and district hospitals were published in january/february 2007 under National Rural Health Mission[NRHM] which was launched in the year 2005. IPHS have been used as the reference point for public health care infrastructure planning & up-gradation OBJECTIVES OF IPHS; To ensure minimum package of assuredservices. To achieve & maintain acceptable standardsof quality of services. To make the services more responsive & sensitive to the needs of the community to enhance patient satisfaction. IPHS GUIDELINES FOR SUB-CENTRES Sub-centres provide health care facilities for a population of 5000 in plains & 3000 in hilly/tribal areas. Staff of sub-centre: Multi purpose Health worker[male & female], who are in linkage with the anganwadi workers, ASHA worker, village healthguide. SERVICES PROVIDED: Maternal & Child health: 1. Early registration of all pregnancies, antenatal, natal & postnatal care, promotion of institutional deliveries. 2. Identification of cases forreferral. 3. Essential newborn care [maintain body temperature, initiate breast feeding] Family planning & contraception: Education, motivation & counseling to adopt appropriate family planning methods. Curative services: Provide treatment for minor ailments like diarrhea, fever, & first aid. Appropriate and prompt referral.. Adolescent & school health services: 1. Education, counselling & referral. 2. Prevention of anemia. 3. Screening & treatment of minor ailments, immunization, prevention & managementof nutritional deficiencies in children. National Health Control Programmes: 1. National AIDS control programme[NACP]: IEC activities to enhance awareness & preventive measures about STIs & HIV/AIDS, & HIV-TB coordination. 2. National vector borne disease control programme [NVBDCP]: Collection of blood slides of fever patients. RDT for diagnosis in endemic areas. Assistance for integrated vector control activities. 3. National leprosy eradication programme [NLEP]: Health education to community regarding leprosy. Referral of suspected cases to PHC. 4. Revised national TB control programme [RNTCP]: Referralof suspected symptomatic cases toPHC. 5. National Programme for Control of blindness [NPCB]: Detection of cases of impaired vision, spreading awareness regarding eye problems. 6. National programme for prevention & control of cancer, diabetes, cardiovascular diseases & stroke: IEC activitiesto promote healthy lifestyle. Record of vital events. IPHS GUIDELINES FOR PHC PHC is health carecentre for a population of 20000- 30000. Staff at PHC: Medical officer-MBBS-1 Medical officer-AYUSH Accountant Pharmacist Staff-nurse Health worker [female] Health assistant [male & female] Laboratory technician SERVICES PROVIDED Medical care: OPD services- 4 hrs in morning & 2 hrs in afternoon. 24 hrs emergency services. In-patientservices[6 beds]. Maternal & child health care: 1.Antenatal care: Early registration. Antenatal checkups. Routine lab investigations. Nutrition & healthcounseling. 2. Intranatal care: Management of normal deliveries. Assisted vaginal deliveries. 3. Postnatal care: Initiation of breast feeding. Counseling on nutrition, hygiene, essential new born care. 4. New born care: Facilities for Essential new born care [ENBC] & Resuscitation [Newborn care corner in labour room/OT]. Management of neonatal hypothermia. Family welfare: Education, motivation & counseling to adopt appropriate family planning methods. Provision of contraceptives. Care of the child: Routine & emergency care of sick children including Integrated management of neonatal & childhood illnesses [IMNCI] strategy. Assessment of growth & development.Full immunization of children. Vitamin Aprophylaxis. Prevention & management of routine childhood diseases, infections. School & adolescent health care: Screening of general health, assessment of nutritional status. Mid-daymeal scheme. IEC regarding reproductive health & RTIs/STIs. National Health Programmes: 1. RNTCP: Function as DOTS centres to deliver treatment as perguidelines. Collection & transport of sputum samples. 2. NLEP: Diagnosis & management of leprosy & it’s complications. Training of patients having ulcers for self-care. 3. Integrated disease surveillance project [IDSP]: Weekly reporting of epidemic prone diseases. Appropriate preparedness & first level action on out- break situations. 4. NPCB: Early detection of visual impairment & referral. Awareness generation through appropriate IEC strategies. 5. NVBDCP: Diagnosis & management of vector borne diseases. 6. National AIDS control programme: IEC activities to enhance awareness & preventive measures about STIs& HIV/AIDS. Help & guide patients receivingART. 7. NPCDCS: IEC services for prevention of cancer & early detection. Health promotion services to modifylifestyle. Early detection, management & referral of cases of non communicable diseases. Training: of- undergraduate medical students & intern doctors in basic health care. - male & female health worker. - ASHA worker. - paramedics in treatment of minorailments Basic lab & diagnostic services: Routine urine & blood tests - Diagnosis of RTI/STDs - sputum testing for mycobacterium. - blood smear examination formalaria - rapid tests for pregnancy. - blood sugar. Promotion of safe drinking water & basic sanitation. Monitoring & supervision of activities of sub-centre. Record of vital events including birth & deathrates. IPHS GUIDELINES FOR CHC A CHC caters a population of 80,000 in tribal/hilly areas & 1,20,000 in plains. Staff of CHC: Block medical officer -Public health specialist-1 - Public health nurse-1 - General surgeon-1 - General physician-1 - Obstetrician & gynaecologist-1 - Paediatrician-1 - Anaesthetist-1 - Dental surgeon-1 -General duty medical officer [MBBS]-6[atleast 2 female doctors] Continued… - Medical officer- AYUSH-1 - General duty medical officer- AYUSH-1 - Staff nurse- 19 -Pharmacist-3 - Lab technician-3 - OT technician-1 - Accountant-1 - Group D staff SERVICES PROVIDED Care of routine & emergency cases in surgery: Dressings & incision & drainage. Care of routine & emergency cases in medicine Maternal health: Antenatal checkups. 24 hr delivery services. Management of complications. Postnatalcare for 0 & 3rd day. Newborn care & child health: Essential newborncare& resuscitation in newborn corner in labour room & OT. Newborn stabilization unit. Routine & emergency care of sick children. Immunization & prevention &control of childhood diseases. Management of malnutrition. Family planning: Full range of family planning services including sterilisation techniques. Safeabortion services as per MTP. National Health Programme: 1. RNTCP: All diagnostic services & treatment. 2. HIV/AIDS control programme: Integrated counseling & testing centre. Sexually transmitted infection clinic. 3. NVBDCP: Diagnosis & treatment for routine& complicated cases of vector bornediseases. 4. NLEP: Diagnosis , treatment & managementof complications to preventdisabilities. 5. NPCB: Vision testing & early detection ofvisual impairment. Awareness generation through IECactivities 6. NPCDCS: Early detection & referral of cancer cases. Screening for cervical, breast & oral cancers. Modification of lifestyle of people. Treatment & timely referral of complicated cases. Assured investigations. Other services: 1. School & adolescent health: Screening of general health, nutritional assessment, immunization, Mid- day meal. Education for reproductive health &STDs to adolescents & management. 2. Blood storage facility. 3. Diagnostic services: In addition to lab facilities , X- ray & ECG should be madeavailable. 4. Referral [transport] services.