Study of Civil Dispensaries & Urban-Primary Health Centers ...
ACCREDITATION STANDARDS FOR PRIMARY URBAN HEALTH …
Transcript of ACCREDITATION STANDARDS FOR PRIMARY URBAN HEALTH …
ACCREDITATION STANDARDS FORPRIMARY URBAN HEALTH CENTRE
FIRST EDITION : NOVEMBER, 2009
National Accreditation Board For Hospitals& Healthcare Providers
Accreditation Standards for Primary Urban Health Centre
@ National Accreditation Board for Hospitals and Healthcare Providers2
TABLE OF CONTENTS
PART 1 – ACCREDITATION STANDARDS
S.No. Particulars Page No.
SECTION - A STRUCTURAL STANDARDS 5 - 8
01 Physical Facilities 5
02 Functional Plan 5 – 6
03 Equipments & Instruments 6
04 Man Power & Staffing 6 – 7
05 Drugs 7
06 Transport & Ambulance Services 7 – 8
07 Communication Facility 8
SECTION - B PROCESS STANDARDS 9 - 15
08 Access to the facility 9
09 Availability of Staff 9
10 Evaluation of Patients 9 – 10
11 Care of Patients 10
12 Control of Infection 11
13 Bio-Medical Waste Management 11 – 12
14 Sanitation, Hygiene and Potable Water 12
15 Counseling and IEC 12 – 13
16 Preventive Health 13
17 Participation in National Health Programs 14
18 Referral Services 14
19Community Mobilization with RWAs, NGOs and Local Self Help groups
14
20 Social Responsibility 15
SECTION - C GOVERNANCE STANDARDS 16 - 19
21 Ownership of Building 16
22 Quality Assurance 16
23 Rights and Responsibility of Patients 16 – 17
24 Rights and Responsibility of Staff 17
25 Training Development and Motivation of Staff 17 - 18
26 Surveillance of ANMs, LHVs and other field workers 18
Accreditation Standards for Primary Urban Health Centre
27 Public Private Partnership 18
28 Pricing and Services 18
29 Community Based Health Insurance 19
30 License and Statutes 19
31 Local Social Customs 19
32 End of Life Care 19
SECTION - D OUTCOME STANDARDS 20 - 21
33 Utilization indices of the Centre 20
34 Primary Urban Health Centre Statistics 20
35 Reporting of Birth, Death and Other details 20
36 Medical Records 21
37 Patient & Employee Satisfaction 21
38 Health Information System 21
PART 2 - GUIDE BOOK
SECTION - A STRUCTURAL STANDARDS 23 - 58
01 Functions / Service Outlay 24
02 Zones 25 - 27
03 Area & Space Requirements 28 - 33
04 Instruments & Equipments 34
05 Common Surgical Consumables 35
06 Laboratory & Radiology Items 36 - 37
07 Furniture Items 38
08 General & Miscellaneous Items 39 - 40
09 Stationary & Linen Items 41 - 42
10 Manpower & Staffing 43
11 Essential Drug List 44 - 56
12 Ambulance Requirements 57
13 Primary Urban Health Centre Schematic Layout 58
SECTION - B PROCESS STANDARDS 59 - 92
01 Clinical & Diagnostic Service in PUHC 60 - 65
02 Clinical Services in Outreach 66 - 67
03 Convergence with related sectors 68
04 Strengthening of Referral System 69 - 77
05 Capacity Building & Training of Staff 78 - 79
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Accreditation Standards for Primary Urban Health Centre
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06 Behaviour Change Communication (BCC) 80 - 82
07 Information, Education & Communication (IEC) 80 - 81
08 Bio Medical Waste Management 83
09 Hand Washing Techniques 84
10 Management of Information 85 - 86
11 Facility Management 87
12 Community Participation and Empowerment 88 - 92
SECTION - C GOVERNANCE STANDARDS 93 - 147
01 Citizen Charter for primary Urban Health Centre 94 - 100
02 Job Responsibilities of Primary Urban Health Centre Staff 101 - 133
03 Self Appraisal of Primary Urban Health Centre Staff 134 - 146
04List of Licenses and Acts: Applicable to Public Healthcare facilities
147
SECTION - D OUTCOME STANDARDS 148 - 162
01 Optimal Facility Management & Efficient Processes 149 - 150
02 Service Guarantee 151 - 155
03Increased Utilization of Services leading to Positive Health Outcomes
156
04 Client Satisfaction 157
05 Community Involvement and Empowerment 157
06 Patient Exit Interview 158 - 160
07 Quality Assurance (Monitoring & Evaluation) 161 - 162
PART -1
ACCREDITATION STANDARDS
Accreditation Standards for Primary Urban Health Centre
@ National Accreditation Board for Hospitals and Healthcare Providers8
SECTION - A
STRUCTURAL STANDARDS
A - 1 PHYSICAL FACILITIES
Objective Elements
a. The facility shall confirm to the FAR Norms of that particular region as per the State
Government Rules.
b. For all expansions the space shall be acquired as per the standards
c. Land scaping shall be compulsory.
d. The facility shall be fenced to guard against entry of animals.
e. Main entrance shall be easily identifiable, welcoming, well lit and with mattress.
f. Emergency Exits shall be provided.
g. It shall confirm to the covered area ratio vis-à-vis the size of plot.
h. Adequate circulatory space for movement of traffic including trolley and wheel chairs
to be present.
i. Adequate ramps to be present to cater to the requirements of immobile patients.
j. Accommodation (Semi-Full furnished) facilities (as per grades) for the core staff i.e.
MO, Nurse, and Pharmacist to be available.
k. Laundry, Housekeeping, Security and Dietary services shall be out sourced as per a
MOU with the provider on certain quality criteria.
l. There shall be 24X7 availability of electricity and potable water supply with identified
alternate sources.
m. Arrangement for fire safety shall be present.
n. Adequate drainage system shall be built-in.
A - 2 FUNCTIONAL PLAN
Objective Elements
a. The building shall have a good functional plan having ear marked space for waiting
area, OPD, Labour Room, Minor OT, Sterilization Room, Pharmacy, Dressing Room,
Injection Room, X-ray Room, Dark Room, Store Room (for drugs, linen and
equipments), Counseling Centers, Administrative Office, Toilet (male & female) with
Accreditation Standards for Primary Urban Health Centre
running water facilities, Nurses Room, Cold Chain Room, Immunization, space for
Laboratory services shall be as per the area and space requirements annexed.
There shall be rooms for other state run programs like TB, Leprosy, Ophthalmic,
ICTC, Sickle Cell Anemia, ANC, FP, CNDC.
b. OT, Labour room and dressing rooms shall have tiled (glazed) walls to height of four
feet to ensure easy cleaning.
A - 3 EQUIPMENTS AND INSTRUMENTS
Objective Elements
a. The facility shall have adequate number of equipments along with instruments as
stated in instruments and equipments and common surgical consumables list for
Primary Urban Health Centre in the Reference Manual.
b. The equipments shall be in functional order and have an up time of 98%.
c. All equipments shall have insurance cover.
d. There shall be appropriate mechanism for repair, maintenance and two year
renewable AMC of all the equipments.
e. The instruments used shall be adequately disinfected, sterilized and kept in good
working condition.
f. Organization shall have resources for ensuring skill based training on use/ handling
of equipments.
g. There shall be simple yet effective Condemnation Policy for equipments and instruments.
A - 4 MANPOWER & STAFFING
Objective Elements
a. The staffing norms as stated in Reference Manual for Primary Urban Health Centre
to be maintained.
b. At least 2 Medical Officer (MBBS) to be present all the time. Out of the 2 at least 1
shall be trained in emergency obstetric care.
c. One AYUSH expert shall be present.
d. 1 nurse to be present in the centre.
e. Roster for doctor and nurses to be displayed.
f. Emergency call, Roster to be available for the core staff i.e. Doctors, nurses and
pharmacists.
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Accreditation Standards for Primary Urban Health Centre
@ National Accreditation Board for Hospitals and Healthcare Providers10
g. Organization shall have resources and be able to demonstrate carrying out following
trainings:
Managerial/ Administrative training to MO/ Head.
Programme implementation training to MO/ Head.
Induction training to staff at all levels.
Job based skills training.
Special clinical skill training on minor surgical procedure, obstetrics care,
new born care, basic life support and local anesthesia block.
Disaster Management.
A - 5 DRUGS
Objective Elements
a. A unified formulary based on workload, essential drug list of WHO or as specified by
State Government or essential drug list in Reference Manual for Primary Urban
Health Centre to be maintained.
b. Availability of drugs and surgical consumable to be ensured.
c. Availability of drugs to be displayed along with expiry dates.
d. Medical Officers to prescribe drugs based on the available formulary or essential
drug list.
e. Medicines dispensed shall have clear instruction on dose and schedule for
consumption purposes.
f. Consumption report of the drugs to be submitted to the district authorities of the
particular district.
g. Minimum balance and re-order level to be maintained.
h. Lead time of sourcing the drugs and consumable to be maximum of 1 week.
i. Drugs shall be stored in well lit and well ventilated rooms.
j. Certain drugs to be kept in the refrigerator.
k. The Temperature of the refrigerator to be maintained at 4 to 6 degree centigrade.
A - 6 TRANSPORT AND AMBULANCE SERVICES
Objective Elements
a. Local network of ambulances shall be outsourced and linked to Primary Urban
Accreditation Standards for Primary Urban Health Centre
Health centre.
b. There shall be at least one ambulance.
c. Driver for the same to be available all the times.
d. Ambulance shall be in working condition all the time.
e. Emergency drugs to be available in the ambulance.
f. Basic resuscitation kit to be available in the ambulance.
g. At least 2 number of stretcher trolleys to be available.
h. At least 2 wheel chairs to be available.
i. The Stretcher trolleys and wheel chairs to be in working condition all the times.
j. There shall be local public transport facility available.
A - 7 COMMUNICATION FACILITIES
Objective Elements
a. The center shall have adequate stationeries for written communication.
b. At least 2 telephone (24X7) connections to be available in the facility.
c. A dial-up internet connection to be available.
d. Arrangements for a public address system to be available.
e. Organization shall use Signboards, Posters or/ and wall painting displaying the
activities and services (along with timings) at the facility and the important contact
numbers at prominent sites in the campus as well as in all villages. These shall be in
local language.
f. Campaigns for National Health Programs shall be displayed in the form of wall
painting or boards.
g. Lay out map of the Primary Urban Health Centre and signage shall be in vernacular
and symbols to address the needs of vulnerable patients.
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Accreditation Standards for Primary Urban Health Centre
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SECTION - B
PROCESS STANDARDS
B - 1 ACCESS TO THE FACILITY
Objective Elements
a. The facility shall be easily assessable by at least two approachable all weather
roads.
b. There shall be transport facility from main road to the facility campus in case it is at
significant distance.
c. The roads shall be metallic to facilitate the patient’s movement by ambulance, three
wheelers and any other public or private mode of transport.
d. Adequate sign postings to be available at various strategic locations so as to guide
patients to the facility.
B - 2 AVAILABILITY OF STAFF
Objective Elements
a. At least 1 medical officer and 1 nurse shall be available at all times in the facility.
b. Staff shall attend to any emergency at all times beyond the normal OPD or working
hours.
c. At least 1 staff member shall be available at all times to provide guidance or basic
information to the patients and their families.
d. Facility shall have Assistant Professor from Medical College designated as its
Radiological Surveillance Officer.
e. Facility shall be guarded by Security personnel 24X7.
f. Available staff shall be immunized and insured for health / hospitalization.
B - 3 EVALUATION OF THE PATIENT
Objective Elements
a. All patients to under go a unified assessment with privacy and dignity.
Accreditation Standards for Primary Urban Health Centre
b. The nurse / ANM shall carry out assessment in terms of noting the vitals, height and
weight of the patient in a pre designated area of the OPD card.
c. Medical officer to document the findings of the patient in a definite area in the OPD
card.
d. Advise for medication and investigation to be documented in predefined areas of the
card.
e. The documentation to be legible, timed, dated, named and signed by the medical
officers.
f. The instructions to be communicated to the patient in an understandable (verbal and
written) manner.
g. The assessment of the patient is uniform in all settings i.e. Emergency, OPD etc.
h. Records of all such assessments to be maintained (for time limits as per regulations)
in the center.
B - 4 CARE OF PATIENTS
Objective Elements
a. Patients shall have a welcoming effect from the facility.
b. The staff shall be courteous, humane and empathetic.
c. Care shall commensurate with the amenities available.
d. Care shall be provided in manner in which dignity and privacy of patient is
maintained.
e. Centre shall have written SOPs on Care.
f. Care shall be comprehensive in nature i.e. preventive, promotive, curative and
rehabilitative in nature.
g. A Referral card to be given to the patients on their referral to the higher facility for
treatment.
h. In case of death a death summary to be given to the patient’s family.
i. A general consent to be obtained for all patients accepted in the center.
j. An informed consent to be obtained for patients undergoing any procedures.
k. A list of procedures for which informed consent to be obtained shall be available in
the center.
l. The consent for shall be in vernacular / local language.
m. Consent shall be obtained either by the medical officer or the nurse.
n. Behavior of the staff towards all the patients and family members to be very cordial,
caring and basic health services to be provided all the time.
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Accreditation Standards for Primary Urban Health Centre
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B - 5 CONTROL OF INFECTION
Objective Elements
a. Organization shall have written Infection Control Policy.
b. Organization shall have identified/ ear marked resources (0.5% Sodium
Hypochlorite, Laboline etc) for infection control.
c. Organization shall have written protocols on cleaning of the infection prone areas
(OT and Labour room) and equipments used in patient care.
d. The center shall take all precautions to control infection.
e. Adherence to standard precautions to be maintained by all staff.
f. Mopping (by latest available disinfectants) of all areas of the center to be carried out
at least twice a day.
g. Carbolisation of the OT, Labour Room, Laboratory to be carried out at least twice a
day.
h. Availability of running tap water for hand washing of staff to be maintained 24 hours
a day.
i. The hospital environment to be kept clean from litters, pest and stray animals.
j. Adequate lighting arrangement and cross ventilation to be present in all areas.
k. Sanitation of the toilets and hygiene of the staff to be maintained.
l. Adequate amount of bleaching lotion to be available for disinfection purposes.
m. The labour room, OT and OPD areas to be washed with soap and water at least
once in 2 weeks and a documentation there of to be maintained.
n. Autoclaving of all the instruments and linen used in the labour room, OT, dressing
room to be done.
o. Quality checks of the autoclave to be maintained by using quick strips (Signaloc).
B - 6 BIO-MEDICAL WASTE MANAGEMENT
Objective Elements
a. Centre waste generated shall be managed in accordance with the Bio-medical waste
management and handling rules 1998.
b. General waste to be collected in black bags.
c. The yellow bags to be subjected to deep burial and a pit for the same to be created with
in the premises according to the dimensions specified by the biomedical rules 1998.
Accreditation Standards for Primary Urban Health Centre
d. Facilities for syringe and needle destruction to be available and practiced.
e. Chemical treatment of plastics to be carried out by using freshly prepared bleaching
lotion.
f. A site for composting of biodegradable waste to be available with in the hospital
premises.
g. Annual report to be submitted to the competent authority by 31 st January every
year.
h. Accidental spillage of waste shall be reported and handled as per the BMW
Guidelines.
i. Segregation of wastes to be done in maximum of 3 bags (Black, Yellow & Blue).
j. Organization shall have resources to train all health personnel on handling BMW as
per regulations.
B - 7 SANITATION, HYGIENE AND POTABLE WATER
Objective Elements
a. The facility shall have Reverse Osmosis (RO) Plant.
b. The center shall promote sanitation hygiene and availability of potable water in the
community by involving the RWAs, Self Help Groups and NGOs.
c. The center shall distribute chlorine tablets to the community and educate them about
their usage.
d. The perils of open defecation to be informed to the community living in JJ clusters
and slums.
e. Creation of soak pit and trench lavatories to be carried out by involving the local self
help groups and NGOs in JJ clusters and slums.
f. Health education and maintenance of hygiene to be done by adopting
the principles of school health and involving public opinion makers.
g. A plan to combat disasters, epidemics in the community shall be ready in the facility,
communicated to all concerned and rehearsed at least twice a year.
B - 8 COUNSELING AND IEC
Objective Elements
a. The health workers and related staff to be involved in counseling the community
regarding population stabilization, safe sex, hygiene, breast feeding, anemia,
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Accreditation Standards for Primary Urban Health Centre
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nutrition, spacing of children, Vitamin-A deficiency etc.
b. Appropriate IEC tools to be available so as to create awareness amongst the
community for availing the services of the center.
c. Thrust to be given for reproductive and child health services.
d. Staff of the center to disseminate the plans and programs (specific to the area) of the
Government by using all IEC tools available e.g. posters, pamphlets, wall hangings,
paintings, audiovisual tools etc.
e. Counseling shall also include knowledge about HIV/AIDs and other communicable
and lifestyle diseases.
f. Organization shall have policy of printing "name & contact number of doctor" on the
cards (OPD & Discharge), IEC tools used.
B - 9 PREVENTIVE HEALTH
Objective Elements
a. The organization shall give impetus to the preventive aspect of health care.
b. The staff (Doctors, Nurses, ANMs, Pharmacist, Laboratory technician, Radiographer
etc.) shall maintain open channels of communication with the patients and their
families.
c. Immunization shall commensurate with the universal immunization program.
d. Expecting mothers to be given two doses of tetanus immunization in their antenatal
checkups.
e. New borns to be immunized according to the schedule and a card stating their
immunization status and growth pattern along with the mile stones to be available
with all parents.
f. Field health workers shall educate about adolescent health and life style
management.
g. Organization shall be involved in:
Management of disease outbreaks- Identification, classification (water-borne,
vector-borne, vaccine preventable), incidence reporting, investigation, data
collation, analysis and reporting.
Water quality surveillance.
Disaster mapping- identification, preparedness (equipments, antidotes,
emergency care, referral services) and networking.
h. Organization shall have identified resources (equipments & drugs) for
handling such preventive programmes/ actions.
Accreditation Standards for Primary Urban Health Centre
B - 10 PARTICIPATION IN NATIONAL HEALTH PROGRAMS
Objective Elements
a. The center shall participate in all the National Health programs as stated in
Reference Manual for Primary Urban Health Centre.
b. Community mobilization and their participation to make the program successful is
responsibility of the centre.
c. Report of such program shall be submitted to the authorities periodically by the
MOIC.
B -11 REFERRAL SERVICES
Objective Elements
a. The center shall practice a bi-directional or standardized referral system as per the
policy.
b. The referral cards (with contact numbers) according to the colour coding to be
available and a document there of to be maintained.
c. Patient shall be referred to the secondary or tertiary healthcare facility in the close
proximity to the center, based on the condition of the patient.
d. All such patient to be followed up for their progress by the MOIC.
e. Entries of the transferring in or out to be maintained in register or the computer.
f. Patient referred from the center shall be transported in an Ambulance.
B - 12 COMMUNITY MOBILIZATION WITH RWAs/ NGOs / LOCAL
SELF HELP GROUPS
Objective Elements
a. The organization shall have a continuous interaction with the RWAs / NGOs / Local
Self Help Groups.
b. All meetings shall be planned and that the agenda of meeting shall be area specific
and / or as per the requirements of the community.
c. All meetings to be documented.
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Accreditation Standards for Primary Urban Health Centre
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d. Disease profile along with seasonal variation to be discussed and appropriate
proactive intervention to be planed.
e. Gatekeeper approach in mobilizing the community shall be followed.
B - 13 SOCIAL RESPONSIBILITY
Objective Elements
a. The center shall understand that it is and integral part of the society.
b. The center shall carry out camps, melas, and healthy competitions etc. periodically.
c. Respect to the senior citizens and active participation in school health shall be
documented.
d. Training to the community on household remedies and first Aid shall to be carried out
and documented.
e. A sense of ownership of the facility by the community to be created.
f. Center shall participate in all cultural activities in the community.
Accreditation Standards for Primary Urban Health Centre
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SECTION - C
GOVERNANCE STANDARDS
C - 1 OWNERSHIP OF BUILDING
Objective Elements
a. A building of the facility to be owned by the government.
b. It shall have the approved building plan along with sanction from the local authorities.
c. The X-ray facility shall be approved by AERB.
C - 2 QUALITY ASSURANCE
Objective Elements
a. The hospital shall have a quality assurance manual.
b. Standards operating procedures to be available at various patient care area e.g.
OPD, Emergency, Pharmacy, Lab and Imaging.
c. The manual shall include infection control and waste management issues.
d. Safety of patients and staff shall have due consideration in the manual.
e. Scope of Corporate Social Responsibility (CSR) shall be encouraged for upgrading
the services.
C - 3 RIGHTS AND RESPONSIBILITY OF PATIENTS
Objective Elements
a. Rights and responsibility of the patients shall be in accordance with the Citizen
Charter for Primary Urban Health Centre.
b. A citizen charter to be displayed mentioning the user charges, quality of the services,
name of the medical officer with the telephone numbers etc.
c. The rights of the patients as a consumer have to be respected and displayed e.g.
rights to choose, right to deny, right to gather information etc.
d. A mechanism for grievance redressal to be in place and practiced.
Accreditation Standards for Primary Urban Health Centre
e. All redressal mechanisms to be documented.
f. Users and providers will be jointly responsible to maintain the building of the Primary
Urban Health Centre in an orderly manner.
g. Patients to follow the instruction of the health care providers sincerely.
h. The patients have the right to their privacy, information and disease condition that
shall not be disclosed to others.
i. Citizen charter and rights of the patients shall be displayed in local language and
shall be universal for the state.
C - 4 RIGHTS AND RESPONSIBILITY OF STAFF
Objective Elements
a. The staff shall respect patients' right.
b. They shall carry out their respective job responsibilities as described in the annexure.
c. They shall demonstrate reasonable skill to provide care to the patients.
d. They are entitled to all the benefits (immunization, healthcare cover through
insurance, semi to fully furnished staff quarters as per entitlement and availability, its
maintenance and security) due to them by virtue of their employment.
e. Staff shall be cordial, humane, empathetic and respectful to their colleagues and the
patients.
f. Employees to be immunized for Hepatitis, Tetanus etc.
C - 5 TRAINING DEVELOPMENT AND MOTIVATION OF STAFF
Objective Elements
a. The organization shall arrange for continuous updation of knowledge and skills of the
staff.
b. Periodic training programs on the subjects of waste management, infection control,
communication etc. to be carried out and documented.
c. Training for behavioral change communication shall be carried out and documented.
d. Training on all aspects of various national health programs to be carried out.
e. Evaluation of all such training to be documented.
f. Several cash and non-cash incentives to be given so as to constantly motivate the
staff.
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Accreditation Standards for Primary Urban Health Centre
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g. All trainings provided must be on both theoretical as well as practical aspects
h. There shall be policy on encouragement and appreciation of performers through
incentives and awards.
C - 6 SURVEILLANCE OF ANMS, ASHAS AND OTHER FIELD
WORKERS
Objective Elements
a. The activities of ANMs and ASHAs to be reviewed regularly by the MOIC.
b. Feedback mechanisms to exist so as to asses the visits of the above workers in the
community.
c. Local NGOs and Community Based Organizations to be involved in the surveillance
program.
d. Monitoring of distribution of iron tablets, motivating patient for institutional deliveries
to be carried out as an on going program.
e. The field workers shall have sufficient materials for their use.
f. A training and motivational program to exist for the above workers.
g. Validation of the process shall be carried out by higher authorities.
C - 7 PUBLIC PRIVATE PARTNERSHIPS
Objective Elements
a. Involving a private provider for scavenger services.
b. Involving a private transporter for transporting patients.
C - 8 PRICING AND SERVICES
Objective Elements
a. Unified pricing mechanism as per the policy of the state concerning the user fee to
be applied.
b. Patients to be informed about the charges.
c. Always a receipt to be given to the patients.
d. Proper accounting of the collections to be maintained.
Accreditation Standards for Primary Urban Health Centre
C - 9 COMMUNITY BASED HEALTH INSURANCE
Objective Elements
a. A mechanism for micro health insurance through a co-operative approach to exist so
as to cater to the requirements of the patients.
b. Local NGOs and co-operative society to be involved to arrange for certain basic
expenses for the patients.
C - 10 LICENSE AND STATUTES
Objective Elements
a. All licenses to be available in the hospital e.g. Narcotics, Waste management,
BARC, AERB, fire safety etc as applicable.
b. Statutory requirements concerning patient and staff safety and welfare shall be met
with.
C - 11 LOCAL SOCIAL CUSTOMS
Objective Elements
a. Respect for local social customs to be given by the organization.
b. Myths concerning health availing practices to be evaded e.g. taking of local pudia for
viral hepatitis (jaundice) isolating post partum mothers etc.
C - 12 END OF LIFE CARE
Objective Elements
a. Centre shall provide appropriate respect and dignity to the dying and the dead.
b. All death cases to be recorded and reported.
c. Death certificate (MCCD- Medical Certificate for Cause of Death) to be issued to the
next of kin.
d. Organization shall carry out Death Audits periodically.
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SECTION - D
OUTCOME STANDARDS
D - 1 UTILIZATION INDICES OF THE CENTRE
Objective Elements
a. Hospital to record all parameters as stated in the Quality Assurance Manual for
Primary Urban Health Center.
b. Utilization of OPD, IPD, X-ray, Labor Room, Man Power, Laboratory services,
Referral services (to & from the facility), ambulance services, MLC services to be
analyzed and maintained for continuous quality improvement.
c. Utilization of equipments shall be monitored on regular basis.
D - 2 PRIMARY URBAN HEALTH CENTRE STATISTICS
Objective Elements
a. Hospital statistics in terms of OPD attendance, Immunization rate, birth rate, death
rate, minor and major operations etc. to be documented and reported.
b. A bulletin is published every quarterly stating the above details.
D - 3 REPORTING OF BIRTH, DEATH AND OTHER DETAILS
Objective Elements
a. All the birth and the death in the Centre and the population to be reported to the
concerned Nagar palikas, municipal authorities and other local authorities.
b. Incidence and prevalence of diseases to be reported to the district authorities.
c. Epidemics and communicable diseases to be reported to the authorities.
d. Accidents and mishaps shall also be reported to authorities as per decided timelines.
Accreditation Standards for Primary Urban Health Centre
D - 4 MEDICAL RECORDS
Objective Elements
a. The contents of the medical records are pre-defined.
b. An audit of the medical records is carried out every quarter.
c. The records are kept at for pre defined duration as per the policy.
d. There shall be provisions for storing and retrieval of the records.
e. All entries by the doctors and nurses are legible and complete.
f. All records must be computerized for accurate record maintenance.
D - 5 PATIENT & EMPLOYEE SATISFACTION SURVEY
Objective Elements
a. On going mechanism of conducting patient satisfaction through involvement of local
NGOs, RKS and RWA members shall be present.
b. On going mechanism of conducting employee satisfaction shall be present.
c. Organization shall have Grievance Redress Policy and mechanism.
d. Organization shall have in use feedback mechanism like use of feedback forms,
suggestion forms to be dropped in suggestion/ complaint boxes at identified places.
D - 6 HEALTH INFORMATION SYSTEM
Objective Elements
a. Community statistics like IMR, MMR, birth rate, death rate etc. to be documented
and reported.
b. Reporting of all the details to be done through a web based health information
system to the authorities on a daily, weekly, monthly and annual basis.
c. Health Information System tools shall be as per the state directives.
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PART – 2 GUIDE BOOK
STRUCTURAL STANDARDS
Accreditation Standards for Primary Urban Health Centre
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FUNCTIONS/ SERVICE OUTLAY
Primary Urban Health Centre is a first level contact facility serving a range of customers,
containing as much as possible all specialties such as:
OPD CLINICS
Obstetrics & Gynaecology Paediatrics
General Medicine AYUSH
Dental
DIAGNOSTIC SERVICES
LABORATORY IMAGING
Haematology/ Cytology X-Ray
Biochemistry/ Microbiology Ultrasound/ Doppler
ECG
OTHER SERVICES
Physiotherapy Minor OT / Procedure Room
Dressing / Injection / Plaster
SUPPORT SERVICES
Facility Maintenance Ambulance
Primary Urban Health Centre is basically working as an outpatient department only. It is
usually not integral to a hospital but linked to the identified secondary & tertiary level
healthcare providers through a functional two way referral linkage.
.
Accreditation Standards for Primary Urban Health Centre
ZONES
For planning purposes the Public Urban Health Centre has been divided into zones as
under:
Zone Functions
Entrance Zone (A)
Reception and Registration
- Reception counter
- Record storage
Pharmacy
- Issue counter
- Formulations
- Drugs storage
Public utilities
Ambulatory Zone (OPD) (B)
Examination and Workup
- Examination room
- Sub-waiting
Consultation
- Consultation rooms
- Toilets
- Sub-waiting
Nursing Station
- Nurses Desk
- Clean Utility
- Dirty Utility
- Treatment rooms (Injection, Dressing, Plaster,
ECG)
- Sub-waiting
Casualty / Emergency
Public Utilities
Diagnostic Zone (C)
Pathology (optional)
- Laboratory
- Sample Collection
- Bleeding Room
- Washing / disinfection
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- Storage
- Sub-waiting
Imaging (Radiography, Ultrasound)
- Preparation
- Change & Toilet
- Control
- Dark Room (film developing and processing)
- Ultrasound Room
- Sub-waiting
Public Utilities
Critical Zone (Labour Room &
Sterilization) (D)
Patient Area
- Preparation & Examination
- Pre-anesthesia
- Post Operative
Staff Area
- Toilet & Changing
Supplies Area
- Trolley Bay
- Equipment Storage
Sterilization
- Receipt
- Wash
- Assembly
- Sterilization
- Sterile Storage
- Issue
Minor OT /L.D.R. Area
- Labour Room
- Minor OT
- Scrub and Gown
- Instrument Sterilization
- Disposal
Public Utilities
Facility Management Zone (E) Civil Engineering
- Building maintenance
Accreditation Standards for Primary Urban Health Centre
- Horticulture
- Water Supply
- Drainage and Sanitation
Electrical Engineering
- Sub-station and generation
- Illumination
- Ventilation
Mechanical Engineering
- Air-conditioning
- Refrigeration
Other Services
- Telephone and Intercom
- Fire Protection
- Waste disposal
- Mortuary
Administrative Zone (F)
General Administration
General Stores
Public Utilities
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Accreditation Standards for Primary Urban Health Centre
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AREA & SPACE REQUIREMENTS
Functional Areas represent the areas where the primary functions of the respective sub-unit
are performed e.g. the Consulting Rooms in an OPD, Treatment Room in an Emergency,
etc. As far as possible, the size of these areas shall not be changed. Relations of all other
areas shall be established in relation to the properties of these areas.
Support Areas are the ones where functions which directly support or enable the primary
functions of the respective sub-unit are performed e.g. the clean utility room in a Nursing
Unit, Recovery room in a LDR Suite, etc. The size of these areas can be changed to
accommodate design constraints but the integrity of their relation to functional areas shall be
maintained. Support areas of two or more similar functional units, located in proximity of
each other, or on the same floor, can be grouped and shared by each functional unit.
