CHNC
CHNC
CHNC
As envisioned by the
Drafted By
SPIU Co nsul tant ant s
Dr.Rammohan.S
Sri.App aRao.
Dr.PV.Ramesh.IAS.Secretary to
GoAP
Dr.RamSwaroop .Dirctor of
PH&FW
Director FHI.
MCRHRD.
As envisioned by the
This manual serves as a guide and reference book for different functionaries in
the Department and will be useful for the betterment of their functions to meet
the day to day challenges in the field of Health and overall objectives of the
Department of Health, individually and collectively.
I am happy to utilize the expertise of the all the officers of this Directorate and
members of SPIU in the preparation of this manual. They all have provided
valuable information and support in collection, organization and presentation of
the information. Suggestions for improvement are welcome and may be sent to
Director of Health.
Message
The Government of Andhra Pradesh committed to ensure the easy access to good
quality primary secondary and tertiary health care services to the people of the
Andhra Pradesh state. The Department of Health, Medical and Family Welfare is
implementing various health programmes to improve the quality of life of the
citizens in the state. Government is taking up focused interventions to provide
reliable comprehensive mother and child health services, school health and
infectious disease control programs, and strengthen the public health surveillance
system.
The GoAP also aims at improving general sanitation, improving preventive and
curative health services and bringing about a change in the health practices of the
people, particularly the rural and underserved
I am confident that all the functionaries of the Department would find this Manual
very useful.
Health Minister
Fore word
Dear Reader,
We all realize and accept that all of us the functionaries and the Government are in
place because of the People. All of us are accountable to the state and the citizens of
Andhra Pradesh. The Department of health medical and family welfare is one of the
essential departments which deals with health & lives of the citizens of Andhra
Pradesh.
The CHNC functionary Department Manual will indicate the roles, responsibilities
and functions of the CHNC and functionaries. The Functionary Manual will detail, as
the nomenclature indicates, the functions and responsibilities of the functionaries
within the CHNC, at all levels. While doing so, the evolving role of governmental
functionaries in being effective managers of change in a welfare state has been
delineated.
The Departmental Manual also details the department’s organizational chart, the
rules, regulations, legislations and enactments which govern its functioning and
direct its activities and the various interdepartmental interactions it has to perform.
The Manual also facilitates a definition of the Department’s role in serving the
general public as customer while drawing up a vision for its future development in
the coming decades.
***
1. Preamble.
This document is called PHC and CHNC functionary manual, which is drafted based on
the concept of Community Heath & Nutrition clusters as envisioned by the
Government of Andhra Pradesh as part of Andhra Pradesh health sector reforms.
(Ref: GOMS. 92 , Memo No. 12231/F1/2008 Dated: 23-04-2010 )
2.The primary health system.
The primary health system comprises of three-tier system of sub-centre, PHC and CHC.
The service area of each institution, i.e., sub-centre, PHC and CHC, should be clearly
defined so that every person living in that area is aware not only of the health
institution responsible for package of services for his / her village but also the referral
network. The objective is to provide access for every citizen to quality health care
system.
Area hospital.
District
Hospital.
***
6. Organogram of a Community Health Nutrition
Cluster (CHNC)
6. Organogram of a Community Health Nutrition Cluster (CHNC).
District Medical & Health Officer & Addl. District Medial & Health Officer
Sector - I Sector - II
8. PHC STAFF
1) PHC Medical Officer & Drawing and disbursing officer.
2) PHC Medical Officer.
3) Community Health officer.
4) Public health Nurse.
5) Multipurpose Health Extension Officer.
6) Assistant paramedical officer.
7) Senior assistant.
8) Staff nurse – 1.
9) Staff nurse – RCH.
10) Pharmacist .
11) Lab-technician.
12) LD-Computer
13) Dhai / Scavenger (under NRHM).
14) Multipurpose Health Supervisor (M) .
15) Multipurpose Health Supervisor (F).
16) Multipurpose Health assistant (F) .
17) Multipurpose Health assistant (F) .
18) Multipurpose Health assistant (M).
19) Attender / office subordinate.
***
9.CHNC & PHC & Sub Center Staff Job Charts.
The job responsibilities of the functionaries are provided in the following pages.
These job responsibilities are subject to modification, redrafting or redefinition
as desired by the government for providing improved health services to the
citizens of A.P.
He/She shall work under the administrative control of the District medical and
health officer. All the medical officers in the PHCS of CHNC report to the DM&HO
through SPHO.
All the CHNC HQ staff will report to the SPHO directly. He/She may assign any
job to any health functionality in his team, which is deemed essential by him towards
achieving National Health goals.
He will ensure the preparation monthly progress report of the CHNC by his
supportive staff namely CHO, PHN, DPMO, COMPUTER, and Senior assistant.
General
The SPHO ensures that PHC Medical officers and staff under his
administrative control reach out to the community and provide integrated –
RCH, disease prevention and management, health promotion services. - And
comprehensive preventive, promotive and curative services.
The SPHO should effectively utilize the services of all the headquarter
staff, PHC Medical officers and all field staff,. He / She will ensure that the
Medical Officers of PHCs visit each and every village in the service area of each
PHC at least once a month.
1 . S U P P O RT I V E S U P E RV I S I O N O F C U R AT I V E WO R K
2. SUPPORTIVE SUPERVISION OF PREVENTIVE AND PROMOTIVE WORK
3. SUPPORTIVE SUPERVISION AND ENSURING THE EFFECTIVE DELIVERY PACKAGE
OF SERVICES UNDER VARIOUS NATIONAL STATE HEALTH PROGRAMS THROUGH PHC
S.
I . SUP PORTIV E SUP E RV ISI ON OF CUR ATIV E WOR K IN THE P HC s IN
CHN C.
1. He/She will ensure that the medical officers of the Primary health centre &
their supervisory staff prepare the annual health action plan for the.
2. He/She will periodically visit PHC s and ensure that the Medical Officer will
organize the out-patient department as per standard guidelines and will
allot duties to the ancillary staff to ensure smooth running of the O.P
department
3. He/She will periodically visit PHC s and ensure that the MOs will make
suitable arrangements and distribute the work to the staff for the treatment
of emergency cases which come outside the normal O.P. Hours.
4. He/She will periodically visit PHC s and ensure that the laboratory services
properly organized for patients for proper diagnosis of the disease where
ever necessary and within the scope of PHC laboratory.
5. He/She will periodically visit PHC s and ensure that the Medical Officer will
cooperate and/or coordinate with other institutions like CHC, Area hospital
providing medical care services in his area and refer appropriate cases to
these institutions for further care.
6. He/She will periodically visit PHC s and ensure that the MOs will visit each
sub- centre in his area at least once in a fortnight on a fixed day not only to
check the work of the staff but also to provide curative services.
2. He/She will periodically visit PHC s and ensure that the PHC Medical Officer will
assess quality and reliability of the work at sub centers periodically both in the
clinics and in the community setting to give them the necessary guidance and
direction.
3. He/She will ensure that the Mos of PHC s will prepare operational plans and
ensure effective implementation of the same to achieve the laid-down targets
under different National Health Family Welfare Programs
4. He/She will ensure that the Mos of PHC s will keep close liaison with Mandal
development officers and his staff, community leaders and various social
welfare agencies in their areas and involve them to the best advantage in the
promotion of health program in the area.
5. He/She along with the Mos of PHC s will conduct field investigation to delineate
local health problems for planning changes in strategy of the effective delivery
of Health and FW services.
6. He/She will ensure that the Medical Officer will ensure the regular conduction
of IEC programs at habitation level.
iii. SUP PORTIV E SUP ERV ISION OF D E LVA RY OF PACKAGE OF SERVICES
UNDER MATERNAL AND CHILD HEALTH PROGRAM. (NRHM)
SPHO will periodically visit PHC s , assess and ensure that the PHC MOs and
staff will deliver the package of services under this program.
The overall program is monitored status reports related to this program
implementation in the CHNC will be prepared by him.
2. Immunization Program.
5. School Health.
6. Family Planning.
2. Child health screening using IMNCI protocols where applicable age groups
of
1. 0-1 year: Immunization, growth monitoring, exclusive breast feeding
and weaning advice, treatment of pre-existing conditions, care of
Grade 3 and 4 malnutrition children in health facility/FRU and
screening for childhood illness and referral as appropriate.
2. 1-5years: immunization, growth monitoring, vitamin A
supplementation, nutrition support.
3. 5-15 years: registration and coverage by the school health program
2. UNIVERSAL IMMUNISATION PROGRAM (UIP)
1. The Medical Officer will plan and implement UIP in line with the
latest policy and ensure cent-percent coverage of the target
population in the PHC (i.e., Pregnant mothers and new born infants).
1. The Medical Officer will ensure through his health team early
detection of diarrheal diseases and dehydration.
