J OB RESPONSIBILITIES OF DIFFERENT CATEGORIES IN

C OMMUNITY HEALTH

A role might be defined as a work function which encapsulates a particular approach or

set of tasks which others can reasonably expect the worker to perform.

Job Responsibilities of Medical Officer

Duties of Medical Officer.:

The Medical Officer of Primary Health Centre (PHC) is responsible for implementing

all activities grouped under Health and Family Welfare delivery system in PHC area. He/she

is responsible in his individual capacity, and as overall in charge. It is not possible to

enumerate all his tasks. However, by virtue of his designation, it is implied that he will be

solely responsible for the proper functioning of the PHC, and activities in relation to RCH,

NRHM and other National Programs. The detailed job functions of Medical Officer working

in the PHC are as follows:

Curative Work

 The Medical Officer will organize the dispensary, outpatient department and will allot

duties to the ancillary staff to ensure smooth running of the OPD.

 He/she will make suitable arrangements for the distribution of work in the treatment

of emergency cases which come outside the normal OPD hours.

 He/she will organize laboratory services for cases where necessary and within the

scope of his laboratory for proper diagnosis of doubtful cases.

 He/she will make arrangements for rendering services for the treatment of minor

ailments at community level and at the PHC through the Health Assistants, Health

Workers and others.

 He/she will attend to cases referred to him/her by Health Assistants, Health Workers,

ASHA/ Voluntary Health Workers where applicable, Dais or by the School Teachers.
  He/she will screen cases needing specialized medical attention including dental care

and nursing care and refer them to referral institutions.

 He/she will provide guidance to the Health Assistants, Health Workers, Health Guides

and School Teachers in the treatment of minor ailments.

 He/she will cooperate and coordinate with other institutions providing medical care

services in his/ her area.

 He/she will visit each Sub-Centre in his/her area at least once in a month on a fixed

day not only to check the work of the staff but also to provide curative services. This

will be possible only if more than one Medical Officer is posted in PHC.

 Organize and participate in the “Village Health and Nutrition Day” at Anganwadi

Centre once in a month.

P reventive and Promotive Work

The Medical Officer will ensure that all the members of his/her Health Team are fully

conversant with the various National Health & Family Welfare Programs including NRHM to

be implemented in the area allotted to each Health functionary. He/she will further supervise

their work periodically both in the clinics and in the community setting to give them the

necessary guidance and direction.

 He/she will prepare operational plans and ensure effective implementation of the

same to achieve the laid down targets under different National Health and Family

Welfare Programmes. The MO will provide assistance in the formulation of village

health and sanitation plan through the ANMs and coordinate with the PRIs in his/ her

PHC area.

 He/she will keep close liaison with Block Development Officer and his/her staff,

community leaders and various social welfare agencies in his/her area and involve

them to the best advantage in the promotion of health programmes in the area.
  Wherever possible, the MO will conduct field investigations to delineate local health

problems for planning changes in the strategy for the effective delivery of Health and

Family welfare services. He/she will coordinate and facilitate the functioning of

AYUSH doctor in the PHC.

Job Functions of Health Worker Female (ANM)

She will carry out the following functions: She will carry out all the activities related

to various programs in an integrated manner when visiting the village/households.

Maternal and Child Health

 Register and provide care to pregnant women throughout the period of pregnancy.

Ensure that every pregnant woman makes at least 4 (Four) visits for Ante Natal

Check-up including

Registration.

Suggested schedule for antenatal visits

1st visit: Within 12 weeks—preferably as soon as pregnancy is suspected—for registration of

pregnancy and first antenatal check-up However, even if a woman comes late in her

pregnancy for registration, she should be registered, and care given to her according to

gestational age.

2nd visit: Between 14 and 26 weeks

3rd visit: Between 28 and 34 weeks

4th visit: Between 36 weeks and term

Provide ante natal check-ups and associated services such as IFA tablets, TT immunization

etc.

 Test urine of pregnant women for albumin and sugar. Estimate haemoglobin level.

 Refer all pregnant women to PHC/CHC for RPR test for syphilis and Blood

grouping.

 Refer cases of abnormal pregnancy and cases with medical and gynaecological

problems to Health
Assistant Female (LHV) or the Primary Health Centre.
 Conduct deliveries in Sub-centre, if facilities of a Labour room are available and, in

her area, when called for.

 Supervise deliveries conducted by Dais and assist them whenever called for.

 Refer cases of difficult labour and new-borns with abnormalities, help them to get

institutional care and provide follow up to the patients referred to or discharged from

hospital.

 ANM will identify the ultimate beneficiaries, complete necessary formalities and

obtain necessary approvals of the competent authority before disbursement to the

beneficiaries under Janani Suraksha Yojana (JSY) and by 7th of each month will

submit accounts of the previous month in the prescribed format to be designed by the

State. ANM will prepare a monthly work schedule in the meeting of all accredited

workers to be held on every 3rd Friday of every month, which is mandatory. The

guideline under JSY is to be followed. In addition, ANM will take weekly/fortnightly

meetings with all ASHAs of her area to guide and monitor them.

 Tracking of all pregnancies by name for scheduled ANC/PNC services.

 Make post- natal home visits on 0, 3, 7 and 42nd day for deliveries at home and Sub-

centre and on 3, 7, and 42nd day for institutional delivery. Post-natal visits are to be

made for each delivery happened in her area and she should render advice regarding

care of the mother and care and feeding of the new born.