Service Areas represents the areas where such functions are performed which do not
directly support the performance of primary functions of the respective sub-unit e.g. the
Sluice Room in a Nursing Unit, etc. The size of these areas and their relation to functional
areas can be changed to accommodate design constraints.
1. OUT PATIENT DEPARTMENT
Functional Area Minimum Functional Area Total Functional Area
Consulting Rooms (4) 10 Sq mtrs. 40 Sq mtrs.
Support Areas
Reception & Registration 8 Sq mtrs. 8 Sq mtrs.
Waiting Areas 15 Sq mtrs. 15 Sq mtrs.
Social Workers Office 8 Sq mtrs. 8 Sq mtrs.
Dressing & Plaster Room 10 Sq mtrs. 10 Sq mtrs.
Sample Collection Room 6 Sq mtrs. 6 Sq mtrs.
Immunization Room 6 Sq mtrs. 6 Sq mtrs.
Pharmacy cum Dispensary 12 Sq mtrs. 12 Sq mtrs.
Physiotherapy 10 Sq mtrs. 10 Sq mtrs.
Service Areas
Accreditation Standards for Primary Urban Health Centre
Water Facility 3 Sq mtrs. 3 Sq mtrs.
Toilet (Male & Female) 5 Sq mtrs. 10 Sq mtrs.
Janitor’s Closet 3 Sq mtrs. 3 Sq mtrs.
Trolley Bay 4 Sq mtrs. 4 Sq mtrs.
Total 135 Sq mtrs.
2. EMERGENCY
Functional Area Minimum Functional Area Total Functional Area
Consulting Room 10 Sq mtrs. 10 Sq mtrs.
Treatment/ Procedure Room 10 Sq mtrs. 10 Sq mtrs.
Injection Room 8 Sq mtrs. 8 Sq mtrs.
Service Area
Ambulance Receiving Area 20 Sq mtrs. 20 Sq mtrs.
Trolley Bay 4 Sq mtrs. 4 Sq mtrs.
Total 52 Sq mtrs.
3. LABORATORY & IMAGING
Functional Area Minimum Functional Area Total Functional Area
Clinical Pathology 10 Sq mtrs. 10 Sq mtrs.
Bio-chemistry 6 Sq mtrs. 6 Sq mtrs.
Microscopic 3 Sq mtrs. 3 Sq mtrs.
Staining Area 4 Sq mtrs. 4 Sq mtrs.
X-ray Room 16 Sq mtrs. 16 Sq mtrs.
Dark Room 6 Sq mtrs. 6 Sq mtrs.
Ultrasound Room 10 Sq mtrs. 10 Sq mtrs.
Support Areas
Reception and Waiting 15 Sq mtrs. 15 Sq mtrs.
Laboratory Store 6 Sq mtrs. 6 Sq mtrs.
Imaging Store 4 Sq Mtrs. 4 Sq Mtrs.
Service Area
Toilet (Male & Female) 4 Sq mtrs 8 Sq mtrs.
Janitor’s Closet 2 Sq mtrs. 2 Sq mtrs.
Total 90 Sq mtrs.
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Accreditation Standards for Primary Urban Health Centre
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4. MINOR OT / LABOUR & DELIVERY SUITE
Functional Area Minimum Functional Area Total Functional Area
Minor OT 20 Sq mtrs. 20 Sq mtrs.
Labour Room (2 Table) 25 Sq mtrs. 25 Sq mtrs.
Scrub Room 3 Sq mtrs. 3 Sq mtrs.
Sterilization Room 6 Sq mtrs. 6 Sq mtrs.
Support Area
Examination Room 8 Sq mtrs. 8 Sq mtrs.
Counseling Room 10 Sq mtrs. 10 Sq mtrs.
Store 4 Sq mtrs. 4 Sq mtrs.
Recovery Room 6 Sq mtrs. 6 Sq mtrs.
Sterile Store 4 Sq mtrs. 4 Sq mtrs.
Service Area
Trolley Bay 4 Sq mtrs. 4 Sq mtrs.
Toilet 6 Sq mtrs. 6 Sq mtrs.
Janitor’s Closet 3 Sq mtrs. 3 Sq mtrs.
Sluice Room 3 Sq mtrs. 3 Sq mtrs.
Waiting Area 6 Sq mtrs. 6 Sq mtrs.
Total 108 Sq mtrs.
5. ADMINISTRATIVE DEPARTMENT
Functional Area Minimum Functional Area Total Functional Area
MOICs Room 10 Sq mtrs. 10 Sq mtrs.
Account Office 7 Sq mtrs. 7 Sq mtrs.
Medical Records Room 10 Sq mtrs. 10 Sq mtrs.
Central Reception 5 Sq mtrs. 5 Sq mtrs.
Toilet (Male & Female) 5 Sq mtrs. 10 Sq mtrs
Total 42 Sq mtrs.
6. STORE & PHARMACY SERVICES
Functional Area Minimum Functional Area Total functional Area
Medical Store 15 Sq mtrs. 15 Sq mtrs.
General Store 15 Sq mtrs. 15 Sq mtrs.
Mortuary 8 Sq mtrs. 8 Sq mtrs.
Total 38 Sq mtrs.
Accreditation Standards for Primary Urban Health Centre
7. GENERATOR ROOM
Functional Area Minimum Functional Area Total Functional Area
Generator Room 8 Sq mtrs. 8 Sq mtrs.
Water Pump Room 4 Sq mtrs. 4 Sq mtrs.
Total 12 Sq mtrs.
8. RESIDENTIAL ACCOMMODATION
Functional Area Minimum Functional Area Total Functional Area
Doctors
Nurses
Pharmacist
Sweeper/Driver
80 Sq mtrs.
60 Sq mtrs.
60 Sq mtrs.
45 Sq mtrs.
80 Sq mtrs.
60 Sq mtrs.
60 Sq mtrs.
45 Sq mtrs.
Total 245 Sq mtrs
Total area required barring residential accommodation is 477 Sq mtrs. approximately. We
need to add 30% of this area for circulation space and corridors, stairs, ramps, emergency
exit etc. Hence the total covered area would be around 620 Sq mtrs.
Since the health center is a horizontal structure the space calculated above is adequate, to
this accommodation area for the staff is to be added which comes to 865 Sq mtrs. Adequate
space for landscaping, gardening and parking area needs to be added. Therefore, a total
area of 1600 Sq. mtrs. would be adequate for creating a Public Urban Health Centre.
PRIMARY URBAN HEALTH CENTRE (PUHC) BUILDING
a. Location:
i. It shall be located in an easily accessible area. The building shall have a
prominent board displaying the name of the centre in the local language. The
area chosen shall have the facility for electricity, all weather road
communication, adequate water supply, telephone.
ii. It shall be well planned with the entire necessary infrastructure. It shall be well lit
and ventilated with as much use of natural light and ventilation as possible.
iii. Shall have non-slippery floors.
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Accreditation Standards for Primary Urban Health Centre
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b. Entrance:
i. It shall be well-lit and ventilated with space for Registration and record room,
drug dispensing room, and waiting area for patients.
ii. The doorway leading to the entrance shall also have a ramp facilitating easy
access for handicapped patients, wheel chairs, stretchers etc.
iii. Waiting area:
• This shall have adequate space and seating arrangements for waiting
patients / attendants.
• The walls shall carry posters imparting health education.
• Booklets / leaflets may be provided in the waiting area for the same
purpose.
• Toilets with adequate water supply separate for males and females shall be
available, preferably with Western and Indian WC sheets.
• Drinking water shall be available in the patient’s waiting area.
• There shall be proper signage displaying parts of the centre, a board
displaying available services, names of the doctors, list of members of the
Rogi Kalyan Samiti, and the referral facilities.
• A locked complaint / suggestion box shall be provided and it shall be
ensured that the complaints/suggestions are looked into at regular intervals
and the complaints are addressed.
• The surroundings shall be kept clean with no water-logging / vector
breeding places in and around the centre.
• The Citizen’s Charter shall be displayed in a prominent position on the
centre premises.
• There shall be green area – wherever space is available, horticulture /
plantation of trees and plants. In areas with space constraint potted plants
can be used.
c. Outpatient Department:
• The OPD shall have separate rooms, atleast (air-conditioned) for consultation
and examination with a wash basin and attached toilet. (Atleast two rooms one
for MO I/C and the other for two Medical Officers.)
• The Consultation rooms shall have separate areas for consultation and
examination.
• The area for examination shall have sufficient privacy.
• In PUHCs with AYUSH doctors, necessary infrastructure such as consultation
room for AYUSH Doctor and AYUSH Drug dispensing shall be made available.
Accreditation Standards for Primary Urban Health Centre
• Clean linen shall be provided and cleanliness shall be ensured at all times.
d. There shall be separate room for Injection & Emergencies, one for Dressings and
minor procedure.
• It shall be located close to the OPD Consulting rooms to provide easy and quick
access to patients for injections / minor surgeries and emergencies during OPD
hours.
• It shall be well equipped with all the emergency drugs and required instruments.
e. Labour & Delivery Suite:
Labour & Delivery suite shall have in its close proximity sufficient space for
examination / history taking / weighing / recording BP / immunization / group and
individual counseling. The rooms shall be well lit and ventilated and preferably with
dual entrance.
f. Laboratory
• Sufficient waiting space
• Separate area for sample collection and conducting the tests shall be available.
• Shall have marble/stone table top for platform and wash basins.
• Running water supply shall be available in Lab.
• Exhaust fan shall be available.
g. X-Ray & Ultrasound Room
• AERB and BARC certificates to be obtained for the equipments & building plan.
• Radiation safety devices shall be provided to radiographers and patients.
• Lead shielded doors of X-ray room
• Wall thickness of X-ray room shall be 0.1 mm
• Radiation hazards warning symbols display as per AERB guidelines.
• Display of instructions in Hindi and English warning women of child bearing age
on dangers of radiation in pregnancy.
• Patient instructions like full bladders; empty stomach etc shall be displayed
outside the USG room.
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Accreditation Standards for Primary Urban Health Centre
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INSTRUMENTS & EQUIPMENTS
S.No. Name of Item Quantity
1 Nebulizer with heavy duty motor (portable) single port 1
2 Ambu's Bag (Adult & Child) 1
3 Anterior Wall retractor vaginal size S/M/L 2
4 Artery Forceps Curved 6"ss 6
5 Artery Forceps Straight 6"ss 6
6 Autoclave ISI marked with 4 Dressing Drum 2
7 B.P. Apparatus 4
8 Bowl SS 20 cm 4
9 Cuscus speculum Small / Medium / Large 4
10 Digital Thermometer 6
11 Forceps Chital 9"ss 4
12 Forceps Dissecting Plain 6"ss 2
13 Forceps Dissecting Toothed 6"ss 4
14 Forceps Sinus 6"ss 2
15 Forceps Sponge Holding 9" 4
16 Gynae Examination Light with ordinary bulb floor model 2
17 Height Measuring Scale 2
18 SS Instrument Tray with Cover 8" x 10" 4
19 Key spanner for oxygen cylinder 2
20 Kidney Tray SS 25 cms 4
21 Needle Holder Straight / Curved 6"ss 2
22 Oxygen Cylinder B Type 10 Ltr. ISI Marks with all requisite certificates. 2
23 Oxygen Cylinder Trolley 2
24 Oxygen Flow meter with humidifier bottle 2
25 Posterior Wall retractor (Sims) Small / Medium / Large 4
26 Scissors 6' SS 4
27 Scissors Sharp Tailor Model 2
28 Stethoscope having good conduction tube for adult & child 4
29 Syringe Cum Needle Destroyer Manual Model 2
30 Uterine Sound ss 4
31 Volsellum ss 4
32 Alis Tissue Forceps 2
33 Adult Weighing Scale (Manual) 1
34 Foot Operated Suction Machine 1
Accreditation Standards for Primary Urban Health Centre
35 Electrical Suction Machine 1
36 B.P. Handle 4 2
37 Nasal Speculum 2
38 Percussion Hammer 4
39 Electric Sterilizer 2
40 Spot Light 1
41 Weighing Scale digital (Neonatal) 1
42 Single Panel X-ray view box 1
COMMON SURGICAL CONSUMABLES
S.No. Name of Item Quantity
1 Bandage all sizes do
2 Cotton do
3 Adhesive wound Dressing different Sizes do
4 Alcohol Swab do
5 Adhesive Plaster do
6 Disposable Blade do
7 Oxygen Mask Adult & Pediatrics do
8 Disposable Draw Sheet do
9 Sterile Surgical pad 10 x 10 cm do
10 Crepe Bandage 8 cm / 10 cm / 15 cm do
11 Disposable Syringe AD 2 cc, 5 cc, 1 cc 10 cc do
12 IV Set do
13 Scalp Vein Set 23, 24 G do
14 Lint Cloth do
15 Hypodermic Needle 22G, 23G, 26G, 24G do
16 Disposable Gloves different sizes Sterile & Non Sterile do
17 Hypo Allergic Paper Tape 1" do
18 Face Mask do
19 Poly Mask (Adult / Paeds) do
20 Ryle's Tube do
21 Gastric Levage Tube do
22 Suction Catheters do
23 Mucus Extractor with Suction Tube do
24 Rubber Sheething do
25 Wooden Tongue Depresser do
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26 Suture Silk 1-0 do
27 Tuberculin Syringe do
28 Suture Catgut 1-0 do
29 I.V. Canula 22, 24 do
30 Paraffin Gauze / Chlorhexidine Gauge do
31 Baladona Plaster do
32 First-Aid Dressing water proof do
Accreditation Standards for Primary Urban Health Centre
LABORATORY & RADIOLOGY ITEMS
S.No. Name of Item Quantity
1 Acetic Acid Glacial do
2 Acetone do
3 Beakers all sizes do
4 Blood Cell Counter 6 units do
5 Blood Grouping kit Anti A, B, AB & D (Rh) do
6 Boric Powder do
7 Blood Grouping Plate do
8 Bleaching Powder / Solution do
9 Carbol Fuschin do
10 Cedar Wood Oil do
11 Centrifuge Tube do
12 Cover Slip all size do
13 Diamond Pencil for Slide Marking do
14 Distille Water 5 Ltr. Pack do
15 Dropper do
16 ESR Pipette Disposable do
17 ESR Stand (6 Tubes) 2
18 EDTA Tubes (Glass) do
19 Filter Paper Sheet Round do
20 Glucometer 1
21 Glucometer Strip Compatible do
22 Hb Pipette with rubber tube do
23 Hb tube do
24 Haemoglobinometer Complete do
25 Hydrogen peroxide for lab use do
26 Improved Neubaur's chamber do
27 Lancet Disposable Sterile do
28 Lieshman Stain do
29 Microscope slide (glass) deluxe do
30 Multi stick for urine do
31 N/10 HCL do
32 Pasture pipette do
33 Pipette RBC do
34 Pipette WBC (as per requirement)
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Accreditation Standards for Primary Urban Health Centre
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35 Pipette Stand do
36 Platelets count fluid do
37 Pot Permanganate do
38 Pregnancy test card / strip do
39 R B C diluting fluid do
40 Slide Staining Tray do
41 Sod. Citrate Soln. do
42 Sprit Lamp / Bunsen Burner do
43 Stop Watch do
44 Sulphur Powder do
45 Sulphur Acid do
46 Tepol Liquid do
47 Test Tube Holder do
48 Test Tube Size 12 x 100 mm do
49 Test Tube Size SS body do
50 Tissue Paper Roll do
51 TLC / DLC Counting Chamber do
52 Tourniquets (Velcro) do
53 Uristicks for Glucose and Albumin do
54 WBC Diluting Fluid do
55 Widal Testing kit do
56 Xylene do
57 Urine Sticks for Microalbumin do
58 Binocular Microscope 1
59 Centrifuge Machine for 8 tubes 1
60 EDTA Powder do
61 Vacutainers Plain do
62 Filter Paper do
RADIOLOGY ITEMS
1 100 MA X-ray Machine 1
2 High End Ultrasound Machine 1
3 ECG Machine 1
4. TLD Badge for Radiographer 1
5. Lead Apron 2
Accreditation Standards for Primary Urban Health Centre
FURNITURE ITEMS
S.No. Name of Item Quantity
1 Steel Almirah Big 9
2 Steel Almirah Small 4
3 Table Officer 2
4 Office Table Assistant 6
5 Office Table Clerk 2
6 Office Chair 24
7 Office Chair 3
8 Bench Stell 4
9 Airport Bench (3 Seats) 4
10 Examination Table 4
11 Gynae Examination Table 2
12 Mattress for Examination Table 4
13 Foot Step 6
14 Steel Racks with cover 6 shelve 6
15 Steel Racks with cover 2 shelve 5
16 Revolving Stool ss top 8
17 Wooden Stool 6
18 Revolving Stool adjustable height for dispensary / lab with cushion top 2
19 Hydraulic Stool 2
20 Screen Three Fold / Hanging Screens 6
21 Notice Board 1
22 Computer Table 1
23 Computer Chair 1
24 Notice Board Pannel for IEC 2
25 Wheel Chair 1
26 Stretcher with Trolley 1
27 Instrument Trolley 3
28 Dressing Trolley 1
29 Side Wooden Rack 1
30 I. V. Stand 1
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Accreditation Standards for Primary Urban Health Centre
@ National Accreditation Board for Hospitals and Healthcare Providers44
GENERAL & MISCELLANEOUS ITEMS
S.No. Name of Item Quantity
1 Broom phool (as per requirement)
2 Broom Naryal do
3 Liquid Soap do
4 Room Freshener do
5 Floor Mops do
6 Duster do
7 Wiper do
8 Dustbin Plastic- Small/ medium / big do
9 Electric Tubes do
10 CFL Bulb do
11 Phenyl 5 Ltr. do
12 Finit/ Baygon do
13 Finit Pump do
14 Degradable polybags Black for BMW do
15 Degradable polybags Yellow for BMW do
16 Degradable polybags Red for BMW do
17 Bleaching Powder do
18 Glass Tumber do
19 Toilet Cleaner do
20 Naphthalene Ball do
21 Odonil do
22 Safety Razor do
23 Measuring Tape do
24 Plastic Bucket - 30 Ltr do
25 Detergent Powder do
26 Soap Cake do
27 Locks with Keys Big & Small do
28 Biomedical Waste Bins do
29 Mugs do
30 Water Jugs 20 Ltr. do
31 Hot Case Electric do
32 R.O.System do
33 Water Cooler do
34 Desert Cooler do
Accreditation Standards for Primary Urban Health Centre
35 Air Condition (window type) (as per requirement)
36 Invertors with Adequate Back up do
37 Domestic Refrigerators 165 Ltr. do
38 Computer with Broad Band and Accessories do
39 Fire Extinguishers do
40 Signages do
41 Torch Medium / Large do
42 Torch Cells do
43 Telephone with Intercom facility do
44 Vaccine Carrier do
45 Brush for Toilet do
46 Calculator 10 Digits do
47 Canvas Bag do
48 Door Mat Rubber / Small / Medium / Large do
49 Rat Trape do
50 Jerican White Empty 5 Ltr/ 10 Ltr / 20 Ltr do
51 Table Glass do
52 Dial Thermometer do
53 Rain Coat do
54 Sealing Wax do
55 Suggestion Box do
56 Stand for Refrigerator do
57 Cup & Plate Set do
58 Hot Plate do
59 Umbrella do
60 Lathi for Chowkidar do
61 Voltage Stabilizer 1/2, 1 & 2 KV do
62 Fire Extinguishers
63 Waste Paper Basket Plastic do
64 Emergency Light do
65 Gloves for Cleaning (Heavy duty Rubber) do
66 Gum Boots do
67 Tissue Paper Roll do
68 Paper Napkins do
69 Liquid Spray cleaner (Colin/Brisk) do
70 Heat Convertor do
71 Room Heater do
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Accreditation Standards for Primary Urban Health Centre
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72 Chemical Treatment Bucket 20 Ltr. (as per requirement)
73Foot operated dustbin ss Frame with Removable Pot made of HDPE material Black / Yellow / Red do
74 UPS for Computers do
75 Pen Drive 4 GB / 8 GB do
76 Goggles for Universal Precautions do
77 CVT 2 KVA do
78 Hot Water Bottle do
79 Fly Catcher do
80 Extension Board do
81 PUC Pipe do
82 Bamboo for Floor Mops do
Accreditation Standards for Primary Urban Health Centre
STATIONARY & LINEN ITEMS
S.No. Name of Item Quantity
1 OPD Slips As per requirement
2 OPD Register As per requirement
3 Stock Register As per requirement
4 Rulled Register 2Q, 4Q As per requirement
5 Immunization Register As per requirement
6 Immunization Card As per requirement
7 Eligible Couple Register As per requirement
8 Special Drug Forms As per requirement
9 Morbidity Reporting Proforma ICD-10 As per requirement
10Reporting Proformas Under Various National Health Programmes As per requirement
11 Pilot Pen (Blue/Red) V5 As per requirement
12 Zotter Pen (Blue/Red/Green) As per requirement
13 Ball Pen As per requirement
14 Gel Pen As per requirement
15 Marker Pen As per requirement
16 Permanent Marker As per requirement
17 Ink for Pilot Pen As per requirement
18 Refills for Zotter Pen As per requirement
19 Refills for Ball Pen As per requirement
20 Pencil HB As per requirement
21 High Lighter Pen As per requirement
22 Eraser/Rubber As per requirement
23 Scale (12") As per requirement
24 Stapler Pin As per requirement
25 All Pin As per requirement
26 Board Pin 13mm As per requirement
27 U Clip As per requirement
28 Tags Cotton As per requirement
29 All Pin Cushion As per requirement
30 Gum Botle 700 ml Big As per requirement
31 Stamp Pad As per requirement
32 Ink for Stamp Pad As per requirement
33 White Fluid As per requirement
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Accreditation Standards for Primary Urban Health Centre
@ National Accreditation Board for Hospitals and Healthcare Providers48
34 Cello Tape Size 1/2 Inches, 1 Inches As per requirement
35 Slip Pad As per requirement
36 White Envelop (4"X6") As per requirement
37 White Envelop (4"X9") As per requirement
38 White Envelop A-4 Size As per requirement
39 Envelop (File size) brown Plastic Coated As per requirement
40 Dak Pad As per requirement
41 Paper Weight As per requirement
42 File Cover As per requirement
43 File board As per requirement
44 File Wrapper As per requirement
45 Photocopy Paper (all size) 75 GSM & ISI As per requirement
46 Typing Paper As per requirement
47 Duplicating Paper As per requirement
48 Note sheet Superior As per requirement
49 Carbon paper (Blue) all size As per requirement
50 Short hand book As per requirement
51 Attendance Register As per requirement
52 Diary Register As per requirement
53 Dispatch Register As per requirement
54 Cartridges for Printers As per requirement
LINEN ITEMS
1 Bed Sheet As per requirement
2 Draw Sheet As per requirement
3 Towel Large/Medium/Small As per requirement
4 Screen Cloth As per requirement
5 Pillow As per requirement
6 Pillow Cover As per requirement
7 Curtain Cloth As per requirement
8 Doctor Coat As per requirement
9 Coat for Paramedical Staff As per requirement
10 Apron As per requirement
11 Patient Blanket As per requirement
12 Blanket for Chowkidar As per requirement
Accreditation Standards for Primary Urban Health Centre
@ National Accreditation Board for Hospitals and Healthcare Providers50
MANPOWER & STAFFING
S.No. Category of Staff Recommended*
1.
Medical Officer In-charge (MO I/C)
Second Medical Officer
1 (1 MBBS Doctor and 1 Lady Medical Officer or from AYUSH)
1
2.Pharmacist (Storekeeper) Pharmacist
1
1
3. Physiotherapist 1
4. Public Health Nurse (PHN) 1
5. Auxiliary Nurse Midwife (ANM) 1 for PUHC (plus 1 for each 10,000 urban poor population attached to the centre) in slums / JJ Clusters etc.
6. Laboratory Technician 1
7. Radiographer 1
8. Dresser 1
9. Nursing Orderly / Peon 1
10. Sweeper cum Chowkidaar (SCC) 3
11. CDEO cum Assistant 1
12. Medical Records Clerk 1
13. Social Mobilization Officer 1
14. Driver 1
15.Electrician
Plumber
1 (On Contract)
1
Total Manpower 23
Note: * This recommendation is for 50,000 population. In case of higher catchment
population the staff will be increased proportionately till such time as there is one PUHC for
every 50,000 population. In addition care must be taken to ensure sufficient leave reserve
and staff for special programs like Pulse Polio etc.
Accreditation Standards for Primary Urban Health Centre
ESSENTIAL DRUG LIST
ANAESTHETICS
General Anesthetics
Sodium thiopentone Inj. 0.5, 1 g powder/vial
Halothane Inhalation
Ether inhalation
Nitrous oxide inhalation
Oxygen inhalation
Carbon dioxide inhalation
Ketamine hydrochloride
Inj. 50 mg/ml
Local Anesthetics
Bupivacaine hydrochloride Inj. 0.25, 0.5%
Lignocaine hydrochloride Inj. 1,2,4,5% jelly 2%, Oint 2%
Lignocaine with adrenaline 5 mcg/ml adrenaline Dental cartridge 2% adrenaline (1:80,000)
Ethyl chloride spray
Preoperative Medication and Sedation for Short Term Procedures
Atropine sulphate Inj. 0.6 mg/ml.
Promethazine Inj. 25 mg/ml
Syrp. 5 mg/5ml
Diazepam Inj. 5 mg/ml, Tab. 5 mg
Midazolam Inj. 1 mg/ml.
Glycopyrrolate Inj. 0.02 mg/ml.
ANALGESICS, ANTI-PYRETICS AND DRUGS FOR GOUT
Non Opioids
Acetyle salicylic acid Tab. 100, 325 mg
Allopurinol Tab. 100 mg
ParacetamolTab. 500 mg/Syp. 125 mg/5 ml
Inj. 1.50 mg/ml
IbuprofenTab. 200, 400 mg
Syr. 100 mg/5 ml
Indomethacin Cap 25 mg.
Diclofenac sodium Tab. 50 mg, Inj. 25 mg/ml
Opioids
Pentazocin lactate Inj.30 mg/ml
Morphine sulphate Inj. 10 mg/ml
Pethidine hydrochloride Inj. 50 mg/ml
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Anti-Migraine Drugs
Dihydroergotamine mesylate Tab. 1 mg
For Prophylaxis propranolol 10, 40 mg
ANTIALLERGIC AND DRUGS USED IN ANAPHYLAXIS
Chlorpheniramine meleate Tab. 4 mg
Prednisolone Tab. 5 mg
Epinephrine hydrochloride Inj. 1 mg/ml
Pheniramine meleate Inj. 22.75 mg/ml
Promethazine Tab. 10, 25 mg, Syr. 5 mg/ml
Dexamethasone sodium phosphate Tab. 0.5 mg, Inj. 4 mg/ml
Hydrocortisone sodium succinate Inj. 100 mg/ml
Cetirizine Tab. 10 mg
ANTIDOTES AND OTHER SUBSTANCES USED IN POISONING
Atropine Inj. 1 mg/ml
Activated charcoal power PAM Inj. 25 mg/ml
Anti snake venom Inj Polyvalent
Desferrioxamine Power for Inj. 500 mg in vial
ANTI-EPILEPTIC DRUGS
Phenytion sodiumTab. 50, 100 mg
Inj. 50 mg/ml
PhenobarbitoneInj. 200 mg/ml, Elixir 15 mg/5 ml
Tab. 30, 60 mg
Carbamazepine Tab. 100, 200 mg, Syr. 100 mg/5ml
Sodium valproate Tab. 200 mg, Syr. 200 mg/5 ml
Diazepam Inj. 5 mg/ml
ANTI-INFECTIVE DRUGS
Anti Helminthics
Intestinal Anthelmintics
Albendazole Tab. 400 mg, Susp. 200 mg/5ml
Pyrantel pamoate Tab. 200 mg, powder for susp. 50 mg/ml
ANTI-BACTERIALS
Penicillins
AmoxicillinCap. 250, 500 mg, powder for susp. 125 mg/5ml
Inj. 125 mg/ml
AmpicillinCap. 250, 500 mg, powder for susp. 125 mg/5ml
Inj. 500 mg/vial
Cloxacillin Cap. 500 mg, powder for susp. 125 mg/5ml
Accreditation Standards for Primary Urban Health Centre
Inj. 500 mg/vial
Benzathine penicillin Powder for Inj. 0.6 1.2, 2.4 MU/vial
Benzyl penicillin Powder for Inj. 0.5 MU/vial
Procaine penicillin Powder for Inj. 0.4 MU/vial
OTHER ANTI BACTERIALS
Gentamicin Inj. 10, 40 mg/ml
Amikacin Inj. 100, 250, 500 mg/2ml
Ciprofloxacin
Tab. 200, 400 mg
Infusion 100 mg/50mg,
Susp. 200 mg/5ml
Nalidixic acid Tab. 500 mg, Syr. 300 mg/5ml
Metronidazole
Tab. 200, 400 mg
Inj. 500 mg/100ml. Vial
Susp. 200 mg/5ml
Caftazidime Inj. 250 mg, 500 mg, 1 g
Cephalexin Cap. 250, 500 mg
Syr. 125 mg/5ml
Ceftriaxone Inj. 500 mg. 1 g
Chloramphenicol Cap. 250 mg. Syr. 125 mg/ml
Inj. 1 g/vial
Erythromycin (as estolate) Tab. 250 mg, powder for susp. 125 mg/5ml
Sulfamethoxazole trimethoprim
Tab. 400 mg + 80 mg
Tab. 800 mg + 160 mg.
Susp. 200 mg + 40 mg in 5 ml
Doxycycline Cap. 100 mg
Tetracyclin Ap. 250, 500 mg
Norfloxacn Tab. 400 mg, 200 mg
ANTI-LEPROSY DRUGS
Clofazimine Cap. 50, 100 mg
Dapsone Tab. 50, 100 mg
Rifampicn Cap., Tab. 150, 300, 450, 600 mg
ANTI-TUBERCULOSIS DRUGS
Ethambutol Tab. 400, 800 mg
Isoniazid Tab. 100, 300 mg, Syp. 100 mg/5ml
Rifampicin Cap. 150, 300, 450, 600 mg. , Syp. 0.75 g/vial
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Streptomycin Inj. 0.75 g/vial
PyrazinamideTab. 300, 500, 750 mg
Syp. 250 mg/5ml
ANTI-FUNGAL DRUGS
Griseofulvin Tab. 125, 250 mg
Ketoconazole Tab. 200 mg
ANTI-PROTOZOAL DRUGS
Trinidazole Tab. 300, 600 mg, powder for susp. 150 mg/5ml
Diloxanide furoate Tab. 500 mg
Choloroquine phosp. Tab. 250 mg, Inj. 40 mg/ml
Syp. 160 mg/10ml
Primaquine Tab. 7.5, 15 mg.
