition that the State Government / UT Administration will give an undertaking that adequate arrangements for running the equipments and their maintenance for disposal of hospital waste shall be made. Civil and Electrical works 6. in the form of equipment should be.35. Vol. iii. posters.000. vi. The cost of equipments to be purchased should be indicated. iv.10. The equipments will be purchased as per prescribed procedure. Incinerator or Microwave 2.00 lakhs Rs. The application for financial assistance should be forwarded to this Ministry through the State Government/UT Administration concerned. IEC activities including preparation and publication of literature. Shredder (Approx. 100 kg to 360 kg. The State Government/UT Administration should ensure that the existing facilities are inspected by a responsible officer and deficiencies pointed out. etc. Autoclave (Approx. The financial assistance will be limited to Rs. if any.85 lakhs per hospital or Rs. These will be entered into an Assets Register to be maintained by the hospital. colour coded bags.
Scrutiny of Applications: The applications received from the State Government/UT Administrations for setting up of facilities for disposal of hospital waste in the hospitals under their administrative control will be considered in the Ministry in a Committee headed by Additional Secretary and proposals cleared for giving financial assistance. In the case of Central Government Hospitals/Institutions. DDG level officer dealing with hospitals in Dte. The financial assistance will be limited to Rs. The accounts of the hospital about purchase of equipment/maintenance of the equipments/transportation of thw waste/expenditure incurred on civil/electrical works will be audited by the Accountant General of the State Government / UT Administration and its utilization certificate will be forwarded to the Ministry of Health & Family Welfare within a period of six months after the expiry of the financial year during which the grants is sanctioned.85 lakhs per hospital or Rs. The proposals will be examined through a Committee consisting of Additional Secretary.1.GHS concerned with hospitals matters will be the Nodal Officer for implementation of the scheme.5 crore. Joint Secretary (FA) or his representative.5 crore per State/UT. The Joint Secretary (Hospital). However. Chairman.1.vii. the Head of the Institutions may send their proposal through Dte. The Member Secretary of the Committee will be Director/Deputy Secretary dealing with hospital matters. The proposals then will be processed for sanction of financial assistance to the Government Hospitals/institutes. the Joint Secretary dealing with hospital matters. The State/UTs will have the option to choose any equipment (s) from the list above to cover as many hospitals as possible. DDG level officer in the Dte.GHS and one representative of Central Pollution Control Board/Ministry of Environment & Forests as members. 81 .GHS. The funds for setting up facilities for disposal of hospital waste will be sanctioned to the State Government/UT Administration/Occupier and it will be implemented by the concerned Government and to the concerned Head of the Hospital in case of Central Government Hospitals/Institutions. the financial assistance per State will be provided upto a maximum amount of Rs.
Trivandrum Agra BHU MGR Maulana Medical Azad University Medical College. Delhi Neisseria meningitidIs and N. Mumbai. John Medical Medical College College. Delhi 82 . Chest University of Delhi NICD. gonorrheae Staphylococcus SN State PH PGIMER Medical Lab Chandigarh College.Annexure . Delhi STM. Delhi STM. Shigella.diphtheriae VP. Vellore Streptococcus pyogenes and S pneumoniae C. Pune VP Chest Institute. Kolkata BJ MC CMC Vellore AFMC.4 Labs Central Zone Advance Diagnostic Facilities Bacterial diagnosis Enteric bacteria: Vibrio cholerae. Salmonella CMC Vellore South Zone North East Zone Zone South Zone IDSP Level – 5 Labs NICED & PGIMER RMRC KEM Chandigarh Dibrugarh.II REFERRAL LABORATORY NETWORKS Referral Laboratory Network for Advanced diagnostic facilities IDSP Level . Bangalore BHU CMC. Kolkata Surat CMC Medical Vellore & College PGIMER Chandigarh AFMC. NICD Cuttack Medical College AFMC Pune Trivandrum AIIMS Medical Delhi College CRI Kasauli Indore St. Pune NICD.