 In case of Low Birth Weight Baby, a total of six post-natal visits are to be made on 0,

3, 7,14, 21 and 28th day to screen for congenital abnormalities, assess the neonate for

danger signs of sickness etc. as per IMNCI guidelines and appropriate referral.

 Initiation of early breast-feeding within one hour of birth, exclusive breastfeeding for

6 months and timely weaning at 6months as per Infant and Young Child Feeding

Guidelines.
  Assess the growth and development of the infants and under 5 children and make

timely referral.

 Provide treatment for all cases of Diarrhoea, acute respiratory infections (pneumonia)

and other minor ailments and refer cases of severe dehydration, respiratory distress,

infections, severe acute malnutrition and other serious conditions as per IMNCI

guidelines/National Guidelines.

 Educate mothers individually and in groups in better family health including maternal

and child health, family planning, nutrition, immunization, control of communicable

diseases, personal and environmental hygiene.

 Assist Medical Officer and Health Assistant(Female) in conducting antenatal and

postnatal clinics at the Sub-centre.

Family Planning:
 Utilize the information from the eligible couple and child register for the family

Planning programme. She will be squarely responsible for maintaining eligible couple

registers and updating at all times.

 Spread the message of family planning to the couples and motivate them for family

planning individually and in groups.

 Distribute conventional contraceptives and oral contraceptives to the couples, provide

facilities and to help prospective acceptors in getting family planning services, if

necessary, by accompanying them or arranging for the Dai/ASHA to accompany them

to hospital.

 Provide follow-up services to female family planning acceptors, identify side effects,

give treatment on the spot for side effects and minor complaints and refer those cases

that need attention by the physician to the PHC/ Hospital.

 IUCD insertion can be done by a trained ANM.

 Establish female depot holders, help the Health Assistant (Female) in training them,

and provide a continuous supply of conventional contraceptives to the depot holders.

  Build rapport with acceptors, village leaders, ASHA, Dais and others and utilize them

for promoting Family Welfare Programme.

 Identify women leaders and train them with help of the Health Assistant (Female).

 Participate in Mahila Mandal meetings and utilize such gatherings for educating

women in Family Welfare Programme.

Medical Termination of Pregnancy

 Identify the women requiring help for medical termination of pregnancy and refer

them to nearest approved institution.

 Educate the community of the consequences of unsafe abortion methods and septic

abortion, inform them about the availability of services for medical termination of

pregnancy.

Nutrition:
 Identify cases of Low Birth weight, malnutrition among infants and young children

(zero to five years), give the necessary treatment and advice and refer serious cases to

the Primary Health Centre.

 Distribute Iron and Folic Acid tablets as prescribed to pregnant women, nursing

mothers, adolescent girls and syrups to young children (up to five years), as per the

national guidelines.

 Administer Vitamin A solution to children as per the guidelines.

 Educate the community about nutritious diet for mothers and children.

 Coordinate with Anganwadi Workers.

Universal Programme on Immunization (UIP)

 Immunize pregnant women with tetanus toxoid.

 Administer DPT vaccine, oral poliomyelitis vaccine, measles vaccine and BCG

vaccine to all infants and children, (Hepatitis B in pilot areas) as per immunization

schedule.
 Ensure injection safety, safe disposal and record, report and manage minor & serious

Adverse Event Following Immunization (AEFI). Submit monthly UIP reports, weekly

surveillance reports (AFP, Measles under IDSP). Serious AEFI and outbreak should

be reported immediately.

 ANM is responsible for cold chain maintenance for vaccines during fixed and

outreach sessions.

 Manage waste generated during immunization as per GOI/CPCB guidelines.

 Preparing work plan, estimating beneficiaries and logistics, preparing due list of

expected beneficiaries in coordination with Anganwadi worker and ASHA/mobilizer

on the session day and ensure their vaccination through adequate mobilization.

 Maintain Tracking Bag/Tickler box at each Subcentre, file updated counterfoils and

utilize them for follow up.

 Tracking of dropouts and left outs, records/ reports (including MCH register and

immunization card counterfoils), surveillance/reporting Vaccine Associated Paralytic

Poliomyelitis (VAPP) and AEFI incidents in catchment area.

 Indent order of vaccines and logistics should be weekly based on the due beneficiary

list. HW/Alternate Vaccinator should receive the required quantity of vaccine and

logistics on the day of Immunization and supply to the session site.

 Work plan indicating village, place, date & time of organizing proposed session,

including the names of ASHA and AWW must be displayed at each Sub-centre.

 Posters/Paintings on key messages, Immunization schedule, positioning during

vaccine administration, Safe Injection Practices, VVM, AEFI awareness, use of Hub

cutters.
 Communicable Diseases

Notify the MO, PHC immediately about any abnormal increase in cases of diarrhoea/

dysentery, fever with rigors, fever with rash, flaccid paralysis of acute onset in a child <15

years (AFP), , Tetanus, fever with jaundice or fever with unconsciousness, minor and serious

AEFIs which she comes across during her home visits, take the necessary measures to

prevent their spread, and inform the Health Assistant (Male)/LHV to enable him/her to take

further

action.

 HIV/STI Counseling, HIV/STI screening after receiving training.

 Leprosy

 Impart Health Education on Leprosy and its treatment to the community.