SPHO will periodically visit PHC s , assess and ensure that the PHC Medical
Officer and staff working under him will deliver the package of services under
this program.
Package of services under this program are:
1. The Medical Officer will ensure through his health team early
detection of pneumonia cases and provide appropriate
treatment.
To be started in June/ July in all the Govt. schools and social welfare hostels
and all the children in the schools of the area to undergo basic health
screening initially and those identified as high risk to be ear marked for follow
up visits.
1. each child to have a card
2. DPT/ TT as per the schedule are given
3. De-worming to be under taken in the initial visit and the next after a
six months period.
4. Children requiring specialist care are to be referred to the concerned
specialist at a referral unit.
5. Further follow up visits to the schools may be once in 3 months.
6. FAMILY PLANNING.
SPHO will periodically visit PHC s , assess and ensure that the PHC Medical
Officer and staff working under him will deliver the package of services under
this program.
The overall program is monitored status reports related to this program
implementation in the CHNC will be prepared by him.
2. KALA-AZAR
********
1.1.2. JOB RESPONSIBILITIES OF SENIOR COMMUNITY HEALTH OFFICER at
CHNC.
One Senior Community Health Officer will be posted at each CHNC. He will be
under direct administrative and technical control of SPHO in charge of the CHNC.
The Senior Community Health Officer will carry out the following duties at
CHNC.
He/She will assist the SPHO and ensure that all necessary steps are being
taken for the control of the communicable diseases in the CHNC involving the
PHC staff.
Assist the SPHO in taking the necessary action in case of any outbreak of an
epidemic in the PHC s in CHNC area involving all the Staff of the PHC s.
i. He will assist the SPHO and coordinate with district and PHC staff
and ensures that the activities connected with community
involvement and health education, training, management and
supervision in the context of Kala-Azar are taking up. He ensures
that search operations, diagnosis and treatment of Kala-Azar
patients and spray activities in his CHNC area are effectively taken
up by the PHC staff.
i. He will assist the SPHO and coordinate with district and PHC staff
and ensures that the activities connected with community
involvement and health education, training, management and
supervision in the context of J. E also. He ensures that J.E search
operations, diagnosis and treatment of J.E patients and spray
activities in CHNC area are effectively taken up by the PHC staff.
1. Supervise and guide the, Health Supervisors and Health Workers and
actively involve the Health Guides and trained Dais in the effective
implementation of the program for Maternal and Child health.
1. He will periodically visit schools in the CHNC area and assess the
quality and effectiveness of the school health program environmental
sanitation and health education and guide PHC for the better
implementation of the program.
5. FAMILY PLANNING.
Supervise and guide the Male Supervisors and Male Health Workers
and actively involve the Health Guides and trained Dais in the
effective implementation of the Family Planning Program works to
promote vasectomies and spacing.
6. NUTRITIONAL.
Supervise and guide the Health Supervisors and Workers and actively
involve the Health Guides and trained Dais in the effective
implementation of the nutrition program, such as administration of
vitamin A and Iron and Folic Acid tablets. Helps the Field staff to
bring about field level functional convergence with AWW, mahila self
help groups, voluntary organizations.
7. ENVIRONMENTAL SANITATION.
Supervise and guide the Health Supervisors and Health Workers and
actively involve the ASHA s, CHV s, Health Guides and trained Dais in
the effective provision of safe drinking water and for the
improvement of environmental sanitation in the villages in CHNC
area.
Supervise and guide the Health Supervisors and Workers and actively
involve the Health Guides and trained Dais and Primary School
Teachers in the treatment of minor aliments as carried out by them,
and ensure early referral to the M. O. PHC in the CHNC area.
3. Facilitates and guides Work closely with the community leaders and
community organizations such as Mahila, Farmer's clubs, and other
Voluntary Organizations and involve them to the advantage in the
promotion of health programs in the CHNC area.
1. Under the supervision of SPHO along with PHN supports the Medical
Officers of PHC s, organizes and conducts various health program
related training for ASHA s, Health Guides, Primary School Teachers
and Dais. Services of Health Supervisors and Health Workers, MPHA s
will be utilized in conducting these training Programs.
2. Assist the SPHO in staff skill development programs for the M. O. PHC
s , Health Supervisors and Health Workers, at the PHC s as well as in
the field.
2. Ensure that the PHC s sub centers are properly maintained and managed
by the Medical Officers, Health Workers (MPHA s) and Health
Supervisors.
3. Tours all the PHC s and sub centers along with SPHO and ensures that
supplies and equipment such as drugs, contraceptives, vaccines,
nutritional supplements, bleaching powder, health educational materials,
etc., are supplied in time to the sub centers to enable the Health
Supervisors and Health Workers to carry out their functions effectively.
4. Tours all the PHC s and sub centers along with SPHO and ensures the
regular replenishment of kits and the supply of drugs and dressings for
the ASHA s Primary School Teachers and trained Dais and ensure regular
disbursement of stipends/honorarium to the ASHA s, and Dais.
5. Scrutinize the work plans of the Health Supervisors and Health Workers.
7. Obtain the reports from the PHC s analyze and interpret the data
available, and utilize the findings for improving the implementation of
the health programs in the CHNC area.
10. Keep notes of his activities in the CHNC area and submit his tour report
at regular intervals to the SPHO.
11. Any other duty assigned by SPHO should be carried out by CHO
********
1.1.3. JOB RESPONSIBILITIES OF SENIOR PUBLIC HEALTH NURSE AT CHNC.
One Public Health Nurse will be posted at each CHNC. She will be under the
direct administrative and technical control of SPHO in charge of the CHNC.
The Public Health Nurse will carry out the following duties.
She will guide the PHC supervisory staff in the preparation of annual action
She will assist the SPHO and ensure that all necessary steps are being taken for
the control of the communicable diseases in the CHNC involving the PHC staff.
Assist the SPHO in taking the necessary action in case of any outbreak of an
epidemic in the PHCs in CHNC area involving all the Staff of the PHC s.
5. Supervise and guide the Health Supervisors and Health Workers and
actively involve the Health Guides and trained Dais in the effective
implementation of the program for Maternal and Child health.
6. She will assist the SPHO and PHC staff in organizing campaigns,
meetings and awareness programs to promote the Institutional
deliveries.
7. She will assist the SPHO and PHC staff in organizing campaigns,
meetings and awareness programs to promote the Brest Feeding.
10. She will assist the SPHO and Medical Officers of PHC s in organizing
skill development and capacity building programs for the field staff.
11. She will accompany the SPHO in tours and assist the SPHO in
evaluation of the effectiveness of the program.
3. SCHOOL HEALTH.
3. She will periodically visit schools in the CHNC area and assess the
quality and effectiveness of the school health program environmental
sanitation and health education and guide PHC staff for the better
implementation of the program.
4. Evaluates the treatment and follow up of those students found to
have defects and suffer from chronic illness.
5. She will ensure that the adolescent girl children receive training in
Life skills and personal hygiene through PHC staff.
6. She will identify the villages where school drop out rate of girl
children is more due early marriages and discrimination. She plan
and assist the SPHO in organizing the awareness campaigns in such
villages.
7. She will inspect the school health records both at sub centers and the
schools.
8. She will submit her inspection reports to the SPHO for necessary
action.
She will scrutinize the immunization records of field staff and guides
them for providing safe, good quality services.
She will visit all the PHC s in the CHNC periodically and check the
functionality of the cold chain equipment and suggest the corrective
actions if needed.
She submits her inspection reports to the CHNC SPHO suggesting the
corrective actions.
5. FAMILY PLANNING.
She will receive the family planning performance reports from the
PHC s , analyze and guide the PHC for better performance .
She will help the PHC medical officers and nursing staff in organizing
the operation theaters at PHC s.
She will inspect and evaluate the diaries of the supervisory staff and
MPHA s of the PHC s.
She will asses the quality of pre and post operative care extended by
the field staff and client satisfaction.
She assists SPHO in all the family planning program related training
activities.
6. NUTRITIONAL.
Supervise and guide the Health Supervisors and Workers and actively
involve the ASHA s and trained Dais in the effective implementation
of the nutrition program, such as administration of vitamin A and
Iron and Folic Acid tablets.
Helps the SPHO and the PHC medical officers and the Field staff to
bring about field level functional convergence with AWW, mahila self
help groups, voluntary organizations.
She will assist the SPHO and PHC staff in organizing campaigns,
meetings and awareness programs to promote awareness on
balanced diet, Back yard kitchen gardens, consumption of locally
available nutritious foods, good practices in cooking.
She will coordinate with ICDS, SERP, and other NGOs, from the cluster
head quarter level, prepare plans and facilitates for involving the field
staff of the PHC s at habitation level.
7. ENVIRONMENTAL SANITATION.
Supervise and guide the Health Supervisors and Health Workers and
actively involve the ASHA s, CHV s, Health Guides and trained Dais in
the effective provision of safe drinking water and for the
improvement of environmental sanitation in the villages in CHNC
area.
