Modifications in the updated Indian Public Health Standard (IPHS)

for Community Health Centre (CHC) document

(Major changes have been highlighted in yellow colour)
A. The newly revised IPHS (CHC) has considered the services, infrastructure, manpower,
equipments and drugs in two categories of Essential (minimum assured services) and Desirable
(the ideal level services which the states and UT shall try to achieve).
B. Services: Standards of existing services under programmes were updated based on the inputs
from various programme division.
i. New born stabilization unit added.
ii. MTP facilities for second trimester pregnancy (desirable)
iii. The Integrated Counselling and Testing Centre (ICTC), Blood storage, link Anti
Retroviral Therapy centre added
C. Standards added for following newly developed (non communicable) disease programmes.
i. National Programme for prevention and control of deafness.
ii. National Mental Health Programme.
iii. National Cancer control programme.
iv. National program for prevention and control of Diabetes, Cardio Vascular Disease, and
Strokes.
v. National Iodine deficiency Disorders control program
vi. National program for prevention and control of Fluorosis : in-affected Districts
vii. National Tobacco Control program
viii. National program for health care of Elderly
ix. Oral Health
x. Physical medicine and rehabilitation services.
D. Infrastructure:
i. Signage.
ii. Barrier free access.
iii. disaster prevention measures (desirable for new upcoming facilities),
iv. Residential quarter for the staff.
v. Functions and space requirements are updated.
E. Manpower: the new IPHS recommends the changes in manpower at CHC
i. Part time cancer surgeon / physician (under Public Private Partnership mode) is desirable.
ii. On lady health visitor (desirable)
iii. One dietician (desirable)
iv. One dental assistant.
v. One cold chain and vaccine logistic assistant
vi. Multi rehabilitation worker / community based rehabilitation worker ( on essential and
one desirable)
vii. One counsellor (desirable)
viii. Three drivers for the facility vehicles. ( out sourced)
F. Drugs: the list of essential drugs updated; the drug list for obstetric care and sick newborn &
child care (for First Referral Unit (FRU) / CHC) incorporated in these guidelines.
G. Equipment: List updated.
H. Reporting format under Integrated Disease Surveillance Project included in annexure.

1
I. Facility based MDR (Maternal Death Review) is added as annexure and is supposed to be one of
the essential services at CHC
J. Annexure for new born care corner and new born stabilization unit added.
K. Annexure for Referral transport model is deleted.

2
 Draft

Indian Public Health Standard

(IPHS)
For
Community Health Centres
(Revised 2010)

Directorate General of Health Services

Ministry of Health & Family Welfare
Government of India

3
 Executive Summary

The Community Health Centres (CHCs) which constitute the secondary level of health care were
designed to provide referral as well as specialist health care to the rural population. These centres
are however fulfilling the tasks entrusted to them only to a limited extent. The launch of the
National Rural Health Mission (NRHM) gives us the opportunity to have a fresh look at their
functioning.
In order to provide Quality Care in these CHCs, Indian Public Health Standards (IPHS)
are being prescribed to provide optimal expert care to the community and achieve and maintain
an acceptable standard of quality of care. These standards would help monitor and improve the
functioning of the CHCs.

Service Delivery:
• All Essential (Minimum Assured Services) as envisaged in the CHC should be available,
which includes routine and emergency care in Surgery, Medicine, Obstetrics and
Gynecology, Paediatrics, Dental and AYUSH in addition to all the National Health
Programmes.
• States/UTs must also aspire to achieve the ideal levels which have been indicated as
‘Desirable’.
• Appropriate Guidelines for each National Programme for Management of routine and
emergency cases are being provided to the CHC.
• All the support services to fulfill the above objectives will be strengthened at the CHC
level.
Minimum requirement for delivery of the above-mentioned services:
The following requirements are being projected based on the assumption that there will be
average bed occupancy of 60%. The strength may be further increased if the occupancy
increases with subsequent up gradation. As regards Manpower, 2 specialists, namely,
Anaesthetist and Public Health Programme Manager will be provided on contractual
basis in addition to the available specialists, namely, Surgery, Medicine, Obstetrics and
Gynecology and Paediatrics.