 Refer suspected new cases of leprosy and those with complications to PHC.

 Provide subsequent doses of MDT to patients Ensure regularity and completion of

treatment and assist health supervisor in retrieval of absentee/defaulter.

 Update the case cards at Sub-centres & treatment register at sector PHC.

 Assist leprosy disabled people in self-care practices, monitor them and refer them to

PHC whenever required.

 Assist the Health Worker (Male) in maintaining a record of cases in her area, who are

under treatment for malaria, tuberculosis and leprosy, and check whether they are

taking regular treatment, motivate defaulters to take regular treatment and bring these

cases to the notice of the Health Worker (Male) or Health Assistant (Male).

 Give Oral Rehydration solution to all cases of diarrhoea/dysentery/vomiting. Identify

and refer all cases of blindness including suspected cases of cataract to M O, PHC.

 Education, Counselling, referral, follow-up of cases of STI/RTI, HIV/AIDS.

 Malaria
 She will identify suspected malaria fever cases during ANC or Immunisation Clinic

and home visits and will make blood smears or use RDT for diagnosis of Pf malaria.

 To advise seriously ill cases to visit PHC for immediate treatment. All the fever cases

with altered sensorium must be referred to PHC/District Hospital. The cases will be

referred after collection of blood smear and performing RDT. To arrange

transportation for such patients from home to the PHC/District Hospital.

 To contact all ASHAs/FTDs of the area during visit to the village and collect blood

smears for transportation to laboratory. To cross verify their records by visiting

patients diagnosed positive between the previous and current visit.

 To provide treatment to positive cases as per the drug policy.

 To replenish the stock of micro slides, RDKs and/or drugs to ASHAs/FTDs wherever

necessary.

 To keep the records of blood smears collected and patients given anti-malarial

treatment.

 To ensure early diagnosis & radical treatment of the diagnosed positive cases (PV &

Pf) compliance of Radical Treatment (Pf – 45 mg …. & Pv – 15 mg) for 15 days.

 To take all precautions to use properly sterilized needles and clean slides while

collecting blood smears.

 She will ensure that all pregnant women are provided insecticidal treated nets in high

malaria endemic areas.

 Where Filaria is endemic:

 Where Kala-Azar is endemic:

 Where Dengue/Chikungunya is endemic

NON-COMMUNICABLE DISEASES
 IEC Activities for prevention and early detection of hearing impairment/deafness in

health facility, community and schools, harmful effects of Tobacco, mental illnesses,

Iodine Deficiency Disorders (IDD), Diabetes, CVD and Strokes. House to House

surveys to detect list & refer cases of hearing & visual impairment and (along with

annual survey register/enumeration survey. Minimum is annual survey, desirable to be

done twice yearly subject to availability of second ANM).

 Sensitization of ASHA/AWW/PRI about prevention and treatment of deafness.

Mobilizing community members for screening camps and assisting in conduction of

screening camps to identify hearing or visual impairment cases if needed. Motivation

for quitting and referrals to Tobacco Cassation Centre at District Hospital.

Sensitization of ASHA/AWW/PRI about the Non-communicable diseases.

 Identification and referral of carer of common mental illnesses and Epilepsy for

treatment and follow them up in community. Greater participation/role of Community

for primary prevention of NCD and promotion of, healthy lifestyle. Ensuring regular

Testing of salt at household level for presence of Iodine through Salt Testing Kits by

ASHAs.

In Fluorosis affected districts

 IEC to prevent Fluorosis.

 Identify the persons at risk of Fluorosis, suffering from Fluorosis and those having

deformities due to Fluorosis.

 Line listing, source reduction activities, reconstructive surgery cases, rehabilitative

intervention activities, focused local action and referral of what is not possible

locally. Promoting formation and registration of Self Health Care Group of Elderly

Persons’.
Vital Events
Record and report to the health authorities the vital events including births and deaths,

particularly of mothers and infants in her area.

Record Keeping
1. Maintenance of all the relevant records concerning mothers, children and eligible couples

in her area.

2. Register

(a) pregnant women at earliest contact

(b) infants zero to one year of age

(c) women aged 15-44 years (d) Under and above five children (e) Adolescents.

3. Maintain the pre-natal and maternity records and child care records.

4. Prepare the eligible couple and child register and maintaining it up-to-date.

5. Maintain the records as regards contraceptive distribution, IUD insertion. Couples

sterilized, clinics held at the Sub-centre and supplies received and issued.

6. Prepare and submit the prescribed weekly/ monthly reports in time to the Health Assistant

(Female).

7. maintaining passive surveillance register

Treatment of Minor Ailments

1. Provide treatment for minor ailments, first-aid for accidents and emergencies and refer

cases beyond her competence to the Primary Health Centre/Community Health Centre or

nearest hospital.

2. Provide treatment as per AYUSH* as needed at the local level.

House-to House Surveys

These surveys would be done once in April annually. Some of the diseases would require

special surveys- but at all times not more than one survey per month would be expected.
Surveys would be done with support and participation of HW (male), ASHAs, Anganwadi

Workers, community volunteers, panchayat members and Village Health Sanitation and

Nutrition Committee.

J ob Functions of Health Worker Male

His duties pertaining to different National Health Programme are:

He will carry out all the activities related to various national health programmes in an

integrated manner when visiting the village/households

IEC
1. To educate the community about signs & symptoms of malaria, its treatment,

prevention and vector control.