1. Supervise and guide the Health Supervisors and Workers and actively
involve the Health Guides and trained Dais and Primary School
Teachers in the treatment of minor aliments as carried out by them,
and ensure early referral to the M. O. PHC in the CHNC area.
7. Facilitates and guides Work closely with the community leaders and
community organizations such as Mahila, Farmer's clubs, and other
Voluntary Organizations and involve them to the advantage in the
promotion of health programs in the CHNC area.
8. She will assist the SPHO and PHC medical officers in planning and
organizing the camps, meetings, and health education talks,
demonstrations display of posters, exhibitions of films videos related
to the girl children, women and child health and involve the Health
Supervisors, Health Workers and ASHA s in these activities.
7. Under the supervision of SPHO along with PHN supports the Medical
Officers of PHC s, organizes and conducts various health program
related training for ASHA s, Health Guides, Primary School Teachers
and Dais. Services of Health Supervisors and Health Workers, MPHA s
will be utilized in conducting these training Programs.
8. Assist the SPHO in staff skill development programs for the M. O. PHC
s Health Supervisors and Health Workers, at the PHC s as well as in
the field.
10. Assist the SPHO in conduction fortnightly & monthly staff meetings at
the CHNC.
13. Ensure that the MCH services at PHC s, and sub centers are properly
managed by the PHC staff.
14. Tours all the PHC s and sub centers along with SPHO and ensures that
supplies and equipment such as drugs, contraceptives, vaccines,
nutritional supplements, bleaching powder, health educational materials,
etc., are supplied in time to the sub centers to enable the Health
Supervisors and Health Workers to carry out their functions effectively.
15. Tours all the PHC s and sub centers along with SPHO and ensures the
regular replenishment of kits and the supply of drugs and dressings for
the ASHA s Primary School Teachers and trained Dais and ensure regular
disbursement of stipends/honorarium to the ASHA s, and Dais.
16. Scrutinize the work plans of the Health Supervisors and Health Workers.
17. Supervise and evaluate the maintenance of the prescribed records of the
field staff at PHC and the sub center level.
18. Obtain the reports from the PHC s analyze and interpret the data
available, and utilize the findings for improving the implementation of
the health programs in the CHNC area.
19. He assists the SPHO in organizing monthly meetings, not only for
evaluating the progress of work and suggesting steps to be taken for
further improvement but also as a means of staff development and
continuing education.
20. He assists the SPHO in organizing meetings at regular intervals with the
community level workers for discussing their activities and for providing
continuing education.
21. Keep notes of her activities in the CHNC area and submit her tour report
at regular intervals to the SPHO.
22. Any other duty assigned by SPHO should be carried out by CHO.
********
1.1.4. Health Educator.
The Health educator works under direct administrative control and technical
guidance of CHNC SPHO. Health educator’s services are to be exclusively
utilized IEC ( information ,Education ,Communication ) , BCC (behavioural
change communication ) activity planning implementation and monitoring.
General
1. He/She will prepare annual action plan for CHNC for the health education ,
regular and proposed training programs to be undertaken involving all the
stakeholders and submit it to the SPHO for the approval.
2. He / She will accompany the SPHO when he goes on tour as and when
instructed.
3. He/She will prepare press releases and assist the SPHO in conducting
periodic press meets.
4. He will prepare and display (along with other staff ) the maps of CHNC ,
Data charts and other program related IEC material in the CHNC office room.
1.He / She will collect , document and file the IEC material related to all the
national and state programs at CHNC office.
3.He / She will visit the PHC regularly to evaluate and guiding the PHC staff in
conducting IEC Activities.
Trainings
1. He / She will assess training need for various categories of Health and
Family Planning personnel for health education.
2. He / She will develop annual training calendar for all the PHC , & Sub
centre staff training.
3. He / She will assist in develop training curriculum for the various
categories to be trained in health education and organize and evaluate
this training programme with involvement of SHEBs and RF PTCs.
FUNCTIONS:
1. He will prepare his fixed tour program and integrate it with fixed day health
services program of CHNC.
2 He will screen and provide the basic eye out patient services and refer the cases
to appropriate institutions as when required..
4. He will assist the Medical Officer of the PHC / Ophthalmic surgeons in routine
diagnostic and investigation procedures.
5. He will accompany and assist the medical officer & fixed day health services
team in providing eye care services, distribute spectacles to the cataract
operated cases & provide follow–up visit.
6. He will assist and organize eye camps at Primary Health Centers under the
supervision of the District ophthalmic Surgeons and PHC Medical Officers of the
CHNC.
7. He will actively participate in school health program for early detection of eye
diseases. He will assist the SPHO and Medical Officer PHC s in training the
school teachers, community health workers and volunteers in prevention and
control of the blindness. He will maintain a CHNC record of school children with
poor vision (Mandal wise, PHC and school- wise) and ensure follow up.
10. To refer the serious cases to the ophthalmic surgeon in District Hospitals and
General Hospitals.
12. To maintain a register of private eye surgeons and eye care nursing homes
existing in the CHNC and collect information on cataract operations done every
month in each of them and to send a consolidated report to the District
Ophthalmic Surgeon and D.P.M. Who in turn will consolidate the district figures
and send them to the State Program Officer. He should also maintain Blind
register, village – wise, for each PHC in the CHNC.
13. To consolidate vitamin A distribution at PHC s and send it to the State Program
Officer through the DM & HO.
14. His services are meant for eye care and prevention of blindness.
He will supervise the work of 5-6 Assistant Para Medical Officers who cover a
population of 1.5 to 2.0 lakhs in the CHNC area.
FUNCTIONS
1. Plan the work of para – medical workers in case detection, mobilization of cases for
treatment and follow –up treatment and coordinate with health education.
2. Plan and supervise the work, performance of para- medical workers including
pre-clinic drivers, mobilization and response of patients at treatment points,
absenteeism, seeing of contacts, population and schools surveys etc.
3. Supervise the para- medical workers activity in their work and verify their records,
reports and drug sheets.
4. Plan and guide para- medical workers in organization and conducting of surveys.
MEDICAL
8. Recognize and refer cases with drug side effect and lepra reaction.
10. Promote knowledge of leprosy and its treatment during all contacts with
patients and families, school children and public in general.
He will coordinate with CHO PHN and assist the SPMO in all the CHNC activities.
1.1.6 Malaria sub unit officer.
Malaria sub unit officer will work under the administrative control of CHNC SPHO
and technical control of the district Malaria Officer.
1. He will work under the administrative control of CHNC SPHO and technical
control of the District Malaria Officer.
2. He will have close coordination with the Medical Officers of the Primary Health
Centers in his jurisdiction.
3. He will exercise technical supervision over the surveillance staff and furnish his
findings to the CHNC SPHO & concerned Medical Officers with copy to the
District Malaria Officer.
4. He will have administrative and technical control over the spray staff in his sub-
unit.
SPRAYING
3. He will ensure that the expenditure of insecticide is not more than the
prescribed norms.
4. He will take adequate precautions for safe custody of insecticide in his sub-units
as well as in dumping places. He shall maintain insecticide Dumping register.
6. He shall carry out any technical instructions issued by the zonal officer.
7. He shall ensure token system of insecticide suspension supply in the field with
necessary Geru making about spray status.
SURVEILANCE
3. He will the Primary Health Centers and check up laboratory work. Before
checking the laboratory he shall contact the Medical Officer and have
preliminary discussions. At the end of the visit he shall give his findings to the
Medical Officer and mark a copy to the District Malaria Officer.
1. Diary
1 2 3 4 5 6 7 8 9 10
PHYSICAL TARGETS
1) Tour days 20
2) Night Halts 12
3) Sectors covered 6
6) Verification of positives 10
7) Laboratories to be visited 3
1. Diary in ProForma is submitted to CHNC SPHO and Dt. Malaria Officer by 10th of
every succeeding month.
2. Weekly spray reports in MF6 to CHNC SPHO & DMO and Medical Officer PHC
concerned.
3. Monthly spray report in MF6 to CHNC SPHO & DMO & M.O. PHC concerned by
10th of succeeding month.
WORKING RELATIONSHIP
The computer is a member of the supervisory team of the CHNC. He must keep
close contact with all the members in the team. He will function under the
administrative control and guidance of the SPHO, of CHNC. He will receive technical
support and guidance from the Statistical assistant at district level.
2. He will compile and send such monthly reports and ad-hoc returns on
Malaria, T.B, Leprosy, Blindness, Dental care and Family Welfare
Programs and other National Health Programs.(also, Neonatal tetanus
and Poliomyelitis)
7. He will maintain a register of vital events in the area from the register of
births and deaths of the PHC registers and also from reports of the vital
events observed by Health Workers in the area.