Metronidazole Tab. 200, 400 mg, Inj. 500 mg/100ml, Susp. 200 mg/5ml
ANTI VIRAL
Acyclovir Inj. 250 mg, Tab. 200 mg
ANTI-PARKINSONISM DRUGS
Trihexyphenidyl Tab. 2 mg
Bromocriptine Ab. 2.5 mg
Levodopa + Carbidopa Tab. 100 mg + 10 mg
Tab. 250 mg + 25 mg
Selegilline Tab. 5 mg
DRUGS AFFECTING BLOOD
Anti Anaemic Drugs
Ferrous Sulphate Tab. 200 mg (equivalent to 60 mg elemental iron)
Ferrous fumerate Drops 5 mg/drop
Folic acid Tab. 1.5 mg
Iron sorbital citric acid complex Inj. 75 mg iron / 1.5 ml
Ferrous fumerate + folic acid 60 mg + 0.2 mg
Hydroxy cobalamine Inj. 1 mg/ml
Drugs Affecting Coagulation
Vitmin K Inj. 10 mg/ml
Heparin Inj. 5000 IU/ml, 20,000 IU
Inj. 5000 IU/ml low molecular weight
Streptokinase Inj. 15,00,000 IU
Protamine sulphate Inj. 10 mg/ml in 5 ml ampoule
Acenocoumarin Tab. 1, 2, 4 mg
BLOOD PRODUCTS AND SUBSTITUTES
Accreditation Standards for Primary Urban Health Centre
Polymer from degraded Inj. Gelatin as 0.63g of nitrogen + electrolytes (3.5g) made isotonic solution
Dxtran 40 injectable solution
CARDIOVASCULAR DRUGS
Anti-Anginal Drugs
Propranolol Tab. 10, 40, 80 mg
MetoproololInj. 1 mg/ml
Tab. 50, 100 mg
Atenolol Tab. 50, 10 mg
Glyceryl Trinitrate Tab. 0.5 mg
Inj. 5, 25 mg
Isosorbide dinitrate Tab. 10, 20 mg
Isosorbide mononitrate Tab. 10, 20, 40 mg
Diltiazem Tab. 30. 60 mg
Anti Dysrhythmic Drugs
MexiletineCap. 50, 150 mg
Inj. 250 mg/10ml
Lignocaine Inj. 2% (21.3 mg/ml)
Amiodarone Tab. 200 mg
VerapamilTab. 40, 80 mg
Tab. Syr. 240 mg, Inj. 5 mg/2ml
Anti-Hypertensive Drugs
Nifedipine Cap. 5, 10 mg
Hydralazine Tab. 25, 50 mg, Inj
Methyldopa Tab. 250 mg
Enalpril Tab. 2.5, 5 mg
Sodium Nitroprusside Inj. 50 mg/5ml
Amlodipine Tab. 5 ml
Hydrochlorothiazide Tab. 25 mg
Chlorthalidone Tab. 25, 50 mg
Drugs used in Vascular shock and Peripheral Vascular Diseases
Dobutamine Nj. 125 mg/10 ml
Mephentermine Inj. 30 mg/ml
Dopamine Inj. 40 mg/ml
Cardiac Glycosides
Digoxin Tab. 0.25 mg
DERMATOLOGICAL DRUGS
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Anti-Fungal Drugs
Clotrimazole Oint. 1% powder 1% Vaginal pessary 100 mg
Miconazole Oint 2%
Benzoic acid + Salicylic acid Oint. (6% + 3%)
Anti-Infective Drugs
Silver sulfadiazine Cream 1%
Framycetin Cream 1%
Povidone iodine Powder 5%, lotion 5%, Hand scrup 10%, Ointment
Gentian violet 0.5% 1%
Acyciovir Cream 5%
Anti Inflammatory and Anti Pruritic Drugs
Betamethasone Oint/Cream 0.025%
Calamine Lotion
Keratoplastic and Keratolytic Agents
Coal tar Sol. 5%
Salicylic acid Oint. 2%
Podophyllin Resin 10, 25%
Dithranol Oint. 0.1, 2%
Glycerine Sol. 5%
Scabicides and Pediculocides
Benzyl benzoate Lotion 12.5, 25%
Gamma benzene hexachloride Lotion 1%
Ultra-violet blocking Agents
Para amino benzoic acid Cream/gel 10%
Zinc oxide Cream/Oint.
DIAGNOSTIC AGENTS
Ophthalmic Diagnostic Agents
Flurescein 2% eye drops
Tropicamide 1% eye drops
Contrast Agents
Barium sulphate
Powder, Susp. 95% w/v
Powder (HD) 95% w/w,
250% w/v
Sodium diatrizoate and Inj. Meglumine diatrizoate
Inj. 60, 76%
DISINFECTANTS AND ANTISEPTICS
Cetrimide + chlorhexidine Cream, lotion (15% + 7.5%, 5%)
Ethyl alcohol Solution
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Glutaraldehyde activated Lotion 2% w/v
Tincture benzoin Co. Carbolic acid Solution
Hydrogen peroxide Sol. W/v
Acriflavin + Glycerine Sol. (0.1% acriffavin)
Potassium permanganate Crystals for sol.
Povidone iodine Sol. 10%
Acetic acid 3%
Calcium hypochlorite Powder
Methyl alcohol Solution
Eusol Solution
Spirit Solution
DIURETICS
Frusemide Tab. 40 mg, Inj. 10 mg/ml
Spironolactone Tab. 25 mg
Mannitol Inj. 10%, 20
Glycerol Syp.
Amiloride Tab. 5 mg
Hydrothiazide Tab. 25 mg.
GASTROINTESTINAL DRUGS
Antacids and other Anti-ulcer drugs
Mangesium hydroxide+aluminium hydroxide+activated methylpoly siloxane
Tab. (250 mg + 50 mg)
Ranitidine Tab. 150 mg, Inj. 50 mg/2ml
Omeprazole Cap. 20 mg
Cisapride Tab. 10 mg
Famotidine Tab. 20, 40 mg
Anti-Emetic Drugs
Metoclopromide Inj. 5 mg/ml, Tab. 10 mg
Domperidone Syp. 1 mg/ml, Tab. 10 mg
Inj. 2.5 ml
Prochlorperazine Tab. 2.5, 5 mg. Inj. 5 ml
Anti-Haemorrhoidal Drugs
5 Amino Salicylic acid Tab. 400 mg, Suppository
Sulfasalazine Tab. 500 mg
Hydrocortisone 25 mg suppository
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Anti-Spasmodic Drugs
Dicylomine Tab. 10 mg, Inj. 10 mg/ml
Hyoscine butylbromide Tab. 10 mg, Inj. 20 mg/ml
Cathartic Drugs
Bisacodyl Tab. 5 mg
Lactulose Syp. 667 mg/ml
Ispaghula Husk
Drugs used in Diarrhoea
ORS (WHO) Powder 27.9 g/ft
Furazolidone Tab. 100 mg, powder for susp. 25 mg/5ml
HORMONES, OTHER ENDOCRINE DRUGS AND CONTRACEPTIVES
Adrenal hormones and Synthetic Substitutes
Prednisolone Tab. 5 mg
Methylprednisotone Inj. 500 mg/ml
Dexamethesone Tab. 0.5, 4 mg
Hydrocortisone Inj. 100 mg/ml
Androgens
Testosterone propinate Inj. 25, 50 mg/ml
Nandrolone decanoate Inj. 25 mg/ml
Contraceptives
Ethinyl oestradiol + levonorgestral Tab. 30 mcg + 150 mcg
30 mcg + 250 mcg
Ethinyl oestradiol + norethisterone Tab. 35 mcg + 1 mg
Oestrogens
Ethinyl oestradiol Tab. 0.01, 0.05 mg
Conjugated estrogen Tab. 1.25, 0.625 mg
Insulin and other Anti-Diabetics Drugs
Glibenclamide Tab. 5 mg
Metformin Tab. 500, 850 mg
Insulin soluble Inj. 40 IU/ml
Insulin semilente Inj. 40 IU/ml
Insulin Lente Inj. 40 IU/ml
Ovulation Inducer
Clomiphene Tab. 50 mg
HMG Inj. 1000, 5000, 10,000 IU
HCG Inj. 1000, 5000, 10,000 IU
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Progesterones
Norethisterone Tab. 5 mg
Medroxy progesterone acetate Tab. 10 mg
17 Hydroxy progesterone caproate Inj. 500 mg
Thyroid Hormones and Anti-Thyroid Drugs
Thyroxine sodium Tab. 100 mcg
Carbimazole Tab. 5 mg
IMMUNOLOGICAL AGENTS
Tetanus toxoid Inj.
B.C.G. IP (Freeze dried) Inj.
D.P.T. IP (adsorbed) Inj.
D.T. IP (Adsorbed) Inj.
M.M.R. USP (live vaccine Inj.
Rubella BP (live vaccine) Inj.
T.I.G. Inj., 250 IU
Hepatitis B Inj. 20 mcg.
Hepatitis B Sera
Antiscorpion Sera
Tuberculin PPD Inj.
Anti D-Immuno globulin (human) Inj
Diphtheria Anti toxin Rabies Immunoglobulin Inj.
Measles IP Inj. 100 TICD 50
Poliomyelitis IP Oral
Anti rabies (Vero cells) Inj.
MUSCLE RELAXANT AND ANTICHOLINESTERASE
NeostigmineTab. 15 mg
Inj. 0.5, 2.5 mg/ml
Vecuronium Inj. 2 mg/ml
Atracurium Inj. 10 mg/ml
Pancuronium Inj. 2 mg/ml
Suxamethonium Nj. 50 mg/ml
OXYTOCICS AND ANTIOXYTOCICS
Isoxsuprine Tab. 10 mg, nj. 5 mg/ml
Methylergometrine maleate Tab. 0.125 mg
Inj. 0.2 mg/ml
Ergometrine Tab. Inj. 0.2 ml
Salbutamol Tab. Inj.
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Oxytocin Inj. 10 IU/ml
Magnesium sulphate Inj. 25% w/v
Dinoprostone Inj. 0.5 mg/syringe
Ethacridine lactate Inj. 1 mg/ml
Terbutaline Tab. Inj.
DRUGS ACTING ON RESPIRATORY SYSTEM/ANTIASTHMATIC DRUGS
Etiophylline + theophylline
Tab. 100 mg (77 + 23 mg,
Tab. SR 300 mg, Inj. 220 mg/2ml (169.4 + 50.6 mg)
Salbutamol Tab. 2, 4 mg, Syp 2 mg/5ml
Terbutaline Tab. 2.5, 5 mg, Inj. 0.5 mg/5ml
Syp. 1.5 mg/5ml
Aminophylline Inj. 25 mg/ml
Epinephrine Inj.
Sodium Cromoglycate Inhalation
Salbutamol Solution for nebulizer 5 mg/ml
Beclomethasone Inhalation 100 mcg/dose
Anti-Tussives
Bromhexine hydrochloride Syp. 4 mg/5ml
Noscapine linctus 7 mg/ml, Drps 1.83 mg/ml
SOLUTION CORRECTING WATER AND ELECTROLYTE
Dextrose Inj. 5%, 10% 25%, 50%
Sodium chloride Inj. 0.9%, 1.8%, 3.5%
Ringer lactate Inj.
Distilled water Inj.
Dextrose with saline Inj. 2.5% + 0.9%, 5% + 0.45%, 5% + 0.9%
Water for Injection Inj.
Dextran 10% in dextrose 5%
Potassium chloride Inj. 150 mg/ml
Calcium Gluconate Inj. 37.5 mg/ml
Calcium chloride Inj. 10% solution
27% calcium For IV use
Sodium bicarbonate Inj. 1.4% isotonic
Isolyte G
Isolyte M
Chlorine tablets Tablets
Accreditation Standards for Primary Urban Health Centre
VITAMINS AND MINERALS
Vit. B1, B6, B12 Tab. 10 mg + 3 mg + 15 mcg.
Inj. 100 mg + 50 mg + 1000 mcg.
Vit. A Tab. 5000 IU
Inj. 1 lac/ml
Vit. B1 Tab. 100 mg
Inj. 100 mg/ml
Vit. B12 Tab. 50 mcg.
Inj. 500 mcg/ml
Vit. D3 Granules 1 g sachet (60,000 IU)
Vit. C Tab. 100, 500 mg
Iron Folic acid Tab.
Nicotinamide Tab.
Riboflavin Tab.
Vit. B complex with multi. Vit as per schedule 5
Pyridoxine Tab. 10, 25 mg
Calcium Gluconate Tab. 500 mg
Multivitamin NFI Drops
DENTAL PREPARATIONS
Tannic acid Gum paint 20%
Povidine iodine Mouth wash 1%
Cetrimide + Choline salicylate Gel for oral ulcer (0.01% + 9% all w/v)
Idofoam Powder
OPHTHALMOLOGICAL PREPARATIONS
Anti-Infective Agents
Sulfacetamide Eye drops 20%
Oxytetracycline Eye oint. 1%
Chloramphenicol Eye oint 1%
Eye drops 0.5%, 1%
Miconazole Eye applicaps 1% w/v
Framycetin Eye oint. 0.5, 1%
Eye drops 0.5, 1%
Ciprofloxacin Eye drops 0.3%
Eye oint. 0.3%
Gentamycin Eye drops 0.3%
Acylovir Eye applicap 3%
Ketoconazole Eye drops 1%
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Anti-Inflammatory Agents
Dexamethasone + Neomycin Eye oint. (0.1% + 0.5%)
Dexamethasone Eye drops 0.1%
Flubiprofen Eye drops 0.3%
Dexamethesone + Gentamycin Eye drops (0.1% + 0.35)
Xylometazoline Eye drops 0.05%, 1%
Indomethacin Eye drops
Miotics and Anti-Glaucoma Drugs
Pilocarpine Eye drops 2%, 4%
Timolol Eye drops 0.5%
Acetazolamide Tab. 250 mg
Mydriatics
Homatropine Eye Drops 2%
Cyclopentolate Eye drops 1%
Tropicamide Eye drops 1%
Phenylepherine Eye drops 5, 10%
Atropine Eye oint. 1%
Others
Methyl Cellulose In. 2%
Balanced Salt Sol for irrigation
Fluoroscein Drops 2%
SOLUTIONS FOR PARENTERAL NUTRITION
Fat emulsion for infusion parenteral nutrition 10%
Human normal serum albumin infusion 5, 20% (salt free)
ENT DRUGS
Gentamicin Ear drops (0.3% w/v)
Gentamicin + betamethasone Ear drops (0.3% w/v +0.1%)
Sodabicarb glycerine Drops 8%
Clotrimazole Ear drops 1%
Xylometazoline Nasal drops 0.1, 0.05%
Glucose in glycerine Drops 25%
Chloromphenicol Ear drops 1%
Paraffin Liquid
Boric acid with spirit Drops
Icthyol glycerine Ear packing 10%
Bismuth iodoform paraffin Paste
Accreditation Standards for Primary Urban Health Centre
AMBULANCE REQUIREMENTS
The basic life support vehicle shall have two compartments: Drivers cabin & patient’s cabin.
Communication System (Wireless or Mobile phone)
Siren & Light switch DRIVERS CABIN
PA system
Room height of at least 6 ½ feet
Two stretchers with one trolley
Railing for IV suspension
Oxygen cylinder
Suction machine (foot operated)
ET tube
Ambu bag
Laryngoscope
Suction catheters
Foley’s catheter
PATIENTS CABIN
EMERGENCY DRUGS
Atropine, Adrenaline
Sodabicarbonate, Digoxin
Efcorline, Decadron
Dopamine, 25% Dextrose
IV fluids, Plasma Expanders
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PRIMARY URBAN HEALTH CENTRE SCHEMATIC LAYOUT
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CLINICAL & DIAGNOSTIC SERVICES IN PUHC
Each PUHC must provide a mandated set of healthcare services. These healthcare services
will be delivered in two modes - Centre based activities and Outreach activities.
1. Centre Based Clinical Processes: Encompassing all the essential elements of
preventive, promotive, curative and rehabilitative primary healthcare. This includes:
• OPD Services for curative medical care
• Emergency care during the OPD hours
• Preventive and promotive services.
• Implementation of all National Health programmes
• Referral to higher centers as per need and follow-up
• Basic laboratory services
• IEC / BCC component of healthcare
I. Center based Curative Medical care
a. No indoor patient facility is envisaged for PUHC. Wherever required the patient
can be observed during the OPD hours before shifting the patient to the FRU for
which one to two observation beds will be provided.
b. Service delivery will be mainly OPD based: Six hours a day.
c. Provision of 24 hours emergency services in Primary Urban Health Centre is not
visualized as operationalizing effective functional round the clock emergency
services will require lot of manpower and infrastructural inputs which will not be
cost effective.
(In selected PUHCs the 24 x 7 emergency may have to be provided. Selection
of these health facilities will be guided by the presence / accessibility of the first
referral unit especially in the peripheral rural belt).
d. Minimum OPD attendance visualized is 40 patients per doctor per day.
Standard Treatment Protocols for the common diseases are available and shall
be followed at the PUHCs. All centre personnel (medical and otherwise) shall be
well trained and equipped to provide this level appropriate care at the PUHC
level. The training component has to be ensured and periodically assessed and
updated. All PUHCs must possess the "Standard Treatment Protocols" as
developed by the State.
i. Emergency Medical care during OPD hours: First aid for injuries and
accidents, animal bite, burns, dehydration and other emergency conditions.
Stabilization of the condition of the patient before referral.
Accreditation Standards for Primary Urban Health Centre
ii. Selected Surgical Procedures: Simple incision and drainage, suturing of
simple Clean Lacerated wounds. During surgical procedures, universal
precautions will be adopted to ensure infection prevention.
iii. Referral for the Cases requiring Secondary / Tertiary Care: All patients
requiring higher level care to be referred in time to a linked and identified centre
with a complete referral slip. The centre must have a two way referral linkage to
facilitate back referrals / follow-up.
iv. Rehabilitation: Disability prevention, early detection and referral for appropriate
intervention to an identified linked referral unit.
v. Provision of AYUSH Services (atleast one system of ISM / Homeopathy)
wherever AYUSH unit is co-located.
vi. Provision of OPD based specialist services in the disciplines like Internal
medicine, Gynecology, Pediatrics, Ophthalmology, ENT, Dental services. These
services provided near home will increase the credibility o the PUHC, increase
its utilization and decongest the overburdens secondary / tertiary care facilities.
Rogi Kalyan Samitis can play an important role in facilitating / monitoring these
clinics.
• One out of every four to five PUHCs may run a specialist clinic with the nearest
centres being linked to it.
• The following specialties can be taken up, guided by a felt need.
1. Medicine
2. Gynecology
3. Pediatrics
4. Ophthalmology (Refractionist)
5. ENT
6. Dental Services
• The selection of the centre will be guided by the proximity / distance from the
hospital or an existing Polyclinic, availability of the space, perceived need of the
community.
• The specialist clinic can be operationalized through the State or be a RKS
initiative.
• The Logistics will be guided by the specialty chosen.
• In case sufficient space is not available the separate PUHCs may host different
specialist clinic and the information regarding the same may be disseminated to
the linked PUHCs.
vi. Evening OPDs might be conducted in PUHCs where a significant portion of
catchment population cannot access the health facility during morning hours.
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Selection of PUHCs for evening OPDs shall be guided by its proximity to
Slums, JJ Clusters, Industrial areas, absence of any other service provider in
the vicinity like ESI dispensary etc.
Services: The evening OPD shall provide all services except the Lab services.
The weekly ANC clinics, Well baby Clinics, etc shall continue to be a part of
morning shift but all pregnant women and children coming to evening OPDs
must be registered / examined and provided appropriate care. One out of the
two immunization days of the week can be conducted in evening OPD.
Timings of OPD: 2 pm to 8 pm.
The Staff for the evening OPD shall be over and above that for a PUHC. This
shall include - one Medical Officer, one Pharmacist, one ANM, one Nursing
Orderly and one CDEO cum assistant. SCC is already present in the evening
shift. The entire staff be pooled and will do evening shifts by rotation.
Logistics: No separate Logistics are required.
This activity may be facilitated and monitored through the Rogi Kalyan Samitis.
vii. Geriatric care: Special emphasis shall be there for taking care of the senior
citizens visiting the health centre. From having user friendly access, freedom
from long waiting queus, assistance in obtaining and understanding medications
to special assistance like that in obtaining dentures / spectacles etc. In providing
this special assistance, Rogi Kalyan Samiti can play an important role.
• Safe and affordable transport to the PUH centre shall be available for all,
especially for the older persons, whenever possible, by using a variety of
community-based resources, including volunteers.
• Simple and easily readable signage shall be posted throughout the PUHC
centre to facilitate orientation and personalize providers and services.
• Key PUHC staff shall be easily identifiable using name badges and name
boards.
• The PHC facility shall be equipped with good lighting, non-slip floor surfaces,
stable furniture and clear walkways, comfortable seating facility.
II. Centre based Preventive and Promotive services
a. Maternal and Child Health Care:
i. Antenatal care:
• Early registration of all pregnancies with a duly filled ANC Card ideally in the first
trimester (before 12th week of pregnancy) and provision of antenatal care
appropriate to gestation.
• Minimum 3 antenatal checkups, appropriately timed as per RCH guidelines and
provision of complete package of services. Registration as soon as pregnancy is
Accreditation Standards for Primary Urban Health Centre
detected, preferably within first trimester, Provision of associated services like
providing iron and folic acid tablets, injection Tetanus Toxoid etc.
• Laboratory investigations -- hemoglobin, urine albumin and sugar.
• Nutrition and health counseling
• Identification of high-risk pregnancies / appropriate management. Referral to
First Referral Units (FRUs) / other linked hospital for high risk pregnancy.
ii. Preparation / planning for delivery in an institution.
iii. Postnatal care
• A minimum of 2 postpartum home visits, first within 48 hours of delivery, 2nd
within 7 days
• Initiation of early breast-feeding within half-hour of birth
• Education on nutrition, hygiene, contraception, essential new born care (As per
Guidelines of GOI on Essential new-born care)
• In case of availability of special schemes for pregnant women -- JSY,
MAMTA Scheme, Ladli Scheme the same shout be publicized through the
centre and the ANM / ASHA shall facilitate utilization of these benefits by the
eligible beneficiaries.
iv. Care of the child:
• Emergency care of sick children including Integrated Management of Neonatal
and Childhood Illness (IMNCI) during the working hours.
• Care of routine childhood illness.
• Essential Newborn Care (the staff / centre shall be equipped to give basic
essential newborn in case a new born is brought to the centre or a home
delivery takes place in the catchment area).
• Promotion of exclusive breast-feeding for six months.
• Full immunization of all infants and children against vaccine preventable
diseases as per guidelines of GOI / State.
• Vitamin A prophylaxis for the children as per guidelines.
• Prevention and control of childhood diseases, infections.
B. Adolescent Health Care: Special emphasis on detection and management of
nutritional disorders and high risk behaviour. Life skill education, counseling and
appropriate treatment.
C. Management and Prevention of Reproductive Tract Infections / Sexually
Transmitted Diseases: Treatment of Reproductive Tract Infections and
Sexually Transmitted diseases and health education for prevention of RTIs /
STDs
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D. Family Planning:
i. Education, Motivation and counseling to adopt appropriate Family planning
methods.
ii. Provision of contraceptives such as condoms, oral pills, emergency
contraceptives.
iii. Carry out IUCD insertions.
iv. Follow up services to the eligible couples adopting permanent methods
(Tubectomy / Vasectomy).
v. Counseling and appropriate referral for safe abortion services (MTP) for those in
need.
vi. Counseling, workup and appropriate referral for couples having infertility.
E. Implementation of National Health Programmes:
a. Integrated Disease Surveillance Project (IDSP)
Disease Surveillance and Control of Epidemic
i. Alertness to detect unusual health events and take appropriate remedial
measures
ii. Disinfection of water sources
iii. Testing of water quality using H2S Strip Test (bacteriological)
iv. Promotion of sanitation including use of toilets and appropriate garbage
disposal.
b. Revised National Tuberculosis Control Programme (RNTCP)
i. All PUHCS to function as DOTS Centers to deliver treatment as per RNTCP
treatment guidelines through DOTS providers.
ii. Treatment of common complications of TB and side effects of drugs.
iii. Record and report on RNTCP activities as per guidelines.
c. National Programme for Control of Blindness (NPCB)
i. Basic services: Diagnosis and treatment of common eye diseases.
ii. Screening for refraction disorders and referral for Refraction study.
iii. Detection of cataract cases and referral for cataract surgery.
d. National Vector Borne Disease Control Programme (NVBDCP):
i. Diagnosis of Malaria cases, Microscopic confirmation and treatment.
ii. Cases of suspected Dengue, Chikungunia to be provided symptomatic
treatment, referral for hospitalization and case management as per the
protocols.
Accreditation Standards for Primary Urban Health Centre
iii. IEC Activities regarding spread and prevention, symptoms of VBDs to enable
early detection of disease and its complications.
iv. Elimination of Vector breeding sites.
e. National Leprosy Elimination Programme (NLEP):
i. Identification of leprosy patients on basis of clinical examination.
ii. Referral of the patients to secondary care level when required - doubtful clinical
diagnosis requiring investigations, complicated cases, severe drug reaction etc.
iii. Complete treatment with Multi Drug Therapy.
iv. Information, Education and Communication (IEC) activities.
v. Rehabilitation / Disability prevention.
f. National Iodine Deficiency Disorder Control Programme (NIDDCP):
i. Goitre detection and appropriate management / referral.
ii. Urine iodine estimation in children aged 6-12 yrs.
iii. Salt iodine estimation of salt samples collected from household.
iv. IEC activities to create awareness of lodine deficiency disorders.
g. National AIDS Control Programme (NACP):
i. IEC activities to enhance awareness and preventive measures about STIs and
HIV / AIDS, Prevention of Parents to Child Transmission (PTCT) services.
ii. Screening of persons practicing high-risk behaviour at the nearest ICTC.
iii. Risk screening of antenatal mothers with one rapid test for HIV from linked
ICTC.
iv. Linkage with Microscopy Centre for HIV-TB co-ordination.
v. Condom Promotion & distribution of condoms to the high risk groups.
vi. Help and guide patients with HIV/AIDS receiving ART.
f. Provision of Essential Laboratory Services:
1. H b%, TLC
2. Blood Sugar
3. VDRL
4. Urine Albumin, Sugar and Microscopy
5. Urine Pregnancy Test
6. Stool Microscopy
7. Diagnosis of RTI / STDs with wet mounting, Grams stain, etc.
8. Blood smear examination for malarial parasite
@ National Accreditation Board for Hospitals and Healthcare Providers 73
Accreditation Standards for Primary Urban Health Centre
@ National Accreditation Board for Hospitals and Healthcare Providers74
9. Tests specified as a part of IDSP
g. Radiological Services
a. X RAY
• Plain and Computed Radiography
• Contrast studies like Barium swallow, Barium meal, follow through and Barium
enema; IVU; RGU / MCU; HSG ; water soluble contrast studies for GIT;
Fistulograms: Sinograms
b. ULTRASONOGRAPHY
• General Abdominal and Pelvic studies.
• Obstetrical and Gynecological including endovaginal exams, TIFFA
• Soft tissue and superficial structures including Breast, Thyroid, Scrotal and
Transrectal Prostate examinations.
• Pediatric and Neonatal studies.
• Musculoskeletal examinations such as Hips, Shoulders and Knees.
c. DOPPLER STUDIES (if available)
• Peripheral, Cerebro-vascular and abdominal Doppler.
• Assessment of post Kidney and Liver Transplant patients.
• Penile Doppler examination
Accreditation Standards for Primary Urban Health Centre
CLINICAL SERVICES IN OUTREACH
One ANM is assigned to each 10,000 population. She will carry out the household survey of
her assigned area and also prepare and maintain the eligible couple registers. At any given
time she will know about the individuals / families requiring help i.e. pregnant women / the
children requiring immunization, patients with TB. Leprosy on MDT, the cataract cases
requiring surgery, households requiring Chlorine drops to make drinking water safe, families
eligible for special health schemes - JSY, MAMTA, LADLI.
Need for Outreach Clinical services: Although in an urban setting the distances are
relatively smaller, the terrain easy and transport more easily available, there might be areas /
situations / certain specific vulnerable groups which might require provision of outreach
services. Constraints like pre-occupation of the habitants with earning a livelihood, women
and children of a particular segment finding it difficult to access a Health Centre in absence
of a male attendant create a need for outreach activities to reach these beneficiaries. Such
outreach activities are especially required in the slums, JJ clusters, resettlement colonies,
unauthorized colonies and villages.
These can be carried out in two forms:
i. Periodic Health & Nutrition Days: Without setting up any fixed units like sub centres,
health posts etc, outreach activities can be in the form of regular Health and Nutrition
days, Immunization sessions. This activity shall be structured with prescribed
manpower and equipment and will be amenable to objective assessment in terms of
the services being provided, both quantitatively and qualitatively. PUHC will be
responsible for conducting this activity in its catchment area. The staff and logistics will
flow from the PUHC.
ii. By setting up a fixed Outreach Centre: Setting up of fixed outreach centers ie. sub
centre / health post like structure for every 5000 to 6000 population is not mandated
and is only recommended on a felt need basis. Experience has shown that setting up
of these structures and making them optimally functional is not an easy task and many
times not cost effective or even workable in overcrowded slums / constantly shifting JJ
clusters. Also, smaller distances and easier terrain obviate the need for setting up of
these structures on every five to six thousand population.
However in the initial phase till the required number of PUHCs is made available with
equitable distribution, a fixed outreach centre may be required in certain areas guided by the
distance of the habitation / cluster from the nearest PUHC. An already existing structure i.e.
a willing mother anganwadi / extant subcentre / health outpost of MCD / IPPVIII / Basti Vikas
Kendra may be used for this purpose. In such a case while making the PUHC health action
plan this activity may be reflected and requirements in terms of necessary logistics may be
projected in the plan.
@ National Accreditation Board for Hospitals and Healthcare Providers 75
Accreditation Standards for Primary Urban Health Centre
@ National Accreditation Board for Hospitals and Healthcare Providers76
IMMUNIZATION SCHEDULE
VACCINES
Birth6
Weeks 10
Weeks 14 wks 9 mths 15 mths 2 to 5 yrs
PRIMARY VACCINATION
BCG X
Oral Polio X X X X
DPT X X X
Hepatitis B X X X X
Measles X
MMR X
Typhoid X
BOOSTER DOSES
Oral Polio + DPT 16 months to 24 months
DT 5 years
Tetanus Toxoid At 10 years and again at 16 years
Typhoid 2 years the first dose
Vitamin A 9, 18, 24, 30, and 36 months.
PREGNANT WOMEN
Tetanus Toxoid (PW)
First Dose as early as possible during pregnancy after 1st trimester
Second dose 1 month after first dose
Booster if previously vaccinated within 3 years
Immunization schedule may get modified with introduction of newer vaccines in the National
/ State immunization programme.
Accreditation Standards for Primary Urban Health Centre
CONVERGENCE WITH RELATED SECTORS
a. Nutritional Services (in convergence with ICDS)
i. All the anganwadis in the catchment area must be identified and mapped. There
shall be functional Iiason between the ANM and the the Anganwadi worker in
the area.
ii. Diagnosis of and nutrition advice to malnourished children, pregnant women and
others.
iii. Diagnosis and management of Anemia and Vitamin A deficiency.
iv. Coordination with ICDS. A child / woman / adolescent diagnosed as
malnourished / anemic in the health and nutrition day / or in the PUHC to be
attached to the anganwadi and systematically monitored. MO / ANM / ASHA /
AWW to take responsibility.
b. Health of School going Children:
All Schools in the catchment area to be mapped. Children referred from the school
for investigations, management to be taken care of. Participation in school health
fairs, monitoring activities if required.
c. Health of School dropouts / Children not going to School
Identification of children not going to schools through ASHAs and facilitating their
health checkup.
d. Promotion of Safe Drinking Water and Basic Sanitation
ANMs / ASHAs / Health & Sanitation Committees to find local solutions with the help
of provisions under State Health Mission and Departments of Health / Water &
Sanitation. All PUHCs to have sufficient stock of Chlorine Tablets / drops. All ASHAs
to be given adequate stock of Chlorine Tablets / drops.