2. Advance spray information to community/ villages.

3. To participate in the activities of anti-malaria month.

4. Sensitize the community for sleeping under Long Lasting Insecticidal Net (LLIN) in the

high endemic areas.

Recording & Reporting

1. To maintain record of fever cases diagnosed by blood slides/RDTs in M1 and prepare a

Sub-centre report (M4) for all cases in the area, including those of ASHAs and FTDs and

submit it to PHC.

2. To keep a record of supervisory visits in Tour diary and submit to MO-PHC during

monthly meetings for verification.

3. To keep records & reports as per guidelines of NVBDCP.

4. Minutes of VHSNC decisions.

Village Health Sanitation & Nutrition Committee

1. MPW is expected to be a member of Village Health Sanitation and Nutrition Committee.

He must take part in the meetings actively and lead the discussions. He must convey the

importance of source reduction activities.

House- to House Surveys

These surveys would be conducted once annually in April. Some of the diseases

would require special surveys but at all times not more than one survey per month would be

expected.

Surveys would be done with support and participation of ASHAs, Anganwadi

Workers, community volunteers, panchayat members and Village Health Sanitation and

Nutrition Committee members. The Male Health Worker would take the lead and be

accountable for the organization of these surveys and the subsequent preparation of lists and

referrals.

Environment Sanitation

Chlorinate the public water sources including wells at regular intervals.

Educate the community on

a. The method of disposal of liquid wastes

b. The method of disposal of solid waste

c. Home sanitation

d. Advantage and use of sanitary type of latrines

e. Construction and use of smokeless chulhas

f. Coordination with Village Health Sanitation and Nutrition Committee.

Primary Medical Care

Provide treatment for minor ailments, first aid for accidents and emergencies and refer

cases beyond his competence to the nearest hospital or PHC/CHC.

Health Education

Educate the community and family planning about the availability of maternal and child

health services and encourage them to utilize the facilities.

Nutrition
Identify cases of Low Birth Weight and malnutrition among infants and young children

(0-5 years) in his area, give the necessary treatment and advice or refer them to the

anganwadi for supplementary feeding and refer serious cases to the PHC. Educate the

community about the nutritious diet for mothers and children utilizing locally

available food.

Vital Events
Enquire about births and deaths occurring in his area, record them in the births and deaths

register, sharing the information with ANM and report them to the Health Assistant

(Male)/Health Assistant (Female).

Educate the community on the importance of registration of births and deaths.

Record Keeping and other Miscellaneous

Functions:

 Survey all the facilities in his area and prepare/ maintain maps and charts for the

village. Prepare, maintain and utilize family and village records. Assist the ANM to

prepare and maintain the eligible couple as well as maternal & child Health register.

Maintain a record of cases in his area, who are under treatment for tuberculosis and

leprosy.

 Prepare and submit the prescribed monthly reports in time to the Health Assistant

(Male). While maintaining passive surveillance register for malaria cases, he will

record:

 No. of fever cases

 No. of blood slides prepared

 No. of malaria positive cases reported

  No. of cases given radical treatment, prepare an annual Village Health Plan in

association with ANM, PRI and VHSC members and submit the same to block.

Job Responsibilities of Health Assistant Female (LHV – Lady Health

Visitor) (Female Supervisor)

Supervision and guidance

 Supervise and guide the Health Worker Female, Dais and guide ASHA in the

delivery of health care service to the community.

 Strengthen the knowledge and skills of the Health Worker Female.

 Helps the Health Worker Female in improving her skills in working in the

community.

 Help and guide the Health Worker Female in planning and organizing her

programmes of activities.

 Visit each Sub-Centre at least once a week on a fixed day to observe and guide the

Health Worker Female in her day to day activities.

 Assess fort nightly the progress of assessment report works of the Health Worker

Female and submit with respect to their duties under various National Health

Programmes.

 Carry out supervisory home visits in the area of the Health Worker Female with

respect to their duties under various National Health Programmes. Supervise referral;

of all pregnant women for RPR testing at PH. Supplies, equipment and maintenance

of Sub-Centres.

 In collaboration with the Health Assistant Male, check at regular intervals the stores

available at the Sub-Centre and help in the procurement of supplies and equipment.

 Check that the drugs at the Sub-Centre are properly stored and that the equipment is

well maintained.
  Ensure that the Health Worker Female maintains her general kit, midwifery kit and

Dai kit in the proper way.

 Ensure that the Sub-Centre is kept clean and is properly maintained.

Records and Reports

 Scrutinize the maintenance of records by the Health Worker Female and guide her in

their proper maintenance.

 Review reports received from the Health Workers Female, consolidate them and

submit monthly reports to the Medical Officer of the Primary Health Centre

Training:

 Organize and conduct training for Dais/ASHA with the assistance of the Health

Worker Female.

 Assist the Medical Officer of the Primary Health Centre in conducting training

programme for various categories of health personnel.

Maternal and Child Health

 Conduct weekly MCH clinics at each Sub-Centre with the assistance of the Health

Worker Female and dais.

 Respond to calls from the Health Worker Female, the Health Worker Male, the health

guides and the trained Dais and render the necessary help.

 Conduct deliveries when required at PHC level and provide domiciliary and

midwifery services. Family Welfare and Medical Termination of Pregnancy.