10. He will prepare and display the charts and graphs depicting
2. Analytical review of the data collected under the guidance of the SPHO
and /or statistical staff at District/State levels.
11. He will carry out other statistical functions assigned by the SPHO of
CHNC.
12. He will do any other office documentation work as and when given by
the SPHO.
********
1.1.8 Senior Assistant.
One Senior assistant is posted at CHNC head quarters. He will work under direct
administrative control of CHNC SPHO.
He/She will maintain all the records and documents as per standard Office
management procedure manuals and Financial Procedure manuals ( A.P treasury
code , Financial code , C.C.A rules , A.P. Leave rules , District office manual and other up
to date manuals as accepted and prescribed by the Government of Andhra Pradesh.
He is equally responsible in maintaining all the office records accurately and
sending all the reports, letters, information, bills, and other documents to appropriate
authorized authorities in time.
All the activities of a senior assistant are supervised and are subject to the
approval of the SPHO.
He / She will maintain files as per standard filing file keeping procedures.
He/she will index all the files and keep safely in appropriate storage place to avoid
destruction by fire, water, chemicals, theft, electric ignition, etc.
1. Office communication.
1. He/She maintains all the records and registers related to the office
communication (letters, memos, recorded telephone / telegraph
communication, etc) as per standard office management procedures.
2. He/She will give acknowledgement receipt to every person / postal dept /
messenger / person who submits any document, letter, cheques , D.D. , after
entering the information into an appropriate register.
3. He/She will take notes and record minutes of meeting and circulate such
information to the authorized officials after approval by the SPHO.
4. He / will write legibly or type the letters and other documents as instructed by
the SPHO.
5. He/she will submit all the letters, documents, cheques, Demand drafts, etc along
with in ward and out ward registers to the SPHO every day. He will inform the
SHMO on telephone when the officer is in the field or camp.
2. Maintenance of CHNC program records and tentative tour program of the CHNC
staff.
1. He/She will index every file and store the Program guidelines, implementation
orders received for the district state and Central level, time to time program
updates, related to every State and national program implemented in the CHNC
area.
2. He / she may take the help of SCHO, SPHN, and LD computer in office work after
seeking the approval of the SPHO.
1. He/ she will be personally responsible for keeping all the service registers and
records leave accounts of the employees in the safe custody and ensure that all
these are updated regularly.
2. He/She will be personally responsible for entering the pay allowance
particulars and the information in to the service registers accurately in the
event of increment, promotion, and pay fixation as per government orders
receive time to time.
4. Maintenance of all the records related to Financial management and Accounts
and ensuring their safety.
1. He / she will maintain all the Financial management registers and records as
prescribed by the government of Andhra Pradesh.(refer the and guide lines and
procedures given in Financial and Office management training manuals. )
2. He / she shall prepare and counter sign on every bill / financial document
he/she prepares and submits for approval by the SPHO.
3. He/She will record every financial transaction with out any delay and update
the registers during the transaction.
4. He/she will maintain all the supportive registers EG: all the watch registers.
5. He /she will prepare the pay slips and issue the same to all the employees at the
time of salary disbursement.
6. He/she shall furnish any information as requested for by the employee
regarding the pay and allowances , deductions , loans , recoveries etc related to
the same employee.
7. He/she shall furnish any reports records or information of financial
transactions as requested for by the District, regional, state administration after
due approval by the SPHO.
5. Assisting SPHO, in drawing and disbursement of money and recording all the
Trans actions in the prescribed registers.
1. He/she will follow the standard procedures as prescribed by A.P treasury code
Financial Code, and Government orders in enforcement as on date , in the
conduct of all the financial transactions and assist the SPHO.
2. He/she will prepare the pay bills and other bills as per standard treasury office
procedures and present them in time to A.P.Treasury offices (STO, DTO).
3. He/she will draw the money and bring the same to CHNC office ensuring the
safety and security in such activity.
4. In the case if the payments are made through bank transactions due precautions
are to be taken to ensure that the money is paid to the authorized person/party.
5. He / She will ensure monthly reconciliation of accounts is done.
6. Internal and External Audit.
1. He/She will keep all the office records up to date and present them before internal
or external auditing officers on receipt of orders from the competent authorities.
2. He/She shall assist the Audit party in physical verification of assets and registers
and other documents of the CHNC.
7. Safe maintenance of stock files, Old records, files in Archives.
1. He / she will maintain stock files for all the communication originated &
received by the office and also for the government orders received from time
to time.
2. He / She will ensure the security and proper maintenance of all the old files
in archives for future reference and use as per standard office procedures.
He / She will execute any other work given by the CHNC SPHO for the smooth
running of the office.
1.1.9. Driver.
One driver is posted to PHC headquarter office where ever the vehicle is
available. He will work under the administrative control of the PHC MO. The driver is
responsible for the safe and official use of the government vehicle and as instructed by
the PHC MO.
He is personally responsible for proper keep up and complete maintenance of
the vehicle at the PHC.
He will abide by all the applicable existing laws, rules and regulations related to
road transport and, Health Medical and family welfare department.
His basic job responsibilities are described under the following heads.
1. Vehicle maintenance.
2. Maintenance of vehicle related documents.
3. Code of conduct.
Vehicle maintenance.
1. He will maintain the vehicle in fit and working condition taking all the due
precautions.
2. He will keep the vehicle ready to be used by the SPHO.
3. He will ensure the periodic technical inspection by a competent authority and
get it certified.
4. He will adopt all the good practices to improve the vehicle’s service life and fuel
efficiency.
5. He will keep the vehicle clean and neat.
6. He will park the vehicle in protected authorized areas either in the offices or
public parking places or vehicle shed.
Maintenance of vehicle related documents.
1. He will maintain the vehicle usage log book and ensures that all the information
regarding the vehicle usage is entered in to it by the users.
2. He will keep his driving license and essential vehicle documents all ways with
him along with his official photo identity card, and produce the same before the
RTA officers and other competent authorities on demand.
3. For all the goods and materials which are transported in the vehicle the driver
will seek authorization from his controlling officer in writing and will produce it
as proof of evidence before the competent authority on demand.
Code of conduct.
1. He is expected to be Polite, responsible and well disciplined capable of working
in harmony with CHNC team.
2. He will avoid consumption of intoxicants like alcohol, tobacco, etc when on duty.
3. He will keep himself fit and healthy. He shall under go periodic health check up
and get certified.
He will execute any other work entrusted by the CHNC SPHO for the smooth running of
the CHNC.
1.1.10. Sweeper attender
2. He/She will sweep the premises of CHNC , dust the furniture wash the floor weekly ,
and when ever necessary as instructed by the SPHO.
3. Assist the SPHO and CHNC staff in maintaining the files and filing racks.
4. He / She will attend to and help the visitors in meeting the senior CHNC officers
during the visiting hours.
5. He /She will help the Driver of the vehicle in washing and maintaining the vehicle
neat and tidy.
6. He/She will wash the table cloths and curtains once in a month.
8. He / She will do any other work as and when given by the SPHO.
10. PHC STAFF and their JOB CHARTS.
10. PHC STAFF and their JOB CHARTS .
Job charts of the following PHC staff are included in this manual.
********
1. DUTIES OF THE MEDICAL OFFEICERS.
General
Most of the primary health centers are sanctioned with two medical officer posts. One
of the two medical officers will be identified as drawing officer and in charge of the
PHC.
Medical Officer identified to be In charge of the PHC who is also the drawing and
disbursing officer of the PHC is the administrative head of Primary Health Center. In
addition to the preventive promotive and curative health functions of the Medical
officer, he/She shall discharge administrative functions entrusted to him/her.
The second medical officer have to involve himself/herself equally in all the activities
of the PHC, manage the resources and take part in effective implementation of every
health program in the PHC area.
General
The PHC Medical officers and staff under his administrative control should
reach out to the community and provide integrated – RCH, disease prevention and
management, health promotion services. - And comprehensive preventive, promotive
and curative services.
The PHC Medical officers should effectively utilize the services of all the
headquarter staff and all field staff,. The Medical Officers should visit each and every
village in its service area at least once a month.
Ideally each PHC should have two medical officers; and one should be mobile for
at least six days a week (for two weeks in a month) the other should provide services at
PHC headquarters (for two weeks in a month) at any given point of time. Where there
is only one MO, she/ he shall be mobile for at least four days a week.
I . CURATIV E WOR K
1. Both the medical officers of the Primary health centre must ensure the
preparation of the annual health action plan by the CHO involving the MPHS
and MPHA.
2. The Medical Officer will organize the out-patient department and will allot
duties to the ancillary staff to ensure smooth running of the O.P department
3. The Medical Officer will make suitable arrangements and distribute the
work to the staff for the treatment of emergency cases which come outside
the normal O.P. Hours.
4. The Medical Officer will organize laboratory services for patients for proper
diagnosis of the disease where ever necessary and within the scope of PHC
laboratory.