4
The support manpower will include a Public Health Nurse, ANM, Dental Assistant and Cold
Chain and Vaccine Logistic Assistant in addition to the existing staff. An Ophthalmic
Assistant will also need to be provided in centres where currently there is none. One
Ophthalmologist (MS or Diploma in Ophthalmology) for every 5 CHCs is recommended in
addition to existing Provisions. One Dental Surgeon, 6 GDMOS, one AYUSH specialist and
one AYUSH general doctor are also recommended in this IPHS.

Facilities:
The equipment provided under the Child Survival and Safe Motherhood Programme (CSSM) is
deemed adequate. Physical Infrastructure will be remodeled or rearranged to make best
possible use for optimal utilization. New Constructions will follow the specifications
provided in this document. Space requirements for different functional areas has been listed
out.

Human Resource Management:

Capacity Building will be ensured at all levels by periodic training of all cadres.

Accountability:
It is mandatory for every CHC to have “Rogi Kalyan Samiti” (RKS) to ensure accountability.
Every CHC shall have the Charter of Patients’ Rights displayed prominently at the entrance.
A grievance redressal mechanism under the overall supervision of RKS would also be set up.

Quality of services:

Every CHC shall also have the Standard Operating Procedures and Standard Treatment
Protocols for common ailments and the National Health Programmes.
Social audit by involvement of the community through RKS is being recommended. To
maintain quality of services, external monitoring through Panchayati Raj Institutions and
internal monitoring at appropriate intervals will be advocated. Guidelines are being provided
for management of routine and emergency cases under the National Health Programmes so
as to maintain uniformity in Management in tune with the National Policy.

5
 Indian Public Health Standards (IPHS)
for Community Health Centres
Introduction:

Health care delivery in India has been envisaged at three levels namely primary, secondary and
tertiary. The secondary level of health care essentially includes Community Health Centres
(CHCs), constituting the First Referral Units (FRUs) and the District Hospitals. The CHCs were
designed to provide referral health care for cases from the Primary level and for cases in need of
specialist care approaching the centre directly. 4 PHCs are included under each CHC thus
catering to approximately 80,000 populations in tribal / hilly/ desert areas and 1,20,000
population for plain areas. CHC is a 30-bedded hospital providing specialist care in Medicine,
Obstetrics and Gynaecology, Surgery, Paediatrics, Ophthalmology, Dental and AYUSH. There
are 4276 CHCs functioning in the country as per Rural Health Statistics Bulletin published in
July, 2009. These centres are however fulfilling the tasks entrusted to them only to a limited
extent. The launch of the National Rural Health Mission (NRHM) gives us the opportunity to
have a fresh look at their functioning.

NRHM envisages bringing up the CHC services to the level of Indian Public Health Standards.
Although there are already existing standards as prescribed by the Bureau of Indian Standards
for 30-bedded hospital, these are at present not achievable as they are very resource-intensive.
Under the NRHM, the Accredited Social Health Activist (ASHA) is being envisaged in each
village to promote the health activities. With ASHA in place, there is bound to be a groundswell
of demands for health services and the system needs to be geared to face the challenge. Not only
does the system require up-gradation to handle higher patient load, but emphasis also needs to
be given to quality aspects to increase the level of patient satisfaction. In order to ensure quality
of services, the Indian Public Health Standards (IPHS) are being set up for CHCs so as to
provide a yardstick to measure the services being provided there. This document provides the
essential requirements for a Minimum Functional Grade of a Community Health Centre and the
desirable requirements needed for an ideal situation.

6
Objectives of Indian Public Health Standards (IPHS) for CHCs:

• To provide optimal expert care to the community

• To achieve and maintain an acceptable standard of quality of care
• To ensure that service at CHC are commensurate with universal best practices and are
responsive and sensitive to the client needs/expectations.

