JOB RESPONSIBILITIES OF CHOs AT HWCs

HWCs need to deliver Preventive, Promotive, Curative, Rehabilitative and Palliative care for wider
range of services close to communities.

provide care for most common ailments, enable referral for doctor or specialist consultations and
undertake follow-up.

CHOs have been appointed with the vision to improve access to healthcare, Reduce OOPE, increase
the utilization of public health services and Reduce work load of secondary and tertiary care facilities

To provide a set of 12 essential services needed by specific population sub-groups and remaining
services are required to be delivered for the entire population.

These services will be delivered at the level of households and outreach sites in the community with
the help of suitably trained frontline workers (ASHAs and MPWs) in the primary health care team

1. Care in Pregnancy and Child-birth

2. Neonatal and Infant Health Care Services

3. Childhood & Adolescent Health Care Services

4. Family Planning, Contraceptives services & other Reproductive Health Care Services

5. Screening, Prevention, control and management of NCDs for above 30 years age
group

6. Elderly and Palliative health care services

7. Management of Communicable diseases including National Health Programs

8. Management of common Communicable diseases and outpatient care for acute

simple illnesses & minor ailments

9. Basic Oral Health Care Services

10. Care for Eye, Ear & Nose and Throat problems

11. Emergency Medical Services

12. Screening and Basic Management of Mental Health problems

CHOs are broadly expected to perform the following three functions

1. Clinical functions to provide ambulatory (out-patient) care and management.

2. Public health functions for health promotion, prevention and disease surveillance.

3. Managerial functions for efficient functioning of the Health and Wellness Centres.

CLINICAL FUNCTIONS

1. Early detection, screening and first level management

2. Undertake referral to enable continuum of care

 3. Provide follow up care

4. Provide counselling support for the following

5. Facilitate Teleconsultation

PUBLIC HEALTH FUNCTIONS FOR HEALTH PROMOTION, PREVENTION AND DISEASE SURVEILLANCE

1. Ensure collection of population-based data and planning for organizing services at HWCs

2. Community level action for health promotion prevention

3. Disease surveillance

MANAGERIAL FUNCTIONS FOR EFFICIENT FUNCTIONING OF HWCS

1. Recording, reporting and monitoring of service delivery

2. Undertake administrative functions of HWCs

3. Supportive Supervision of HWC Team

CLINICAL FUNTIONS
1. EARLY DETECTION, SCREENING AND FIRST LEVEL MANAGEMENT

Undertake detailed history, physical examination to assess general signs and symptoms for
identifying a disease condition

Identify and provide the first level management for all conditions covered under the 12 essential
packages of services and various national health programs.

2. UNDERTAKE REFERRAL TO ENABLE CONTINUUM OF CARE

Coordinate referrals, entering patient case records in referral slip/IT application,

providing information on the closest and most appropriate health facility for seeking care,

informing the service providers at referral centres, and

providing pre-referral stabilization if required.

Few examples where CHOs will be required to provide active referral support are

1. High risks cases, complications, medical emergencies and trauma,

2. Cases screened positive for NCDs, chronic infectious diseases requiring confirmation of
diagnosis and initiation of treatment plan,

3. Refractory and serious cases related to common communicable diseases and acute illnesses
etc,

4. Women in need of safe abortion services, eligible couples opting for limiting method of
contraception/injectable contraceptives,

5. Children 0-18 years age to mobile health teams for assessment of four Ds-Diseases,
Disability, Defects and Developmental delays,
 6. cases for deaddiction – tobacco/ alcohol/substance abuse,

7. Cases in need of rehabilitative care e.g. provision of physiotherapy, crutches, MCR foot ware,
etc,

8. Cases with tertiary or secondary care under PMJAY

3. PROVIDE FOLLOW UP CARE

When patient visit HWCs or with support from ASHAs and MPWs when they undertake their
household visits.

Follow up for the patients who were treated by CHO as well as patients who were referred to
higher centres for treatment.

Key examples are: ANC, PNC, Sick child, Pt with HTN, DM, TB, Leprosy for treatment compliance,
regular home visits to palliative care patients for treatment adherence and counselling, post
operative follow up to detect complications

4. PROVIDE COUNSELLING SUPPORT for the following

Assisting people to understand, and cope, more effectively with their problems, improve health
seeking behaviour, bring about life style modifications etc

Examples: ANC, PNC, essential newborn care, IYCF, nutrition counselling, IFA, Water and
sanitation, child immunization, prevention of STI/RTIs, high risk behaviors like tobacco, alcohol,
ARSH, Contraception, Prevention of vector born and infectious diseases, life style modifications
for NCDs, psychosocial support for mental health and stigma reduction activities

5.FACILITATE TELECONSULTATION

• On first follow up visit to NCD patient who has been initiated treatment from your MO-PHC,

• Seek clarification regarding provision of care.

• Seek advice to start pre-referral stabilization/first aid where timely interventions are
necessary for prevention adverse outcomes.

PUBLIC HEALTH FUNCTIONS FOR HEALTH PROMOTION, PREVENTION AND DISEASE SURVEILLANCE

1. Ensure collection of population-based data and planning for organizing services at HWCs

Ensure that all households/population in the service area are listed, individuals are empanelled
at HWC for seeking health care services and a database is maintained- in digital format of CPHC-
IT application/paper format as required by the state

Support and supervise the collection of population-based data by frontline workers, collate and
analyse data and reporting data to the next level in an accurate and timely fashion

2. Community level action for health promotion prevention

Plan and undertake monthly health promotion activities to improve community awareness and
uptake of services for- sanitation, nutrition rehabilitation, substance use, life style modifications,
 eating right and eating safe, control of communicable diseases TB, leprosy, HIV/AIDS, vector
borne illnesses, family planning etc.

Conduct monthly VHSND & VHSNC meetings for monitoring of community level activities for
health promotion.

Organize at least 30 Heath promotion campaigns in a year on different themes.

3. Disease surveillance

coordinate and lead local response to disease outbreaks, emergencies and disaster situations
and support the medical team or joint investigation teams for disease outbreaks

Assertain the diagnosis of the condition, verify the existence of epidemic, inform MO or other
authorities, search for cases and do linelisting and actively participate in all control activities

MANAGERIAL FUNCTIONS

As a team leader of the HWC Team CHO will also be responsible for undertaking managerial and
administrative functions of the HWC such as inventory management, upkeep and maintenance,
and management of untied funds. Details of the activities to be undertaken for each of these
tasks are as follows:

i) Recording, reporting and monitoring of service delivery:

Support MPWs in maintaining updated information

Maintain patient records, family health folders, health risk assessment data, and treatment
details for enrolled patients

Ensure accurate and timely completion/updation -HMIS, RCH Portal, CPHC NCD Application,
NIKSHAY

ii) Undertake administrative functions of HWCs- Inventory management, display of services

available at HWC, proper utilization of HWC funds

iii) Supportive Supervision of HWC Team: Conducting monthly HWC meetings with MPWs and
ASHAs, Conducting visits to beneficiary households with ASHAs and MPWs, Monitoring the
conduction of community/village level meetings such asVHSND, Facilitate multi-sectoral
convergence for action by ASHA/MPW