5. The Medical Officer will make arrangements for rendering services for the
treatment of minor ailments at community level and at the PHC through the
agency of Community Health Officer, Health Supervisors, Multipurpose
heath assistants.
7. The Medical Officer will screen cases needing specialized medical attention
including dental care and nursing care in the treatment of minor ailments.
8. The Medical Officer will cooperate and/or coordinate with other institutions
providing medical care services in his area.
9. The Medical Officer will visit each sub- centre in his area at least once in a
fortnight on a fixed day not only to check the work of the staff but also to
provide curative services.
2. The Medical Officer will further supervise their work periodically both in the
clinics and in the community setting to give them the necessary guidance and
direction.
3. The Medical Officer will prepare operational plans and ensure effective
implementation of the same to achieve the laid-down targets under different
National Health Family Welfare Programs
4. The Medical Officer will keep close liaison with Mandal development officer and
his staff, community leaders and various social welfare agencies in his area and
involve them to the best advantage in the promotion of health program in the
area.
6. The Medical Officer will ensure the regular conduction of IEC programs at
habitation level.
iii. PACKAGE OF SERVICES UNDER MATERNAL AND CHILD HEALTH PROGRAM.
(NRHM)
Package of services under MCH are:
2. Immunization Program.
5. School Health.
6. Family Planning.
4. The Medical Officer will plan and implement UIP in line with the
latest policy and ensure cent-percent coverage of the target
population in the PHC (i.e., Pregnant mothers and new born infants).
3. The Medical Officer will ensure through his health team early
detection of diarrheal diseases and dehydration.
3. The Medical Officer will ensure through his health team early
detection of pneumonia cases and provide appropriate treatment.
4. The Medical Officer will supervise the work of health supervisors and
health workers in treatment of mild and moderate ARI.
To be started in June/ July in all the Govt. schools and social welfare hostels and all the
children in the schools of the area to undergo basic health screening initially and
those identified as high risk to be ear marked for follow up visits.
6. each child to have a card
7. DPT/ TT as per the schedule are given
8. De-worming to be under taken in the initial visit and the next after a six
months period.
9. Children requiring specialist care are to be referred to the concerned
specialist at a referral unit.
10. Further follow up visits to the schools may be once in 3 months.
6. FAMILY PLANNING.
The Medical Officer will be responsible for giving immediate and sustained
attention to any complications the acceptor develops due to acceptance of
Family Planning methods.
The Medical Officer will extend family planning motivation and spacing
advice to all the eligible women who visit the OPD.
The Medical Officer will get himself trained in tubectomy, wherever possible,
and organize tubectomy camps.
The Medical Officer will seek help of other agencies such as District Bureau,
Mobile Van and other associations/ Voluntary organizations for
tubectomy/IUD camps and MTP services.
7. State and National Health programs
1. NATIONAL MALARIA ERADICATION PROGRAM (NMEP) AND VECTOR CONTROL
PROGRAM
N. M. E. P
1. He will be responsible for all NMEP operations in his PHC area and
will be responsible for all administrative & technical matters.
3. The Medical Officer will guide the Health Workers on all treatment
schedules, especially Presumptive and radical treatment with
Chloroquine & primaquine.
5. He will ensure that health education activities are taken up in all the
villages of the PHC area involving all the PHC staff.
6. He will ensure that CHO/MPHEO all the HC staffs is involved in the J.E
control activities in his areas including spray operations.
4.1. LEPROSY
1. He will provide facilities for early detection of cases of
Leprosy and confirmation of their diagnosis and treatments.
2. He will ensure that all cases of Leprosy take regular and
complete treatment
4.2. TUBERCULOSIS - RNTCP
1. He will provide facilities for early detection of cases of
Tuberculosis, confirmation of their diagnosis and
treatment.
2. He will ensure that all cases of Tuberculosis take regular and
complete treatment.
3. He will sensitize the community and organize directly
observed treatment provider (DOTS) services.
4.3. SECUALLY TRANSMITTED DISEASES (STD)
1. He will ensure that all the cases of STD are diagnosed and
properly treated and their contacts are traced for early
detection.
2. He will provide facilities for VDRL test for all pregnant
women at the PHC.
b) Testing of vision.
c) Referral services
********
2. JOB RESPONSIBILITIES OF COMMUNITY HEALTH OFFICER.
Note: One Community Health Officer will be posted at each new Primary Health
Centre and will cover 30,000 populations (20, 000 in trial and hilly areas). He will
be under direct administrative and technical control of M.O In charge of the PHC.
The Community Health Officer where ever exists will carry out the following
duties.
Ensure that all necessary steps are being taken for the control of the
communicable diseases in the village.
Assist the Medical Officer of the Primary Health Centre in taking the necessary
action in case of any outbreak of an epidemic in the PHC area.
1. Supervise and guide the Health Supervisors and Health Workers and
actively involve the Health Guides and trained Dais in the effective
implementation of the program for Maternal and Child health.
3. SCHOOL HEALTH.
1. Visit schools in the PHC area at regular intervals and arrange for
Medical check-up by the M.O., PHC, immunization environmental
sanitation and health education.
2. Make arrangements for the treatment and follow up of those students
found to have defects.
1. Supervise and guide the Health Supervisors and Health Workers and
actively involve the Health guide and Trained Dais in the effective
implementation of the Universal Immunization Program.
5. FAMILY PLANNING.
1. Supervise and guide the Supervisors and Health Workers and actively
involve the Health Guides and trained Dais in the effective
implementation of the Family Planning Program.
6. NUTRITIONAL.
1. Supervise and guide the Health Supervisors and Workers and actively
involve the Health Guides and trained Dais in the effective
implementation of the nutrition program, such as administration of
vitamin A and Iron and Folic Acid tablets.
7. ENVIRONMENTAL SANITATION.
1. Help to ensure that all steps are being taken for the provision of safe
drinking water and for the improvement of environmental sanitation
in the villages.
10. Maintain a close liaison with the Mandel Development Officer and his
staff and with other development program workers such as those
under the National Adult Education Programs
13. Educate the community about the Health Guide scheme and take the
necessary steps to train the Health Guide from the PHC area.
14. Under the supervision of Medical Officer PHC, he should organize and
conduct training for ASHA s, Health Guides, Primary School Teachers
and Dais, be responsible for field training of these community level
workers and utilize the services Health Supervisors and Health
Workers MPHA s in these in these training Programs
16. Assist the M. O. PHC in staff development programs for the Health
Supervisors and Health Workers, at the PHC as well as in the field.
24. Ensure that the sub centers are properly maintained and managed by the
Health Workers ( MPHA s) and Health Supervisors.
27. Scrutinize the work plans of the Health Supervisors and Health Workers.
28. Supervise the maintenance of the prescribed records at sub center level.
29. Obtain the reports from the periphery, analyze and interpret the data
available, and utilize the findings for improving the implementation of
the health programs in the PHC area.
30. He should organize monthly staff meetings, not only for evaluating the
progress of work and suggesting steps to be taken for further
improvement but also as a means of staff development and continuing
education.
32. Keep notes of his activities in the PHC area and submit his tour report at
regular intervals to the M.O. PHC.
33. Any other duty assigned by Medical Officer should be carried out by CHO
********
4. JOB DESCRIPTION OF MULTIPURPOSE HEALTH EXTENSION OFFICER.
The Multipurpose Health Extension Officer will be under the administrative control of
the Medical officer I/C PHC. One of his primary responsibilities is to promote community
participation for ensuring self reliance in the community. The Multipurpose Health Extension
Officer will function under the technical supervision and guidance of Dist. Extension & Media
Officer/Dy. DEMO He will be responsible for providing support to all National Health & Family
Welfare Programs in the PHC.
I. MAINTANCE OF DATA.
II. TRAINING.
1. He will assist the Medical Officer- in- charge in conducting training of Health
Workers in various schemes.
3. He will maintain a complete set of educational aids for his own use and for
training purpose.
2. He will ensure proper functioning of all Health Committees in the PHC area.
4. He will support, guide and supervise the field workers in the area of
information dissemination, education and motivation.
5. He will adequately tour with a minimum of one night halt in every health
workers area. While in tour, he will ensure proper utilization of
educational materials, provide support & guidance to Health Workers in
their educational activities.
V. VITAL STATISTICS.
(b) NPSP (National Polio Surveillance project): Involving all the case of
weakness in <15 years age group (AFP) and all measles cases of all age groups
in the community to the Medical Officer/DIO
Revised Nat ional Tubercul osis Control Program (RNTCP) :
MPHEO will ensure that the following activities are implemented and
supervise the following activities of the field staff.
Referral of suspected symptomatic cases to the PHC/Microscopy
centre; and provision of DOTS at sub-centre and proper documentation and
follow-up.
