Primary Health Centre.pdf
- 1. INDIRA GANDHI SCHOOL AND COLLEGE OF NURSING
- 2. PRIMARY HEALTH CENTER PRESENTED BY; Ms. Anushri Srivastav IGSCON
- 3. CONTENT Introduction Definition Objectives of Indian Public Health Standards (IPHS) for Primary Health Centres (PHC) Services at the Primary Health Centre for Meeting the IPHS Infrastructure Manpower Drugs The Transport Facilities with Assured Referral Linkages Laundry Services Dietary Facilities for Indoor Patients Waste Management at PHC Level Quality Assurance Monitoring of PHC Functioning Accountability Statuary and Regulatory Compliance
- 4. INTRODUCTION The concept of Primary Health Centre (PHC) is not new to India. The Bhore Committee in 1946 gave the concept of a PHC.
- 5. DEFINITION According to K Park, Primary health center as a basic unit, to provide, as close to the people as possible, an integrated curative and preventive health care to the rural populations with emphasis on preventive and promotive aspects of health care. The primary health center is the basic structural and functional unit of the public health services in developing countries, to provide accessible affordable and available primary health care to people.
- 6. OBJECTIVES OF INDIAN PUBLIC HEALTH STANDARDS (IPHS) FOR PRIMARY HEALTH CENTERS (PHC) The objectives of IPHS for PHCs are: i. To provide comprehensive primary health care to the community through the Primary Health Centers. ii. To achieve and maintain an acceptable standard of quality of care. iii. To make the services more responsive and sensitive to the needs of the community.
- 7. SERVICES 1. Medical care 2. Maternal Child Health care including family planning 3. MTP 4. Management of Reproductive tract infections/STDs 5. Nutrition Services 6. School Health 7. Adolescent HealthCare 8. Promotion of Safe drinking water and Basic Sanitation 9. Prevention and control of locally endemic diseases 10. Collection and Reporting of vital events
- 8. 11. Other National Health Programmes 12. Oral Health 13. Physical Medicine and Rehabilitation 14. Health Education and Behavior Chang Communication 15. Referral Services 16. Training 17. Basic Laboratory and Diagnostic services 18. Monitoring and Supervision 19. Functional Linkage with Sub center 20. Mainstreaming Of AYUSH 21. Record and Reports of vital events 22. Selected surgical procedures 23. Maternal Death Review
- 9. INFRASTRUCTURE Location Area Sign age Entrance Disaster Prevention Measures Waiting Area OPD Wards Operational Theatre Labor Room Minor OT/ Dressing Room/Injection Room/ Emergency
- 10. MANPOWER STAFF TYPE- A TYPE- B Medical Officer- MBBS 1 1 Accountant cum Data Entry Operator 1 1 Pharmacist 1 1 Nurse-midwife (Staff-Nurse) 3 4 Health worker (Female) 1 1 Health Assistant. (Male) 1 1 Health Assistant. (Female)/Lady Health Visitor 1 1 Laboratory Technician 1 1 Multi-skilled Group D worker 2 2 Sanitary worker cum watchman 1 1 TOTAL 13 14
- 11. DRUGS All the drugs available at the Sub-Centre level should also be available at the PHC, perhaps in greater quantities, (if required). Oxygen Inhalation Diazepam Acetyl Salicylic Acid Ibuprofen Paracetamol Chlorpheniramine Maleate Dexchlorpheniramine Maleate Dexamethasone Pheniramine Maleate Promethazine Ampicillin Benzylpenicillin Cloxacillin , etc.
- 12. EMERGENCY DRUGS Inj. Adrenaline, Inj. Hydrocortisone, Inj. Dexamethasone, Ambu bag (Paediatric), Sterile hypodermic syringe for single use with reuse prevention feature 2ml and 5ml syringes, Needles (Size 24, 22, 20). o AYUSH DRUGS Ayurvedic Medicines for PHCs (Sanjivani Vati, Godanti Mishran) Unani Medicines for PHCs (Arq-e-Ajeeb,Arq- e-Gulab)
- 13. EQUIPMENTS Normal Delivery Kit. Equipment for assisted vacuum delivery. Equipment for assisted forceps delivery. Standard Surgical Set (for minor procedures like episiotomies stitching). Equipment for Manual Vacuum Aspiration. Equipment for New Born Care and Neonatal Resuscitation. IUCD insertion kit. Equipment/reagents for essential laboratory investigations. Refrigerator. ILR (Small) and DF (Small) with Voltage Stabilizer. Cold Boxes (Small & Large): Small- one, Large – two. Vaccine Carriers with 4 Icepacks: Two per SC (maximum 2 per polio boot, others
- 14. THE TRANSPORT FACILITIES WITH ASSURED REFERRAL LINKAGES Referral Transport Facility It is desirable that the PHC has ambulance facilities for transport of patients for timely and assured referral to functional FRUs in case of complications during pregnancy and child birth. This may be outsourced either through Govt/PPP model or linkages with Emergency Transport system should be in place. Transport for Supervisory and Other Outreach Activities It is desirable that the vehicle is made available through outsourcing.
- 15. LAUNDRY SERVICES Provision for clean linen shall be made for admitted patients. At least 5 sets of linen shall be made available. Laundry Services may be available in house or outsourced.
- 16. DIETARY FACILITIES FOR INDOOR PATIENTS Desirable Nutritious and well- balanced diet shall be provided to all IPD patients keeping in mind their cultural prefernces. A suitable arrangement with a local agency like a local women’s group/NGO/Self-Help Group for provision of nutritious and hygienic food at reasonable rates may be made wherever feasible and possible.
- 17. WASTE MANAGEMENT AT PHC LEVEL Guidelines for Health Care Workers for Waste Management and Infection Control in Primary Health Centres” are to be followed.
- 18. QUALITY ASSURANCE Periodic skill development training of the staff of the PHC in the various jobs/responsibilities assigned to them. Standard Treatment Protocol for all National Health Programmes and locally common disease should be made available at all PHCs. • • Regular monitoring is another important means.A few aspects that need definite attention are: I. Interaction and Information Exchange with the client/patient II. Cleanliness should be maintained in all areas.
- 19. MONITORING OF PHC FUNCTIONING Internal Mechanisms: Record maintenance, checking and supervision. Medical Audit Death Audit Patient Satisfaction Surveys: For both OPD and IPD patients. Evaluation of Complaints and suggestions received; External Mechanisms: Monitoring through the PRI/ Village Health Sanitation and Nutrition Committee/Rogi Kalyan Samiti/community monitoring framework. (as per guidelines of GOI/State Government).
- 20. YOUR RIGHTS IN THE PHC Right to access to all the services provided by the PHC. Right to Information-including information relating to your treatment. Right of making decision regarding treatment. Right for privacy and confidentiality. Right to religious and cultural freedom. Right for Safe and Secure Treatment. Right for grievance redressal.
- 21. STATUARY AND REGULATORY COMPLIANCE Authorisation under Bio-medical Waste (Management and Handling) Rules, 1998 Hazardous Waste (Management, Handling and Trans-boundary Movement) Rules 2008 Drug & Cosmetic Act 1950 Fatal Accidents Act 1855 Insecticides Act 1968 Maternity Benefit Act 1961 MTP Act 1971 Persons with Disability Act 1995 Pharmacy Act 1948 Others
- 22. ROLE OF NURSE IN PHC