 She will ensure through spot checking that Health Worker Female maintains up-to

date eligible couple registers all the times.

 Conduct weekly family planning clinics along with the MCH clinics at each Sub-

Centre with the assistance of the Health Worker Female. Personally, motivate

resistant case for family planning.

  Provide information on the availability of services for medical termination of

pregnancy and for sterilization. Refer suitable cases for MTP to the approved

institutions.

 Guide the Health Worker Female in establishing female depot holders for the

distribution of conventional contraceptives and train the depot holders with the

assistance of the health workers female.

 Provide IUCD services and their follow up.

 Assist M.O. PHC in organization of family planning camps and drives.

Nutrition

 Ensure that all cases of malnutrition among infants and young children (0-5 years) are

given the necessary treatment and advice and refer serious cases to the Primary Health

Centre.

 Ensure that iron and folic acid vitamin A are distributed to the beneficiaries as

prescribed.

 Educate the expectant mother regarding breast feeding.

 Universal Immunization Programme

 Supervise the immunization of all pregnant women and children (0-5 years).

 She will also guide the MPW (M) and MPW(F) to procure supplies organize

immunization camps provide guidance for maintaining cold chain, storage of vaccine,

health education and also in immunizations.

 Supervise the immunization of all pregnant women and infants.

 Follow the directions given in Manual of Health Worker (female) under National

Immunization Programme.
Acute Respiratory Infection

 Ensure early diagnosis of pneumonia cases. Provide suitable treatment to

mild/moderate cases of ARI.

 Ensure early referral in doubtful/severe cases.

School Health

 Assist Medical Officer in school health services.

Primary Medical Care

 Ensure treatment for minor ailments, provide ORS & First Aid for accidents and

emergencies and refer cases beyond her competence to the Primary Health Centre or

nearest hospital.

Health Education

 Carry out educational activities for MCH, Family Welfare, Nutrition and

Immunization, Control of blindness, Dental care and other National Health

Programmes like leprosy, Tuberculosis and NCD programmes with the assistance of

the Health Worker Female.

Job Responsibilities of Laboratory Technician

General Laboratory Procedures

1. Manage the cleanliness and safety of the laboratory.

2. Ensure that the glassware and equipment are kept clean.

3. Handle properly and ensure maintenance of the microscope.

4. Sterilize the equipment as required.

5. Dispose of specimens and infected material in a safe manner.

6. Maintain the necessary records of investigations done and submit the reports to the

Medical Officer, PHC.

7. Prepare monthly reports regarding his work.

8. Indent for supplies for the laboratory though the Medical Officer, PHC and ensure the safe

storage of materials received.

Laboratory Investigations
Carry out examination of urine

 Specific gravity and PH.

 Test for glucose.

 Test for protein (albumen).

 Test for bile pigments and bile salts.

 Test for ketone bodies.

 Microscopic examination.

Carry out examination of stools

 Gross examination.

 Microscopic examination.

Indian Public Health Standards (IPHS) Guidelines for Primary Health Centres

Carry out examination of blood

 Collection of blood specimen by finger prick technique.

 Hemoglobin estimation.

 RBC count.

 WBC count (total and differential).

 Preparation, staining and examination of thick and thin blood smears for malaria

parasites and for microfilaria.

 Erythrocyte Sedimentation Rate.

 VDRL.

 Blood grouping and Rh typing.

 Rapid HIV and STI Screening test

Carry out examination of sputum

Preparation, staining and examination of sputum smears for Mycobacterium tuberculosis

(wherever the PHC is recognized as microscopy centre under RNTCP)

Carry out examination of semen

i. Microscopic examination.

ii. Sperm count motility, morphology etc.

Prepare throat swabs

Collection of throat swab and examination for diphtheria.

 Testing of samples for gross impurities.

 Test samples of drinking water

 Rapid tests for detecting faecal contamination by H2S strip test.

 Residual chlorine in drinking water by testing kits.

Under NVBDCP, in endemic areas, he will also

 Conduct rapid diagnostic test for Kala-azar for suspected case of Kala-Azar (rk 39) in

OPD or referred by ASHAs or Health Workers.

 Conduct Aldehyde test, maintain all records of sera samples drawn, aldehyde tests and

also assist in Kala-Azar search operations.

 Collect sera samples from suspected encephalitis cases and send to sentinel

surveillance laboratory for testing, maintain all records of sera samples drawn and

their results.

Job Responsibility y of Immunization Staff at PHC / CHC /Sub -Divisional

District Hospital Cold Chain and Vaccine Logistic (CC&VL) Assistant

Qualification & Experience: Graduate or Diploma in Pharmacy/Nursing with 1-2 years’

experience in medical store management.

Job Responsibilities
1. Support the MO I/C in UIP implementation, focusing on improved management of the cold

chain inclusive of basic preventive maintenance of cold chain equipment, vaccine & logistics

management (goods clearance, elimination of overstocking and stock outs of vaccine) and

injection safety including proper waste disposal.

2. Ensure monthly reporting of Immunization data including vaccine usage, VAPP and AEFI

cases as per GOI guidelines and annual progress report.

3. Assist MO I/C to conduct periodic programme reviews and undertake action on operational

procedures specifically logistics affecting the implementation and management of the UIP.