Service delivery in CHCs:

• OPD Services and IPD Services: General, Medicine, Surgery, Obs. & Gynae.,
Paediatrics and AYUSH, fixed day services by Ophthalmologist & Dentist
(Essential) and daily basis (Desireable).
• Emergency Services
• Laboratory Services
• National Health Programmes

Every CHC has to provide the following services which can be known as the Assured Services.
They have been indicated as Essential and Desirable. All States/ UTs must ensure the
availability of all Essential services and aspire to achieve Desiable services which are the ideal
that should be available.

I. Care of routine and emergency cases in surgery

Essential
• This includes dressings, incision and drainage, and surgery for Hernia, Hydrocele,
Appendicitis, Haemorrhoids, Fistula, and stitching of injuries.
• Handling of emergencies like Intestinal Obstruction, Haemorrhage, etc.,

• Other management including nasal packing, tracheostomy, foreign body removal etc.

• Fracture reduction and putting splints/plastic cast.

II. Care of routine and emergency cases in medicine

Essential
• Specific mention is being made of handling of all emergencies like Dengue
Haemorrhagic Fever, Cerebral Malaria and others like snake bite cases, Poisonings,

7
 Congestive Heart Failure, Left Ventricular Failure, Pneumonias, meningoencephalitis,
acute respiratory conditions, statusepilepticus, Burns, Shock, acute dehydration etc. In
case of National Health Programmes, appropriate guidelines are already available, which
should be followed.
III. Maternal Health :
Essential
• Minimum 4 ANC including Registration : As some antenatal cases may directly register
with CHC, the suggested schedule of antenatal visits is reproduced below
1st visit: Within 12 weeks—preferably as soon as pregnancy is suspected—for registration of
pregnancy and first antenatal check-up
2nd visit: Between 14 and 26 weeks
3rd visit: Between 28 and 34 weeks
4th visit: Between 36 weeks and term
24-hour delivery services including normal and assisted deliveries.

• Managing labour using Partograph.

• All referred cases of Complications in pregnancy, labour and post-natal period must be
adequately treated.

• Ensure post- natal care for 0 & 3rd day at the health facility both for the mother and
new-born and sending direction to the ANM of the concerned area for ensuring 7th &
42nd day post-natal home visits

• Minimum 48 hours of stay after delivery, 3-7 days stay post delivery for managing
Complications.
• Proficiency in identification and Management of all complications including PPH,
Eclampsia, Sepsis etc. during PNC.

• Essential and Emergency Obstetric Care including surgical interventions like Caesarean
Sections and other medical interventions

IV. New Born Care and Child Health:

Essential

• Essential New Born Care and Resuscitation by providing Newborn Corner in the Labour
Room and operation theatre (where caessarian takes place). Details of New Born Corner
given at Annexure 1.

i) Early initiation of breast feeding with in one hour of birth and promotion of exclusive
breast-feeding for 6 months.

8
 • New Born Stabilization Unit (Details given at Annexure 1A)

• Counseling on Infant and young child feeding as per IYCF guidelines.

• Routine and emergency care of sick children including Facility based IMNCI strategy
• Full Immunization of infants and children against Vaccine Preventable Diseases and
Vitamin-A prophylaxis as per guidelines of Govt. of India.
• Prevention and management of routine childhood diseases, infections and anemia etc.

V. Family Planning. :

Essential

• Full range of family planning services including IEC, counseling, provision of

Contraceptives, Non Scalpel Vasectomy (NSV) & Laparoscopic Sterilization Services
and their follow up

• Safe Abortion Services

Desirable

• MTP Facility approved for 2nd trimester of pregnancy

VI Other National Health Programmes (NHP): (Essential except as indicated)