@ National Accreditation Board for Hospitals and Healthcare Providers 77
Accreditation Standards for Primary Urban Health Centre
@ National Accreditation Board for Hospitals and Healthcare Providers78
STRENGTHENING OF REFERRAL SYSTEM
Referral services from operational point of view could be primary health care, medical care,
secondary, tertiary and apical care. Referrals are defined as a system by which patients
while undergoing treatment by a doctor are given facilities from the hospital to avail the
specialized consultation, medical care, ancillary services etc. wherever required. The
cardinal feature of referral system is that the individual continues to be the patient of the
doctor whom he consulted first.
Existing hospitals, including Urban Local Body maternity homes, state government hospitals
and medical colleges, apart from private hospitals will be empanelled / accredited to act as
referral points for different types of healthcare services like maternal health, child health,
diabetes, trauma care, orthopedic complications, dental surgeries, mental health, critical
illness, deafness control, cancer management, tobacco counseling / cessation, critical
illness, surgical cases etc.
There might be different and multiple facilities for the different healthcare services,
depending upon type of hospitals available in the city. This will not only ensure flexibility to
adapt to different conditions in different cities but also increase the range of options for the
beneficiaries.
The empanelled / accredited facilities would be reimbursed for the services provided as per
the pre-decided rates, negotiated with them at the time of empanelling / accrediting them.
The rates will be determined by the consultations undertaken during preparation of the PIPs
and based on the National Commission on Macroeconomics and Health report.
For empanelled government facilities, apart from District / Sub-District Hospitals (being
supported under NRHM), Rogi Kalyan / Hospital Management Societies will be funded (per
case basis including support for referral transportation), which will be utilized for
providing cash-less services to urban poor covered under NUHM.
Such empanelled hospitals, which do not have hospital management societies, will be
required to form such societies to be eligible for receiving the funding support. During the
field visits it was observed that many of ULBs have maternity homes functioning with heavy
case load but inadequate infrastructure, therefore it is proposed to support the existing
maternity hospitals on a city specific case to case basis as referrals for maternal and child
care.
The referral services will be cash-free for the beneficiary and will be financed by community
health insurance or voucher scheme as per the PIP developed for the city.
All engagements would be contractual with no permanent liability to Government of India.
Collaboration with local Medical Colleges may be promoted for strengthening the training
support and supplement human resource at the PUHC level.
Accreditation Standards for Primary Urban Health Centre
The Commandments for referral system are-
• Unified system of records appropriate to each level of medical care in the area shall
be developed. These records would entail referral registers, referral cards/referral
slips and patient history cards. These basic records shall be of the same type in all
institutions in a given area. Records shall ultimately reflect flow of patients from the
periphery to the institutes of middle order or higher order.
• The records shall also be able to give information on the investigations and
treatment given to a patient in an institution where he has been referred. After due
treatment has been given to the patient, the patient records shall move back to the
referring agency/ doctors etc. and the patient records shall reflect the diagnosis
and treatment suggested to enable the referring physicians to carry out the follow
up. The importance of such records cannot be over emphasized as these records
form the basis for the functioning of the referral service system.
• Whenever a patient is referred to an institution there shall be arrangements for
identification of the patient so that the patient does not get lost in general crowd
attending a large hospital. This can be achieved through distinct and identifiable
referral cards and having local arrangements for the reception of these patients.
The details of the modality of such reception system can be worked out by each
institution depending upon the local circumstances.
• In some bigger hospitals there may be need for having a separate reception
counter for referred cases if the workload justifies. In others there may not be a
separate reception counter, but some system of segregating referred patient from
the general patients shall be instituted. It would not suffice to identify these patients
when they are referred to an institution. Arrangements must be made to give little
priority to these patients in so far as diagnosis and treatment is concerned. The
dictum is to treat referral cases as VIP.
• Ideally all the patients who are referred shall be provided some transport facility to
reach the institution where they have been referred.
• Perhaps it would not be practical and neither feasible to undertake the
transportation of these patients by the medical organizations. However, all
emergencies which are referred to various institutions as far as possible must be
direct responsibility of medical institutions. For other deserving cases voluntary
organizations may be involved in the transportation process.
• For instance, cooperation could be sought from the NGO’s to provide transportation
to the patients residing in the interiors at least once a week. It has been observed
that absence of transportation facility hampers the flow of poor and emergency
patients from the periphery to the institutions of high order and visa versa. Unless
some provisions are made in this regard the system is not likely to work.
• The patients shall have the choice to choose their own entry points in the referral
services system, but once the patients enter a particular entry point further referral
@ National Accreditation Board for Hospitals and Healthcare Providers 79
Accreditation Standards for Primary Urban Health Centre
@ National Accreditation Board for Hospitals and Healthcare Providers80
to the institutions of higher order or peripheral institutions shall be regulated by the
system.
• The referral service system will not work unless all the professionals located in all
the segments of the medical care organization understand and appreciate the
importance of the referral services system. To include the importance of this
system all the professionals in various organizations need to be developed into one
team of workers whose members are located in different organizations. Team
building does not come on its own or through office orders. It can only be achieved
through a process of in service education, continuous meetings and reinforcing the
importance and the use of the referral services system. It is therefore
recommended that efforts in this direction be made at all levels of the referral
service system.
• In an ideal referral system not only the patients move from one segment of the
organization to another, the movement of specialists from the institutions of higher
order to the more peripheral institutions is also an integral part of the system. This
will not only enable the patients to get specialist advice near their homes but also
would act as an educational tool for the professionals who are working in the more
peripheral institutions. The added advantage of the flow of specialist to the
periphery is the understanding of the working conditions in the periphery as well as
understanding of the problems of the population which is located in the rural areas.
The community orientation of the professionals is one of the essential features of
the referral service system.
• For provision of transport in emergency cases, the golden rule of “1 hour” needs to
be kept in mind. The ambulance shall be used for transporting patients only and
not staff, materials etc.
• Transportation of referred cases particularly emergency or serious cases generally
poses problems. While steps to smoothen such situations shall be initiated, it is
worthwhile to consider active involvement of the community in this regard.
• The immediate practical steps like convincing the community about the importance
of referral and need for its support through transport facilities, making them aware
of their role and responsibility towards their own healthcare, helping them in
organizing locally suited transport system village based or sub-centre based and
enabling them in its effective management etc., need to be initiated by health staff.
• Active involvement of community must be considered. Interalia to transport system,
development of communications (telephone, intercom, cellular, pager etc.) be
considered.
• It shall be emphasized that referral system is a two-way process and that retention
of patients in a referral institution shall be as brief as possible.
Accreditation Standards for Primary Urban Health Centre
Acute Conditions / Trauma:
Appropriate and prompt referral of case needing hospital care including:
• Stabilization of patient.
• Appropriate support for patient during transport.
• Providing transport facilities either by ambulance or other available referral transport.
Chronic Conditions requiring referral for Specialist Consultation / Care:
• Complete referral slip (including history / examination / differential diagnosis / tests &
treatment done till date) shall be made.
• Subsequent Follow-up of these case and care as per the plan of action outlined by
the consultant. Liasoning with the referral institutions identified for PUHC area.
Having a two way linkage with the concerned officials of the referral centre.
Indicative Service Norms by levels of Service Delivery*
Levels of Service delivery
Services**Community (Outreach)
First point of service
delivery (PUHC)
Referral Centre - RC
(Specialist services)
A. Essential Health Services
Maternalhealth
Registration, ANC,
identification of danger signs, referral for institutional delivery, follow-up.
Counseling and behaviour
promotion
ANC, PNC, initial management of complicated delivery cases and referral, management of regular maternal health conditions,
referral of complicated cases
Delivery (normal and complicated), management of
Complicated gynae /maternal
health condition, hospitalization and surgical interventions, including blood transfusion.
Familywelfare
Counseling, distribution of
OCP/CC, referral for
sterilization, follow-up of
contraceptive related
complications
Distribution of OCP/CC, IUD insertion, referral for sterilization, management of contraceptive related
complications
Sterilization operations, fertility
treatment
Child health and nutrition
Immunization,identification of danger signs, referral, follow-up, distribution of ORS, pediatric cotrimoxazole post-natal visits / counseling for newborn care
Diagnosis and treatment of
childhood illnesses, referral of acute cases / chronic illness Identification and
referral of neonatal sickness
Management of complicated
Pediatric / neo-natal cases, hospitalization, surgical interventions, blood transfusion
@ National Accreditation Board for Hospitals and Healthcare Providers 81
Accreditation Standards for Primary Urban Health Centre
@ National Accreditation Board for Hospitals and Healthcare Providers82
RTI/STI
(including HIV/AIDS)
Symptomatic search, referral, community level follow-up for ensuring adherence to treatment regime of cases undergoing treatment
Diagnosis and treatment, referral of complicated cases
Management of complicated cases, hospitalization (if needed)
Nutrition
deficiencydisorders
Height/weight measurement,
Hb testing, distribution of
therapeutic doses of IFA,
promotion of iodized salt,
nutrition supplements to
identified children and
pregnant/ lactating women Promotion of breast feeding,
complementary feeding for
prevention of under-nutrition
Diagnosis and treatment of seriously deficient patients,
referral of acute deficiency cases. Early identification of mild and severe under-nutrition, counseling for optimal feeding practices or
referral
Management of acute deficiency cases, hospitalization
Treatment and rehabilitation of
severe under-nutrition
Vector-borne
diseases
Slide collection, testing using
RDKs, DDT ,chemical,
biological larvicides etc
Counseling for practices for
vector control and protection
Diagnosis and treatment, referral of terminally ill cases
Management of terminally ill cases, hospitalization
Mental Health
Case detection and referral,
counseling, rehabilitation
Diagnosis and treatment
Psychiatric and neurological services, including hospitalization, if needed
Oral Health
Basic dental education,
screening for precancerous
lesions, referrals
Diagnosis and treatment
Management of complicated cases, hospitalization (if
needed)
A7.2Hearing
Impairment/
Deafness
Early detection and awareness
for preventive steps/actions,
referral
Diagnosis and treatment
Management of complicated cases, hospitalization (if
needed)
Chestinfections
(TB/ Asthma)
Symptomatic search and
referral, ensuring adherence to
DOTs, other treatment
Diagnosis and treatment, referral of complicated cases (MDR, reactions,
terminal illness)
Management of complicated cases
Cardio- BP measurement, Diagnosis and Management of emergency
Accreditation Standards for Primary Urban Health Centre
vascular
diseases
symptomatic search and
referral, follow-up of under treatment patients
treatment, emergency resuscitation, referral of cardiac
emergencies cases
cases, hospitalization and
surgical interventions (if needed)
Diabetes
Blood/urine sugar test (using
disposable kit), symptomatic
search and referral, follow-up
of under-treatment patients
Diagnosis and treatment, referral of complicated cases
Management of complicated cases, hospitalization (if
needed)
Cancer
Symptomatic search and
referral, follow-up of under treatment patients
Identification and referral, follow-up of under-treatment patients
Diagnosis, treatment,
hospitalization (if and
when needed)
Trauma care
(burns & injuries)
First aid and referral
First aid , emergency
resuscitation, documentation for MLC (if applicable) and referral
Case management and hospitalization,physiotherapy and rehabilitation
Other surgical
interventions--- not applicable ---
Identification and referral
Hospitalization and surgical interventions
B. Other support services
IEC/BCC
IPC, Health Camps / fairs,
performing arts, wall/poster
writing, events (in schools,
women’s groups)
Distribution of health
education material
Distribution of health
education material
Counseling
Individual and group/family
counseling – HIV / AIDS / Mental disorders / stress management / Tobacco /Alcohol. Substance abuse
Patient / attendant counseling
Patient / attendant counseling
Personal & Social
Hygiene
IEC on hygiene, community
mobilization for cleanliness
drives, disinfection of water
sources, etc.
--- not applicable --- --- not applicable ---
*Norms adapted from NCMH Report ** Services based on situational analysis
@ National Accreditation Board for Hospitals and Healthcare Providers 83
Accreditation Standards for Primary Urban Health Centre
@ National Accreditation Board for Hospitals and Healthcare Providers84
HUB & SPOKE MODEL OF REFERRAL SYSTEM
PRIMARY URBAN HEALTH
CENTRES / DISPENSARIES
SECONDARY CARE HOSPITALS
TERTIARY CARE HOSPITAL
Accreditation Standards for Primary Urban Health Centre
@ National Accreditation Board for Hospitals and Healthcare Providers 85
REFERRAL SLIPS
(NAME & LOCATION OF PRIMARY URBAN HEALTH CENTRE)
REFERRAL SLIP
Referred from:
Casualty /OPD /C.R. No. ---------------------------------------------------------------------
Name: -------------------------------------------------------------------- Age ------------ Sex ---------------
W/o, D/o, S/o: ---------------------------------------------------------------------------------------------------
Address (complete) : ------------------------------------------------------------------------------------------
----------------------------------------------------------------------------------------------------------------------
H.O.P. I. : --------------------------------------------------------------------------------------------------------
----------------------------------------------------------------------------------------------------------------------
Investigations: --------------------------------------------------------------------------------------------------
----------------------------------------------------------------------------------------------------------------------
Treatment given: -----------------------------------------------------------------------------------------------
----------------------------------------------------------------------------------------------------------------------
Diagnosis: -------------------------------------------------------------------------------------------------------
----------------------------------------------------------------------------------------------------------------------
Referred to Senior Resident: -------------------------------------------------------------------------------
Hospital: ----------------------------------------------------------------------------------------------------------
Name:------------------------------------------------ Signature: ------------------------------------
Date: ------------------------------------------------- Designation: ---------------------------------
Accreditation Standards for Primary Urban Health Centre
@ National Accreditation Board for Hospitals and Healthcare Providers86
(NAME & LOCATION OF PRIMARY URBAN HEALTH CENTRE)
REFERRAL SLIP
asualty /OPD /C.R. No. ------------------------------------------------------------------------------------
ame: ------------------------------------------------------------------- Age ------------ Sex ---------------
/o, D/o, S/o: --------------------------------------------------------------------------------------------------
ddress (complete) : -----------------------------------------------------------------------------------------
----------------------------------------- Designation: ---------------------------------
Referred from:
C
N
W
A
----------------------------------------------------------------------------------------------------------------------
H.O.P. I. : --------------------------------------------------------------------------------------------------------
----------------------------------------------------------------------------------------------------------------------
Investigations: --------------------------------------------------------------------------------------------------
----------------------------------------------------------------------------------------------------------------------
Treatment given: -----------------------------------------------------------------------------------------------
----------------------------------------------------------------------------------------------------------------------
Diagnosis: -------------------------------------------------------------------------------------------------------
----------------------------------------------------------------------------------------------------------------------
Referred to Senior Resident: -------------------------------------------------------------------------------
Hospital: ---------------------------------------------------------------------------------------------------------
Name:------------------------------------------------ Signature: ------------------------------------
Date: --------
Accreditation Standards for Primary Urban Health Centre
@ National Accreditation Board for Hospitals and Healthcare Providers 87
CAPACITY BUILDING & TRAINING OF STAFF
The increasing pace of technological change is perhaps the single biggest impetus for
training & capacity building in healthcare. Training & Capacity Building is essential because
technology is developing continuously at a very fast pace. The systems and practices that
w
discoveries
aspects,
ca h
their career plans. Capacity Building and Training is a part of
a
It r
S
employee and the client. The management shall coordinate and provide comprehensive
in n
te ll
employees
Many researches have e
m
could work at 80-90% of their capacity. Behavioural Science concepts like motivation and
g n
su
A s
a
reinforce the learning and maintain the desired behaviour.
It is essential that each
a
G g methods can be used with different categories of
staff. Some of this are:
ectures
Conferences, projects, panels, etc
Case studies
Role playing, demonstrations and skills etc.
ere in operation a few months ago are no more considered effective due to new
and technology. These discoveries in new technology deal with conceptual
technical aspects, managerial aspect as well as human aspect. A good training &
pacity building system also ensures that employees develop in directions congruent wit
management development and
lso a form of organizational development.
is important for the management to devise a cohesive Infrastructure and Action Plan fo
taff Education, training and development to meet the established needs of both the
ternal training programmes that would encompass the requirement of the organization i
rms of policy, procedure and skill as well as the aspirations, abilities and needs of a
stimated that the average employee in an organization is working at
uch less than his capacity potential. If these employees can be properly motivated, they
ood human relations shall be used. Training could be one of the main instruments to attai
ch improvement.
lso, employees who are well trained produce superior performance, which in turn require
minimum of supervision and correction. Training must be continuously repeated to
staff job group in the Hospital shall have a training road map that is
ppropriate to his needs.
eneral Capacity Building and Trainin
L
Workshops
Accreditation Standards for Primary Urban Health Centre
@ National Accreditation Board for Hospitals and Healthcare Providers88
M
he model depicted below portrays a structure for moving staff to a level of competence and
odel for Staff Development Process
T
confidence in their work. The model includes six steps beginning with the manager clarifying
expectations of the employee (learner). Second, an employee’s manager and the staff
development educator assist the employee in identifying his or her learning needs. Third, the
staff development educator identifies learning resources appropriate to meet the learner’s
needs. Fourth, the learner participates in the appropriate learning experience. Fifth, the
learner receives coaching and validation in the new knowledge or skill in the work setting.
Sixth, the learner obtains feedback from his or her immediate supervisor. The model
continues with step 1 as new learning needs are identified.
All Clinical & Paramedical staff of Primary Urban Health Centre has to be updated in their
asic skills. The training shall be held regularly and on the job assessment shall be an
Induction and refresher trainings of ASHAs have to be undertaken. Ongoing support in the
ded through formation of Mentor groups.
b
essential part of routine monitoring.
field has to be provi
Accreditation Standards for Primary Urban Health Centre
@ National Accreditation Board for Hospitals and Healthcare Providers 89
BEHAVIOUR CHANGE COMMUNICATION
Behavior change has become a central objective of public health interventions over the last
half decade, as the influence of prevention within the health services has increased. The
increased influence of prevention has coincided with increased multi-lateral and bi-lateral aid
in the area of human development, and the increased need for the international development
community to show cost-effectiveness for allocated money spent.
Behavior change programs, which have evolved over time, encompass a broad range of
ctivities and approaches, which focus on the individual, community, and environmental
influences on behavior.
Behavior change programs usually focus on activities that help a person or a community to
reflect upon their risk behaviors and change them to reduce their risk and vulnerability are
known as interventions.
Sensitization of
1. Service Providers: For patient friendly behaviour, client – centered services and
treatment of patients with dignity and respect
2. Community: On influencing the health seeking behaviour of potential beneficiaries
and orient them towards seeking safe and rational health care. There will be a focus
towards making the community aware about the available health services.
3. Specific Issues: The BCC activities will be focused to create awareness in the
community on specific diseases like malaria, TB, Diarrhea, Non Communicable
diseases like Coronary Heart Disease, Diabetes Mellitus and Cancer etc. Women
and Children will be specifically targeted.
a
INFORMATION, EDUCATION & COMMUNICATION (IEC)
formation, Education and ComIn munication (IEC) are essential component of any
C programme’s accent so far has been on awareness generation about the programme
nd service facilities, with the presumption that this would ensure adequate utilization. IEC
aterials were produced and activities developed on mass scale to reach out to people with
essages on health and population issues.
s have surely raised information and awareness levels but have fallen short in
hanging behaviours and attitudes. It is increasingly becoming evident that if a change in
development programme. IEC is a strategic approach to health communication that uses
information and education materials and activities to generate awareness and influence
ealth practices.h
IE
a
m
m
These effort
c
Accreditation Standards for Primary Urban Health Centre
@ National Accreditation Board for Hospitals and Healthcare Providers90
a provider level and at manufacturer level
w ecific, client-centered IEC strategy that
ddresses the individual, group and creates a supporting and enabling environment.
s and graduate towards
ehaviour and social change.
would include evidence based meticulously packaged information
omponent, and a simple mode of communication so that the target group can understand
• The population to be targeted, their problems of public health and family health
information, awareness and behaviour message content, structure and
propriate products and activities,
hieve this
ifically address the following aspects of
the behaviour:
awareness about the health services
• s and with the help of
ttitude and behaviour is desired, at user level, at
e need a need-based, demand-driven, area-sp
a
IEC has a major role to play in creating demand by repositioning the accessibility and
availability of services and the service provider’s image in such a way that it would match
people’s perspectives and needs. Information alone is not sufficient to change behaviour, we
need to work beyond information and awareness parameter
b
IEC for Primary Urban Health Centre requires a clear, holistic and (creative, cultural, gender)
sensitive perspective. It
c
and use the information easily resulting in desired healthy behaviour practices. This
necessarily has focus on four essential elements:
• The health
form
• The creation and dissemination of culturally ap
• The facilitation of behaviour change through creation of a supportive environment
Each of these components needs to be fully and accurately understood. To ac
goal, it would require clearly defined project objectives, a strong organizational structure, a
sound training programme and a positive attitude of those involved in policy formulation and
implementation of the programmes.
The BCC & IEC strategy at PUHC would spec
• Sensitizing providers for friendly behaviour with patients
• Promoting provider behaviour for rational drug use and adequate prescriptions
• Facilitating community to demand services by service providers
• Improving
• Promoting correct perception about the gravity of different types of sickness
• Reducing the perceived quality gap though better communication
• Promoting cleanliness, proper waste disposal, and prevention of diseases
Organizing of the camps / campaigns / outreach activitie
ASHAs ensure active participation by the community.
• Celebration of health days and weeks and publicity programmes al local fairs on
market days etc.
Accreditatio
@ Natio
n Standards for Primary Urban Health Centre
nal Accreditation Board for Hospitals and Healthcare Providers 91
• Mass communication programmes like film shows, exhibition, lectures and dramas,
with the help of the District BCC officer.
• Maintaining a list of prominent acceptors of family planning methods and opinion
leaders and will try to involve them in the promotion of Health and Family Welfare
programmes.
• Orientation training for Health and Family Welfare workers, opinion leaders, local
medical practitioners, school teachers, dais and others involved in Health & Family
Welfare work. Arrange group meetings with the leaders and involve them in
of BCC activities in the PUHC area.
• Make sure that IEC and BCC activities cover the entire population through map
spreading the message for various health programmes. He / she will organize health
education sessions in schools and for out of school youth.
• Organize and utilize Mahila Mandal, teachers and other women including ICDS
personnel in the community in various National Health Programmes.
• Preparing a monthly report on the progress
based micro planning.
BEHAVIOUR CHANGE COMMUNICATION MATRIX
BEHAVIOUR CHANGE COMMUNICATION MATRIX
S.NO. PRACTICES SEGMENT BEHAVIOUR CHANGE MESSAGE THEME MEDIA CHANNEL INDICATOR
1.
Utilization of public
health services
Urban Demanding Reasonable
we believe in
h
UHC
Scroll
Radio
Poste
Inform
Broch
TV sp
Healt
board
Jingles
rs
ation booklet
ures
ots
Insurance
PBelieve in our services as
you! Statistics
2. Drinking water Urban Aware Reinforce measuresWater for survivapurified watebeing!
ater
cide
TV sp
Hoard
Bus p
Kiosk
ots
ings
anels
s
W
In
l,r for well
borne d
nce rate
isease
3.Sanitarypractices
UrbanHygiene conscious
ReiterateCleanliness is healthiness!
sea encte
TV sp
Wall
Bus p
Kiosk
ots
Writings
anels
s
Dira
se Incid e
4. Injury UrbanPrompt health seeking behaviour
Seek public health services
Holistic services from womb to tomb… a we care
sUHC ion
News
Kiosk
papers P Utilizat rate.bec use
5. Poisoning UrbanSkeptical about MLC
Awareness of the importance of seeking immediate, trained and reliable medical help
Trust us……we’l nlet you down!
pap UHC ion l wo ’t
ers P rateNews Utilizat
6. Snake bite UrbanSeek help from nearest hospital
Mobilization towards public services
Anti snake bite v monly available hethink…just act!
N pap UHC ion enore D
is on’t ers Pews Utilizat rate
n Standards for Primary Urban Health Centre
nal Accreditation Board for Hospitals and Healthcare Providers 83
COLOUR CODE YELLOW BAG
BLUE/WHITE
PUNCTURE
PROOFCONTAINER
BLACK BAG RED BAG
TREATMENTOPTION
INCINERATION AUTOCLAVING/SHREDDING
SHREDDING DISPOSAL
AUTOCLAVING/SHREDDING
WASTECONSTITUENTS
LABEL FOR BIO-MEDICAL WASTE
CONTAINERS/BAGS
BIOHAZARD SYMBOL
HUMAN ANATOMICAL WASTE – TISSUES,
ORGANS, BODY PARTS, PLACENTA OR ANY OTHER
MATERIALS WHICH WAS ONCE A PART OF THE
BODY.
MICROBIOLOGY AND BIOTECHNOLOGY WASTE,
HISTOPATHOLOGY SPECIMEN,
SOLID WASTE ITEMS CONTAMINATED WITH
BLOOD & BODY FLUIDS LIKE COTTON, SWABS,
DRESSINGS,
SANITARY PADS, LINEN ETC.
DISCARDED MEDICINES/ CYTOTOXIC DRUGS
SHARP WASTES HYPODERMIC
NEEDLES
SYRINGES
SCALPELS
LANCETS
BLADES.
BROKEN GLASS
ALL SOAKED IN 1% HYPOCHLORITE SOLUTION AND
TAKEN FOR SHREDDING AND FINAL DISPOSAL.
WRAPPING MATERIAL, PAPER,
CARD BOARD PLASTIC BAGS, DISPOSABLE GLASS & PLATES,
METAL CANS,FLOWERS
KITCHEN WASTE
LEFT OVER FOOD
(TAKEN AWAY BY LOCAL AUTHORITIES
FOR DISPOSAL)
IV TUBINGS/ CATHETERS/
IV SETS/ URINE BAGS/ DIALYSIS KIT/GLOVES/ BLOOD EMPTY BAGS/
SYRINGES SEPARATED FROM BARREL & ALSO
VACUTAINERS WITHOUT NEEDLES CUT INTO PIECES
AT SOURCE OF GENERATION,
PUT IN TO 1% SODIUM HYPOCHLORITE SOLUTION
FOR AT LEAST HALF AN HOUR & TRANSFERRED TO
BAG FOR AUTOCLAVING AND SHREDDING
Accreditatio
@ Natio
BIO MEDICAL WASTE MANAGEMENT
HANDWASHING TECHNIQUES
Accreditation Standards for Primary Urban Health Centre
@ National Accreditation Board for Hospitals and Healthcare Providers 85
MANAGEMENT OF INFORMATION
All health servic nizati the rovide.
Usually, they are on p ca e form
of monthly o rt
This information is supplem s c s and
administrative re Alth iquitous, spread
dissatisfaction with them.
Monitoring systems are multi-functio to monitor whether or not services
are going according to plan by tracking how funds are expended and what activities are
undertaken.
They also n ude m ce is more
often used to describe the process of monitoring disease incidence lth status.
Monitori st also or ds, setting
priorities, a urces and in nci
1. PUHC has a set of periodical reports to be generated as per the formats provided by
the State / the Health Mission.
2. Th at
he
3. As ble
for
4. Each PUHC functionary will have a component to contribut
must be trained and facilitated in collection, compilation, report generation from work
done by
5 MO I/C w fo mp a
reports.
6 Maintena le C,
logistics non he
centre ha d m
7 Recordin : A t on
deaths ta lace in her assign . The a ess of the nearest linked birth /
deaths registration office must be displayed in the centre.
The various parameters for monitoring are-
O ce
AN of preg
e orga
based
rterly
cords.
ons ha
eriodic
s.
ented
ough
ve s
retu
by
such
ystems for monitoring
rns received from health
other sources such a
systems are ub
services they p
re providers in th
ensuses, survey
there is wide
r qua repo
nal. They must help
g of o
ed f
flue
eed to incl
ng systems mu
llocating reso
onitorin
be us
utcomes – tho
other functions
ng change.
ugh
– a
the
sse
term surveillan
and hea
ssing health nee
e rec
alth c
far a
scrut
ords
enter
s pos
iny a
shall be
and thro
sible the
nd use.
mainta
ugh the
record
ined as per guidelines for se
outreach
s and rep
rvices rendered both
terized and easily availa
e in the report. He / She
se
orts
ssio
sha
ns.
ll be compu
them.
ill be r
nce o
(Consu
s to be
g of V
king p
.
.
.
esponsible
f all the re
mables /
maintaine
ital Events
r accuracy / co
vant records con
consumable item
eticulously.
NM must collec
ed area
leteness
cerning se
s) and th
informati
ddr
nd timely
rvices provid
e personnel
on all ma
submission of all
ed in
workin
ternal
PUH
g in t
and infant
PD attendan
C check-up nant women
Accreditation Standards for Primary Urban Health Centre
@ National Accreditation Board for Hospitals and Healthcare Providers86
Tetanus toxoid (2nd dose) coverage among pregnant women
Institutional deliveries
Total number of still births
Complete immunization among children < 12mnths
Number of live births,
Total number of investigations done
Total number of referred cases (BPL referrals)
Patient satisfaction
Case detection for malaria through blood examination
Case detection of TB through identification of chest symptomatic
Referral for sputum microscopy examination for TB
Number of cases screened and treated for dental ailments
Number of cases screened for diabetes at PUHCs
Number of cases referred and operated for heart related ailments
First aid and referral of burns and injury cases
Death rate,
Awareness of community about tobacco products / alcohol and substance abuse.
Equipment utilization rate,
Ambulance utilization rate,
Discipline state-absenteeism, misconduct, negligence
Frequency of training of various categories of staff
Hospital Management Information System
Cities / population with all slums and facilities mapped
Number of Slum/ Cluster level Health and Sanitation Day
Number of ASHA receiving full honorarium
Number of Mahila Arogya Samiti formed
Accreditation Standards for Primary Urban Health Centre
@ National Accreditation Board for Hospitals and Healthcare Providers 87
FACILITY MANAGEMENT
1. Physical upkeep of the premises including white wash and minor repairs. No
seepage, leaking cisterns, taps, water pipes.
2. Availability of continuous water supply including that in the toilets.
. Upkeep of the equipment and timely renewal of the Annual Maintenance contracts.
. Availability of security and sanitation services.
Cleanl
a. uired. The floors shall be mopped
and dried before the patient inflow begins. Periodical washing as directed by the
Cleaning of walls, tiles and window panes periodically.
c.
d. stbins daily.
v. Toilet must be inspected by the Medical Officer incharge daily.
3. Availability of Drinking water.
4. Electricity with functional / sufficient power backup (Generator / Inverter as per of the
required strength)
5. Uninterrupted supply of logistics by following the inventory management principles ,
Factoring in the seasonal variations, other events like camps / outreach sessions
while preparing the indents / placing timely indents.
