INFRASTRUCTURE

Health Care Infrastructure | Health Centre Details | Family Welfare Centres | Health Posts |
Post Partum Centres |Urban Family Welfare Centres | Sterilisation Beds Scheme |Other Statistics |

The stress in the National Health Policy, which was adopted by the Parliament in 1983, is on the provision of preventive, promotive and rehabilitative health services to the people. The main objective is to place the health of the people in the hands of the people through the Primary Health Care approach. The delivery of Primary Health Care is the foundation of rural health care system and forms an integral part of the national health care programmes. Health care programmes have been restructured and reoriented from time to time. Priority has been accorded to extension, expansion and consolidation of the Rural Health Infrastructure viz. Sub-Centres, Primary Health Centres and Community Health Centres.

The Primary Health Care infrastructure in Rural Area has been developed as a three tier system and is based on the following population norms:-

SUB CENTRES

Sub-Centre is the peripheral health institution available to the Rural Population. It is manned by one multi purpose worker (Male) and one multi purpose worker (Female)/ANM. In addition, one LHV is entrusted with the supervision of six Sub-Centres. While the salary of ANM and LHV is borne by the Central Government, that of the male worker is borne by the State Government. In addition, Honorarium to Voluntary Health Worker @ Rs.50 p.m., Rent for the building Rs.1000 p.a., contingencies at Rs.600 p.a. and Medicines worth Rs.2000 p.a. are also borne by the Centre. As on 30.06.99, 137271 Sub-Centres are functioning in the country. Only 97757 Sub-Centres are funded by the Ministry and the rest are being funded under the State Minimum Needs Programme/ Basic Minimum Services Programmes (BMS).

PRIMARY HEALTH CENTRES (PHCs)

PHC is the first contact point between village community and the Medical Officer. These are established and maintained by the State Governments under the Minimum Needs Programme (MNP). A PHC is manned by a Medical Officer supported by 14 paramedical and other staff. It acts as a referral unit for 6 Sub Centres. It has 4-6 beds for patients. The activities of PHC involve curative, preventive, promotive and Family Welfare Services. As on 30.06.99, 22,971 PHCs are functioning in the country.

COMMUNITY HEALTH CENTRES (CHCs)

CHCs are being established and maintained by the State Government under MNP/BMS. It is manned by four medical specialists i.e. Surgeon, Medicine, Gynaecologist and Paediatrician supported by 21 paramedical and other staff. It has 30 in-door beds with one OT, X-ray, Labour Room and Laboratory facilities. It serves as a referral centre for 4 PHCs. 2935 CHCs are functioning in the country as on 30.06.99.

Some Statistical Data w.r.t. the Health Centres

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In addition to the above, various other centres have been established over the different plan periods by the department. 

HEALTH AND FAMILY WELFARE TRAINING CENTRES

Health and Family Welfare Training Centres have been established in the country with the objective to improve the quality of services by providing in-service orientation training to the Medical and Para-Medical personnel engaged in the delivery of Health & Family Welfare Services. There are 47 Health & Family Welfare Training Centres functioning in the country.

RURAL HEALTH & TRAINING CENTRE, NAJAFGARH & F.W.T.R.C., Mumbai.

RHTC, Najafgarh was established as a Najafgarh Health Instt. with the assistance of Rockfeller Foundation in 1937 and emerged as a Rural Health & Training Centre in 1960. It has been rendering various training services to the Rural Community-Training to Medical & Para Medical Health Workers and Nursing Personnels from different Nursing Training Schools of Delhi, orientation training to Public Health students & ANMs, training of ANM (10+2 Vocational Course under CBSE & Training of traditional birth attendants.

FAMILY PLANNING TRAINING & RESEARCH CENTRE, MUMBAI

Family Welfare Training & Research Centre (FWTCRC) Mumbai, was the First Family Planning Training Centre, established in June, 1957 and was made responsible for the training needs of State & District level categories of Health Personnel from Western Zone. This centre has been recognised as an Institution for Training of Central Health Service Officers in the areas of National Family Welfare Programmes and National Health Policy. FWT & RC is also conducting Community based Research Projects in the field of Health & Family Welfare.

HEALTH MANPOWER IN RURAL AREAS

The following table gives the manpower involved in Health related activities in Government institutions as on 30.06.99 is given below:

Special Scheme

1. ALL INDIA HOSPITAL POST PARTUM PROGRAMME

Post Partum Centres besides RCH package provide the following services also:

• PAP Smear facility at 105 PPC attached to Medical Colleges;
• Medical Termination of Pregnancy;
• Sterilisation(Tubectomy);
• Provision of all types of contraceptives;
• Promote family planning as most important health intervention for Health of Mother & Child;
• Promote spacing of birth;
• Follow up services to acceptors;
• Out reach services

At present 550 centres at district level and 1012 centres at sub-divisional level hospitals are functioning. There are three types of Post Partum Centres at district level hospitals - Type A covering Medical Colleges/Institutions conducting 3000 or more Obstetric and abortion cases annually, Type B covering Medical Institutions conducting less than 3000 but 1500 or more cases annually and Type C covering Institutions conducting less than 1500 cases annually. Central assistance is extended towards payment of salaries to staff posted therein, contingencies, replacement of equipment, equipment for glassware, bed maintenance and maintenance of OT. Posts sanctioned centre-wise is given in the table below:

@ Rs 15000/- is admissible for honorarium etc. to Anaestheist/Nursing Staff, Expenditure on maintenance of operation theatre.

*: 1 Paediatrician & 1 Gynaecologist. #: For Medical Colleges having PAP Smear Test Facility.