All NHP should be delivered through the CHCs. Integration with the existing
programmes is vital to provide comprehensive services. The requirements for the
important NHPs are being annexed as separate guidelines with the document and
following are the assured services under each NHP.
Communicable Diseases Programmes
• RNTCP: CHC should provide diagnostic services through the microscopy centres which
are already established in the CHCs and treatment services as per the Technical
Guidelines and Operational guidelines for Tuberculosis Control (Annexure 2).
• HIV/AIDS Control Programme: The services to be provided at the CHC level
are (Annexure 3)
Integrated Counseling and Testing Centre;
Blood Storage Centre1,
Sexually Transmitted Infection clinic,

1
Blood storage units should have atleast number of units equal to double of the average daily
requirement/consumption.

9
 Desirable
Link Anti Retroviral Therapy Centre
• National Vector Borne Disease Control Programme: The CHCs are to provide
diagnostic/linkages to diagnosis and treatment facilities for routine and complicated cases
of Malaria, Filaria, Dengue, Japanese Encephalitis and Kala-azar in the respective
endemic zones (Annexure 4).
• National Leprosy Eradication Programme (NLEP): The minimum services that are to
be available at the CHCs are for diagnosis and treatment of cases and complications
including reactions of leprosy along with conselling of patients on prevention of
deformity and cases of uncomplicated ulcers (Annexure 5).

• National Programme for Control of Blindness: The eye care services that should be
available at the CHC are as given below.
Essential
• Vision Testing with Vision drum/ Vision Charts
• Refraction
• The early detection of visual impairment and their referral.
• Awareness generation through appropriate IEC strategies and involving
community for primary prevention and early detection of impaired vision and
other eye conditions.
Desirable

• Intraocular pressure measurement by Tonometers.

• Syringing and probing
• The provision for removal of Foreign Body.
• Provision of Basic services for Diagnosis and treatment of common eye
diseases.
• surgical services including cataract by IOL implantation

One eye surgeon is being envisaged for every 5 lakh population i.e one eye surgeon will
cater to 5 CHCs. (Annexure 6)

• Under Integrated Disease Surveillance Project, CHC will function as peripheral

surveillance unit and collate, analyse and report information to District Surveillance Unit
on selected epidemic prone diseases. In outbreak situations, appropriate action will be
initiated (Annexure 7).

10
 National Programme for Prevention and Control of Deafness (NPPCD):

CHC will provide following services.

• The early detection of cases of hearing impairment and deafness and referral
• Provision of Basic Diagnosis and treatment services for common ear diseases.
• Awareness generation through appropriate IEC strategies and greater participation /role
of community in primary prevention and early detection of hearing impairment/deafness.

National Cancer Control Programme (NCCP)

Essential

• Facilities for early detection and referral of suspected cancer cases

• Screening for Cervical, Breast & Oral Cancers
• Education about Breast Self Examination and Oral Self Examination

Desirable
• PAP smear for Cancer Cervix
• Basic equipment (Magna Visualiser, Indirect Laryngoscope, Punch biopsy forceps) and
consumables for early detection of common cancers.
• Public private partnership for laboratory investigations (biochemical, pathological
(including biopsy), microbiological, tumor markers, mammography etc. which are related
to cancer diagnosis).
• Investigations to confirm diagnosis of cancer in patients with early warning signals
through Public Private Partnership mode.

National Mental Health Programme (NMHP)

Essential

• Early identification, Diagnosis and treatment of common mental disorders (anxiety,

depression, psychosis, schizophrenia, Manic Depressive Psychosis).
• IEC activities for prevention, removal of stigma and early detection of mental disorders
• Follow up care of detected cases who are on treatment

Desirable

• With short term training the medical officers would be trained to deliver basic mental
health care using limited number of drugs and to provide referral service. This would
result in early identification and treatment of common mental illnesses in the community.

11
National Programme on Prevention and Control of Diabetes, CVD and Stroke (NPDCS)

Essential

Promotion & Prevention

• Health Promotion: Focus will be on healthy population.