6
7. Ensuring Punctuality and taking care of absenteeism. Delegation of duties to
alternate in case of short absence. Arrangement of alternative staff in case of long
leave.
8
iness and Sanitation:
Mopping of the Floors daily and as and when req
Medical Officer Incharge.
b.
Cleaning of furniture, equipment, counters, shelves daily.
Emptying the du
e. Getting the linen washed regularly.
f. Sanitation :
i. Separate toilets for men and women
ii. Clean tiles and wall
iii. Seat to be cleaned daily with the toilet cleaner and brush.
iv. Continuous water supply must be ensured.
Accreditation Standards for Primary Urban Health Centre
@ National Accreditation Board for Hospitals and Healthcare Providers88
COMMUNITY PARTICIPATION AND EMPOWERMENT
Community participation in planning, implementing and monitoring Primary healthcare
ntres is essential for it to succeed
d yield results. Therefore presence of Rogi Kalyan Samiti,
t to community and various committees has been ingrained in
. The basic structure, objectives, functions of a
been recommended.
delivery in urban settings through Primary Urban Health Ce
in achieving its objectives an
involving ASHA in reaching ou
the recommended Public Health Standards
PUHC Rogi Kalyan Samiti, ASHA and committees has
ROGI KALYAN SAMITI
Rogi Kalyan Samiti (Patient Welfare Committee) is a simple managemen
registered society setup for sustained and result oriented improvement in functioning of the
t structure form of a
d monitoring of the
HC more sensitive and responsive to
cal autonomy and flexibility in implementation of activities
ctivities / initiatives carried with the objective of delivering
as per the Public Health Standards laid
the recommended Public
er logistics.
Ensure accountability of the health providers to the community.
Ensure a rationalized, prioritized utilization of funds.
Introduce transparency with regard to the management of funds.
Generate resources through donations and fund raising events, community
contributions.
health institution (PUHC) and quality of care provided.
Need for Rogi Kalyan Samiti
1. To ensure community participation in planning, implementation an
Primary Urban Health Centre and make the PU
the patients.
2. Provide the required lo
required for optimal functionalization of the centre.
3. To provide funds for local a
quality assured healthcare.
Objectives:
Ensure delivery of the mandated services
down for the PUHC.
Ensure upgradation of the PUHC (Centre / Outreach) to
Health Standards.
Ensure a grievance redressal mechanism.
Ensure availability of the essential drugs and oth
Accreditation Standards for Primary Urban Health Centre
@ National Accreditation Board for Hospitals and Healthcare Providers 89
Functions and activities:
To achieve the above mentioned objectives, the Samiti shall direct its efforts and resources
liness / quality of
ions / average waiting time for the patients.
vels regarding the services being provided.
condition.
HC.
Monitor attendance of all categories of staff of the PUHC.
rms, Badges, I-Card by all the PUHC staff.
er, Display of referral map and chain, whether
same to patient /
, Tet. Toxoid, Oxygen Cylinder etc.
he complaints of patients / patient party.
and materials of the Primary Urban Health
ealth Centre building
ble with the PUHC.
ntenance and upkeep of the PUHC.
for day-to-day
management of the Primary Urban Health Centre e.g. Scientific Disposal of wastes,
Solar Lighting Systems etc.
Instal signages, repair of furniture.
To undertake customized solutions to address problems like lack of running water.
for undertaking following activities:
Periodical monitoring, visits, patient feedbacks to assess the time
services / adherence to the Public Health Standards / attitude in interactions with
patient / availability of medicat
Monitoring of the outreach activities.
Assessment of patient satisfaction le
Assessment of the problems / limitations being faced by the staff and finding
solutions.
Minor repairs / renovation / upkeep of the PUHC premises.
Minor electrical works / repairs of the electrical gadgets.
Ensure that all equipments at the PUHC are properly maintained and kept in good
running
Improve the laboratory testing facilities at the PU
Ensure wearing of Unifo
Monitor quality and use of Ambulance services, if available, at the PUHC.
Ensure timely submission of report and returns.
Referral system & referral regist
ground(s) for referring are properly elaborated.
Maintenance of Grievance Book at PUHC and availability of the
patient party.
Ensure adequate stock of ARV, AVS
Enquiry into t
Assessment and rationalization of men
Centre.
Making arrangement for maintenance of Primary Urban H
(including residential buildings), vehicles and equipment availa
Encouraging community participation in the mai
Adopting sustainable and environmental friendly measures
Accreditation Standards for Primary Urban Health Centre
@ National Accreditation Board for Hospitals and Healthcare Providers90
ty and its compliance.
Regularly examine, address the complaints received in the complaint box positioned
an drinking water.
Ensure clean male & female toilets with running water availability.
nerated in the centre / outreach.
awareness generation especially on issues like female
foeticide, gender bias.
he unit level mentoring activity.
funds / maintenance funds are made available to the
KS. In addition the RKS has the mandate to generate its funds through donations /
ents. The State funds separately approved for activities which are to be carried
ut by the RKS can be released to the RKS account.
entoring group will provide the orientation training to the RKS
ucture, Memorandum of Association, Rules & Regulations will be
is (RKS) for improved
etter services to the
Centres shall be as
Ward Counselor – Chairman
Medical Officer In-charge of the PUHC – Secretary & Convener
Ensure display of the Citizen's Charter in the health facili
in a prominent position in the waiting area.
Operationalization of periodical Specialist clinics.
Facilitating / monitoring OPDs
Beautification / landscaping / horticulture of the PUHC premises.
Making the waiting area patient friendly.
Ensure availability of cle
Establish clothes and toy banks through which those who have plenty can share with
those less privileged.
Ensure safe disposal of the biomedical waste ge
Play a catalyst role in
Ensure continuous capacity building of the PUHC staff / ASHAs / workers of
converging agencies like ICDS.
Ensure timely payments to ASHAs, contribute in t
Constitution as per the State Guidelines
Revenue: Certain funds like untied
R
fundraising ev
o
District / State level RKS M
members as to how to discharge the functions of RKS functionaries.
Detailed Guidelines on Str
provided by the State.
Each Primary Urban Health Centre shall have a Rogi Kalyan Samit
functioning of the Primary Urban Health Centres and for rendering b
patients.
The composition of the Rogi Kalyan Samiti for the Primary Urban Health
under:
Accreditation Standards for Primary Urban Health Centre
@ National Accreditation Board for Hospitals and Healthcare Providers 91
One ANM of the PUHC – Member
orking in the area of health or social sector – Member
number of
be Chairman of more than one RKS.
The
ed.
Pharmacist – Member
One NGO representative w
In case where there are two Ward Counselors within the area of a PUHC, the Ward
Counselor having the largest part of the PUHC area falling within his ward constituency, will
be the Chairman of the Rogi Kalyan Samiti. If there are more PUHCs than the
Ward Counselors, one Ward Counselors can
The details of the Rogi Kalyan Samiti will be displayed in Primary Urban Health Centre.
Samiti will have the mandate to improve the service delivery and ensure adherence to the
standards prescrib
ASHA
Accredited Social Health Activist (ASHA) for every 2000 (1500 to 2500) population
pocket, one local woman volunteer is to be selected and will serve as the link worker called
t (Paracetamol, ORS, Chlorine
rea will facilitate the outreach
ill validate / verify the work
e field.
ch as nutrition, basic sanitation
e information on existing health services and the need for their timely
lth
es,
and complementary feeding, immunization, care of the young child,
ch
5. She will work with the Health & Sanitation Committee of her area to get optimum
y pregnant women & children requiring treatment
th
ASHA. She will be trained and provided a basic drug ki
tablets, bandages, cotton, betadine etc. Her work in her a
activities of the ANM, initiate local health planning. ANM in turn w
done by her and also provide support and guidance to these volunteers in th
Role envisaged for ASHAs:
1. To carry out the survey of the households in her area.
2. To create awareness about determinants of health su
& hygienic practices, healthy living and working conditions.
3. She will provid
utilization. She will mobilize the community and facilitate them in accessing hea
services available at the Primary Urban Health Centres, referral centr
anganwadis.
4. To counsel women on birth preparedness, importance of safe delivery, breast
feeding
contraception and prevention of common infections including Reproductive Tract
Infections / Sexually Transmitted Infections (RTIs / STIs). She will ensure that ea
child in her area is fully immunized.
benefit from various initiatives related to safe water supply and sanitation being
undertaken by the Government. She will promote construction of household /
community toilets.
6. She will arrange escort / accompan
/ admission to the nearest pre-identified health facility i.e. Primary Urban Heal
Accreditation Standards for Primary Urban Health Centre
@ National Accreditation Board for Hospitals and Healthcare Providers92
Centre / Maternity home / Sub district / District hospital as per the need. She will
r ailments such as diarrhoea, fever
ctly Observed Treatment
vised National Tuberculosis Control Programme. She
al Programmes by
made available to every
ts) packets for Oral Rehydration Therapy
Condoms etc. A
nusual health problems / disease outbreaks in the community
cluster of households. ASHA will be trained for the role envisaged for her as per the modules
ixed
or some of the activities carried out by her. ANM will provide the supervision and
e work done by her. There will be continuous
nd in the field ASHA will be supported by the
Ensure safe drinking water
open defecation.
omposition of a Health and Sanitation Committee (one for 2000 population)
nt: Representative Self Help Group, Senior Citizen Group, Resident Welfare
ssociation, Gender Resource Centre in that order.
make the women in her area aware of the Janani Suraksha Yojana and help them in
availing benefits of the scheme.
7. ASHA will provide Primary Medical care for mino
and first aid for minor injuries. She can be a provider of Dire
Short course (DOTS) under Re
will help in effective field level implementation of other Nation
creating awareness about them.
8. She will act as adepot holder for essential provisions being
habitation like ORS (Oral Rehydration Sal
(ORT), Iron Folic Acid Tablet (IFA), Chlorine Tablets, Oral Pills &
Drug kit will be provided to each ASHA.
9. To inform about any u
to the Primary Urban Health Centre.
ASHA will initiate local health planning by assessing the quantum of healthcare needs in her
prepared for such a community worker.
She will enter her activities in the diary provided to her. She will be paid certain f
incentives f
mentoring support in the field and also verify th
capacity building and training of ASHAs a
mentor groups / ANMs / PHN / MO / Social Mobilization Officer.
HEALTH & SANITATION COMMITTEES
Activities:
Cleanliness & Sanitation activities
Setting up community toilets / facilitating household toilets / promoting use of toilet
and preventing
To be vigilant and eliminate / render safe all vector breeding sites.
Local Health & Nutrition activities, Health and Nutrition days
C
Preside
A
Convener: Area ASHA
Accreditation Standards for Primary Urban Health Centre
@ National Accreditation Board for Hospitals and Healthcare Providers 93
Members:
i. Government Employees (retired) / honorarium paid staff e.g. School teacher,
Anganwadi Worker, preferably not more than one third.
ii. Representative of local women’s self help group
iii. Representative of the local NGO
Accreditation Standards for Primary Urban Health Centre
@ National Accreditation Board for Hospitals and Healthcare Providers96
CITIZEN CHARTER FOR PRIMARY URBAN HEALTH CENTRE
Primary Urban Health Centre is the peripheral most health facility manned by the Medical
fficer and support staff along with the required logistics to provide holistic primary
ealthcare to the citizens residing in the catchment area of the centre. One PUHC is
isualized for every 50,000 population. It is a manifestation of the commitment of all
ealthcare providers to make quality assured, affordable, accountable, responsive primary
ealthcare universally available.
bjective of this document:
o inform the beneficiaries about the health facility, its structure, its mandate, the service
omponents available in the health facility, the entitlements of the beneficiary, the
sponsibilities of the beneficiaries and the available mechanism of grievance redressal.
ommitment of the Charter:
Access of all beneficiaries to the PUHC and utilization of existing facility without
discrimination.
• Quality oriented service delivery in a responsive and responsible manner.
• To provide holistic primary healthcare in an OPD mode with the level appropriat
emergency care and referral after stabilization.
Dissemination of information about the existence / location of referral centres and
facilities involved in dealing with other determinants of health.
• To provide the information in writing about the diagnosis / treatment advised and
being administered.
• Provision of timely, detailed and complete referral as and when required with
facilitation of access to the referral facility.
• Community involvement in planning / implementation and monitoring of the PUHC
activities.
• Provision for the complaints / grievances to be addressed in a time-bound fashion.
Service Components of a Primary Urban Health Centre
• Registration timings and timings for delivery of services to be mentioned clearly.
• Mention the services which are free of cost and services having nominal user fee.
• Layout of available services along with locations within the facility.
Curative Component:
OPD Services: Management of the common ailments as per the Standard
Treatment Protocols developed by the State.
O
h
v
h
h
O
T
c
re
C
•
e
•
Accreditation Standards for Primary Urban Health Centre
@ National Accreditation Board for Hospitals and Healthcare Providers 97
Emergency Medical care: During the OPD hours, first aid and stabilization followed
by referral if required for injuries / accidents / animal bite cases and other emergency
conditions.
Minor Surgical Procedures: Simple Incision and drainage, suturing of simple clean
lacerated wounds. During all these surgical procedures, universal precautions will be
adopted to ensure infection prevention.
Referral for the Cases requiring Secondary / Tertiary care: All patients requiring
higher level care to be referred in time to a linked and identified centre with a
complete referral slip. Follow up of these cases in Primary Urban Health Centre.
Rehabilitation: Disability prevention, early detection, intervention and referral.
Provision of AYUSH services wherever AYUSH unit is co-located.
Geriatric care: Special emphasis on taking care of the senior citizens visiting the
health centre. From having user friendly access, freedom from long queues,
assistance in obtaining and understanding medications to special assistance like that
in obtaining dentures / spectacles through the Rogi Kalyan Samitis.
II. Preventive & Promotive services
1. Reproductive and Child Health Programme:
Maternal Health Services:
a. Antenatal Care:
i. Early registration (ideally before 12th week) of all pregnancies with a duly filled
ANC card.
ii. Antenatal checkups and provision of complete package of services.
iii. Provision of associated services like providing iron and folic acid tablets, injection
tetanus toxoid etc. (as per the guidelines for antenatal care)
iv. Laboratory investigations like haemoglobin, urine albumin and sugar.
v. Nutrition counselling.
vi. Identification of high risk pregnancies / referral to First Referral Units (FRUs) /
other linked hospital for high risk pregnancy.
b. Preparation / planning for delivery in an institution
c. Postnatal Care
Two postpartum home visits through the ANM to ensure wellbeing of mother and
newborn within 48 hrs and seven days of delivery – to initiate early breast
feeding and reinforce advice on nutrition, hygiene, contraception.
Accreditation Standards for Primary Urban Health Centre
@ National Accreditation Board for Hospitals and Healthcare Providers98
Child Health Services:
for the children as per the guidelines.
:
ling to adopt appropriate family planning
es etc.
name of the person
Treatment of RTIs and STDs and health education for prevention of RTIs / STDs.
ated Disease Surveillance Project (IDSP):
c. Promotion of sanitation including use of toilets and appropriate garbage disposal.
entres to deliver
ders and
common complications of TB and side effects of drugs.
a. Care of routine childhood illness.
b. Promotion of exclusive breast feeding for 6 months.
c. Full immunization of all infants and children against vaccine preventable
diseases as per guidelines of Government of India. Immunization days to be
specified.
d. Vitamin A prophylaxis
Adolescent Health
Detection and management of nutritional disorders and high risk behaviour.
Family Planning Services:
a. Education, Motivation and counse
methods.
b. Provision of contraceptives such as condoms, oral pills, emergency
contraceptiv
c. Carry out IUD insertions.
d. Follow up services to the eligible couples adopting permanent spacing / method
(Tubectomy / Vasectomy).
e. Counseling and appropriate referral for couples having infertility.
f. All incentives shall be clearly mentioned along with
responsible.
Management and Prevention of Reproductive Tract Infections / Sexually
Transmitted Diseases:
2. Integr
a. To detect unusual health events and take appropriate remedial measures.
b. Facilitate disinfection of water sources.
3. Revised National Tuberculosis Control Programme (RNTCP):
All Primary Urban health Centres to function as DOTS C
treatment as per RNTCP Treatment Guidelines through DOTS provi
treatment of
4. National Programme for Control of Blindness (NPCB):
a. Basic Services: Diagnosis and treatment of common eye diseases.
Accreditation Standards for Primary Urban Health Centre
@ National Accreditation Board for Hospitals and Healthcare Providers 99
b. Screening for refraction disorders and referral for Refraction study.
c. Detection of cataract cases and referral for / facilitation of cataract surgery.
5. National Vector Borne Disease Control Programme (NVBDCP):
a. Diagnosis of Malaria cases, microscopic confirmation and treatment.
b. Cases of suspected Dengue, Chikungunia to be provided symptomatic
treatment, referral for hospitalization and cases management as per the
protocols.
c. IEC activities regarding spread and prevention, symptoms of VBDs and early
detection of complications.
6. National Leprosy Elimination Programme (NLEP):
a. Identification of leprosy patients on basis of clinical examination.
b. Referral of the patients to secondary care level when required.
c. Complete treatment with MDT.
e. Rehabilitation / disability prevention.
Programme (NIDDCP):
up.
c. s to create awareness of Iodine deficiency disorders.
a. res about STIs and
high risk behaviour at the nearest ICTC.
d. s to the high risk groups.
Convergence:
i.
ii. Diagnosis and management of Anemia and Vitamin A deficiency.
d. IEC activities
7. National Iodine Deficiency Disorder Control
a. Goitre detection and work
b. Salt iodine estimation of salt samples collected from household.
IEC activitie
8. National AIDS Control Programme (NACP):
IEC activities to enhance awareness and preventive measu
HIV / AIDS.
b. Screening of persons practicing
c. Risk screening of antenatal mothers with one rapid test for HIV.
Condom promotion and distribution of condom
e. Help and guide patients with HIV / AIDS in receiving ART.
III. Addressing other Determinants of Health – Inter-sectoral
A. Nutritional Services (in convergence with ICDS)
Diagnosis of and nutrition advice to malnourished children, pregnant women and
others.
Accreditation Standards for Primary Urban Health Centre
@ National Accreditation Board for Hospitals and Healthcare Providers100
iii. Health and Nutrition days to be conducted at the identified Anganwadis in the
.
i.
d by the ASHAs and
ssary screening / age appropriate immunization / health
ntre / outreach activities.
C. Promotion of Safe Drinking Water and Basic Sanitation
i. how to make drinking
ii. Provision of Chlorine tablets / drops through the centre / ASHAs.
IV. Ref
rral of cases needing specialist care / indoor care
a.
way link with the concerned officials there.
.
The following tests will be provided at the PUHC laboratory
.
viii.
catchment areas.
iv. Anganwadis in the catchment area shall be listed out
B. Health of School going Children (Convergence with School Health)
All children referred from the school for investigations, management to be taken
care of.
ii. School dropouts / children not going to school to be identifie
provided with the nece
education through the ce
IEC regarding consumption of safe drinking water and
water safe.
erral Services:
Appropriate and prompt refe
including:
Stabilization of patient
b. Appropriate support for patient during transport
c. Follow up of these cases. Liasoning with the referral institutions for PUHC area.
Having a two
V Provision of Essential Diagnostic services:
i. Hb %, TLC
ii. Blood Sugar
iii. Urine Albumin, Sugar and Microscopy
iv. Urine Pregnancy Test
v. Stool Microscopy
vi. Sputum testing for tuberculosis (if designated as a microscopy centre under
RNTCP)
vii Blood smear examination for malarial parasite
Tests specified as a part of IDSP
Accreditation Standards for Primary Urban Health Centre
@ National Accreditation Board for Hospitals and Healthcare Providers 101
The following investigation will be provided at the PUHC Radiology
a. X RAY
nd Barium
b. ULTRAS OGRAPHY
• Obstetrical and Gynecological including endovaginal exams, TIFFA
ast, Thyroid, Scrotal and
uch as Hips, Shallers and Knees.
iii. ukkad Nataks, well baby shows, camps etc.
LADLI.
and private hospitals
mandated to provide free services to under privileged shall be displayed.
II.
ou
colonies, unauthorized colonies and villages through regular Health & Nutrition days,
• Plain and Computed Radiography
• Contrast studies like Barium swallow, Barium meal, follow through a
enema; IVU; RGU / MCU; HSG ; water soluble contrast studies for GIT;
Fistulograms: Sinograms
ON
• General Abdominal and Pelvic studies.
• Soft tissue and superficial structures including Bre
Transrectal Prostate examinations.
• Pediatric and Neonatal studies.
• Musculoskeletal examinations s
c. DOPPLER STUDIES (if available)
• Peripheral, Cerebro-vascular and abdominal Doppler.
• Assessment of post Kidney and Liver Transplant patients.
• Penile Doppler examination
VI. Education about Health and its Determinants / National Health Programmes /
Special schemes of the department
i. Display of IEC material in the waiting areas.
ii. Distribution of handbills / leaflets / pamphlets.
Conduct of N
iv. Use of available IEC material in outreach activities.
v. Effective Behaviour Change Communication through ASHAs.
vi. Dissemination of information about special schemes like MAMTA / JSY /
vii. List of Gender Resource Centre, local grant in-aid NGOs,
V Provision of Services through Outreach activities
Provision of basic curative / preventive care in areas / certain specific vulnerable
gr ps through outreach activities especially in the slums, JJ clusters, resettlement
Immunization sessions.
Accreditation Standards for Primary Urban Health Centre
@ National Accreditation Board for Hospitals and Healthcare Providers102
PUHC will be responsible for conducting this activity in its catchment area. The staff
logistics will flow frand om the PUHC.
III. Continuous Capacity Building
s jobs /
.
Any layed on notice boards.
im
2. To keep the surrounding area clean.
age the building / other infrastructure.
Medical Officer Incharge regarding treatment
follow ups.
ut sex selective procedures,
voluntary workers attached to
aint can be directly addresses to the Medical Officer Incharge or
sitioned in a prominent place in the waiting area. These
ner. If required, Medical Officer Incharge
UHC level, the Chief District Medical Officer will
lyan Samiti.
Directorate Services and Family Welfare or State Health Society depending upon
d the Chief District Medical Officer along with
official address and phone numbers will be displayed in the Primary Urban Health Centre.
V
Periodic skill development / training of the staff of the PUHC in the variou
responsibilities assigned to ensure quality. ASHAs will be provided with the induction
/ refresher trainings and ongoing support in the field.
IX Ensure rational use of drugs
short term withdrawal of services shall be disp
Responsibilities of the Citizens
In addition to the rights, the citizens also have certain responsibilities towards the
Pr ary Urban Health Centre.
1. To keep the premises clean, not to spit / smoke / litter the area.
3. Not to disfigure / dam
4. To observe etiquette like standing in the que, talkin low tones, assist old / infirm.
5. Follow the instructions given by the
advised and referrals /
6. Inform the Medical Officer Incharge abo
environmental hazards, excessive vector breeding or reporting of cases in the
community.
7. Cooperation with the health functionaries and
Primary Urban Health Centres like ASHAs.
Grievance Redressal Mechanism
Any grievance / compl
placed in the complaint box po
complaints will be dealt within a time bound man
may bring it up before the Rogi Kalyan Samiti.
In case the grievance is not resolved at the P
take it up through the District Rogi Ka
The next level if required will be the level of the Integrated District Health Society,
of Health
the nature of grievance.
The name of the Medical Officer Incharge an
Accreditation Standards for Primary Urban Health Centre
@ National Accreditation Board for Hospitals and Healthcare Providers 103
Display at the Primary Urban Health Centre
• A board displayed in Hindi, at the
summariz
conspicuous place clearly visible carrying
ed citizens charter showing available services.
r printed pamphlets.
• ckground with white letters
• Preferably no abbreviations to be used
• Language both Hindi and English fo
• Size preferably 4 ft X 6 ft for board.
Colour unique dark blue ba
• Facility specific
Periodical Review of the Charter
Charter will be reviewed periodically and suitably modified.
Accreditation Standards for Primary Urban Health Centre
@ National Accreditation Board for Hospitals and Healthcare Providers104
JOB RESPONSIBILITIES OF PRIMARY URBAN HEALTH CENTRE STAFF
MED AL OFFICER INCHARGE, PRIMAIC RY URBAN HEALTH CENTRE
impleme
PUHC a However, by virtue of his / her
esignation as the incharge and administrative head, it is implied that he /she will be solely
nsive health care including the implementation of
alyan of
I. Healthcare Delivery
d curative to the
enefic
department and will
diagnosis and treatment on the
OPD slip. As far as possible the medications shall be the ones available in the
• ensure that he / she himself / herself along with all others involved
in delivery of curative medical services are fully conversant with the standard
case to the specialist as and when required. While
late organization of the specialist / evening
he working hours appropriate care for
dequate stocks of ORS to maintain availability of ORS packets
Medical Officer Incharge of a Primary Urban Health Centre (PUHC) is responsible for
nting all activities grouped under Health and Family Welfare delivery system in
rea. It is not possible to enumerate all his / her tasks.
d
responsible for provision of comprehe
National Health Programmes. He / She will also be the Member Secretary of the Rogi
Samiti of the Primary Urban Health Centre and will be responsible for executionK
his / her responsibilities in that capacity.
The detailed job responsibilities of Medical Officer working in the PUHC are as follows:
The Medical Officer will provide comprehensive Medical Care, preventive an
b iaries including Family Planning services.
• The Medical Officer will organize the dispensary, outpatient
allot duties to the ancillary staff to ensure smooth running of the OPD.
• After examination of the patient the Medical Officer will record symptoms and
findings in brief, investigations done / advised,
PUHC.
He / She will
treatment protocols appropriate to the category of staff and are using them while
providing healthcare.
• He / She may refer the
making the referral to the specialist or hospital, the Medical Officer will give the
history, short resume of the case, findings, provisional diagnosis and the
treatment given on the OPD slip.
• He / She will supervise and regu
OPDs.
• He / She will ensure that during t
emergencies is promptly available in the PUHC including that for injuries and
burns.
• Will ensure a
throughout the year. He / She will arrange for correction of moderate and severe
dehydration through appropriate treatment (using IV rehydration if required)
Accreditation Standards for Primary Urban Health Centre
@ National Accreditation Board for Hospitals and Healthcare Providers 105
• Monitor all cases of diarrhoea / ARI especially for children between 0 – 5 years.
ring drinking water safe.
(ASHAs),
s who are involved in health care regarding
ealth team early detection of pneumonia
atment. He / She will attend to all cases
entre by ANM / ASHA / School teacher / AWW and provide
t.
higher level care including dental
care and nursing care, he / she will ensure that a complete referral slip is
prepared and the patient to the appropriate higher centre.
• He / She will cooperate and coordinate with the institutions providing medical
care services in his / her area.
• He / She will ensure availability of all laboratory services mandated to be carried
out at the PUHC and refer the patient to an attached centre for more
sophisticated tests.
• He / She will make arrangements for providing services in areas / population
pockets which are not able to access the PUHC services by organizing health
and nutrition days at the anganwadi centres once in a month or through fixed
outreach centres.
• He / She will supervise outreach activities including the fixed outreach centres in
his / her area at least once in a fortnight.
II. Preventive and Promotive Work
The Medical Officer will ensure that all the members of his / her Health Team are fully
conversant with the various National Health & Family Welfare Programmes under National
Urban Health Mission to be implemented in the area allotted to each Health functionary. He /
she will further supervise their work periodically both in the clinics and in the community
setting to give them the necessary guidance and direction.
Based on the information collected by ASHA and the ANM from their surveys, he / she will
prepare operational plans and ensure effective implementation of the same to achieve the
laid down targets under different National Health and Family Welfare Programmes. The
second MO / PHN will provide assistance in the formulation of local health and sanitation
plan through the ANMs and coordinate with the local self help groups / health and sanitation
committees in his / her PUHC area.
He / she will keep close liaison with Block Development Officer and his / her staff,
community leaders and various social welfare agencies in his / her area and involve them to
the best advantage in the promotion of health programmes in the area.
Recording and reporting of all deaths due to diarrhoea / ARI especially for
children between 0 – 5 years.
• Spread awareness and provide chlorine tablets for rende
Training of all health personnel like Accredited Social Health Activist
Anganwadi workers, dais and other
ORT programme.
• He / She will ensure through his / her h
cases and provide appropriate tre
referred to the c
appropriate managemen
• After careful screening in all cases requiring the
Accreditation Standards for Primary Urban Health Centre
@ National Accreditation Board for Hospitals and Healthcare Providers106
W ealth
p amily
elfare services. He / she will coordinate and facilitate the functioning of AYUSH doctor in
• Ensure availability of supplement of Iron / Folic acid and Vitamin A.
Health Programme
entation.
Outreach A
•
isk cases.
Universal
•
.e. pregnant mothers and children in 0 – 5 year
ation sessions if required.
• e will also ensure proper storage of vaccine and maintenance of cold
2. Fam
• He / She will be responsible for proper and successful implementation of Family
Planning Programme in the PUHC area, including education, motivation, delivery
of services and after care.
herever possible, the MO will conduct field investigations to delineate local h
roblems for planning changes in the strategy of the effective delivery of Health and F
w
the PUHC.
1. Nutritional Services
• Liason closely with the Anganwadis and AWWs located in the PUHC area.
• Will provide leadership & guidance for special programmes such as in tackling
anemia, malnutrition, identification, treatment and follow-up of nutritional
disorders especially anemia and malnutrition by ensuring nutritional
supplementation at the nearby Anganwadi and nutritional rehabilitation at home
through ASHA.
2. Reproductive & Child
• Antenatal care / preparation and necessary linkage for Intranatal care / Post natal
care.
• Ensuring antenatal day every week with delivery of complete and quality assured
antenatal care including clinical examination, investigation, and supplem
• Identification and referral of high risk cases. Follow-up of these high risk cases
through pregnancy, intranatal period and postnatal period.
ctivity
• Ensure that areas where center based facilities are not accessible, outreach
activities are carried out and their quality / content are maintained.
Ensure that the essential contacts with PUHC are made for investigations and
management of high r
Immunization Programme
Ensure cent percent coverage as per the State Immunization schedule of the
target population in PUHC area (i
age group) through immunization sessions twice a week and conduct of outreach
immuniz
• He / She will ensure adequate supplies of vaccines miscellaneous items required
from time to time for the effective implementation of UIP.
He / Sh
chain equipment, planning and monitoring of performance and training of staff.
ily Planning Services
Accreditation Standards for Primary Urban Health Centre
@ National Accreditation Board for Hospitals and Healthcare Providers 107
• He / She will be squarely responsible for giving immediate and follow-up attention
to any complications resulting from acceptance of family planning methods.
He / She will ensure that all l • ogistics (equipments, drugs, educational material
•
•
• PUHC to enable the adolescents
• for fever cases.
• of mosquitoes breeding site in the PUHC and in the area
•
• aware of Chikungunia / Dengue and
trained to detect early case of Dengue Shock Syndrome, Dengue Hemorrhagic
priate SOP at the PUHC and community level
• media equipment received from
and contraceptives) required for implementation of family planning activities are
available in the centre.
He / She will assist the districts in organizing the vasectomy camps.
3. Adolescent Health
Conduct of health talks / check up of school dropouts and children not going to
school / adolescents identified and collected by ASHAs.