4. Maintaining of accurate stock records and periodic review of supply requisitions.

5. Assist MO I/C in preparing annual vaccine forecasts of the PHC/CHC.

6. Provide technical guidance to the PHC/CHC level staff on cold chain management and

conduct periodical evaluation for the purpose of repair and replacement.

7. Undertake field visits to session sites and provide supportive supervision to health care

workers to maintain proper cold chain for vaccines, logistics and waste disposal.

8. Assist MO during monthly meetings and provide feedback/refresher trainings to workers

on issues related to cold chain & vaccine logistics.

9. Assist MO in micro planning for adequate & timely supply of vaccines & logistics through

alternate vaccine delivery mechanism.

10. Recording of temperature in the Temp. Record Book twice daily as per guidelines.

11. Any other immunization related work as specified by Medical Officer.

Roles of the Public Health Nurse / Community Health Nurse:

To function in their roles, public health/community health nurses must use advanced

decision-making strategies such as the nursing process, which combines judgment, action,

responsibility, and accountability.

Public health/community health nurses must take the time to inform themselves about current

community health issues and new technologies, so they can properly apply public health

science and epidemiological principles to their work.

These are the areas in which public health/community health nurses play key roles:

Role in Health Promotion

• Encourages the adoption of health beliefs, attitudes, and behaviours that contribute to the

overall health of the population through public policy, community-based action, public

participation, and advocacy or action on environmental and socio-economic determinants of

health, as well as health inequities.

• Supports public policy changes to modify physical and social environments that contribute

to risk.

• Assists communities, families, and individuals to take responsibility for establishing,

maintaining, and/or improving their health by adding to their knowledge or control over (and

ability to influence) health determinants.

• Works with others and leads processes to enhance community, group, or individual plans

that will help society to plan for, cope with, and manage change.

• Encourages skill building by communities, families, and individuals so they can learn to

balance choices with social responsibility and, in turn, create a healthier future for all.

• Initiates and participates in health promotion activities in partnership with others such as the

community and colleagues in other sectors.

Role in Disease and Injury Prevention

• Reduces the risk of infectious disease outbreaks; this includes early identification,

investigation, contact tracing, preventive measures, and activities to promote safe behaviours.

• Applies epidemiological principles and knowledge of the disease process so as to manage

and control communicable diseases using prevention techniques, infection control, behaviour

change counselling, outbreak management, surveillance, immunization, episodic care, health

education, and case management.

• Uses appropriate technology for reporting and follow-up.

• Uses effective strategies to reduce risk factors that may contribute to chronic disease and

disability; this may include changes to social and economic environments and inequities that

increase the risk of disease.

• Helps individuals and families to adopt health behaviours that reduce the likelihood of

disease, injury, and/or disability.

• Encourages behaviour changes to improve health outcomes.

Role in Health Protection

• Acts in partnership with public health colleagues, government, and other agencies to:

– ensure safe water, air, and food,

– control infectious diseases, and

– provide protection from environmental threats (including delegating or carrying out

delegated regulatory functions).

• Takes the lead in identifying issues that may need attention and offers public health advice

to groups such as municipal governments or regional districts about the public health impact

of policies and regulations.

• Works with individuals, families, and communities to create or maintain a safe environment

where people may live, work, and play.

Role in Health Surveillance

• Is aware of health surveillance data and trends; applies this knowledge to day-to-day work.

• Integrates eco-social surveillance that focuses on broad, multi-level conditions that

contribute to health inequalities.

• Mobilizes formal and/or informal networks to systematically and routinely collect and

report health data for tracking and forecasting health events or health determinants.

• Collects and stores data within confidential data systems; integrates, analyzes, and interprets

this data.
• Provides expertise to those who develop and/or contribute to surveillance systems,

including risk surveillance.

Role in Population Health Assessment

• Uses health surveillance data to launch new services or revise those that exist.

• Contributes to population health assessments and includes community viewpoints.

• Plays a key role in producing and using knowledge about the health of communities (or

certain populations or aggregates) and the factors that support good health or pose potential

risks (determinants of health), to produce better policies and services.

Role in Emergency Preparedness and Response

• Contributes to and is aware of public health’s role in responding to a public health

emergency.

• Plans for, is part of, and evaluates the response to both natural disasters (such as floods,

earthquakes, fires, or infectious disease outbreaks) and man-made disasters (such as those

involving explosives, chemicals, radioactive substances, or biological threats) to minimize

serious illness, death, and social disruption.

• Communicates details of risk to population subgroups at higher risk and intervenes on their

behalf during public health emergencies using a variety of communication channels and

engagement techniques.

Advocacy

• Helps individuals, families, and groups become aware of issues that may impact on their

health; the focus may be on those who are disadvantaged due to socioeconomic status, age,

isolation, culture, lack of knowledge, etc.

• Works to develop clients’ capacity to speak for themselves.

• Uses advertising and media in skilful ways, for advocacy.

• Promotes resource development that will lead to equal access to health and health-related

services.
• Uses collaborative approaches and acts as an advocate for change.

• Shows a strong commitment to equity and social justice and speaks out for equity in health

through legislation and policy-making activities.

• Acts as spokesperson, when asked, to represent the views of individuals and groups seeking

to promote their health.

Building Capacity

• Encourages and supports the community to be active in stating and taking ownership of

health issues that need to be resolved; this may include working with the community to

develop skills in how to access resources, how to develop social networks, and how to learn

from the efforts of others.

• Acts as a catalyst to help resolve issues and concerns.

