Professional Documents
Culture Documents
PHC
Dr Rahul Surve
Topics to be
• IPHS Genesis covered
• Objectives of IPHS for PHCs
• Infrastructure
• Types of PHCs
• Manpower
• Drugs
• Services provided
• Basic laboratory & Diagnostic
Services
IPHS
Genesis
• PHC is a basic health unit to provide as close to the people as possible, an
integrated curative and preventive health care to the rural population with emphasis
on preventive and promotive aspects of health care. (Bhore Committee, 1946)
• As of 31st March 2015, there are 1,55,708 PHCs in India. Out of these, 9,192 PHCs
are in Madhya Pradesh. (Rural Health Statistics Bulletin - 2016)
• PHCs are not spared from issues such as the inability to perform up to
the expectation due to:
non-availability of doctors at PHCs
even if posted, doctors do not stay at the PHC HQ
inadequate physical infrastructure and facilities
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insufficient quantities of drugs
lack of accountability to the public and lack of community participation
lack of set standards for monitoring quality care etc.
• In order to provide optimal level of quality health care, NRHM has provided
the opportunity to set Indian Public Health Standards (IPHS) for Health
Centres functioning in rural areas in early 2007.
• IPHS have been used as the reference point for public health care infrastructure
planning & up-gradation.
Objectives of IPHS for
PHCs
a) To provide comprehensive primary health care to the
community through the PHCs.
• Sign-age
• Entrance with Barrier free access
• Disaster prevention measures (desirable for new upcoming facilities)
• Environmental friendly features
• Out Patient Department
• Wards (4-6 beds in a Primary Health Centre)
• Waiting Area
• Labour room
• Laboratory
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• Minor OT/Dressing Room/Injection Room/Emergency
• Dirty utility room for dirty linen and used items
• Computer facility with internet for MIS (Management Information System)
• Provision of new born care corner in the facility
• One room for counselling
• Residential Accommodation
• Waste disposal pit,
• Cold chain, logistic and generator room
• Boundary wall/Fencing
Types of
PHCs
From service delivery angle, PHCs may be of two types, depending upon
delivery case load:
• In addition, all the drugs required for the National Health Programmes and
emergency management should be available in adequate quantities so as to
ensure completion of treatment by all patients.
• Drugs of that discipline of AYUSH to be made available for which the doctor
is present.
SERVICES
PROVIDED
• Medical care:
OPD services
a) 4 hrs in morning & 2 hrs in afternoon,
b) At least two hours per day twice in a week for field duties and monitoring.{desirable}
24 hrs emergency services
Referral Services
4. New born care: Initiation of breast feeding, Facilities for Essential new born care
[ENBC] & Resuscitation [Newborn care corner in labour room/OT],
Management of neonatal hypothermia(KMC*)
5. Care of the child: Routine & emergency care of sick children including IMNCI
strategy; Assessment of growth & development; Full
immunization of children. Vitamin A prophylaxis; Prevention
& management of routine childhood diseases& infections.
6. Family welfare: Education, motivation & counseling to adopt appropriate
family planning methods; Provision of contraceptives.
• School Health:
- Teachers screen students on a continuous basis
- ANMs/HWMs (a team of 2 workers) visit the schools (one school every week)
- Doctor from CHC/PHC will also visit one school per week for screening,
immunization, micronutrient management, de-worming
• Adolescent health care:
Through adolescent friendly clinic for 2 hours once a week on a fixed day.
Adolescent and Reproductive Health Information, counseling and services
related to sexual concerns, pregnancy, contraception, abortion etc.
Services for tetanus immunization
Nutritional Counseling, Prevention and management of nutritional anemia
Services for safe termination of pregnancy
• Training: -
Undergraduate medical students & intern doctors in basic health care.
Orientation training of male & female health worker.
Skill based training to ASHA worker.
Initial and periodic Training of paramedics in treatment of minor ailments
• Promotion of safe drinking water & basic sanitation: Disinfection of water
sources and Coordination with Public Health Engineering department for safe
water supply; Promotion of sanitation
Routine urine, stool and blood tests (Hb%, platelets count, total RBC,
WBC,
bleeding and clotting time).
Diagnosis of RTI/STDs with wet mounting, Grams stain, etc.
Sputum testing for mycobacterium (as per guidelines of RNTCP).
Blood smear examination malarial.
Blood for grouping and Rh typing.
RDK for Pf malaria in endemic districts.
Rapid tests for pregnancy.
RPR test for Syphilis/YAWS surveillance (endemic districts).
Rapid test kit for fecal contamination of water.
Estimation of chlorine level of water using orthotoludine
reagent.
Blood Sugar.