Creating adolescent friendly environment in the
to approach the Medical Officer, Public Health Nurse, ANM with their problems /
queries.
4. National Vector Borne Disease Control Programme (NVBDCP)
Ensure facility for blood testing
• Will liaison with the authorities carrying out spraying activities and providing
logistics like larvicides in PUHC area.
Ensure elimination
through education / awareness generation by ASHAs, ANMs and liaisoning with
local self help groups.
Ensure that all positive cases are treated adequately.
• Ensure that cases of complicated Malaria are referred.
Ensure that all his team members are
Syndrome and institute appro
before prompt referral.
• Ensure sufficient stock of Chloroquine and IV fluids.
• Report all cases of suspected Dengue, Chikungunia and smear positive malaria
cases promptly.
Judicious use of all publicity material and mass
time to time.
• He / She shall ensure that all categories of staff in the centre are sufficiently
trained and observe the instructions laid down under NVBDCP on the treatment
of smear positive cases.
6. Tuberculosis
• Ensure high index of suspicion in the patients visiting OPD, provide facilities for
early detection of case, confirmation and prompt institution of treatment.
Accreditation Standards for Primary Urban Health Centre
@ National Accreditation Board for Hospitals and Healthcare Providers108
• He / She will also ensure that all cases of confirmed Tuberculosis take regular
and complete treatment.
• Ensure smooth functioning of DOTs centre and Microscopy centre if operating in
the PUHC.
7. Sexually Transmitted Disease
• He / she will ensure that all cases of STD are diagnosed and properly treated
and their contacts are traced for early detection.
He / She will provide facilities for RPR test, for all pregnant women at the PUHC.
rosy
•
8. Lep
Leprosy and
confirmation of their diagnosis and treatment.
sy take regular and complete treatment.
9. Control of Communicable Diseases
duties under the IDSP.
.
Blin
III. Tra
• versed with SOPs and follow these in Health
• adequately trained for
• of
skills of his / her staff with the help of State and District level trainings.
Organize training for ASHAs attached to the PUHC.
•
• He / she will provide facilities for early detection of cases of
• He / she will ensure that all cases of Lepro
• He / she will ensure that all the steps are being taken for the control of
communicable diseases and for the proper maintenance of sanitation in the area.
• He / she will take the necessary action in case of any outbreak of epidemic in his
/ her area.
• Perform
10 National Programme for Prevention of Visual Impairment and Control of
dness
• He / she will make arrangements for rendering:
a. Treatment for minor ailments
b. Testing of vision
• He/she will refer cases to the appropriate institutes for specialized treatment.
ining
Ensure that his health team is well
Care delivery at the PUHC.
The team members have defined work allocation and are
it.
Worker specific / relevant training are ensured with continued upgradation
•
Provide hands on training to the ANMs, ASHAs.
Accreditation Standards for Primary Urban Health Centre
@ National Accreditation Board for Hospitals and Healthcare Providers 109
• Provide feedback on value addition done by the different trainings provided to his
/ her staff members at the district and state level under various programmes
• Will maintain a database of the trainees / trainings already conducted for his / her
PUHC staff.
• He / she will supervise the work of staff working under him / her.
eneral cleanliness inside and outside the premises of the
• d stock
• s prepared timely for drugs, instruments, vaccines, ORS
mit them to the
appropriate health authorities.
• He / she will scrutinize the programmes of his / her staff and suggest changes if
• red and display charts in his / her own room to explain
units, morbidity and
ion about his / her area.
own staff with a view to
•
d records at PUHC level.
rmats and their timely submission to the headquarter.
rt to the CDMO.
• day administrative duties and administrative
duties pertaining new schemes.
vi. Administrative Work
• He / she will ensure g
PUHC and also proper maintenance of equipment under his / her charge.
He / she will ensure maintenance of a regularly updated inventory an
register of all the stores and equipment supplied to him / her and will be
responsible for its correct accounting.
He / she will get indent
and contraceptive etc. sufficiently in advance and will sub
• He / she will check the proper maintenance of the transport given in his / her
charge.
necessary to suit the priority of work.
He / she will get prepa
clearly the geographical areas, location of peripheral health
mortality, health statistics and other important informat
• He / she will hold monthly staff meetings with his / her
evaluating the progress of work and suggesting steps to be taken for further
improvements.
He / she will ensure the regular supply of medicines and disbursements of
incentives to ASHAs.
• He / she will ensure the maintenance of the prescribe
• He / she will be responsible for compilation of accurate and complete reports in
the prescribed fo
• He / she will keep notes of his / her visits to the area and submit every month his
/ her tour repo
• He / she will discharge all the financial duties entrusted to him / her.
He / she will discharge the day to
Accreditation Standards for Primary Urban Health Centre
@ National Accreditation Board for Hospitals and Healthcare Providers110
SECOND MEDICAL OFFICER
ative Work I. Cur
he Medical Officer will provide comprehensive Medical Care, preventive and curative to the
ervices.
diagnosis and treatment on the
PUHC.
ill ensure that he / she himself / herself along with all others involved
y of staff and are using them while
providing healthcare.
• He / She may refer the case to the specialist as and when required. While
or hospital, the Medical Officer will give the
history, short resume of the case, findings, provisional diagnosis and the
• He / She will provide appropriate care for emergencies including that for injuries
• He / She will correct moderate and severe dehydration through appropriate
if required). He / she will ensure early detection
of pneumonia cases and provide appropriate treatment.
Recording and reporting of all deaths due to diarrhoea / ARI especially for
hlorine tablets for rendering drinking water safe.
personnel like Accredited Social Health Activist (ASHAs),
ing
will attend to all cases referred to the centre by ANM / ASHA / School
• all cases requiring the higher level care including
ices mandated to be carried
attached centre for more
T
beneficiaries including Family Planning s
• After examination of the patient the Medical Officer will record symptoms and
findings in brief, investigations done / advised,
OPD slip. As far as possible the medications shall be the ones available in the
• He / She w
in delivery of curative medical services are fully conversant with the standard
treatment protocols appropriate to the categor
making the referral to the specialist
treatment given on the OPD slip.
and burns.
treatment (using IV rehydration
• Monitor all cases of diarrhoea / ARI especially for children between 0 – 5 years.
children between 0 – 5 years.
• Spread awareness and provide c
Training of all health
Anganwadi workers, dais and others who are involved in health care regard
ORT programme.
• He / She
teacher / AWW and provide appropriate management.
After careful screening in
dental care and nursing care, he / she will ensure that a complete referral slip is
prepared and the patient to the appropriate higher centre.
• He / She will cooperate and coordinate with the institutions providing medical
care services in his / her area.
• He / She will ensure availability of all laboratory serv
out at the PUHC and refer the patient to an
sophisticated tests.
Accreditation Standards for Primary Urban Health Centre
@ National Accreditation Board for Hospitals and Healthcare Providers 111
• He / She will provide services in areas / population pockets which are not able to
access the PUHC services by participating health and nutrition days at the
anganwadi centres once in a month or through visits in the fixed outreach
centres as per the schedule prepared by the Medical Officer In-charge.
Accreditation Standards for Primary Urban Health Centre
@ National Accreditation Board for Hospitals and Healthcare Providers112
I ork
he Medical Officer will ensure that all the members of his / her Health Team are fully
ational Health & Family Welfare Programmes under National
irection.
prepare ope
laid down ta
will provide in the formulation of local health and sanitation plan through the
/ her PUHC
He / she wil
leaders and agencies in his / her area and involve them to the best
the Social M
Wherever
problems fo of the effective delivery of Health and Family
•
• in Nutritional deficiency
bilitation at home through ASHA.
2. Rep
•
re.
on, and supplementation.
• plete services in areas where center based
•
risk cases.
I. Preventive and Promotive W
T
conversant with the various N
Urban Health Mission to be implemented in the area allotted to each Health functionary. He /
she will further supervise their work periodically both in the clinics and in the community
setting to give them the necessary guidance and d
Based on the information collected by ASHA and the ANM from their surveys, he / she will
rational plans and ensure effective implementation of the same to achieve the
rgets under different National Health and Family Welfare Programmes. The MO
assistance
ANMs and coordinate with the local self help groups / health and sanitation committees in his
area.
l keep close liaison with Block Development Officer and his / her staff, community
various social welfare
advantage in the promotion of health programmes in the area. He / she will be assisted by
obilization Officer in this.
possible, the MO will conduct field investigations to delineate local health
r planning changes in the strategy
welfare services.
1. Nutritional Services
Liaison closely with the Anganwadis and AWWs located in the PUHC area.
Will actively participate in special programmes such as
identification, treatment and follow-up of nutritional disorders especially anemia
and malnutrition by ensuring nutritional supplementation at the nearby
Anganwadi and nutritional reha
roductive & Child Health Programme
Will provide Antenatal care / preparation and necessary linkage for Intranatal
care / Post natal ca
• Conduct antenatal day every week with delivery of complete and quality assured
antenatal care including clinical examination, investigati
• Identification and referral of high risk cases. Follow-up of these high risk cases
through pregnancy, intranatal period and postnatal period.
Outreach Activity
Provide quality assured / com
facilities are not accessible, outreach activities.
Ensure that the essential contacts with PUHC are made for investigations and
management of high
Accreditation Standards for Primary Urban Health Centre
@ National Accreditation Board for Hospitals and Healthcare Providers 113
Universal Immunization Programme
Provide cent percent coverage of the target population in PUHC area (i.e.
pregnant mothers and children in 0 – 5 year age group) through immunization
sessions twice a week and conduct of outreach immunization se
•
ssions if
required.
• Ensure proper storage of vaccine and maintenance of cold chain equipment,
planning and monitoring of performance and training of staff.
3. Family Planning Services
• Provide Family Planning services in the PUHC area, including education,
motivation, delivery of services and after care.
• He / She will be squarely responsible for giving immediate and follow-up
attention to any complications resulting from acceptance of family planning
methods.
• He / She will assist in organizing the vasectomy camps.
4. Adolescent Health
• Conduct of health talks / check up of school dropouts and children not going to
school / adolescents identified and collected by ASHAs.
• Creating adolescent friendly environment in the PUHC to enable the adolescents
to approach the Medical Officer, Public Health Nurse, ANM with their problems /
queries.
5. National Vector Borne Disease Control Programme (NVBDCP)
• Ensure blood testing for fever cases.
• Ensure elimination of mosquitoes breeding site in the PUHC and in the area
through education / awareness generation by ASHAs, ANMs and liaisoning with
local self help groups.
• Treat all positive cases adequately.
• Refer all cases of complicated Malaria in time.
• Ensure that all his team members are aware of Chikungunia / Dengue and
trained to detect early case of Dengue Shock Syndrome, Dengue Hemorrhagic
Syndrome and institute appropriate SOP at the PUHC and community level
before prompt referral.
• Report all cases of suspected Dengue, Chikungunia and smear positive malaria
cases promptly.
• Judicious use of all publicity material and mass media equipment received from
time to time.
Accreditation Standards for Primary Urban Health Centre
@ National Accreditation Board for Hospitals and Healthcare Providers114
• He / She shall ensure that all categories of staff in the centre are sufficiently
trained and observe the instructions laid down under NVBDCP on the treatment
mpt institution of treatment.
of smear positive cases.
6. Tuberculosis
• Maintain a high index of suspicion in the patients visiting OPD, provide facilities
for early detection of case, confirmation and pro
• He / She will also ensure that all cases of confirmed Tuberculosis take regular
and complete treatment.
• Ensure smooth functioning of DOTs centre and Microscopy centre if operating in
the PUHC.
Accreditation Standards for Primary Urban Health Centre
@ National Accreditation Board for Hospitals and Healthcare Providers 115
7. Sexually Transmitted Disease
•
8. Lep
Leprosy take regular and complete treatment.
•
• ties under the IDSP.
0. National Programme for Prevention of Visual Impairment and Control of
• ding charts.
III. Trai
gs.
to the PUHC.
•
•
e. Evaluate the work being done and guide her in
• ntre at least once a week on a fixed day and while
conducting the clinic, also monitor / evaluate the work being done at the centre.
Provide necessary guidance for online correction.
• Diagnose and treat all cases of STD and contacts.
Ensure RPR test, for all pregnant women at the PUHC.
rosy
• Early detection of cases of Leprosy and confirmation of their diagnosis and
treatment.
• Ensure that all cases of
9. Control of Communicable Diseases
• Take all necessary steps for the control of communicable diseases.
Take the necessary action in case of any outbreak of epidemic in his / her area.
Perform du
1
Blindness
• Treatment for minor ailments
Testing of vision to screen using Snellen chart / near rea
• Refer cases to the appropriate institutes for specialized treatment.
ning
• Assist Medical Officer Incharge in organizing / conducting trainin
• Organize training for ASHAs attached
• Provide hands on training to the ANMs, ASHAs.
Provide feedback on value addition done by the different trainings provided to his
/ her staff members
IV. Monitoring & Evaluation
• Will be responsible for monitoring the work being done by the ANMs in the centre
and the field including Outreach activity. Monitoring will be structured and as per
defined formats.
Will periodically check and initial the ANM registers – Survey registers, eligible
couple registers etc.
• Assess fortnightly the progress of work of the ANM. Submit a report to the
Medical Officer Incharg
improving her performance.
Visit each outreach ce
Accreditation Standards for Primary Urban Health Centre
@ National Accreditation Board for Hospitals and Healthcare Providers116
• Similarly will evaluate the performance of ASHAs in consultation with the
concerned PHN and ANM. Provide all support and guidance wherever required
and be an active member of the ASHA mentor group.
o the Medical Officer Incharge on the monitoring and
• He / she will assist the Medical Officer Incharge preparing charts to explain
clearly the geographical areas, location of peripheral health units, morbidity and
mortality, health statistics and other important information about PUHC area.
• He / she will attend weekly / monthly staff meetings with a view to evaluating the
progress of work and suggesting steps to be taken for further improvements.
• He / she will discharge all the financial duties entrusted to him / her.
• He / she will discharge any other duty assigned to him by the Medical Officer
Incharge or upon introduction of a new scheme.
• Provide the feedback t
evaluation.
V. Administrative Work
• He / she will ensure general cleanliness inside and outside the premises of the
PUHC and also proper maintenance of equipment under his / her charge.
• He / she will ensure to keep up to date inventory and stock register of all the
stores and equipment supplied to him / her and will be responsible for its correct
accounting.
Accreditation Standards for Primary Urban Health Centre
@ National Accreditation Board for Hospitals and Healthcare Providers118
PHARMACIST
and for the safe custody of the
with the guidelines / instructions by Medical Officer
me.
with a
•
anliness of the dispensing room, replenishment of stocks, arranging
•
tles
• the
ion of the doses and also will
explain the doses verbally, where required.
• The Pharmacist (s) will remain on duty to clear the patient at the end of the
dispensary hours and shall leave the dispensing room only after taking
permission of the Medical Officer Incharge.
• He / she shall see that the stock registers maintained in the dispensing room are
signed by the Medical Officer Incharge daily.
• The Pharmacist will immediately comply with the instruction and arrange for the
stocks with him to be checked at any time by the Medical Officer Incharge or
Second Medical Officer and any other official deputed to check it.
• In the temporary absence of storekeeper, the Pharmacist shall perform the
duties of the storekeeper whenever required by the Medical Officer Incharge.
• The Pharmacist will wear white coat, the prescribed uniform while on duty.
• He / she will not allow any outsider in the dispensing room unnecessarily.
• He / she will assist in making arrangements for the outreach activities / camps.
• The Pharmacist will perform such other duties as may be assigned to him by the
Medical Officer Incharge from time to time.
• The Pharmacist will be personally responsible for the correct dispensing as per
prescriptions issued by the Medical Officers
stores in accordance
Incharge from time to ti
• The Pharmacist will at all times be courteous and helpful in dealing with the
patients and under no circumstances enter into arguments, whatsoever
beneficiary instead he / she will report the matter to the Medical Officer Incharge.
He / she will be in position at the dispensary 15 minutes before the opening time
to ensure cle
the medicines.
He / she will be personally responsible for ensuring that the dispensing room is
kept absolutely clean all the time, medicines are arranged properly and bot
are properly closed with labels intact.
He / she will dispense medicines with great care, accuracy as per
instructions on the prescription.
• The Pharmacist will write the names of the medicines whenever necessary on
the envelope / container, bottle to avoid confus
Accreditation Standards for Primary Urban Health Centre
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PHARMACIST (STOREKEEPER)
• The Storekeeper is answerable to the Medical Officer Incharge. He / she is
entrusted with the supervision of dispensary stores and the safety, protection
from loss, theft, pilferage and damage or deterioration of the stocks entrusted to
his / her charge.
• He / she will arrange to keep stores in a neat and orderly manner and ensure
that all containers, bottles, packages etc. are properly labeled.
• He / she will prepare and submit regular indents to the Medical Officer Incharge
and after getting approved and countersigned submit it to the Central Medical
Store in accordance with the delivery programme issued by the store from time
to time.
• He / she will ensure sufficient buffer stock and will bring to the notice of the
Medical Officer Incharge when the stock requires replacement / procurement in
time to allow replacement to be made before actual depletion occurs i.e. before
the stock become 'NIL'. If required he / she shall prepare supplementary indents
for submission to the Central Medical Store.
• He / she will procure indents from Central Stores / any other source whenever
required.
• He / she will examine, count, measure or weigh, as the case may be, the stores
received and supervise its safe delivery to the dispensary stores. At the time of
the receipt, he / she will check that the quantities are correct and that the stores
are in good condition. He / she will immediately bring to the notice of Medical
Officer Incharge anything found contrary before the stocks are taken on the
stock register.
• He / she will meticulously maintain the expiry date register. All received stock will
be entered with the batch no. / date of expiry / quantity received at the time of
receiving the stock. He / she will plan release of stores in such a way that the
items are used well before expiry dates.
• He / she will bring to the notice of the Medical Officer Incharge stocks of such
preparations which are accumulating in the dispensary store beyond the need of
the dispensary.
• He / she will be responsible for correct accounting of all the stocks and for
maintaining stock and issue registers and inventories in respect of the
consumable, non consumable items, the dead stock and liveries. He / she shall
make entries in the register and file the vouchers in serial order and produce the
same for checking / inspection at the time of verification of stores and get the
entries in the register counters signed by the Medical officer Incharge.
• He / she shall issue to Pharmacist, Lab technician, ANM etc. stores under his
custody only on the authorization of the Medical Officer Incharge. He / she will
ensure that seal is broken / label defaced before issue of items.
Accreditation Standards for Primary Urban Health Centre
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rekeeper will be responsible for obtaining written acknowledgement from
sons to whom the stores are issued from the stores. These shall be filed
in serial order.
• ctions regarding store keeping and accounting
•
•
PUHC.
deputed by the controlling authority.
s / DPMU / and other agencies. He / she will
•
•
l
ty and
e the required entries in the stock
registers.
• He / she will ensure the smooth working of the PUHC equipment like
microscope, refrigerators, inverter, coolers, water cooler with aquaguard etc. by
maintaining AMCs and ensuring their payments in time.
• The Sto
the per
• He / she will initial all entries in the stock ledger pertaining to the receipts and
issue of the store. Receipt entries will be made in red ink and issue entries in
blue ink.
He / she will comply with all instru
procedure issued by the controlling authority from time to time.
On transfer or while proceeding on leave. he / she will hand over the charge of
the store to his successor and furnish a handling over and taking over charge to
the Medical Officer Incharge in the prescribed form / register.
He / she will assist in dispensing work whenever so required by the Medical
Officer Incharge of the
• The Pharmacist will immediately comply with the instruction and arrange for the
stocks with him to be checked at any time by the Medical Officer Incharge or
other Medical officers and any other official
• He / she will assist the Medical Officer Incharge in dealing with the
correspondence with the Directorate
also assist Medical Officer Incharge in preparing reports / statistics.
In case of epidemics and under special circumstances, storekeeper will have to
arrange for the required medicines / logistics.
• The bag and the raincoat / umbrella for outdoor official duty shall be kept in such
a manner that these are made readily available in the dispensary for performing
outdoor duty.
• Storage and prevention of losses in the stores. The articles are to be properly
stored in the Store room. The Storekeeper is also responsible for preventing
damages in the store. The store must be free from rats, termites, cockroaches.
He / she will not allow any outsider to sit in the store unnecessarily.
• He / she will check at regular intervals the stores available at the outreach centre
and help in the procurement of supplies and equipment. Check that the drugs at
the outreach centre are properly stored and that the equipment is wel
maintained.
• Ensure that sufficient stock is there for the outreach activities / ASHA activi
to provide for referrals from the nearby schools.
• Periodically check stock registers of the outreach centre. Issue the indents
required at the outreach centre and mak
Accreditation Standards for Primary Urban Health Centre
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rticles beyond repair are condemned and disposed
cedure and functional replacements are available
without any delay.
•
charge from time to time.
• He / she will see that the a
through the laid down pro
• He / she will actively participate in the camp activities by providing various
logistics / and the Medical Officer in organizing the activity.
He / she will carry out such other duties as may be assigned to him by the
Medical Officer In
PUBLIC HEALTH NURSE (PHN)
Public Healt
the healthcare delivery in the centre and the catchment area of the PUHC, especially the
slum population, JJ clusters, resettlement colonies etc. She will act as a guide supervisor to
PHN is resp
Role:
• Provision of healthcare delivery including implementation of the National Health
• supervisor to ANM and ensure ASHA – ANM synergy.
•
Provision o
Maternal &
ed postnatal care. All high risk cases to
prophylactic / therapeutic doses of iron and compliance is ensured through
•
ANMs.
Whenever necessary, actively participate in immunization related activities
h Nurse will assist the Medical Officers in planning, implementing and evaluating
various health functionaries while also improving their skill through hands on training. The
onsible to Medical Officers and community in general.
Programmes.
To act as a
To assist the Medical Officer Incharge in managing various activities of the
health team in PUHC and outreach in the community
f Healthcare:
Child Health
• Conduct of the weekly antenatal clinic, ensure early registration of all the
pregnant women by ANMs in their area, ensure complete checkup,
preparedness for the birth, completion of ANC, JSY, Referral cards wherever
appropriate. Ensure delivery of home bas
be examined by the Medical Officer and necessary management and referral
protocols decided. PHN to ensure follow up through ANM and ASHA. Ensure
that all pregnant women are screened for anaemia and provided with
ANMs and ASHAs.
Supervise the weekly Well Baby Clinics with Immunization sessions, weigh and
record weight of the infant / child on the immunization card with date. Screen the
infant / children for developmental milestones and detect any deviations from the
same. Demonstrate the technique of correct immunization to the
including the adverse events which are to be immediately brought to the notice
of the Medical Officer.
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• Ensure preparation and display of material like growth / development charts in
the immunization / well baby room.
Motivate / scree • n cases for use of appropriate family planning methods – IUCD
• the adolescent health talks and screening clinics at the centre in the
• ancer screening
•
Nutrition
ds for those visiting the centres /
Primary Me
•
•
ic.
preparation of the area maps.
in developing interpersonal skills by practical demonstrations in the
•
insertion and use of oral pills, permanent methods. Advise and educate
regarding use of emergency contraception.
Organize
outreach with the help of ANMs and ASHAs
Participate in special campaigns / screening activities i.e. C
week.
Provide information on the availability of services for MTP and ensure referral of
suitable cases to the approved institutions.
• Preparation of a plan of action for each identified anemic / malnourished baby
with the concerned ANM / ASHA. Appropriate counseling of the mothers of the
identified anemic and malnourished babies and attachment of the babies to the
nearest Anganwadi for SNP and the plan of action shared with the AWW,
Medical Officer to provide required technical advice in management anemia /
malnutrition.
• Hold practical demonstrations on how to prepare nutritious / wholesome meals
with simple, easily available and affordable foo
during outreach sessions.
dical Care
• Supervise the ANMs / ASHAs and give hands on training for treatment of minor
ailments, first aid for accidents and emergencies.
Attend to the cases referred by ANMs / ASHAs
Supervision of ANMs
Preparation of the ANM roster to ensure that ANMs are in the field for atleast
four days in a week. By rotation they would assist in the centre based antenatal /
well baby clin
• Ensure meticulous maintenance of Survey registers and Eligible couple registers
by the ANMs. By making field visits guide them in
• Monitor the outreach activities and guide ANM in conducting them well. Observe
the ANM while on job and strengthen the knowledge and skills of the ANMs.
Help them
centre and the field.
Help and guide the ANM’s in planning and organizing her plan of activities.
Accreditation Standards for Primary Urban Health Centre
@ National Accreditation Board for Hospitals and Healthcare Providers 123
• Conduct regular meeting with ANM’s (weekly) in coordination with Medical
Officer Incharge. Assess periodically the progress of work of ANM and submit a
monthly assessment report to the Medical Officer Incharge of the PUHC. Carry
Mentoring
• Will supervise ANM / ASHA synergy, the support provided by the ANMs to the
ASHAs, the capacity building of ASHAs, filling up of the diaries and verification
ial record maintenance by the ANMs and timely
disbursement of incentives to the ASHAs.
• Planning the schedule of the outreach sessions.
• Supervise the conduct of outreach activities.
of the PUHC.
and regular
• n health camps, well baby
shows, IEC activities and special state / national campaigns and programmes.
IEC Activiti
•
Status of Women
out supervisory home visits in the area of ANM.
of Urban Social Health Activist (ASHAs)
• Will be the key member in the unit level ASHA mentor group.
by the ANMs, financ
• Deliver the health talks in the Mahila Mandal meetings / adolescent health
activities organized by ASHAs.
Outreach Activities
• Participate in the innovative activities being carried out by NGO’s in the
catchment area
• Encourage community involvement and participation by identifying
meetings with community leaders.
Participate as an active member of the health team i
Training
• Organize and conduct trainings of ANMs, ASHAs and AWW with the help of
Medical Officers.
es
Preparation of locally relevant IEC material / charts / monthly report analysis
graphical charts with the help of ANMs and ASHAs.
Topics like:
MCH care
Family Planning
Nutrition
Immunization
Personal Hygiene
Environmental Sanitation
Adult Education
Accreditation Standards for Primary Urban Health Centre
@ National Accreditation Board for Hospitals and Healthcare Providers124
Right Age of Marriage
PNDT
Drug Addition etc.
Collection and judicious utilization of IEC material provided by the district.
Prepare the IEC / BCC plan for the PUHC
•
• group meetings with community leaders, teachers etc. and involve them
Ensure that the ANM maintains her equipment / records in a proper way.
• Ensure that the ANM / Immunization / IUCD insertion room is kept clean and
•
Records &
• Review reports received from ANMs, consolidates them and submits periodical
ical Officer Incharge of the PUHC.
• eing maintained properly.
HA is optimally utilized.
ssigned by Medical Officer Incharge from time to time.
• Supervise distribution of IEC material by ANMs / ASHAs.
• Observation of National / International day & weeks.
Arrange
in spreading the message for family welfare programme.
Supplies, Equipment and Maintenance at Health Centre / Outreach
•
equipment available and functional.
Preparation of a consolidated report of work done by the ANMs at the centre and
in the outreach.
Reports
• Scrutinizes and validates the records / reports prepared by the ANM and guides
her in their proper maintenance. She will be responsible for the completeness
and accuracy of the reports generated by the ANMs.
report to Med
• Supervise the ANM – ASHA chain.
Ensures that the records pertaining to ASHAs are b
• Also ensures that the information gathered by AS
Any other duties / jobs a
AUXILLARY NURSE MIDWIFE (ANM)
• Register and provide care to pregnant women throughout the period of
ll be registered, and care given to her according to
Maternal & Child Health
pregnancy. Registration of a pregnant woman for ANC shall take place as soon
as the pregnancy is suspected, ideally in the first tri-mester (before or at 12th
week of pregnancy). However, even if a woman come late in her pregnancy for
registration, she sha
gestational age.
Accreditation Standards for Primary Urban Health Centre
@ National Accreditation Board for Hospitals and Healthcare Providers 125
• Ensure that every pregnant woman makes at least 3 visits for Antenatal
checkup. First visit to the antenatal clinic as soon as pregnancy is suspected /
between the 4th and 6th month (before 26 weeks), 2nd visit at 8th month (around
32 weeks) and 3rd visit at 9th month (around 36 weeks). Ensure complete
antenatal checkups and associated services such as IFA tablets, TT
umin and sugar.
•
r facilitate the access to this referral
m hospital.
g with ASHAs will identify the ultimate beneficiaries, complete
e beneficiaries under Janani
ed in her areas and
• n
• including
anning
will be squarely responsible for maintaining eligible couple
registers and updating at all times.
message of family planning to the couples and motivate them for
• ptives to the couples,
spective acceptors in getting family planning services, if necessary,
hem or arranging for the ASHA to accompany them to
services to female family planning acceptors, identify side
n the spot for side effects and minor complaints and call
tion by the Medical Officer to the PUHC.
ASHAs, help in training them, and provide a
ot holders.
immunization etc.
• Ensure investigations – urine of pregnant women for alb
Estimation of haemoglobin level, blood sugar, blood group, VDRL.
Ensure that all cases of abnormal pregnancy and cases with medical and
gynaecological problems have been examined and provided a complete referral
to an identified referral unit. She will furthe
unit by providing the address, timings etc. If need be the ASHA of the area can
accompany the woman. ANM along with ASHA will provide follow up to the
patients referred to or discharged fro
• ANM alon
necessary formalities before disbursement to th
Suraksha Yojana (JSY)
• Make at least two post natal visits for each delivery happen
render advice regarding care of the mother and care and feed of the newborn.
Assess the growth and development of the infant and take necessary actio
required to rectify the defect.
Educate mothers individually and in groups in better family health
maternal and child health, family planning, nutrition, immunization, control of
communicable diseases, personal and environmental hygiene.
Family Pl
• Utilize the information from the eligible couple register for the family planning
programme. She
• Spread the
family planning individually and in groups.
Distribute conventional contraceptives and oral contrace
facilitate pro
by accompanying t
hospital.
• Provide follow-up
effects, give treatment o
those cases that need atten
• Establish female depot holders in
continuous supply of conventional contraceptives to the dep
Accreditation Standards for Primary Urban Health Centre
@ National Accreditation Board for Hospitals and Healthcare Providers126
• local leaders, ASHA, dais and others and take their
Family Welfare Programme.
• ndal meetings and utilize such gatherings for educating
Medical Termination of Pregnanc
pregnancy and refer
of pregnancy. Help in
adoption of a spacing method after MTP conducted for an unwanted pregnancy.
• ition among infants and young children, with
lement it with the help of ASHAs and AWWs. Refer the severe /
complicated malnutrition cases to the linked hospital.
Iron and Folic Acid tablets as prescribed to pregnant women, nursing
•
•
Universal I
nus toxoid
G
ization
schedule.
Report all adverse events to the Medical Officer.
oordination with Local Dais
and involve them in promoting Family welfare
Communic
•
the necessary measures to prevent their spread.
Build rapport with acceptors,
help in promoting
Participate in Mahila Ma
women in Family Welfare Programme.
y
• Identify the women requiring help for medical termination of
them to nearest approved institution.
• Educate the community of the consequences of septic abortion and inform them
about the availability of services for medical termination
Nutrition
• Have a strong liaison with the Anganwadi worker (AWW) of her area.
