The document describes the structure and functions of primary health care centers in India from the village level up to the Primary Health Center (PHC) level. It outlines the roles and responsibilities of different health workers like Auxiliary Nurse Midwives and Multi-Purpose Workers at the sub-center level, and the services provided at the PHC level like maternal and child health care, immunization, treatment of common illnesses, and referral services. The staffing and facilities available at a typical PHC are also mentioned.

1. Dr. Amol Koshti MD (Ayu)
Associate Professor
Department of Swasthavritta
SSAC Kalol

2. Sub center level

3. Sub center
 It’s a peripheral out post of PHC
 4-6 sub centers under each PHC
 Sub center for 5000 in plain area, for 3000 in
hilly, tribal areas

4. Health Worker (M & F)
 One HW male & one HW female posted in
each sub center
 Female health worker - Auxiliary Nurse Midwife(ANM)
 Male health worker – Multi Purpose Worker (MPW)

5. Health worker female
 Maternal & child health
1. Register & provide care
2. Atleast 3 visit
3. Test urine,Hb
4. Refer to PHC if abnormal pregnancy, med. &
gynec problems, syphilis
5. Conduct deliveries in her area
6. ANM will identify beneficiaries, obtain approval
under Janani Suraksha Yojana

6. 7. Meeting of all accredited workers- 3rd Friday of every
month- ANM prepare monthly work schedule
8. At least 2 post natal visits & render advice
9. Assess growth & development
10. Educate mothers in family health

7.  Family planning
1. Utilise information from eligible couple & child
register
2. Spread message, motivate
3. Distribute conventional contraceptives, provide
facilities & help getting family planning services
4. Follow up, Rx side effects, refer
5. Build rapport with acceptors, village leaders &
DiasS

8.  MTP
1. Identify women, refer
2. Educate consequences of septic abortion, services
of MTP
 Nutrition
1. Identify malnutrition (birth to 5 yrs), give necessary
Rx, refer
2. Distribute Iron folic acid tablets
3. Administer Vit A solution
4. Educate
5. Coordinate with Anganwadi workers

9.  Immunization of child, also pregnancy
TT
 Dai training
 Record keeping
◦ Pregnant women, infants, women 15-
44yrs, eligible couple
◦ Malaria cases- fever cases, blood slides,
malaria +ve cases, radical Rx
 Treatment of minor ailments

10. Health Worker Male
 Does not reside in sub center
 Does not carry MCH care

11. Record keeping
 Records of village survey
 Family records
 Records of community diseases
 Records of family planning services & immunization

12. Role in control of
communicable diseases
 Malaria
 Active surveillance
 Takes Thick & thin blood smears
 Administer presumptive treatments
 Sends smear for Lab test
 +ve cases- radical treatment
 Leprosy
 Identifies cases- refer them to MO
 Motivates defaulters to take treatment completely
 Educates family members

13.  Tuberculosis
 Identifies cases- sputum smears of cases of cough
with fever for more than 21 days
 Sends slide for lab test
 Acts as DOTS agent
 Provides Rx
 Motivates TB cases for COMPLETE Rx

14.  Other communicable diseases
 Identifies cases of fever with rash, diarrheas, jaundice,
tetanus, whooping cough, diphtheria etc
 Refer them to MO
 Acute flaccid paralysis surveillance
 Distributes ORS packets
 Improvement of environmental sanitation
 Disinfects sources of water
 Educates people on hazards of open air defecation
 Motivates them to use sanitary latrines
 Educates people on methods of disposal of solid & liquid
wastes

15.  Immunization
 Administer DPT, OPV & BCG vaccines to all infants in his
area
 Participates in pulse polio program
 Family welfare services
 Educates couple on family planning
 Distributes condoms
 Motivates target couples for sterilization
 Follow up services to male family planning acceptors

16.  Miscellaneous activities
 Attends monthly meetings in PHC – submits report
 Assists MO in organizing sterilization camps,
immunization camps

17. HW
male
Record
keeping
Role in
commu.
diseases
Env.
sanitation
Immunization
Family
welfare
services
Misce.

18. Primary
health care
Village level
Village
health guide
Dais
Anganwadi
worker
Sub center
level
PHC Level

20.  1 PHC for
 Plain areas- 30,000 population
 Hilly, tribal areas 20,000
 Provides comprehensive health care services
– Preventive, Curative, Rehabilitative & Referral Services

21. Building
 Concrete building
 Consultation room for MO
 Waiting hall for patients
 MCH & FW services room
 Dispensary
 Minor OT
 Lab
 Store room
 An office record room
 Ward of 6 beds
 Some PHCs have quarters for staff members

22. Staff of PHC
 Medical officer
 Pharmacist
 Staff nurse
 Health worker female
 Health educator
 Health assistant M& F
 Clerks
 Lab technician
 Driver
 Class IV
 1
 1
 1
 1
 1
 2
 2
 1
 1
 4
 Total - 15

23. Objectives of PHC
To improve comprehensive primary
health care to community
To achieve & maintain acceptable
standard of quality care
To make services more responsive &
sensitive to the needs of community

24. Functions of PHC
 Medical care
 MCH services including family planning
 Improvement of environmental sanitation
 Prevention & control of endemic diseases
 Collection & reporting of vital statistics

25. Functions of PHC
 Health education
 Implementation of National Health Programs
 Basic laboratory services
 Referral services
 Training programs for health workers, health
assistants, local dais etc

26. Medical care
 OPD services –
 Morning 4 hr, evening 2 hr
 Minimum 40 patients per doctor per day
 24 hr emergency services
 Management of accident cases
 Dog bite/scorpion bite/snake bite cases
 Other emergency conditions
 IPD- 6 beds
 Referral services

27. Maternal & Child Health Care
 Antenatal care
 Early Registration of pregnancy
 Minimum 3 antenatal check ups
 Lab investigation – Hb, urine tests
 Nutrition & health counseling
 IFA tablets, TT injections
 Identification of high risk pregnancy & management
 Intranatal care
 24 hr services for normal delivery
 Promotion of institutional delivery
 Conducting assisted delivery whenever needed
 Manual removal of placenta

28.  Post natal care
 Minimum 2 post partum home visits
 1st within 48 hrs of delivery & 2nd within 7 days
 Initiation of breast feeding within half hour of delivery
 Education on nutrition, hygiene & contraception
 Provision of facilities under Janani Suraksha Yojana

29.  New born care
 Facilities & care for neonatal resuscitation
 Management of neonatal hypothermia & jaundice
 Child care
 Emergency care for sick child
 Care for routine childhood illness
 Promotion of breast feeding for 6 months
 Immunization
 Vit A prophylaxis

30. Job description of MO

31. Duties of MO
 OPD in morning
 Afternoon – field work supervision
 Implementation of UIP
 School visits
 Conduct tubectomy, vasectomy camps

32. Duties of MO
 Organize training for health workers
 Implementation of national health programs
 Visits sub centers regularly
 1 staff meeting every month – discuss problems &
reviews progress of health activities