• Educates community members about the political process as it relates to community health

issues and about how they can become active in decisions about health issues.

• Helps the community (and its members) better understand that their own abilities may be

their best health resource.

• Uses group process and leadership skills.

Building Coalitions and Networks

• Sees the need for and identifies opportunities to build coalitions and networks to promote

health or prevent illness.

• Identifies the type of coalition that best fits the mission or purpose.

• Facilitates skill development (capacity building) of community members and supports

community engagement.

• Makes clear how leadership and guidance will work and supports development of agreed-

upon roles, rules, and procedures.

• Helps to create links between the broader community and the coalition/network.

• Provides support as requested by the coalition or network.

Care/Counselling

• Establishes a therapeutic relationship based on trust, respect, caring, and listening.

• Uses clinical skills to assess the client’s ability to participate in joint planning,

implementation, and evaluation of nursing interventions.

• Uses health promotion, illness, and injury prevention techniques that are client centred,

client-driven, and strengths-based.

• Helps clients to accept their share of responsibility for health.

• Sets and maintains boundaries, monitors the counselling relationship, and effectively plans

and manages the process until the relationship ends.

• Remains sensitive to how each client is unique and to the client’s vulnerabilities, while

placing the focus on enhancing the client’s strengths.

• Promotes client self-care and/or avoidance of harm to self and others.

Case Management
• Actively engages with individuals, groups, and communities; this may involve case-finding,

a process of identifying individuals and/or families who may be at risk and who meet the

agency’s criteria for case management.

• Assesses the resources and services that will be needed to build on the client’s strengths and

skills and thus help the client to attain and/or maintain a desired health status or set of healthy

behaviours for improved quality of life.

• Builds trusting relationships and works with clients to identify and resolve health issues.

• Develops, implements, and evaluates an agreed-upon plan with the client; the plan respects

the client’s (and sometimes a family’s) control over their health and decisions; it prepares the

client for an end to the professional relationship (except when child protection or other

welfare concerns apply).

• Supports individuals and families to build on their strengths and skills so they can find and

access available resources and services and thus attain or maintain a desired health status.
• Links individuals and/or families with needed services and resources.

• Uses an inter-disciplinary approach and cooperates with other organizations as needed,

based on how complex the circumstances are.

• Coordinates services and applies plans in a logical sequence together with individuals

and/or families.

• Helps to resolve potential or actual barriers in the way services are provided.

• Evaluates progress with individuals and/or families and revises service plan(s) as needed.

Communication

• Uses oral and written skills, along with visual, print, and other media to:

– build trusting, helping relationships,

– convey health information, including details on risk,

– assess knowledge, attitudes, beliefs, etc.,

– help clients find options for making choices that will meet their health needs and/or allow

them to speak up for themselves.

• Negotiates or contracts with health care, social services, or resource agencies, and all

segments of the community, to ensure clients have access to services.

• Uses effective communication with team members.

• Effectively addresses and manages conflict.

• Contributes to and plays an active role in health promotion and social

marketing that support attitudes and/or beliefs to reduce health inequalities and improve

health outcomes.

• Works to achieve inter-agency and inter-governmental cooperation.

• Uses effective risk communication approaches.

• Acts as a spokesperson, as needed, on public health issues.

• Uses appropriate technology to manage, mitigate, and communicate about public health

events; this includes good record keeping.

Community Development

• Applies knowledge of community assessment and community development models to

support public participation in identifying and resolving health issues.

• Uses a strengths-based approach that supports capacity development and empowerment in

the community.

• Works with the community to make decisions about, and claim ownership of, changes

needed to enhance community health.

• Recognizes the value of community wisdom and supports community-generated plans for

economic development, environmental improvement, or other community-based plans.

• Assists in the development of health services and programs based upon community

assessments, in order to meet the health needs of the community.

• Fosters and supports inter-agency links and working relationships.

• In developing programs, uses awareness of factors which impact on or affect health such as

social, cultural, and economic issues, as well as environmental hazards.

Consultation

• Uses knowledge and expertise in public health, especially in health promotion, disease and

injury prevention, epidemiology, and emergency preparedness to inform clients, lay helpers,

nursing students, colleagues, other professionals, professional associations, non-profit

agencies, organizations, institutions, the public, and all levels of government.

• Acts as a resource person to communities, groups, and individuals.

• Uses knowledge of a community to link those needing services to the correct community

resources.

• Uses discussion with the client to clearly outline what will happen during a consultation.

• Collaborates with the client and adapts the consultation to meet the client’s needs; helps the

client find ways and options for change and improvement.

Facilitation

• Works with groups or individuals to use effective processes to:

– bring people together and create a setting where ideas and points of view may be shared

openly;

– clarify issues or processes;

– ensure that meetings are run well and achieve a high degree of agreement on the meeting’s

stated goals and objectives;

– support building of community, group, and individual capacity.

Health Education

• Assesses the knowledge, attitudes, values, beliefs, behaviours, practices, stage of change,

and skills of the learner.

• Considers contexts that may impact the person’s ability to learn, such as

environment, readiness, and other factors; involves the learner in setting health education

needs.

• Supports knowledge development, generation, and translation.

• Selects and adapts the teaching methods that are most likely to meet the needs of the learner

and considers the learner’s cultural preferences and stage of change.