Identify cases of anemia and malnutr
the Medical Officer / Public Health Nurse make a plan of action for the identified
children and imp
• Distribute
mothers, and young children (upto five years) as per the guidelines.
Administer Vitamin A solution to children as per the guidelines.
Educate the community about nutritious diet for mothers and children.
mmunization Programme
• Immunize pregnant women with teta
• Administer DPT vaccine, oral poliomyelitis vaccine, measles vaccine and BC
vaccine to all infants and children, Hepatitis B, Typhoid as per the immun
• Ensure injection safety.
•
C
List Dais in her area
able Diseases
Inform the Medical Officer, PUHC immediately about any abnormal increase in
cases of diarrhoea / dysentery, fever with rigors, fever with rash, fever with
jaundice or fever with unconsciousness which she comes across during her
home visits, take
Accreditation Standards for Primary Urban Health Centre
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• If she comes across a case of fever during her home visits she will advise the
patient to come to PUHC for the blood examination.
Identify cases of skin patches, especially if accompanied by loss of sensation,
which she comes across during her home visits and bring them to PUHC for
examination by the Medical Officer.
•
•
Vital Event
d
• t records concerning mothers, children and eligible
Record Ke
egisters
register (ANM specific) in which she records detailed household survey
•
d couples. Accordingly she prepares her
• PUHC) – details of ANC, intranatal
•
ach, Cases referred for Tubectomy / Vasectomy and cases operated.
•
• Keep a follow up of patients on t/t for leprosy, tuberculosis and ensure
compliance and completion of treatment with the help of ASHAs wherever
available. Motivate defaulters to take regular treatment.
• Give Oral Rehydration solution to all cases of diarrhoea / dysentery / vomiting.
Train ASHA in ORT as she is a depot holder for ORS.
Identify and call all cases of visual impairment including suspected cases of
cataract to the PUHC. ASHA can accompany the patient for the required
surgery.
• Education, Counseling, referral, follow-up of cases STI / RTI, HIV / AIDS.
s
• Facilitate (by providing the address of the nearest registering office) according of
vital events including births and deaths, particularly of mothers and infants an
inform the Medical officer of the PUHC.
Maintenance of all the relevan
couples in the area.
eping
R
• Survey
of her area and allotted families.
Eligible couple Register (ANM specific) in which she records the eligible couples
– both protected and unprotecte
workplan and follows them up.
Pregnant women register (common for the
care, outcome of pregnancy and postnatal period.
Detailed record of Family planning activities carried out at the centre – IUCD
inserted, Oral Contraceptives distributed at the centre, in the field through ASHA,
other outre
• Immunization registers with detailed record of child / vaccines given and next
due.
Prepare and submit the prescribed weekly / monthly reports in time.
• Fill up any format provided under the IDSP.
Accreditation Standards for Primary Urban Health Centre
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Treatment of Minor Ailments
Provide treatment for minor ailments i.e. Parace • tamol for fever, first aid for minor
eam Activ
Primary Urban Health Centre
• ith the local self help groups, health and
•
•
•
session and will
le couple register of the village
dopting family planning.
intake of full course of IFA tablets and TT
A on the dose schedule and side effects of oral pills.
abour so that she
ASHA on date, time and place for initial and periodic training
•
• She will also maintain financial records of the ASHAs working in her area.
accidents while on a home visit.
itiesT
• Organize staff meetings at
• Coordinate her activities with the Health volunteers / NGOs / ASHA and Dais.
Help in creation of and coordinate w
sanitation committees.
Dispose medical waste as per the guidelines.
Participate as an active member of the team in camps and campaigns.
Role of ANM as a facilitator of ASHA
Auxillary Nurse Midwife (ANM will guide Urban Social health Activist (ASHA) in performing
the following activities:
She will hold weekly / fortnightly meeting with ASHA and discuss the activities
undertaken during the week / fortnight. She will guide her in case ASHA had
encountered any problem during the performance of her activity.
• ANM will act as a resource person for the training of ASHA.
• ANM will inform ASHA regarding date and time of the outreach
also guide her for bringing the beneficiary to the outreach session.
• ANM will participate and guide in organizing the Health days at Anganwadi
centres.
• She will take help of ASHA in updating eligib
concerned.
• She will utilize ASHA in motivating the pregnant women for coming to PUHC for
initial checkups. She will also help ANMs in bringing married couples to the
PUHC for a
• ANM will ensure compliance in
injections etc. with the help of ASHAs.
• ANMs will orient ASH
• ANMs will educate ASHA on danger signs of pregnancy and l
can timely identify and help beneficiary in getting further treatment.
• ANMs will inform
schedule. She will also ensure that during the training ASHA gets the
compensation for performance and also TA / DA for attending the training.
She will be responsible for ensuring correct filling up of diaries by the ASHAs,
verification of the work done and timely disbursal of incentives.
Accreditation Standards for Primary Urban Health Centre
@ National Accreditation Board for Hospitals and Healthcare Providers 129
LABORATORY TECHNICIAN
All Primary Urban Health Centre will have Laboratory technician / assistant. The Laboratory
ill be under the direct supervision of the Medical Officer Incharge, PUHC. The technician w
laboratory technician will carry out the following duties:
I. Gen
1.
4.
5. f specimens and infected material in a safe manner as per the
6. Maintain the necessary records of investigations done and submit the reports to
e Medical Officer, PUHC
8.
II. Lab ns
ut examination of urine
i. Specific gravity and PH
III. Car Examination of Blood
iii. RBC count
eral Laboratory Procedures
Maintain the cleanliness and safety of the laboratory
2. Ensure that the glassware and equipment are kept clean
3. Handle and maintain the microscope
Sterilize the equipment as required
Dispose o
Biomedical Waste Disposal guidelines
th
7. Prepare monthly reports regarding his work
Indent for supplies for the laboratory though the Medical Officer, PUHC well in
time and ensure the safe storage of materials received
oratory Investigatio
1. Carry o
ii. Test for glucose
iii. Test for protein (albumen)
iv. Test for bile pigments and bile salts
v. Test for ketone bodies
vi. Rapid Test for Pregnancy (RPT)
viii. Microscopic examination
2. Carry out examination of stools
i. PH
ii. Microscopic examination
ry out
i. Collection of blood specimen by finger prick technique
ii. Hemoglobin estimation
Accreditation Standards for Primary Urban Health Centre
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iv WBC count (total and differential)
ocyte sedimentation rate
x. Typhoid (Typhi Dot)
i. Preparation, staining and examination of sputum smear for Mycobacterium
PUHC is recognized as microscopy centre under
V. Carry out Examination of Semen
ii.
iii. hlorine in drinking water by testing kits
v. Preparation, staining and examination of thick and thin blood smears for malaria
parasites and for microfilaria
vi. Erythr
vii. Blood Sugar
viii. Blood Grouping
ix. VDRL
Rapid Diagnostic test for
IV. Carry out Examination sputum
tuberculosis (wherever the
RNTCP).
i. Microscopic examination
Sperm count and motility
VI. Test samples of drinking water
i. Testing of samples for gross impurities
ii. Rapid tests for detecting faecal contamination by H2S strip test
Residual c
Perform any other tests as per the IDSP (Integrated Disease Surveillance Project)
Perform any other duty as assigned by Medical Officer Incharge from time to time.
Accreditation Standards for Primary Urban Health Centre
@ National Accreditation Board for Hospitals and Healthcare Providers 131
All Primary Urban Health Centre will have Radiographer. The Radiographer will be under the
direct supervision of the Medical Officer Incharge, PUHC. The Radiographer will carry out
e following duties: th
• Maintain the cleanliness and safety of the X-Ray, Dark room and USG room
in the medical diagnosis
ological diagnosis.
ls, such as kilo voltage and mili amperage to
timing of exposure; regulates the length and
• nd restrains patients; and takes x-rays of
he work area.
•
as patient records, daily logbooks, and monthly
ssure x-ray unit meets standards required by
olicies
uired.
and day-to-day utilization.
accounts and statistics of each room to
s for patients in surgery.
ins and makes minor adjustments to radiographic equipment,
including determining repairs needed to equipment and report equipment failure
t rectified well in time.
onnel from radiation hazards.
ough the Medical Officer,
PUHC well in time and ensure the safe storage of materials received
• Administers contrast media to patients for gastrointestinal and other special
• Sets up and operates radiographic equipment used
and/or treatment of patients.
• Selects proper ionizing factors for radi
• Adjusts and sets radiographic contro
prescribed specifications for proper
intensity of film exposure.
Receive patient's requisition, positions a
patient’s chest, limbs or other parts of the body as required by the Medical
Officer.
• Implements infection control procedures for t
• Checks X-rays for clarity of image, and retakes x-rays when needed.
Develops, fixes, washes, and dries exposed films using film processing and
drying equipment.
• Maintains required records such
reports.
• Distribute films to appropriate medical staffs.
• Maintains quality control checks to a
laws, rules and departmental p
• Assist Medical Officers as and when req
• Responsible for films used
• Provide details on daily poor quality films
be handed over to the management.
• Performs radiographic procedure
• Cleans, mainta
to Medical Officer Incharge and get i
• Protects patient and other pers
• Indent for radiographic supplies, film and equipment th
studies.
RADIOGRAPHER
Accreditation Standards for Primary Urban Health Centre
@ National Accreditation Board for Hospitals and Healthcare Providers132
• Observes the safety requirements and follow safety procedures and instructions
erformed and percentage of wastage.
y other duties as may be assigned to him by the Medical
ns
• Plain and Computed Radiography
meal, follow through and Barium
b. ULTRASONOGRAPHY
ding endovaginal exams, TIFFA
ctures including Breast, Thyroid, Scrotal and
ions.
.
• Penile Doppler examination
and shall refrain from any willful act that could be detrimental to self, co-workers,
and the radiation installation and public.
• To provide statistical details of cases p
• He will carry out an
Officer Incharge
Radiological Investigatio
a. X RAY
• Contrast studies like Barium swallow, Barium
enema; IVU; RGU / MCU; HSG ; water soluble contrast studies for GIT;
Fistulograms: Sinograms
• General Abdominal and Pelvic studies.
• Obstetrical and Gynecological inclu
• Soft tissue and superficial stru
Transrectal Prostate examinat
• Pediatric and Neonatal studies.
• Musculoskeletal examinations such as Hips, Shallers and Knees
c. DOPPLER STUDIES (if available)
• Peripheral, Cerebro-vascular and abdominal Doppler.
• Assessment of post Kidney and Liver Transplant patients.
Accreditation Standards for Primary Urban Health Centre
@ National Accreditation Board for Hospitals and Healthcare Providers 133
DRESSER
• The Dresser will be responsible for the overall management of the Dressing
room and do the require dressings.
• He will render first aid in emergency cases and help the Medical Officer in
e Medical Officer.
f lotions, powders and
• dressing material will be kept in a separate tray.
•
at a time and keep it in a sterilized tray.
zed
medical Waste disposal.
patient or the female attendant of the PUHC or will call
• tles / jars etc. properly covered, corked,
dages, gauze etc. stored
• a white apron and liveries provided.
e removal of foreign
• tore and maintain a
ntain separate register for special drugs like eye, ear, and ointment
•
handling the injured.
• He will issue the lotions and ointments to the patients under the guidance of the
Pharmacist as prescribed by th
• He will keep the Dressing room clean and tidy. All types o
ointments shall be properly labeled and arranged.
• He will keep medicaments for Eye and Ear in a separate tray.
The lotions, paints etc. and
• He will prepare the drum with instruments and dressing material for sterilization.
He will take out for use from the dressing drum a small quantity of sterilized
dressing
• He will wash his hands with soap and water before dressing and use sterili
dressings provided for the purpose.
• He will take proper care of the soiled dressings and put the same in covered
waste receptacle. These soiled dressings must be disposed as per the
guidelines issued for Bio
• In case of a female patient, he will not do the dressing except in the presence of
a female relative of the
ANM to do the dressing if need be.
• He will maintain proper accounts of the medicaments, drawn from the stores.
He will keep the bulk containers, bot
stoppered and labeled.
• He will keep dressing material i.e cotton, linen, ban
properly and not exposed to dust.
The dresser while on duty will have on
• He will assist the Medical Officer in minor operations lik
body, repair of wounds etc. and keep sutures (needle thread) instruments etc.
sterilized and ready for use.
He will indent the creams / lotions / ointments from the s
stock register for these.
• He will mai
issued from the dressing room.
He will carry out any other duties as may be assigned to him by the Medical fficer
Incharge.
Accreditation Standards for Primary Urban Health Centre
@ National Accreditation Board for Hospitals and Healthcare Providers134
NURSING ORDERLY / PEON
to
him by the Medical Officer Incharge.
• h a Medical Officer he will control the influx of patients to the
doctor’s room.
ble for the proper upkeep and cleaning of doctor’s consulting
er rooms including all furniture, equipment therein.
d examination table for the patients.
dical Officer Incharge.
• Similarly he will collect dak any other logistics from the District / State HQ / or
the Medical Officer Incharge.
et the indents from the main store.
ndant at the
• e for procurement of water for mixtures /
r official duty
shall return / deposit the raincoat / umbrella / bag to the concerned official.
responsibility in the conduct of
him by the Medical
Officer Incharge from time to time.
The Nursing Orderly / Peon will carry out duties in the PUHC or outside that as assigned
When posted wit
• He will be responsi
rooms and oth
• He will arrange the doctor’s tables an
• He will be responsible for the delivery of dak or any other material to the district
headquarters / to the Central store and such other place as may be required
under instructions from Me
any other place as instructed by
• He will accompany the storekeeper and g
• The Nursing Orderly / Peon will perform duties of watchmen / atte
PUHC as specified by the Medical Officer Incharge at the time of need.
Wherever necessary, he will arrang
drinking purposes.
• The Peon / Nursing Orderly / Messenger after performing outdoo
• He will participate enthusiastically and with
various camps / all outdoor activities.
• He will perform such other duties as may be assigned to
Accreditation Standards for Primary Urban Health Centre
@ National Accreditation Board for Hospitals and Healthcare Providers 135
SWEEPER CUM CHOWKIDAAR - SCC(Dual work of security and sanitation in shift duties)
The SCC on morning shift will report • for duty sufficiently early to sweep and mop
• take the charge of the Primary Urban Health
• d locked so as to exclude the
• re taking over duty and show
per on relief from
s placed outside, the rooms are
• lights, heaters, fans etc. are
•
•
ons etc. He will empty waste
•
iomedical waste. These activities will be
performed before opening or after closing of the centre.
ing and unloading store from the vans.
g to
•
se of the specimen after the completion of their
• e shelves when he is attached with the store.
the Primary Urban Health Centre floors etc. so that work can start at the
scheduled hour.
The Sweeper cum Chowkidaar will
Centre premises after the PUHC hours.
He will ensure that all the rooms are properly bolte
possibility of entry by an unauthorized person.
He will inspect the lock and seal of the medical sto
the same to the next SCC, Medical Officer Incharge / Storekee
duty.
• He will check that the almirahs containing store
properly locked and sealed. Any deficiency noticed will be brought to the notice
of the Medical Officer Incharge by him immediately.
Before closing the rooms he will ensure that all
switched off and the water taps are closed.
The SCC will not sleep while on duty.
• He shall arrange for procuring water needed for mixtures and drinking purposes.
He will daily sweep and mop the floors of the PUHC building and surroundings,
clean all wash basins, latrines and urinals, spitto
paper baskets, dustbins etc. at the provided places.
He will see that the biomedical waste is segregated and disposed as per the
guidelines issued for disposal of b
• He will clean the walls / cisterns with a brush broom at least once a week.
• He will in turn do dak work, urgent indents, telephone duties on both working and
closed days besides load
• He will indent and obtain phenyl, vim in time, sweeping material like brooms,
mops etc. for performing his duties.
• When posted to the laboratory he will perform the cleaning duties pertainin
the laboratory and its surroundings as detailed above.
He will wash and clean laboratory slides, bottles etc. used for investigation
purposes and correctly dispo
examination and when they are no longer required.
He will wash and clean th
• Under mo condition, he will leave the PUHC premises without handing over the
charge.
• The SCC will perform such other duties as may be assigned to him by the
Medical Officer Incharge.
Accreditation Standards for Primary Urban Health Centre
@ National Accreditation Board for Hospitals and Healthcare Providers136
SOCIAL MOBILIZATION OFFICER (SMO)
He /she will be under the immediate administrative council of the Primary Urban Health
Centre Medical officer. He / she will be responsible for providing support to all health and
Communitization Activities
of various h establish and
nit i.e.
together sm
dedicated e ce by an individual trained in
them awar s, accessing and
•
• r Incharge in organizing regular meetings of RKS
•
• Coordinating District / State level trainings for RKS members
Related to s / Local Self Help Groups (like Mahila
Arogya Samiti) / other Community Based Groups (CBOs)
• Help ASHA in the formulation of Health and Sanitation Committees in community
and plan for their capacity building.
• Hand holding and Capacity Building training for SHG / MAS members in
consultation with Medical Officer.
• Make sure the reimbursement of HSCs seed fund.
• Supporting institutionalization of HSCs / MAS / CBO through training on themes -
group meeting, recording of meetings, book keepings.
• Promoting community risk pooling through collection of small thrift for health
exigency in HSCs / MAS / CBO.
• Facilitating linkage with bank by opening up bank account for MAS / CBO.
• Will assist in the health insurance scheme implementation once it is taken up.
family welfare programmes in the area. His focus work areas will be:
With the emphasis on Community Involvement in planning, implementation and monitoring
ealth interventions there has to be a strong and concerted effort to
maintain a continuous interaction between the community and the local health u
PUHC. Many of the important interventions like setting up and registering the Rogi Kalyan
Samitis / forming health and sanitation committees for every 2000 population / putting
aller self help groups required for mounting risk pooling activity will require
ffort at the grassroot level and active field presen
these activities. He / she will stimulate and guide this local initiative, assist them by making
e of the existing guidelines, available funds for various activitie
using the same and record keeping.
Related to Rogi Kalyan Samitis:
Help in identification of the members
• Registration of the society
Assist Medical Office
• Taking minutes of the proceedings and ensuring follow up activities
Maintaining records including financial records
• Preparing reports of RKS
Health & Sanitation Committee
Accreditation Standards for Primary Urban Health Centre
@ National Accreditation Board for Hospitals and Healthcare Providers 137
Related to Accredited Social Health Activist (ASHA)
• Assist the Medical Officer to develop the plan for ASHAs induction training and
•
HAs. Building credibility, helping her access the resistant
will help field workers in winning over
• ach ASHA considering 400 - 450
• NM in monitoring work of ASHAs in the community, through verification of
Support to
Officer. The specific tasks to be
•
• ces and required logistics
Reporting
ces.
• ctivities of PUHC and help Medical Officers
• es for the timeliness and
and their catchments, depiction of households and beneficiaries on the
• le for preparation and display of relevant maps of the
area which will be prepared with the help of the ANM and ASHA
• Facilitate selection of ASHAs
concurrent training and implement the same.
He / she along with the ANM, PHN will be a part of the Unit level core mentor
team for the AS
families, enhancing her communication skills, establishing her contacts with local
water, sanitation functionaries. He / she
resistant cases and drop outs in the health and family welfare programmes.
Map the defined and delineated catchment for e
households each.
Help A
reported beneficiaries.
Outreach Activities
He / she will be responsible for planning of outreach activities in the PUHC catchments in
consultation with PHNs, ANMs, ASHAs and Medical
accomplished are:
• Facilitate preparation of monthly outreach plan for slums in consultation with
concerned ASHAs and ANMs.
Esure the implementation of monthly outreach plan.
Help ASHAs in mobilization of community resour
support for outreach activities – place, tables, chairs, water etc.
and Data Management & Monitoring Activities
Help ANMs / ASHAs in compilation of data for activities outreach and coverage of servi
• Support ASHAs to maintain registers, review registers and reporting formats and
compile data accurately for assigned clusters submit to Medical Officer.
Generating reports on the monthly a
in presenting it to appropriate authority / forums.
Will assist in monitoring the outreach activities / centr
completeness of services being provided. Will ensure that the outreach centre is
kept clean and is properly maintained.
Mapping and IEC / BCC Activities
• Help ANMs / ASHA and MAS in participatory geographical and social mapping
the slums
map.
He / she will be responsib
Accreditation Standards for Primary Urban Health Centre
@ National Accreditation Board for Hospitals and Healthcare Providers138
C
• Coordinate with other Govt. Offices, municipality, District Tuberculosis Office /
t with the school health functionaries in the area.
n organization of the camps /
ivities and with the help of ASHAs ensure active
nd publicity
ization of mass communication programmes like film
strict BCC officer.
• He / she will maintain a list of prominent acceptors of family planning methods
titioners, school teachers, dais and others
preading the message for various health
en leaders with the help of
ious National Health Programmes.
he
oordination and Management
DOTs centres, MDT centres, Malaria circle / beat office.
• Establishing the vital network with the area Anganwadis and their functionaries,
supervisors.
• Establishing contac
• Liasoning closely with the local NGOs and ensuring their participation in various
activities as and when required.
• Risk pooling is a proposed activity under the urban health mission. Once
operationalised it will need a strong community based working mechanism. He
will with the help of ASHAs, local NGOs, existing self help groups if any help in
building this mechanism
• He / she will ensure that the benefit of various entitlement schemes being run by
the Government for vulnerable segments reach them. This activity will include
generation of awareness and facilitation of access to these benefits by the
identified beneficiaries.
IEC & BCC Activities
• Along with the other staff he will participate i
campaigns / outreach act
participation by the community.
• He / she will organize the celebration of health days and weeks a
programmes al local fairs on market days etc.
• He / she will assist organ
shows, exhibition, lectures and dramas, with the help of the Di
and opinion leaders and will try to involve them in the promotion of Health and
Family Welfare programmes.
• He / she will organize orientation training for Health and Family Welfare workers,
opinion leaders, local medical prac
involved in Health & Family Welfare work. Arrange group meetings with the
leaders and involve them in s
programmes. Organize and conduct training of wom
the Medical Officer / ANM.
• He / she will organize health education sessions in schools and for out of school
youth.
• Organize and utilize Mahila Mandal, teachers and other women including ICDS
personnel in the community in var
• He / she will prepare a monthly report on the progress of BCC activities in t
PUHC area.
Accreditation Standards for Primary Urban Health Centre
@ National Accreditation Board for Hospitals and Healthcare Providers 139
• Coordinating the campaign of IEC / BCC in the PUHC catchment.
activities cover the entire population through map
Trainings:
•
Any other y the Medical Officer Incharge
• Make sure that IEC and BCC
based micro planning.
• He / she will assist the Medical Officer, PUHC in conducting training of various
staff and ASHA.
He / she will maintain a complete set of educational aids on Health and Family
Welfare for his / her own use and for training purpose.
• Trainings of RKS / SHG functionaries.
activity assigned b
Accreditation Standards for Primary Urban Health Centre
@ National Accreditation Board for Hospitals and Healthcare Providers140
COMPUTER DATA ENTRY OPERATOR (CDEO) CUM ASSISTANT
The data generated at the PUHC suffers from serious flaws like authenticity, incompleteness
and inconsistencies. Major reason for that being lack of accurate and complete recording by
l Officers on ththe Medica e OPD slips and leaving the work of entering / recording the same
it being the
In order to / reliable data all these problems have to be
a CDEO wi
• ttendance registers. Computer generation of OPD slip
•
• eports – hard and soft copies in the prescribed formats
programmes.
• e diseases to the concerned departments.
• om the ANMs and its compilation
•
•
s for staff / community workers.
in master register to a worker who is not qualified to do so (in most of the cases
Nursing Orderly / Peon) and existence of long elaborate formats.
generate authentic / complete
addresses. CDEO cum Assistant has been proposed to take care of all data collection,
compilation, generation of various kinds of reports and their onward transmission. Duties of
ll be:
Maintenance of the OP a
and patient registration.
Entry of complete diagnosis and treatment prescribed in the computerized
registry.
Generation of monthly r
provided under different
• Transmission of the reports in time to various concerned units – DPMU / SPMU /
Directorates.
Immediate notification of notifiabl
• Accurate compilation and onward transmission of the data pertaining to IDSP.
Collection of data pertaining to ASHA activity fr
in prescribed formats.
Maintaining all relevant records financial and otherwise, related to ASHAs / other
community structures.
Assisting the Medical Officer Incharge in preparing communications, orders,
disseminating various guideline
• Any other work assigned by the Medical Officer Incharge.
Accreditation Standards for Primary Urban Health Centre
@ National Accreditation Board for Hospitals and Healthcare Providers 141
MEDICAL RECORDS CLERK
•
for submittin
To develop and maintain an information base and providing statistical data and
g mothly reports
• Attend the correspondence of birth and death reports requested by the patients
or nearest relatives.
• To initiate, process, and check the patient records from IP, OP, Emergency to
ensure all the necessary forms and information are available.
• To assemble medica record in accordance with the prescribed standard order.
• To maintain & preserve patient records including X rays and diagnostic reports in
a scientific way for the period recommended in the retention schedule.
• To retrieve medical records to meet the needs of patient care, medical
education, training, research, medico legal problems & evaluation of patient care
• To prepare complete procedures related to medical reports, certificates, death
and birth reports, and to submit the data to the appropriate authorities.
• To expedite any responsibilities related to the medical records assigned by the
Medical Officer Incharge from time to time.
• He / she is also responsible for delivery and collection of out patient file from the
respective consultant room/ casualty and then maintaining the same in the
medical records room.
• Compiles and furnishes the required information to the Medical Officer Incharge.
• Issues medico legal files and other certificates to the police in case required by
them.
• Custodian of the MLC registers.
• Send the monthly report of various notifiable diseases (malaria, tuberculosis etc)
to CDEO.
Accreditation Standards for Primary Urban Health Centre
@ National Accreditation Board for Hospitals and Healthcare Providers142
SELF APPRAISAL OF PRIMARY URBAN HEALTH CENTRE STAFF
FORM 6.1 SELF APPRAISAL - MEDICAL OFFICERS: Clinical Care Competencies
Facilitation Help Required at LevelS.No. Skill / Competency Gap
PUHC District State
1.
Clinical Protocol / Standard
Treatment Guidelines adopted by
the State for various management
of comm
level
Am I familiar with the Standard
on illness at the PUHC
2. under LA, carrying out
suscitation pro
Am I confident in setting up IV
es, suturing simple woulin nds
re cedure, using
Nebulizers, Ryles tube, Catheters
3.all the different medications /
gistics available i
Am
effects / dosages / interactions of
lo n my PUHC
I aware of the uses / side
4. equipment / apparatus needed in
the PUHC
Am I confident in use of all the
5.Insertion / abdominal examination
a pregnant woman
Do I have the specific skills like
lvic examination and pe IUCD
in
6.
Am I familiar with guidelines of
National Programs being
nted in my PUHC
impleme
7. cardiovascular emergencies,
snake / dog bites
Am I confident of dealing with
8.
Am I aware of various
empowerments / health and social
sector schemes for the vulnerable
population
9.
Am I aware of the State
Guidelines for Biomedical Waste
Management
10.Am I aware of the PEP Protocols
and policy of procuring the same
Accreditation Standards for Primary Urban Health Centre
@ National Accreditation Board for Hospitals and Healthcare Providers 143
11.Am I aware of referral center
availability of transport facilities
s and
12.slip to the referred patient
Am I giving a duly filled referral
13.recording to be undertaken in
Am I aware of stepwise action /
case of adverse events related to
Immunization / medicines
14.condition and the management
an
Am I spending enough time with
each patient, explaining the
pl
Accreditation Standards for Primary Urban Health Centre
@ National Accreditation Board for Hospitals and Healthcare Providers144
FORM 6.2 SELF APPRAISAL - MEDICAL OFFICERS: Managerial Competencies
Facilitation Help Required at Level S.N
o.Skill / Competency Gap
PUHC District State
1.
Do I have a copy of the Public
Health UHC
available in the centre
Standards for a P
2.
A
re
c
re
m I aware of the roles and
sponsibilities of the staff in my
are and have I delegated
sponsibilities to each one
3.
A
s e / functions / proceedings
o
m
m I clear on the objectives
tructur
f the Jan Swasthya Samitis and
y Role as the member secretary
4.A
s
m I aware of the GFR for the
tate
5.Am I familiar with the I
M
nventory
anagement Principles
6.
A
fo s
for their u
m I aware of the funds available
r the PUHC and the guideline
sage
7.
A
le n arise in a
PUHC
m I aware of possible medico
gal issues that ca
Accreditation Standards for Primary Urban Health Centre
@ National Accreditation Board for Hospitals and Healthcare Providers 145
FORM 6.3 SELF APPRAISAL - STOR KEEPERSE
Facilitation Help Required at Level S.No. Skill / Competency Gap
PUHC District State
1.A
R
m I aware of my Roles /
esponsibilities
2.
A
t the
r
o
q
re the indents I am preparing
imely, rational (as per
equirements of various sections
f the PUHC) and in sufficient
uantities
3.
A y stock registers, issue
registers, vouchers, maintained
as per guidelines
re m
4.Is my store well organized,
clean and pest free
5.
Is my expiry register are in order
and I am always well aware of
the drugs nearing expiry to take
the necessary steps while
issuing
6.
Am I always able to maintain
buffer stocks, plan for the
outreach, ASHA requirements
or there are frequent stock outs
7.
Is all my stock – consumable
and non consumable fully
accounted for and recorded in
separate registers
8.
All bills are paid in time and
necessary records maintained –
Electricity, water, telephone,
internet etc.
9.
Are all equipment / apparatus in
my PUHC like microscope,
refrigerator, inverter, coolers,
water cooler with aqua-guard /
RO etc. functioning properly and
covered under AMC
10.
Are all items beyond repair
condemned and disposed
through the laid down
procedures and functional
replacements are available
without any delay
Accreditation Standards for Primary Urban Health Centre
@ National Accreditation Board for Hospitals and Healthcare Providers146
FORM 6.4 SELF APPRAISAL - PHARMACISTS
Facilitation Help Required at Level S.No. Skill / Competency Gap
PUHC District State
1. s and
Am I aware of the uses, doses,
side effects, interactions,
storage specification
correct dispensing procedure
of the drugs in my charge
2.ith
Is my pharmacy clean,
organized, well stocked w
drugs arranged and within
easy reach
3.
Am I dispensing accurately
and making sure that the
patient understands, especially
use of inhalers etc.
4.
Is my daily consumption
register, stock register being
maintained as prescribed
5.
Am I playing my role in
outreach services / ASHA
mechanism
Accreditation Standards for Primary Urban Health Centre
@ National Accreditation Board for Hospitals and Healthcare Providers 147
FORM (PHN) 6.5 SELF APPRAISAL – PUBLIC HEALTH NURSE
Facilitation Help Required at Level S.N Skill / Competency Gap
PUHC District State
1.A
R
m I aware of my Roles /
esponsibilities
2.A
A
m I aware of the role of
NMs and ASHAS
3.
D
k
c s in
im
N
N Family
P
s
manag nutrition
e
m
o I have the necessary
nowledge / skills /
ompetencie
munization, Antenatal,
atal, Post natal, Essential
ewborn care,
lanning, Nutritional
urveillance and
ement of mal
tc. to play my role
eaningfully
4.