********
5. JOB RESPONSIBILITIES OF HEALTH SUPERVISOR (MALE)
The Health Supervisor Male will carry out the following functions:
1. Supervise and guide the Health Worker Male in the delivery of Health Care
Services to the community.
3. Help the Health Worker Male in improving his skills in working with the
community.
4. Help and guide the Health Worker Male in planning and organising his
program of activities.
5. Visit each Health worker Male at least once a week on a fixed day to
observer and guide him in his day-to-day activities.
6. Assess monthly progress of work of the Health Worker Male and submit an
assessment report to the Medical Officer of the Primary Health Care.
7. Carry out supervisory home visits in the area of the Health Worker Male.
2. TEAM WORK.
2. Coordinate his activities with those of the Health Supervisor Female and
other health personnel, including the health Guides and Dais.
3. Coordinate the health activities in his area with the activities of workers of
other departments and agencies and attend to meetings at PHC level.
6. Assist the medical officer of the Primary Health Centre in the organization of
the different health services.
2. Check that the drugs at sub centre are properly stored and that the
equipment is well maintained.
3. Ensure that the Health worker Male maintains his kit in the proper way.
1. Scrutinize the maintenance of records by the Health Worker Male and guide
him in their proper maintenance.
2. Review records received from the Health Worker Male, Consolidate them
and submit reports to the Medical Officer of the Primary Health Centre.
b) Daily Diary.
3. He will carry with him the proper record forms, diary and guidelines for
identifying suspected Kala-Azar cases.
3. He will carry with him the proper record forms, diary and guidelines for
identifying suspected encephalitis cases.
4. He will be responsible for ensuring complete coverage during the spray
activities and search operations.
2. Ensure that all cases of Leprosy take regular and complete treatment and
inform the Medical Officer PHC about any defaulters to treatment.
10. TUBERCULOSIS.
1. Check whether all T.B cases are taking regular treatment, motivate
defaulters to take regular treatment and bring them to the notice of the
Medical Officer PHC.
2. Ensure that all cases of Tuberculosis take regular and complete
treatment and inform the M.O. PHC about any defaulters to treatment.
2. Supervise the immunization of all children from one to five years and
pregnant women.
2. Guide the Health Workers Male in establishing male depot holders with the
Assistance of the Health Worker Male and supervise the functioning.
3. Assist M.O. PHC in organization of Family Planning camps and drives.
5. Ensure follow-up all cases of vasectomy, tubectomy, IUD and other Family
Planning acceptors.
13. NUTRITION.
1. Ensure that all cases of malnutrition among infants and young children (0-5
years) are given the necessary treatment and advice and refer serious cases
to the PHC.
2. Ensure that Iron and Folic Acid Vitamin A are distributed to the beneficiaries
as prescribed.
1. Collect and compile the weekly report of births and deaths occurring in his
area and submit them to the Medical Officer primary health centre. Ensures
notification of Births and Deaths occurred in the area to the Birth and Death
Register of the local area by the Health Worker Male & Female.
2. Educate the community regarding the need for Registration of Vital Events.
1. Ensure the treatment for minor ailments and first aid for accidents is
provided and refer cases beyond his competence to the PHC or nearest
hospital.
2. Attend the cases referred by the Health Workers and refer cases beyond his
competence to the PHC or nearest hospital.
2. Arrange group meetings with leaders and involve them in spreading the
message for various health programs.
3. Organize and conduct training of community leaders with the assistance of
the Health Team.
18. Any other PHC / Sub centre work may be assigned by the Medical Officer PHC for
smooth running of PHC and in the interest of the health needs of the rural citizens.
********
NOTE: Under the Multipurpose Workers Scheme a Health Supervisor Female expected
to cover a population of 30,000 (20,000 in tribal and hilly areas) in which there
are six sub centers, each with one health Worker Female. The Health Supervisor
Female will carry out the following duties.
1. Supervise and guide the Health Worker Female, Dais and female Health Guides
in the delivery of health care services to the community.
4. Help and guide the Health Worker Female in planning and organizing her
program of activities.
5. Visit each subcenter at least once a week on a fixed day to observe and guide the
Health Worker Female in her day-to-day activities.
6. Assess fortnightly the progress of work of the Health Worker Female and submit
an assessment report to the Medical Officer of the Primary Health Centre.
7. Carry out supervisory home visits in the area of the Health Worker Female with
respect to their duties under various National Health Programs.
8. Supervise referral of all pregnant women for VDRL testing to CHC/ Sub-
Divisional Hospital.
2. TEAM WORK.
2. Coordinate her activities with those of the Health Supervisor Male and other
health personnel including the Dais and Health Guides.
3. Coordinate the health activities in her area with the activities of workers of
other departments and agencies and attend meetings at PHC level.
4. Conduct regular staff meetings with the Health Workers in coordination with
the Health Supervisor Male.
6. Assist the Medical Officer of the Primary Health Centre in the organization of
the different health services in the area.
1. In collaboration with the Health Supervisor Male, check at regular intervals the
stores available at the sub centre and help in procurement of supplies and
equipment.
2. Check that the drugs at the sub center are properly stored and that equipment is
well maintained.
3. Ensure that the Health Worker Female maintains her general and midwifery kit
and Dai kit in the proper way.
c. Review reports received from the Health Workers Female consolidate them
and submit monthly reports to the Medical Officer of the Primary Health
Centre.
5. TRAINING.
1. Organize and conduct training for Dais with the assistance of the Health
Worker Female.
1. Conduct weekly MCH clinics at each sub centre with the assistance of the Health
Worker Female (MPHA) and Dais.
2. Respond to calls from the Health Worker Female, the Health Worker Male, the
Health guides and the trained Dais and render the necessary help.
3. Conduct deliveries when required at PHC level and provide domiciliary and
Midwifery services in emergencies and immediately refers the high risk cases.
1. She will ensure through spot checking that Health Worker Female maintains up-
to -date eligible couple registers all the time
2. Conduct Weekly family planning motivation & ANC clinics (along with the MCH
clinics) at each sub center with the assistance of the Health Worker Female.
5. Guide the Health Worker Female in establishing female depot holders for the
distribution of conventional contraceptives and train the depot holders with the
assistance of the Health Worker Female.
8. NUTRITION.
1. Ensure that all cases of malnutrition among the infants and young children (0-5
years) are given the necessary treatment and advise and refer serious cases to
the Primary Health Centre
2. Ensure that iron and Folic Acid and Vitamin A are distributed to the
beneficiaries as prescribed
1. Supervise the immunization of all pregnant women and children (0-5 years).
2. She will also guide the H.W.(female) to procure supplies organize immunization
camps, provide guidance for maintaining cold chain, storage of vaccine, Health
Education, and also in immunization.
4. Follow the directions given in Manual of Health Worker (Female under National
Immunization Program)
1. Ensure treatment for minor ailments, provide ORS & first aid for accidents
and emergencies and refer cases beyond her competence to the Primary
Health Centre or nearest hospital.
1. Carry out educational activities for MCH, Family Planning, Nutrition and
Immunization, control of blindness, dental care and other National
Health Programs like leprosy and tuberculosis with the assistance of the
Health Worker Female.
2. Arrange group meetings with leaders and involve them in spreading the
message for various health programs.
4. Organize and utilize Mahila Mandal, teachers and other women in the
community in the family welfare programs, including ICDS personnel
12. Any other PHC / Sub centre work may be assigned by the Medical Officer PHC for smooth
running of PHC and in the interest of the health needs of the rural citizens.
*****
1.1.8 Senior Assistant.
One Senior assistant is posted at PHC head quarters. He will work under direct
administrative control of PHC MO.
He/She will maintain all the records and documents as per standard Office
management procedure manuals and Financial Procedure manuals ( A.P treasury
code , Financial code , C.C.A rules , A.P. Leave rules , District office manual and other up
to date manuals as accepted and prescribed by the Government of Andhra Pradesh.
He is equally responsible in maintaining all the office records accurately and
sending all the reports, letters, information, bills, and other documents to appropriate
authorized authorities in time.
All the activities of a senior assistant are supervised and are subject to the
approval of the MO.
He / She will maintain files as per standard filing file keeping procedures.
He/she will index all the files and keep safely in appropriate storage place to avoid
destruction by fire, water, chemicals, theft, electric ignition, etc.
1. Office communication.
1. He/She maintains all the records and registers related to the office
communication (letters, memos, record telephone / telegraph
communication, etc ) as per standard office management procedures.
2. He/She will give acknowledgement receipt to every person / postal dept /
messenger / person who submits any document, letter, cheques , D. Ds , after
entering the information into an appropriate register.
3. He/She will take notes and record minutes of meeting and circulate such
information to the authorized officials after approval by the PHC MO.
4. He / will write legibly or type the letters and other documents as instructed
by the PHC MO.
5. He/she will submit all the letters, documents, cheques, Demand drafts, etc
along with in ward and out ward registers to the PHC MO every day. He will
inform the MO on telephone when the officer is in the field or camp.