• Uses content expertise on a topic to offer formal presentations and educational programs, as

well as informal teaching to communities, groups, families, and individuals.

• Emphasizes health promotion, disease and injury prevention, and the determinants of health.

• Includes knowledge of behavioural sciences in teaching and applies the correct learning

principles, pedagogy, and educational theories to educational activities.

• Evaluates effectiveness of health education interventions.

• Uses novel health promotion strategies in service delivery.

• Uses marketing techniques to promote both community health programs and healthy living.
Health Threat Response

• Supports early identification of a health threat by gathering data from many sources at the

same time (to understand the cause, natural course, and expected outcomes of the disease or

health threat).

• Follows established criteria for responding to population-level threats (such as fire or flood)

as well as criteria for case investigation including: the collection and analysis of data from

multiple valid sources; identification of factors likely to cause the problem or risk; offering

options for prevention (at the primary, secondary, or tertiary levels); providing options for

preventive care as required; and referral and follow-up for those who need treatment.

• Uses effective risk communication techniques to inform individuals and the public, as well

as colleagues and other health professionals.

• Evaluates the impact of the public health response and identifies implications for future

practice.

Leadership

• Applies current knowledge of professional, community, and political issues to develop a

proactive approach to health and environmental issues.

• Initiates and participates effectively in intersectoral efforts.

• Initiates action and encourages individuals, the community, and people in positions of

power to take action.

• Acts as an interim leader until the community can take the needed action.

Outreach

• Uses community assessment data to determine population health needs and designs

activities to address the unique features of the population of interest.

• Uses strategies to engage with people where they live, work, learn, or play.

• Builds trusting relationships and engages the client in identifying and resolving health

issues.
• Uses a holistic approach which includes finding solutions to service access barriers.

• Seeks to get involved in, change, and provide services in environments where risk is higher

(engages in harm reduction activities).

• Uses proven methods, such as early involvement of key stakeholders when developing

outreach plans.

Policy Development and Implementation

• Identifies areas in need of policy and program development.

• Participates in implementing and evaluating policy.

• Helps to set clear philosophies, policies, standards of practice, and program objectives with

measurable outcomes for nurses and other health care providers.

• Uses the political process to promote health.

• As a delegated act, may enforce policy by requiring others to comply with laws, rules,

regulations, and policies.

• Uses excellent communication skills to foster relationship-building, collaboration,

negotiation, and conflict resolution when differing points of view on policy enforcement

occur.

Referral and Follow-Up

• Supports the client’s control of referrals and follow-up; this includes the client’s right to

refuse a referral.

• Supports the referral process by using a number of ways to ensure, where possible, that a

link to service has occurred.

• Uses links with other providers, organizations, and networks to make needed resources and

services available to populations at risk.

• Carries out intervention strategies that fall within the employer/agency’s mission and goals.

• Helps to evaluate referral and follow-up processes and strategies.

Research and Evaluation

• Identifies and supports investigation into key issues and approaches relevant to community

health and wellness; where possible, uses the right methodology, such as participatory

research methods, to involve community members in planning or carrying out research.

• Shares research and program evaluation information with colleagues, educators, nursing

students, other professionals, and the public.

• Participates in research projects.

• Uses structure, process, and outcome-oriented research as a guide to practice and evidence-

informed decisions.

• Uses research findings to assign human and financial resources and to evaluate

interventions.

• Identifies program areas which need to change; works with other colleagues to alter

programs.

Resource Management, Planning, Coordination

• Uses evidence-informed and best practices in planning to support responsible and

accountable resource management.

• Applies concepts of social justice in assigning time and other resources to promote health

equity.

• Acts as agent to marshal and advocate for human, financial, and physical resources.

• Involves communities, families, and individuals in health services planning and priority

setting.

• Shares information about community resources.

Screening

• Conducts evidence-based screening.

• Ensures the client understands the reason for screening and the procedure ensures that

follow-up is available.
• Monitors and evaluates screening activities and documents both the process and the results.

• Seeks input from those to be screened and collaboratively designs culturally sensitive

interventions with other professionals.

• Uses screening activities as an opportunity to provide health education and counselling.

Surveillance

• Uses resources and the correct technology to get the information that is needed about a

problem, its natural course, and its aftermath.

• Actively participates in informal surveillance and shares findings with those who may be

able to use it.

• Follows established protocols for surveillance, such as maintaining the confidentiality of

data/information, and collecting enough data from a number of reliable sources.

• Uses and applies surveillance information to practice.

• Interprets and shares surveillance data in a way that decision-makers, the community, and

the public can understand.

• Understands the implications of surveillance data. Team Building and Collaboration

• Uses techniques that foster team building, mutual respect, and joint decision making in all

interactions with colleagues, educators, nursing students, other professionals, and the

public.

• Uses mediation skills to facilitate inter-agency and inter-governmental cooperation.

• Commits to a capacity-building approach that uses collaboration (with two or more

people or organizations) to promote and protect health.

BIBLIOGRAPHY:

 Park.k. Textbook of preventive and social medicine, 21st edition, bhanot

banarasidas publications, Jabalpur. pg.no.362-369.

 TNAI. A community health nursing, 2nd ed. New Delhi: the trained nurses

association; 2005.p551.

 Indian public health standards, Guidelines for Sub-Centres/PHC/CHC Revised

2012 Directorate General of Health Services Ministry of Health & Family

Welfare, Government of India.