A
c
proto n case of breach of
c
f
o
f
c
im
m I aware about the cold
hain defrosting procedures /
cols i
old chain, contingency plan
or storage of vaccines in time
f electricity / equipment
ailure, stepwise protocol in
ase of adverse event for
munization
5.
A
s iomedical
w
m I fully conversant with the
afe disposal of b
aste
6.
D
/
s nd mentoring
t
m
o I have the necessary skills
competencies for
upervising a
he ANMs and ASHAS under
e
7.
H
t
c
a
ave I made a roster time /
opic wise to impart skills /
ompetencies mentioned
bove to my ANMs
8.
H
n
o
a
v
p nts in
ave I made a systematic
eed analysis for monthly
utreach activities (HNDays)
nd if so have I identified a
enue, made a schedule,
rojected the requireme
Accreditation Standards for Primary Urban Health Centre
@ National Accreditation Board for Hospitals and Healthcare Providers148
the facility level p
logistics and other resources
lanning for
9.Am I s
as per the checklist
supervising the HND
10.
H
A
w
a
t d
p
c
ave I ensured that all my
NMs are doing their field
ork, keeping their records
nd registers in the manner
hat shall lead to a hundre
ercentage coverage of their
atchment population
11.
A
t eporting formats
a
m
c
A
m I clear on the definitions /
erms in the r
nd have developed
echanisms for accurate and
omplete data capture by the
NMs
12.
D
t
d
make / suggest
im
s
o I have the necessary skills
o compile and analyse the
ata, draw inferences and
provements. Do I have IT
kills
13.
Are the ASHAS in my areas
trained in their key activities.
Are their referrals being given
due
Accreditation Standards for Primary Urban Health Centre
@ National Accreditation Board for Hospitals and Healthcare Providers 149
FO )RM 6.6 SELF APPRAISAL – AUXILLARY NURSE MIDWIFE (ANM
Facilitation Help Required at Level S.N Skill / Competency Gap
PUHC District State
1.Do I know my roles and
responsibilities
2.
ls and
on their visit for
ucation about
menstrual hygiene / safe
nseling and facilitation in
adoption of family planning
Do I have the required
knowledge, skil
competencies
Immunization – the
schedule, technique, cold
chain, management of
adverse events, tracking of
defaulters / use of ASHAS to
ensure 100% coverage
Malnutrition – Weighing of
all children, screening them
for anaemia and Vitamin A
deficiency
immunization. Detecting
malnutrition and managing
it.
Complete and appropriate
antenatal, postnatal,
essential newborn care
Detection, counseling,
health ed
sexual practices
Cou
measures.
Suspect and refer TB,
leprosy patient. Help in
initiation and completion of
treatment.
Bring down the incidence /
morbidities associated with
vector borne diseases.
Safe disposal of biomedical
waste.
Prevention and control of
infection.
3. Have I marked my catchment
Accreditation Standards for Primary Urban Health Centre
@ National Accreditation Board for Hospitals and Healthcare Providers150
population and mapped it
4.y
Have I linked myself to m
catchment anganwadis
5.
f my areas
Do I know ASHAs o
and have I developed the
desired rapport with them
6.
Am I providing the necessary
help to my ASHAS facing
problems in the field
7.
isters / Are my surveys reg
eligible couple registers
updated. Have I managed to
devise a network of ASHAS
and Anganwadis in my area to
achieve the objective of 100%
coverage
8. Am I facilitating their timely
incentive disbursal
9.Am I conducting the HNDay as
per the defined structure
10.
ete accurate data as
t
Am I collecting and entering
compl
required. Am I along with the
PHN analyzing the data and
identifying the areas needing
thrus
11.Have I made an IEC / BCC
plan for my area
Accreditation Standards for Primary Urban Health Centre
@ National Accreditation Board for Hospitals and Healthcare Providers 151
FORM 6.7 SELF APPRAISAL – LAB TECHNICIAN
Facilitation Help Required at Level S.No. Skill / Competency Gap
PUHC District State
1. my roles and
responsibilities
Do I know
2.ill and competencies
to carry out the tests mandated at
Do I have the necessary
knowledge, sk
the PUHC
3.
Am I ensuring safe disposal of the
biomedical waste generated in
lab
my
4.
and care of my microscope, digi
diagnostic equipments l
hemoglobinometer, glucomete
semi auto analysers etc.
Am I fully conversant with the use
tal
ike
rs,
5.
Am I carrying out the periodical
standardization of my equipme
to ensu
nt
re accuracy
6.
Is my lab refusing any tests
because of lack of logistics /
equipments / skills
7.
Am I taking the necessary
precautions for prevention and
control of infection
Accreditation Standards for Primary Urban Health Centre
@ National Accreditation Board for Hospitals and Healthcare Providers152
FORM 6.8 SELF APPRAISAL – RADIOGRAPHER
Facilitation Help Required at Level S.N Skill / Competency Gap
PUHC District State
1.Do I know my roles a
responsibilities
nd
2.
Do I have the necessary knowled
skill and competencies to carry
the tests mandated a
ge,
ut
t the PUHC
o
3.
the
Am I ensuring safe disposal of
biomedical waste generated in my
department
4.
e
c
and
Am I fully conversant with the
and care of digital diagnosti
equipments like X-ray
Ultrasound
us
5.
al
my equipment to
Am I carrying out the period
standardization of
ic
ensure accuracy
6.
g any tests
Is my department refusin
because of lack of logistics /
equipments / skills
7.
s ry
ure
fety
like Lead shielded gowns,
Am I taking the neces
precautions for Radiation expos
hazards by using radiation sa
devices
a
badges and gonad shield
Accreditation Standards for Primary Urban Health Centre
@ National Accreditation Board for Hospitals and Healthcare Providers 153
FORM 6.9 SELF APPRAISAL – DRESSER
Facilitation Help Required at Level S.No. Skill / Competency Gap
PUHC District State
1.Do I know my role and
responsibilities
2.
Am I confident in giving
.
basic first aid / dressing of
minor wounds, assisting
my MO in minor
procedures
3.ention and control of
Am I following the
protocols laid down for
prev
infections
4.
Am I fully conversant with
the use of Autoclave for
sterilizing the instruments
5.
Am I disposing the
per
Biomedical waste
generated in the dressing
room safely as
guidelines
6.delines
Am I fully conversant with
the dispensing gui
for the ointments / lotions
/ eye / ear drops
7.
can to
allay the anxiety and pain
of the patient / attendant
accompanying the injured
Am I doing all I
Accreditation Standards for Primary Urban Health Centre
@ National Accreditation Board for Hospitals and Healthcare Providers154
FORM 6. FFICER 10 SELF APPRAISAL – SOCIAL MOBILIZATION O
Skill / Competency Gap Facilitation Help Required at Level S.No.
PUHC District State
1.Do I know my roles and
responsibilities
2.
ional
Am I aware of the different health
initiatives / components of nat
health programs which need to be
implemented outside the PUHC in
the community
3. health workers like
Am I fully familiar with the healthcare
– community partnerships, linkages
and their scope of activities –
Community
ASHAS, Rogi Kalyan Samitis, health
and sanitation committees
4.
Do I have the required skills and
n of members for
competencies to initiate local health
initiatives, build up self help groups,
help in identificatio
RKS, HSCs, potential ASHAS. And
help in their capacity building
5.the help of
ANMs / ASHA
Have I mapped the population,
landmarks, anganwadi workers,
NGOs, in my area with
6.
Am I assisting in RKS meetings and
maintaining the RKS records as per
the guidelines.
7.
Am I providing the necessary
liasoning with the water / sanitation /
Schools / local NGOs
8.
Am I facilitating the PUHC in effective
implementation of BCC strategies in
the field
Accreditation Standards for Primary Urban Health Centre
@ National Accreditation Board for Hospitals and Healthcare Providers 155
FORM 6.11 SELF APPR TOR CUM ASSISTANT AISAL – COMPUTER DATA ENTRY OPERA
Facilitation Help Required at Level S.No. Skill / Competency Gap
PUHC District State
1.Am I fully conversant with
OPD Registratio
the
n system
2.
with
and
Have I familiarized myself
the medical terms
functioning of a PUHC
3.
l
te reports for
Am I generating meaningfu
and accura
analysis and evaluation
4.
ed
will maintained. Am I
rvice
Is my ASHA database upda
ASHA package of services and
incentives
t
able to predict trends in se
provision
5.
lining
in
Is my work helping stream
Management of information
the PUHC.
Accreditation Standards for Primary Urban Health Centre
@ National Accreditation Board for Hospitals and Healthcare Providers156
FORM 6.12 SELF APPRAISAL – NURSING ORDERLY
Facilitation Help Required at Level S.No. Skill / Competency Gap
PUHC District State
1.Do I know my role and responsibilities
2.
Can I say with confidence that my PUHC is a clean, place
with clean walls, furniture and equipment
3.hion
Am I able to regulate and manage the patient inflow in an optimum fas
4.
Am I able to provide them with
sufficient, clean seating area with enough light hand ventilation while waiting
5. Am I facilitating the elderly in obtaining necessary healthcare
6.Am I familiar with the Dispatch and receipt procedures
7.
Am I fully conversant with the guidelines on safe disposal of biomedical waste and prevention and control of infections
Accreditation Standards for Primary Urban Health Centre
@ National Accreditation Board for Hospitals and Healthcare Providers 157
FORM 6.13 SELF APPRAISAL – ROGI KALYAN SAMITI
Facilitation Help Required at Level S.No. Skill / Competency Gap
PUHC District State
1.Am I aware of the objectives
of the Rogi Kalyan Samiti
2. Am I aware of my role in it
3.ns /
Am I aware of the
proceedings / delegatio
responsibilities / record
keeping involved
4.
ent
Am I using this empowerm
judiciously for improving the
healthcare delivery at my
PUHC
Accreditation Standards for Primary Urban Health Centre
@ National Accreditation Board for Hospitals and Healthcare Providers158
FORM 6.14 SELF APPRAISAL – ASHAs
Facilitation Help Required at Level S.No. Skill / Competency Gap
PUHC District State
1. ements for
Do I know about the health
and social entitl
the poor
2. for which I
Do I know the basic health
components
am to mobilize and assist
the community
3.
Have I been able to strike
a rapport with the
community
4.
ed
Do I have the requir
Interpersonal
communication skills
5.Do I know how to fill my
diary
6. Is my household survey
complete and accurate
7. local health
planning
Has it helped me and my
ANM in
8.Have I formed a HSC in
my area
9.
Do I think I have made a
difference in my people’s /
areas life
Accreditation Standards for Primary Urban Health Centre
@ National Accreditation Board for Hospitals and Healthcare Providers 159
LIST OF LICENS LTHCAREES AND ACTS: APPLICABLE TO PUBLIC HEAFACILITIES
1. Building Permit (From the Municipality).
2. N e hief Fire Officer.
3. Li Management and handling Rules, 1998.
4. N er P llution Control Act.
5. R respect of all X-ray and CT Scanners from BARC.
6. Ex
7. N ances license and Act.
8. Vehicle registration certificates.
9. Ai ollution) Act, 1981.
10 Atomic energy regulatory body approvals.
11. Biomedical waste management handling rules 1998.
12. Consumer protection Act, 1986.
13. Dentist regulations, 1976.
14. Drugs and cosmetics Act, 1940.
15. Employees provident fund Act, 1952.
16. Equal remuneration Act, 1976.
17. Fatal accidents Act, 1955.
18. Indian lunacy Act, 1912.
19. Indian medical council Act and code of medical ethics, 1956.
20. Indian nursing council Act, 1947.
21. Indian penal code, 1860.
22. Indian trade unions Act, 1926.
23. Maternity benefit Act, 1961.
24. MTP Act, 1971.
25. Minimum wages Act, 1948.
26. National building code.
27. Negotiable instruments Act, 1881.
28. Payment of wages Act, 1936.
29. Persons with disability Act, 1995.
30. Pharmacy Act, 1948.
31. PNDT Act, 1996.
32. Protection of human rights Act, 1993.
33. BARC, Act.
34. Registration of births and deaths Act, 1969.
35. Tax deducted at source Act.
36. License for the blood bank.
37. Constitution of India.
38. Transplantation of human organs Act, 1994.
o objection certificate from th
cense under Bio-medical
C
o objection certificate und o
adiation Protection Certificate in
cise permit to store Spirit.
arcotics and Psychotropic subst
r (prevention and control of p
.
Accreditation Standards for Primary Urban Health Centre
@ National Accreditation Board for Hospitals and Healthcare Providers162
OPTIMAL FACILITY MANAGEMENT & EFFICIENT PROCESSES
I. Facility Management & Processes
a. Building and Compound
Access clean, old age, disabled friendly.
Well maintained building. Clean green compound, with
no seepage, no water logging.
No broken windows, doors
b. Waiting area
Comfortable sufficient with seating arrangement and
fan.
Potable Drinking water facility available.
Clean separate toilets for male & female available.
Signages appropriately displayed.
IEC Material displayed.
c. Working areas
Space
All rooms clean, well mopped, dust free with clean linen
Privacy of patient maintained
Continuous availability of water
Continuous availability of electricity
Safe and secure work environment
well lit, ventilated.
d. Medicines & Logistics Uninterrupted supply
Rational use
e. Equipment
Availability of functional equipment
AMC mechanisms in place
Reagents, consumables available
f.
Infection prevention and
control (including
Biomedical waste disposal)
All concerned have the necessary knowledge & training
Availability of logistics ensured
g. Records, Registers, Reports
Availability of registers
Records / Registers to be complete and accurate
Reports generated and forwarded in time
Analysed and evaluated locally
h. Availability of Staff Trained staff as per the norms is available
i.Management of Health
information
Accurate information collection, compilation, report
generation by the centre and timely onward
transmission.
Analysis, evaluation and use of data
Accreditation Standards for Primary Urban Health Centre
@ National Accreditation Board for Hospitals and Healthcare Providers 163
Recording and reporting of Vital statistics including
births and deaths, particularly of mothers and infants.
Maintenance of all the relevant records concerning
services provided in PUHC
j Capacity Building
For Staff:
Clinical care skills
Managerial skills
Attitude / Behaviour skills
For Community Representatives:
ASHAs
Rogi Kalyan Samitis
Health & Sanitation Committees
Mahila Arogya Samitis
For Community:
Community based initiatives
Home based care
Preventive and promotive aspects of health
k
Information Education
Communication (IEC) and
Behaviour Change
Communication (BCC)
Judicious use of IEC material prepared by the State /
district
Posters / flex boards placed in the waiting areas /
different rooms
Pamphlets, leaflets distributed / placed in accessible
locations (on registration counter)
IPC at all levels of staff – patient interaction
l Patient Satisfaction Functional Grievance redressal mechanism in place
Accreditation Standards for Primary Urban Health Centre
@ National Accreditation Board for Hospitals and Healthcare Providers164
SERVICE GUARANTEE
1. Clinical Care Component ( Direct Healthcare)
a. Medical services r the Six hours OPD services. Time schedule as pe
department
b. Emergency services
patient before referral,
nd referral of injuries,
accidents, animal bites and other emergencies during OPD
First Aid, Stabilization of condition of
Appropriate PUHC level management a
hours.
c. Curative OPD serviceon acute and chronic infective and non
ent Protocols. s
infective illnesses as per the Standard Treatm
Treatment of comm
d.Non Communicable
Diseases
up /
s) especially
ry vascular disease, Asthma,
Screening / PUHC level Management / Referral / Follow
counseling for Life Style disorders (NCD
hypertension, diabetes, Corona
COPD etc.
e. Eye orders Treatment of common eye dis
f. Nutritional disorders Detection, Management, Counseling
g.disorders artner / follow up and Gynecological
Treatment of Menstrual problems
Diagnosis / treatment of patient and p
counseling for RTI / STI
h. Cancer referral of Screening for malignancies / appropriate
suspected cases
i. Geriatric problems Sensitive Management / Counseling for Geriatric problems
2. Preventive and Promotive
a. Maternal Health
i. ANC Care of Iron and F
Early registration of pregnancies, ideally in first trimester
(Before 12 weeks of pregnancy)
ancy is suspected,
second between 4th and 6
th month (around 26 weeks), 3
rd
2 weeks) and 4th visit at 9
th
ision
e
Attendance
e, Albumin /
h risk, appropriate management and
Antenatal checkups and provision of complete package of
services. First visit as soon as pregn
visit at eighth month (around 3
month (around 36 weeks). Associated services like prov
olic Acid tablets, Injection TT (as per th
Guidelines for Antenatal Care and Skilled Birth
at Birth by ANMs and LHVs)
Minimal Laboratory investigations like Hb%, Urin
Sugar and M/E
Nutrition and health, danger sign counseling
Identification of hig
referral to the attached referral centres
Accreditation Standards for Primary Urban Health Centre
@ National Accreditation Board for Hospitals and Healthcare Providers 165
Management of Pregnancy Induced Hypertension (PIH)
including referral
ii. Intranatal Care e same.
Promotion of Institutional delivery by formulating of Birth plan
and facilitation in implementing th
iii. Postnatal Care
A minimum of two postpartum checkups, first within 48 hrs
livery and detection and
within half an hour of birth
ntraception and essential
n GOI on Essential New
and second within 7 days of de
management (referral for) of any complications
Initiation of early breast feeding
Education on nutrition, hygiene, co
ewborn care. (As per Guidelines of
Born Care)
b. New Born & Child Care:
i. New Born Care
centre, availability
tion & management
lycemia
In case of a new born being brought to the
of facilities / skills for neonatal resuscita
of neonatal hypothermia / hypog
Care of the Child
E sick children
Feeding for six months
accine
phylaxis to the children as per the guidelines
tions.
mergency care of
Care of routine childhood illnesses
Promotion of exclusive Breast
Full immunization of all infants and children against V
preventable diseases as per guidelines of GOI
Vitamin A pro
P
maln
revention and control of childhood diseases like
utrition and infec
c. Adolescent Health
riate Lifestyle education, Nutritional counseling, approp
treatment
d. Family Planning
Education, Motivation and counseling to adopt to appropriate
Family Planning methods
Provisions of contraceptives such as condoms, oral pills,
emergency contraceptives, IUCD insertions
Referral for Tubal ligation, Vasectomy / NSV
Follow up services to the Eligible couples adopting
permanent methods
Counseling and appropriate referral for safe abortion
services (MTP) for those in need
e. Management of RTI and STI diseases
Health education for prevention of RTI & STI
Treatment of RTI / STIs
Accreditation Standards for Primary Urban Health Centre
@ National Accreditation Board for Hospitals and Healthcare Providers166
f. Infertility
Counseling and appropriate referral for infertility
g. Services under other National Health Programmes
i. RNTCP
Sputum examination for Tuberculosis
DOTS regime for Tuberculosis
Follow up / Counseling
ii. NLEP Diagnosis / Management / Counseling and prevention of
disabilities for Leprosy
iii. NBCP
Screening for Refraction disorders and referral for Refraction
study
Detection of Cataract cases and referral for Cataract surgery
iv. NVDCP c treatment and referral for Dengue, Chikungunia
Diagnosis of Malaria cases, Microscopic confirmation and
treatment
Symptomati
if so required
Elimination of vector breeding sites
v. NIDDCP
anagement / referral.
of salt samples collected from
create awareness of lodine deficiency
Goitre detection and appropriate m
Urine iodine estimation in children aged 6-12 yrs.
Salt iodine estimation
household.
IEC activities to
disorders.
vi. IDSP Alertness to detect unusual health events / increase in usual
health events and take appropriate remedial measures
vii. NACP
IEC activities to enhance awareness and preventive
gh risk behaviour at the
for
measures about STIs and HIV / AIDS.
Screening of persons practicing hi
nearest ICTC.
Risk screening of antenatal mothers with one rapid test
HIV.
Condom promotion and distribution of condoms to the high
risk groups.
Help and guide patients with HIV / AIDS in receiving ART.
3. Provision of AYUSH services as per local preference
4. Inter-sectoral Convergence
a. Convergence with Water and Sanitation
oilets and
Promotion of Safe Water supply and basic sanitation
Promotion of sanitation including use of t
Accreditation Standards for Primary Urban Health Centre
@ National Accreditation Board for Hospitals and Healthcare Providers 167
appropriate garbage disposal
b. Convergence with Integ ment Scheme rated Child Develop
tional
Identification of malnourished children and appropriate
supplementation / referral if required / nutri
rehabilitation
c. Convergence with School Health
Investigations and management of children referred from
schools
5. Referral Services
Appropriate and prompt referral of cases needing specialist
care with duly filled referral slips / stabilization if required /
transport if required
6. Basic Laboratory Services
Hb%, TLC
Blood sugar
Urine Albumin, Sugar and Microscopy
Urine Pregnancy test
Stool Microscopy
Sputum testing for Tuberculosis (if designated as Microscopy
SP
centre under RNTCP)
Blood smear examination for malarial parasite
Test specified as a part of ID
7. R oladi ogy Services
X RAY
Plain and Computed Radiography
Contrast studies like Barium swallow, Barium meal, follow
r GIT; Fistulograms: Sinograms
al exams,
perficial structures including Breast,
letal examinations such as Hips, Shallers and
through and Barium enema; IVU; RGU / MCU; HSG ; water
soluble contrast studies fo
ULTRASONOGRAPHY
General Abdominal and Pelvic studies.
Obstetrical and Gynecological including endovagin
TIFFA
Soft tissue and su
Thyroid, Scrotal and Transrectal Prostate examinations.
Pediatric and Neonatal studies.
Musculoske
Knees.
Accreditation Standards for Primary Urban Health Centre
@ National Accreditation Board for Hospitals and Healthcare Providers168
DOPPLER STUDIES (if available)
r.
y and Liver Transplant patients.
Peripheral, Cerebro-vascular and abdominal Dopple
Assessment of post Kidne
Penile Doppler examination
8. H lth yea & Nutrition Da
tion Day on a regular
sanitation, timely care etc.
l Health Programmes
role in making the
bility
The organization of the Health and Nutri
basis as per the guidelines will result in the achievement of the
following Outcomes:
100% coverage with preventive, promotive interventions,
especially for pregnant women, children and adolescents
Preventive and promotive coverage for the National Disease
Control Programmes
Increased awareness about the determinants of health such
as nutrition,
Improved knowledge about the services offered under the
various Nationa
Greater emphasis on the community’s
health system responsive to the health needs of the
community and in demanding and ensuring accounta
Accreditation Standards for Primary Urban Health Centre
@ National Accreditation Board for Hospitals and Healthcare Providers 169
INCREASED UTILIZATION OF SERVICE ALTH S LEADING TO POSITIVE HEOU OTC MES
I is ifficu and not very pr tum but the
utilization trends have to be monito ncrease in the utilization trend of
2 to 0% e period a year ago is expected. This increase
shall vary from service to service depending u the
local need for the service, the nat ice
earlier and the empowerment provid arameters which can be taken up
for evaluating increase in utilization trends:
1. Increase in m
2. Increase in num ing the services.
unization coverage / increased completion of Primary
immunization within first Increase in Hepatitis B birth dose.
4. Increased ANC beneficiaries / Increased first trimester registrations / Increased
referrals for high risk pre
5. Increased number of pregnancies concluding in Institutional deliveries.
6. Increased number of wo tnatal visits – 1 and 2 by ANM.
7. Increase in nu
8. Increase in num
9. Increase in pr ment.
10. Number of Hypertensives / Diabetics being successfully followed up in the centre
11. Increase in number of patients converted from anemic to non anemic state.
12. Increase in nu or without anemia and
liasoned with
13. Number of children (out
free state.
14. Number of patients provided nebulization in the centre.
15. Number of Cataract ca n.
As far as the morbidities a decreasing trend indicates success of the
interventions, especially the pr
1. Decrease in anem
2. Decrease in Lo birth weight babies.
3. Decrease in cases of m
4. Decrease in the cases of acute diarrhea.
t d lt actical to set rigid target in terms of numbers / quan
red and evaluated. An i
0 5 over and above that in the sam
pon the level of previous performance,
ure of bottlenecks hampering the provision of serv
ed now. Some of the p
onthly / average daily OPD attendance.
ber of senior citizens access
3. Increase in Imm
year of life /
gnancy.
men receiving pos
mber of IUCD acceptors.
ber of OC users.
oportion of TB patients on DOTs completing their treat
(as per the protocols).
mber of children identified malnutrition with
local anganwadi and being followed up.
of those identified) brought to normal weight and anemia
se referred and operated with restoration of visio
are concerned
eventive and BCC efforts. Some of the parameters can be:
ia in pregnancy
easles.
Accreditation Standards for Primary Urban Health Centre
@ National Accreditation Board for Hospitals and Healthcare Providers170
5. Decrease in case of S
6. Decrease in nu
The chronic disease trends and difficult to monitor and not in the scope but
the optimum managemen nsured.
cabies / Pyodermas.
mber of vector borne fevers.
of PUHC alone
t / follow up as per protocols can be e
CLIENT SATISFACTION
Client satisfaction shall n re. It
shall cover the access, the our /
attotide pf the care prov r,
clean toilets, the quality
availability of tests and medications hall also
To facilitate objective asse udits shall be made
a port of the PUHC asses re a
part of the Quality Assuran
ow form an integral part of any performance evaluation of cent
time spent by the patient in getting the service, the behavi
iders, the basic requirements like seating space, drinking wate
of care provided, the counseling and follow up advise. The
be assessed.
ssment – Client exit interviews / prescription a
sment protocol. The required formats have been framed and a
ce Manual.
COMMUNITY INVOLVEMENT AND EMPOWERMENT
S. No.
1Forming the link between the centre and each
household
One trained ASHA for every 2000
population.
2Empowering the community by participation in
planning for and monitoring of the PUHC. Formation of Rogi Kalyan Samiti.
3Empowering the community for local health
and related activities.
Formation of Health and
Sanitation Committees for every
2000 population.
4 Individual Empowerment. Display of Citizen's Charter and
Grievance redressal mechanism.
Once upgraded as per the Standards, the PUHC is expected to deliver the above mentioned service
with universal coverage, and equity, in an age / gender / culture sensitive manner responsive to the
community needs. The focus in addition to the complete coverage shall be on the quality of the
services provided.
Accreditation Standards for Primary Urban Health Centre
@ National Accreditation Board for Hospitals and Healthcare Providers 171
PATIENT EXIT INTERVIEW ( Prior Consent to be taken)
PATIENT EXIT INTERVIEW ( Prior Consent to be taken)
Name of the District:
Name of the Primary Urban Health Centre:
Parent Agency - GNCTD / MCD / NDMC /
Others:
Name of the Medical Officer In-charge:
Date of Exit Interview:
Time Taken for Interview:
Starting Time:
ng Time: Finishi
Conducted by:
ame & Designation: N
Signature:
1. Name of the Patient
2. Age of the Patient
3. Sex of the Patient
4. Do you have a BPL / equivalent card
5. Do you belong to SC /ST
6.How long did it take you to travel to this
PUHC
7. What mode of transport did you take
8. Did you spend any money in reaching here
9. How did you come to know of this facility From posters / leaflets
From Neighbours
From ANM
From ASHA
At a Health Camp
From a Private Practitioner
From a Religious leaders
Any other way
10.What is the ailment for which you have
come
Do not know
Already Diagnosed and on treatment
No ailment. Come for advice on Family Planning. Antenatal care, Immunization, Nutritional disorder
ther: Specify Any O
Accreditation Standards for Primary Urban Health Centre
@ National Accreditation Board for Hospitals and Healthcare Providers172
11.How long did you wait to get your Card
made (in minutes
12. Was the staff at registration counter polite Indifferent
Rude
Polite
13.reached the doctor
How long did you have to wait before you
14.Was there clean and comfortable place to
sit while waiting?
15. Did the Doctor greet you warmly
Warmly
Indifferent
Rude
16.Did the Doctor listen patiently to your
complaint Was in a hurry
Did not listen
Yes
17.ask questions
A little
No
Did the Doctor give you an opportunity to Yes
18.e Doctor discuss your illness and
t tme
Yes
No
Did th
rea nt with you A little
19.Was
examinld hav
No
there sufficient privacy for
ation
Yes
Cou e been better
20. D he No
id tell about the next visit Yes
21.How long did you wait to get your
r istraeg tion number
22.How long did you wait in the Pharmacy que
before you got your medicines
23. How was the behaviour of the Pharmacists
Warm and Helpful
Indifferent
Rude
24. Did you get the medicines
All
Some
None
25. Did the pharmacist explain about the dosesYes
No
Accreditation Standards for Primary Urban Health Centre
@ National Accreditation Board for Hospitals and Healthcare Providers 173
26.warm and helpful
Indifferent
Rude
If the service provider was ANM, was she Yes
27. Immunization /
How lon
IUCD Insertion / ANC
checkup
g did you wait for the service –
28. Furniture
Were you satisfied with the cleanliness of
Floor
ation table
es
oSheets on examin
Toilets
Y
N
29. Was drinking water available es / No Y
30.Health Ce
Total time spent in the Primary Urban
nter
31. Time spent with the Medical Officer
32.
sfied with the overall
ff
acility
2 1 0
es Partially No
es Partially No
es Partially No
Were you sati
Behaviour of the sta
Cleanliness of the f
Availability of medicines / tests
Y
Y
Y
33.
se the Primary
:
You would continue to u
Urban Health Center for treatment
because
34.If not then what are the reasons for your
not wanting to return
ong waiting time
irty environment
ehaviour
t staff / ineffective treatment
ity of medicines / tests
L
D
Rude / Indifferent b
Incompeten
Non availabil
Too far
Accreditation Standards for Primary Urban Health Centre
@ National Accreditation Board for Hospitals and Healthcare Providers174
QUA EVALUATION)LITY ASSURANCE (MONITORING &
Effective monitoring followed by evaluation an ssary online corrections is mandatory
for ensuring optimal functioning of the PUHC and delivery of quality healthcare. To facilitate
a systematic upgradation of the PUHCs to the standards defined above and ensure
s ssurance Manual has been devised which
shall form an inseparable addendum to this volume. It outlines the need, management
f the necessary formats* for objectively
assessing the facility and undertaking measures to ensure quality in processes, inputs and
d
*These formats are suggestive and can be altered and improved upon by the users.
Once upgraded as per the Standards, the PUHC is expected to deliver the above mentioned
service iversal coverage, and equity, in nder / culture sensitive manner
responsive to the community needs. The focus in addition to the complete coverage shall be
o e
d nece
ubsequent adherence to the same, a Quality A
ramework for Quality Assurance, and provides
esirable outputs / outcomes.
with un an age / ge
n th quality of the services provided.
Accreditation Standards for Primary Urban Health Centre
@ National Accreditation Board for Hospitals and Healthcare Providers 175
PUHC QUALITY ASSURANCE SUMMARY REPORT
PRIMARY URBAN HEALTH CENTRE QUA ASSURANCE SUMMARY REPORT LITY
Action RequiredS.No. Action Category Gaps
PUHC District StateTimeline Review On
1. Facility Management
a. Land & Building
b. M anpower
c. E ts quipmen
d. Drugs & Logistics
e.Teleph
Water, Electricity,
one
f. Cleanlines s / Sanitation
2. Managing Information
a. Managing Information
3.Serv
U
ice Provision and
tilization Trends
b. C cols /
Procedures
Service Provision –
linical Proto
c. Utilization trends
4. Training Requirements
d.
5. Governance
6. Behaviour Change Communication
7. Grievance Redressal Mechanism