Vellore CMC. Vellore - NIV Neurotropic viruses HIV DRDE DRDE AIIMS & NICD Delhi AIIMS - - NIV NIMHANS NARI. TRC RMRC Port Blair Viral Diagnosis Enteric viruses DRDE CMC. Vellore AIIMS & NICED Villupuram Kolkata Chest Institute AIIMS & NICED NICD Delhi Kolkata Chest Institute AIIMS & NICED NICD Delhi Kolkata Chest Institute AIIMS ICGEB. HSADL Bhopal Hepatitis viruses DRDE CMC. NICD & NACO ICGEB. BJMC Bubaneswar & Dibrugarh NTI. Delhi NICED Kolkata EVRC. Allepey Tamil Nadu University. Delhi DRDE Virology Institute. NIV & NICD NIV Arboviruses DRDE CMC. Delhi Parasitic Diagnosis 83 . Chennai VCRC. Vellore CMC.Tuberculosis Leptospirosis State TB Demonstration & Training Centre (for all zones) ICGEB. Mumbai. Vellore - Myxoviruses DRDE CMC. Vellore - NIV. Pondicherry AIIMS IVRI RMRC.
Delhi ICGEB. Aleppey JE DRDE CRME. AIIMS Madurai & NIMHANS VCRC. Delhi Filaria All State Public Health Laboratories NVBDCP. Mumbai AFMC Pune NICED & NICD Microbial water quality monitoring NEERI. PGIMER RMRC. Pondicherry Plague DRDE NICD Bangalore CMC. Calcutta BJMC NICD IVRI KEM Mumbai. HAFFKIN' s. Cuttack Trivandrum AIIMS Medical Medical Delhi College College CRI Kasauli 84 . Delhi NIV /NICD Rickettsial diseases DRDE Others of Public Health Importance Anthrax DRDE CMC. Vellore NICD. Delhi Haffikins NICD.Malaria All State Public Health Laboratories MRC. Chandigarh Dibrugarh. Delhi VCRC Pondicherry Zoonoses Dengue DRDE VCRC. Institute Delhi AFMC NICD IVRI NICED NIV NICED NIV NIV ICGEB. CMC Nagpur Vellore. Vellore IGIB NICED. AIIMS Pondicherry Institute of Virology.
NTI. NICD.Port Blair NIV. RMRC. NICD Capacity building All the L4 & L5 laboratories (in their area of expertise) NIV.Unknown pathogens Other laboratories to perform support functions NIV. NICD Quality assurance All the L4 & L5 laboratories (in their area of expertise) CMC. NICED. NIV.Port Blair NIV. NARI. VCRC Laboratory data management Medical Colleges. NICED 85 . HSADL Outbreak investigation support Medical Colleges and state public health laboratories as L3/ L4 NICD. NICD Quality control of reagents & kits evaluation All the L4 & L5 laboratories (in their area of expertise) CMC. state public health laboratories and all the L4 & L5 laboratories (in their area of expertise) NIV. RMRC. TRC. BJMC. NARI. NICD. AFMC. TRC.
Pune NARI TRC.MRC. NICED. IVRI. NICD. Port Blair Biosafety & biocontainment Other laboratories to perform support function HSADL. Chennai RMRC.Delhi AFMC. NICD 86 . NIV. NIV/MCC.Production & supply of reagents/ kits/ biological/ standard reference materials DRDE. DRDE.
LIST OF ABBREVIATIONS BJMC CHC CME CSSD CRI CRME DRDE ICGEB EVRC FRU HSADL IGIB IPHS IVRI KEM MRC NARI NEERI NICED NIV NRHM PRI RKS/HMC RMRC STM VCRC BJ Medical College Community Health Centre Continuing Medical Education Central Sterile and Supply Department Central Research Institute Centre for Research in Medical Entomology Defense Research and Development Establishment International Centre for Genetic Engineering and Bio-technology Enterovirus Research Centre First Referral Unit High Security Animal Diseases Laboratory Institute of Genomics and Integrative Biology Indian Public Health Standards Indian Veterinary Research Institute King Edmund Memorial Hospital Malaria Research Centre National AIDS Research Institute National Environmental Engineering Institute National Institute of Cholera and Endemic Diseases National Institute of Virology National Rural Health Mission Panchayati Raj Institution Rogi Kalyan Samiti / Hospital Management Committee Regional Medical Research Centre School of Tropical Medicines Vector Control Research Centre 87 .
Govt. Directorate General of Health Services. (Unpublished) 3. of Tamil Nadu. 2001 2. Part 2 Upto 100 Bedded Hospital. January. Guidelines for Development and Operations. 2001. Govt. WHO. Indian Standard Basic Requirement for Hospital Planning. New Delhi. District Health Facilities. Office of the Registrar General. Indian Public Health Standards (IPHS) for Community Health Centres.References 1. Population Census of India. India. 4. Health & Family Welfare Department. 5. Rationalisation of Service Norms for Secondary Care Hospitals. 1998. of India. Bureau of Indian Standards. Ministry of Health & Family Welfare. 88 .
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