2. Maintenance of PHC program records and tentative tour program of the PHC
staff.
1. He/She will index every file and store the Program guidelines, implementation
orders received for the district state and Central level, time to time program
updates, related to every State and national program implemented in the PHC
area.
2. He / she may take the help of CHO, PHN, and LD computer in office work after
seeking the approval of the PHC MO.
1. He/ she will be personally responsible for keeping all the service registers
and records leave accounts of the employees in the safe custody and ensure
that all these are updated regularly.
2. He/She will be personally responsible for entering the pay allowance
particulars and the information in to the service registers accurately in the
event of increment, promotion, and pay fixation as per government orders
receive time to time.
4. Maintenance of all the records related to financial management and Accounts
and ensuring their safety.
1. He / she will maintain all the Financial management registers and records as
prescribed by the government of Andhra Pradesh.(refer the and guide lines and
procedures given in Financial and Office management training manuals. )
2. He / she shall prepare and counter sign on every bill / financial document
he/she prepares and submits for approval by the PHC MO.
3. He/She will record every financial transaction with out any delay and update
the registers during the transaction.
4. He/she will maintain all the supportive registers EG: all the watch registers.
5. He /she will prepare the pay slips and issue the same to all the employees at the
time of salary disbursement.
6. He/she shall furnish any information as requested for by the employee
regarding the pay and allowances, deductions, loans, recoveries etc related to
the same employee.
7. He/she shall furnish any reports records or information of financial
transactions as requested for by the District, regional, state administration after
due approval by the PHC MO.
5. Assisting MO, in drawing and disbursement of money and recording all the
Trans actions in the prescribed registers.
1. He/she will follow the standard procedures as prescribed by A.P treasury code
and Financial Code, Government orders in enforcement, as on date in the
conduct of all the financial transactions and assist the PHC MO.
2. He/she will prepare the pay bills and other bills as per standard treasury office
procedures and present them in time to A.P.Treasury offices (STO, DTO).
3. He/she will draw the money and bring the same to PHC office ensuring the
safety and security in such activity.
4. In the case if the payments are made through bank transactions due precautions
are to be taken to ensure that the money is paid to the authorized person/party.
5. He / She will ensure monthly reconciliation of accounts is done.
6. Internal and External Audit.
1. He/She will keep all the office records up to date and present them before
internal or external auditing officers on receipt of orders from the competent
authorities.
2. He/She shall assist the Audit party in physical verification of assets and
registers and other documents of the PHC.
7. Safe maintenance of stock files, Old records, files in Archives.
1. He / she will maintain stock files for all the communication originated &
received by the office and also for the government orders received from time
to time.
2. He / She will ensure the security and proper maintenance of all the old files
in archives for future reference and use as per standard office procedures.
He / She will execute any other work given by the PHC MO for the smooth
running of the office.
Under the MPW scheme, one Health Worker Male and one Health Worker Female are
posted at each subcentral and are expected ultimately to cover a population of 5,000
(3,000 in tribal and hilly area).
The Health Worker Male will visit each family once a fortnight. He will record his visit
on the main entrance to the house according to the instructions.
1. MALARIA
b. Whether there was any fever case in the family in between his
fortnight visits.
c. Whether any guest had come to the family and had fever.
d. Whether any member of the family who had fever in between his
fortnight visits had left the village.
2. He shall collect thick and thin blood smears on one glass slide from cases
having fever or giving history of fever and enter details in MF-2 and put
appropriate serial number on the slide.
3. He shall begin presumptive treatment for Malaria after blood smear has
been collected. He will follow the instructions given to him regarding
administration of presumptive treatment under NMEP.
4. He shall contact the village ASHA during his fortnightly visit to the village
and (i) collect blood smears already taken by the village ASHA ii) also
collect details of each case in MF -2 iii)replenish both drugs and glass
slides and look into the account of consumption of antimalarial drugs.
5. He shall dispatch blood smears along with MF-2 collected from the village
ASHA/Multipurpose Worker Female of the Subcentre and also those
collected during his visit in his area to the PHC Laboratory twice in a week,
or as instructed by the Medical Officer PHC.
6. He shall verify the presumptive treatment administered by the ASHA, if
any during his visit.
9. He shall contact the village ASHA and inform him of the spray dates and
request him to motivate the community and prepare them for accepting
the spray operations.
10. Assist the Health Supervisor Male in supervising spraying operations and
training of field spraying staff.
(b) He will identify the fever cases detected by him during visits and not
responding to anti malarials.
(c) Whether any guest had come to the family and had fever Kala-Azar.
(d) Whether any member of the family/guest who had fever of more than
15 days duration and left the village.
2. He will guide the suspected cases to the nearest diagnostic and treatment
centre (Primary Health Care Centre or Community Health Centre) for
diagnosis and treatment by the Medical Officer.
3. He will keep a record of all such cases and shall verify from PHC about their
diagnosis during the monthly meeting or through Health Supervisor during
the visit.
4. He will carry a list of all Kala-azar cases in his area for follow up and will
ensure administration of complete treatment.
7. From each family, he shall enquire about presence of any fever cases with
encephalitic presentation.
8. He will refer the suspended cases to the nearest diagnostic and treatment
Center (Primary Health Care Centre or Community Health Center) for
diagnosis and treatment by the Medical Officer.
9. He will keep a record of all such cases and shall verify from PHC about their
diagnosis during the monthly meeting or through Health Superisor (M)
during his visit.
10. He will carry a list of all JE cases in his area for follow up.
12. He will conduct all health education activities particularly through inter
personnel communication by carrying proper charts etc. and also assist
Health Supervisor and other functionaries in their health education
activities.
4. COMMUNICABLE DISESES.
2. Carry out control measures until the arrival of the Health Supervisor
Male and assist him in carrying out these measures.
7. Report the presence of stray dogs to the Health Supervisor Male and
assist him in carrying out the destruction of stray dogs.
5. LEPROSY
2. Check whether all cases under treatment for leprosy are taking regular
treatment. Motivate defaulter to take regular treatment and bring them to
the notice of the Health Supervisor Male.
6. TUBERCULOSIS
1. Identify persons especially with fever for 15 days and above with prolonged
cough or spitting of blood and take sputum smears from these individuals.
Refer these cases to the M.O PHC for further investigations.
2. Check whether all cases under treatment for tuberculosis are taking regular
treatment. Motivate defaulters to take regular treatment and bring them to
the notice of the Health Supervisor Male.
4. Assist the village ASHA in under taking the activities under TB program
properly. Provide the list of the TB patient living in a village to the village
ASHA so that he is further able to motivate the TB patient in taking regular
treatment.
7. ENVIRONMENTAL SANITATION
3. Assist the Health Supervisor (Male & Female) Health Worker Female in
the school immunization program.
2. Spread the message of family planning to the couples and motivate them
for family planning individually and in groups.
7. Establish male depot holders in the area. Help the Health Supervisor
Male and Female in training them all. Provide continuous supply of
conventional contraceptives.
13. NUTRITION
2. Distribute Iron and Folic Acid as prescribed to children from zero to five
years, pregnant and nursing mothers and family planning acceptors.
3. Administer Vitamin A solution as per prescribed to children from one
year to five years.
4. Educate the Community about nutritious diet for mothers and children
from locally available foods.
1. Enquire about births and deaths occurring in his area, record them in the
births and deaths register and notify them to the Birth and Death
Register of the local area.
1. Provide treatment for minor ailments. Provide first aid for accidents and
emergencies, and refer cases beyond his competence to the Primary
Health Center or nearest Hospital
15 RECORD KEEPING
1. Survey all the families in his area and prepare/ maintain maps and
charts for the villages.
3. With the assistance of the Health Worker Female prepare the eligible
couple and child Register and maintain it up to date.
4. Maintain a record of cases in his area who are under treatment for
tuberculosis and leprosy.
16. Any other PHC / Sub centre work may be assigned by the Medical Officer PHC for
smooth running of PHC and in the interest of the health needs of the rural citizens.
********
8. JOB RESPONSIBILITIES OF MPHA (FEMALE) / ANM
Under Multipurpose workers Scheme, one Health Worker Female and one Health
Worker Male are posted at each Sub-centre and are expected ultimately to cover a
population of 5,000 (3,000 in tribal and hilly areas.)
Under NRHM for strengthening of Rural Family Welfare Sub centers to provide
services guarantee as per the IPHS Standards 2nd ANM post is created
1st ANM and 2nd ANM will carry out the following duties in equally divided Sub-
centre area as per the Job chart.
2. Test urine of pregnant women for albumen and sugar and estimate
haemoglobin level during her home visits and at the clinics.
6. Supervise deliveries conducted by Dais and assist them whenever called in.
7. Refer cases of difficult labour and newborns with abnormalities, help them
to get institutional care and provide follow up to the patients referred to or
discharged from hospital.