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III. URBAN FAMILY WELFARE CENTRES

Urban Family Welfare Centres are on ground since First Five Year Plan to provide family welfare services in urban areas. Most of UFWCs are equipped to provide contraceptive supplies. At present 1083 centres are functioning. There are three types of Urban Family Welfare centres based on the population covered by each centre.The staffing pattern at each type of centre is given below :

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Urban Revamping Scheme

HEALTH POSTS
Urban revamping scheme was introduced in 1983 with a view to provide service delivery outreach, primary health care, family welfare and MCH services in urban areas. There are 871health posts functioning in 10 States and 2 UTs. There are four types (A to D) of Health Posts sanctioned based on the population covered by each health post - Type A for areas with less than 5000 population, Type B for areas with 5000-10000 population, Type C for areas with population 10000-25000 and Type D for areas with population 25000-50000. If population of the area is more than 50000 then it is to be divided into sectors of 50000 population and a post is established at each sector. Central assistance is provided to pay salaries to staff posted at each post, to meet contingencies, if any and for rent for posts run by voluntary organizations, which are 50 in number.

Type-wise staff sanctioned is given below :

* At present there is a ban on these categories of staff

The break up of 871 Health Posts functioning in the States and Union Territories based on Population covered by each health post are: (Statewise break up in Annexure-I)

IV. PAP SMEAR TEST FACILITY PROGRAMME

PAP Smear Test Facility Programme for early detection of Cervical cancer among women has been approved by Govt. of India in 105 Medical Colleges which are equipped with full fledged Department of Pathology and services of a Senior Pathologist i.e. Professor of Pathology under the programme a post of Cyto-technician for preparation/examination of slides and contingent expenditure for purchase of glassware & chemical etc. have been provided by Government of India.

Sterilisation Beds Scheme

A scheme for reservation of Sterilisation Beds in hospitals run by Government, Local Bodies and Voluntary Organisations was introduced in the year 1964 in order to provide immediate facilities for tubectomy operations in hospitals where such cases could not be admitted due to lack of availability of beds etc. The scheme envisages greater involvement of local bodies and NGOs. Thus Government of India sanction beds to the hospital run by local bodies and NGOs.

As on date, Govt. of India is supporting 3217 sterilisation beds throughout the country. 84% of these beds are with NGOs, 14% with local bodies and 2% only to the State Governments. In order to expand the tubectomy facilities and involvement of NGOs, the Government of India has made a provision of sanctioning 200 such beds each year during the IX Plan period. States are requested to invite proposals from the active NGOs and local bodies in the respective states and to forward the same to this Ministry for administrative approval on priority basis.

Pattern of Assistance:-

Under the scheme, Government of India gives a performance based maintenance grant for sterilization beds to various organization & local bodies. The details are as under:-

1. The maintenance grant under "Sterilisation Bed Scheme" would be admissible at the rate of Rs.4500/- per bed per annum subject to the minimum achievements of 60 tubectomies per bed annum by local bodies/voluntary organizations.
2. If the local bodies/voluntary organization fails to achieve the target of 60 tubectomies per bed per annum as stated above, but the performance level is 45 tubectomies per bed per annum, the maintenance charges at the rate of Rs 3000/- would be admissible.
3. If the performance level of the institutions of Voluntary Organisation/Local Bodies is below the level of 45 tubectomies per bed per annum, proportionate grant at the norm of 45 tubectomies per bed per annum and at the rate of Rs.3000/- per annum would be admissible.

The above norms are effective from 01.04.1995 (No.N.12013/8/95-SS, dated 29.11.95)

Procedure for sanction of new beds

A Voluntary Organisation registered under Society Act 1960 and having a fully equipped operation theatre, medical and para medical staff and well qualified medical officers with post graduate qualification, is eligible for reservation for sterilization beds. The eligibility for reservation of beds is decided on the basis of the performance of tubectomy operations done during last two years in a routine course.

The institution willing to implement the scheme is required to submit application on the prescribed format to State Government concerned. The concerned State Government will process the proposal and forward the same to the Ministry of Health and Family Welfare, Govt. of India for according administrative approval.

Monitoring & Evaluation

The performance reports in respect of institutions functioning under Sterilisation Beds Scheme are being collected from the States on quarterly basis, it has been noticed that quarterly performance report are not being received regularly from Uttar Pradesh, Madhya Pradesh, Assam, J&K, Bihar, Punjab, Rajasthan and Kerala.

PROFORMA PRESCRIBED/APPLICATION FORM FOR SANCTION OF NEW BEDS UNDER STERILISATION BED SCHEME

1. Name of the Voluntary Organisation (with complete address)
2. Total number of beds in existence.
3. Number of beds reserved for tubectomy.
4. Is a fully equipped operation theatre existing.
5. Details of medical and paramedical staff available in voluntary organization.
6. Number of medical officers with post graduate qualifications performing tubectomies.
7. Performance of tubectomy operations during last two years in a routine course.
8. Number of Sterilisation beds proposed to be required.
9. Whether the institution is registered under Society Registration Act, 1960.
10. If so, please quote Registration Number and date.
11. (a)Whether the organization is participating in any of the schemes i.e. Post Partum Program/UFWC/Health Posts/Sterilisation beds scheme. (b) If yes, Details there of.
12. Whether the institution agrees to adhere to the terms and conditions mentioned in the letter or that will be fixed by the Government of India from time to time?

Signature
Designation of the Head of
Institution(Voluntary Organisation/Local Body)

Signature
Dt.DHS/Medical Officer-in-Charg, SFWB

Remarks/Recommendations

Dy.DHS/In-charge, SFWB

Annexure-I

URBAN HEALTH INFRASTRUCTURE

UNDER FAMILY WELFARE PROGRAMME

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