8. Make at test three post-natal visits for each delivery conducted in her area
and render advice regarding car of mother and care and feeding of the new
born.
9. Asses the growth and development of the infant and take necessary action
required to rectify the defect.
10. Educate mother individually and in groups in better family health including
maternal and child health, family planning, nutrition, immunization, control
of communicable diseases, personnel and environmental hygiene.
11. Assist Medical Officer and Health Supervisor Female in conducting antenatal
and postnatal clinics at the subcenter.
2. FAMILY PLANNING
1. Utilize the information from the eligible couple and child registers for the
family planning program. She will be responsible for maintaining eligible
couple registers and updating at all times.
2. Spread the message of family planning to the couples and motivate them for
family planning individually and in group.
6. Build rapport with acceptors, village leaders, ASHAs, Dais and other and
utilise them for promoting Family Welfare Program.
7. Identify women leaders and help the Health Supervisor Female to train
them.
1. Identify the women requiring help for medical termination of pregnancy and
refer them to nearest approved institution.
4. NUTRITION
1. Identify the cases of malnutrition among infants and young children (zero to
five years), give the necessary treatment and advice and refer serious cases
to the Primary Health Centre.
2. Distribute Iron and Folic Acid tablets as prescribed to pregnant and nursing
mothers, infants and young children (zero to five years) and family planning
acceptors.
7. DAIS TRAINING
1. List Dais in her area and involve them in promoting Family Welfare.
8. COMMUNICABLE DISEASES
1. Notify the M.O. PHC immediately about any abnormal increase in cases of
diarrhea/dysentery, Poliomyelitis, Neonatal tetanus, fever with rigors, fever
with rash, fever with jaundice or fever with unconsciousness which she come
across during her home visits, take the necessary measures to prevent their
spread, and inform the Health Worker Male to enable him to take further
action.
2. If she comes across cases of fever during her home visits she will take blood
smears, administer presumptive treatment and inform Health Worker Male for
further action.
4. Assist the Health Worker Male in maintaining a record of cases in her area, who
are under treatment for tuberculosis and leprosy and check whether they are
taking regular treatment, motivate defaulters to take regular treatment and
bring these cases to the notice of the Health Worker Male or Health Supervisor
Male.
6. Identify and refer all cases of blindness including suspected cases of cataract to
M.O. PHC
7. Where Kala-azar is endemic
(i) She will assist Health Worker Male in identifying suspected Kala-
azar cases and guiding them to the nearest diagnostic and
treatment centre.
(ii) She will ensure follow up of all the Kala-Azar cases in her area
for complete treatment.
(i) She will assist the Health Worker Male in identifying suspected
encephalitis cases and guiding them to the nearest diagnostic and
treatment centre.
(ii) She will ensure follow up of all J.E. cases in her area.
9. VITAL EVENTS
1.1 Record births and deaths occurring in her area in births and deaths
register and notify them to the local Birth and Death Registrar.
1. Register
(a) pregnant women from three months of pregnancy onward
(b) infants zero to one year of age; and
(c) (c) women aged 15 to to 44 years
2. Maintain the pre-natal and maternity records and child care records.
3. Assist the Health Worker Male in preparation of the eligible couple and child
register and maintaining it up-to-date.
5. Prepare and submit the prescribed monthly reports in time to the Health
Supervisor Female.
Provide treatment for minor ailments, provide first aid for accidents and emergencies
and refer cases beyond her competence to the Primary Health Centre or nearest
hospital.
2. Coordinate her activities with the Health Worker Male and other Health
Workers including the ASHA s and Dais.
3. Meet the Health Supervisor Female each week and seek her advice and guidance
whenever necessary.
********
9. JOB RESPONSIBILITIES OF LABORATORY TECHNICIAN
Note: All Primary Health Centers and subsidiary Health Centers have been provided
with a post of Laboratory Technician/Assistant. The Laboratory Technician will be
under the direct supervision of the Medical Officer, Primary Health Centre. The
Laboratory Technician will carry out the following duties.
6. Maintain the necessary records of investigations done and submit the reports to
the M. O. PHC.
8. Indent for supplies for the laboratory through the M. O. PHC and ensure the safe
storage of materials received.
i. Macroscopic examination
2. Haemoglobin estimation.
3. RBC count
4. WBC count (total and differential)
5. Preparation, staining and examination of thick and thin blood smear for
malarial parasites and for microfilariae.
7. VDRL
1. Macroscopic examination
4. He will maintain all records of sera samples drawn and their results from
Virology Lab.
III. MAINTENANCE OF RECORDS AND REGISTERS UNDER NMEP
1. He will maintain all record of slides examined by him must get the positive
Slides confirmed by the medical Officer of PHC.
She works under the technical and administrative control of Medical Officer of
primary Health Centre.
FUNCTIONS:
1. O. P. D:
She will assist the Medical Officer to ensure smooth running of the O. P. D.
2. Administration of Drugs:
She will be responsible for the administration of drugs (Oral and Parenteral) to
O.P and I.P cases as prescribed by the medical Officer.
3. In Patient Ward
4. Labour Room :
5. She is responsible for autoclaving the required material and keeps drugs
needed in the labour room.
5. Operation Theatre :
6. Maintenance of Stores :
She will prepare indent for the equipments, materials, linen and drugs
etc, needed for operation theatre, labour room and I.P. Ward etc., obtain them
and maintain the stock and issue register.
She will maintain the prescribed records for O.P. & I. P., Labour room and
Operation Theatre services.
She will ensure the cleanliness and take care of sanitation in the PHC
building and premises.
********
12. PHARMACIST FUCTION S:
3. He will maintain the stock register of medicines and vaccines received by him.
4. He will maintain the medical stores and all the registers and records related to
the stores.
5. He will assist the Medical Officer in preparation of indents for medicines and
vaccines etc., as well in advance and when required. He will receive / bring the
indented medicines issued from the district medical stores.
6. He will maintain watch register of medicines indicating expiry date, batch No.
and condition of drugs received by him. He will bring to the notice of the
Medical Officer excess stock of any medicine with nearing expiry date for
redistribution.
7. He will attend to the dressing of injured patients as per the advice of the
medical Officer.
Male,
Female
Children and
Male,
female,
Children and
1.1.9. Driver.
One driver is posted to PHC headquarter office where ever the vehicle is
available. He will work under the administrative control of the PHC MO. The driver is
responsible for the safe and official use of the government vehicle and as instructed by
the PHC MO.
He is personally responsible for proper keep up and complete maintenance of
the vehicle at the PHC.
He will abide by all the applicable existing laws, rules and regulations related to
road transport and, Health Medical and family welfare department.
His basic job responsibilities are described under the following heads.
4. Vehicle maintenance.
5. Maintenance of vehicle related documents.
6. Code of conduct.
Vehicle maintenance.
7. He will maintain the vehicle in fit and working condition taking all the due
precautions.
8. He will keep the vehicle ready to be used by the SPHO.
9. He will ensure the periodic technical inspection by a competent authority and
get it certified.
10. He will adopt all the good practices to improve the vehicle’s service life and fuel
efficiency.
11. He will keep the vehicle clean and neat.
12. He will park the vehicle in protected authorized areas either in the offices or
public parking places or vehicle shed.
Maintenance of vehicle related documents.
4. He will maintain the vehicle usage log book and ensures that all the information
regarding the vehicle usage is entered in to it by the users.
5. He will keep his driving license and essential vehicle documents all ways with
him along with his official photo identity card, and produce the same before the
RTA officers and other competent authorities on demand.
6. For all the goods and materials which are transported in the vehicle the driver
will seek authorization from his controlling officer in writing and will produce it
as proof of evidence before the competent authority on demand.
Code of conduct.
4. He is expected to be Polite, responsible and well disciplined capable of working
in harmony with CHNC team.
5. He will avoid consumption of intoxicants like alcohol, tobacco, etc when on duty.
6. He will keep himself fit and healthy. He shall under go periodic health check up
and get certified.
He will execute any other work entrusted by the CHNC SPHO for the smooth running of
the CHNC.
1.1.10. Sweeper / Attender
2. He/She will keep the premises of PHC clean, dust the furniture wash the floor
weekly, and when ever necessary as instructed by the PHC MO.
3. Assist the PHC MO and PHC staff in maintaining the files and filing racks.
4. He / She will attend to and help the visitors in meeting the senior PHC MO s &
supervisory staff during the visiting hours.
5. He /She will help the Driver of the vehicle in washing and maintaining the vehicle
neat and tidy.
6. He/She will help the pharmacist in maintaining medicine stores , moving stocks from
the stores to OPD, shifting the stocks from transport vehicle to PHC stores a month.
7. He/She will assist the in sanitation work of the PHC under the supervision of the
staff nurse / pharmacist.
8. He / She will do any other work as and when given by the PHC MO.
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