• Modify individual, group and community behaviour through intervention like
Promotion of Healthy Dietary Habits.
Promotion of physical activity.
Avoidance of tobacco and alcohol.
Stress Management
• Treatment & Timely Referral (Complicated cases) of Diabetes Mellitus,
Hypertension, IHD, CHF etc.
• Assured investigations: Urine Albumin and Sugar, Blood Sugar, Blood Lipid
Profile, KFT (Blood urea, creatinine) ECG.

Desirable
Early detection-

Survey of population through simple measures like history taking of symptoms,

measuring blood pressure, checking for sugar in urine etc. and their segregation into
normal, vulnerable, high risk and those suffering from disease.

National Iodine Deficiency Disorders Control Programme (NIDDCP)-

• IEC activities in the form of posters, pamphlets, Interpersonal communication to promote

the consumption of iodised salt by the people and monitoring of iodised salt through salt
testing kits.

National Programme for Prevention and Control of Fluorosis (NPPCF)- Essential in

fuorosis affected villages

• Clinical examination and preliminary diagnostic parameters assessment for cases of

Fluorosis if facilities are available.
• Monitoring of village/ community level Fluorosis surveillance and IEC activities.
• Referral Services. IEC activities in the form of posters, pamphlets, Interpersonal
communication to prevent Fluorosis.

National Tobacco Control Programme (NTCP)

Essential

12
 • Health education and IEC activities regarding harmful effects of tobacco use and second
hand smoke.
• Promoting quitting of tobacco in the community and offering brief advice to all smokers
and tobacco users.
• Making the premises of CHC tobacco free and display of mandatory signages.

Desirable

Setting up a Tobacco cessation Clinic, by training the couselor in tobacco cessation

National Programme for Health Care of Elderly

Desirable

• Medical rehabilitation services.

• Compilation of elderly data from PHC & forwarding the same to district nodal officers.
• Visits to the Homes of disabled/bed ridden persons by rehabilitation worker on receiving
information from PHC/Sub-centre.
• Geriatric Clinic: twice a week.

Physical Medicine and Rehabilitation (PMR)

Essential

• Primary prevention of Disabilities,

• screening, early identification and detection,
• Counselling,
Issue of Disability Certificate for Obivious Disabilities by CHC doctors
• Community based Rehabilitation Services,

Desirable
• Basic treatments like Exercise and Heat therapy, ROM exercises, cervical and Lumbar
Traction, referral to higher centers and follow up etc.

Oral Health

Essential

• Dental care and Dental Health education services as well as root canal treatment and filling
/extraction of routine and emergency cases.
• Oral Health education in collaboration with other activities eg Nutritional education, school
health and adolescent health

VII Other Services

13
Essential

Blood Storage Facility

Diagnostic Services (Annexure 12)
Referral (transport) Services
Maternal Death Review (MDR). Facility Based MDR form is at Annexure 8

Minimum requirement for delivery of the above-mentioned services:

The following requirements are being projected based on the assumption that there will be
average bed occupancy of 60%. The strength may be further increased if the occupancy
increases with subsequent upgradation.

Manpower

In order to provide round the clock clinical services, there is likelihood of shortage of doctors in
8-hourly shift duties. This shortage can be compensated by resource pooling (Block Pooling
Concept) of available doctors posted at Primary Health Centres covered under the CHC.

Under the present scenario of shortage of clinical manpower, it is suggested that doctors of
PHCs may be located at CHCs while attending to routine OPD duties at PHCs of the catchment
area and are required to do shift duties to provide emergency services at CHC.

Personnel Essential Desirable Qualifications Remarks

Block Health Senior most Will be responsible for
Officer specialists/GDMO coordination of NHPs,
preferably with management of ASHAs
experience in Public Training and other
Health. responsibilities under NRHM
1 apart from overall
administration / Management of
CHC etc. He will be responsible
for quality & protocols of
service delivery being delivered
in CHC.

14
 General MS/DNB, (General
1
Surgeon Surgery)
Physician MD/DNB, (General
1
Medicine)
Obstetrician & DGO /MD/DNB
1
Gynaecologist
Paediatrics DCH/MD(Paediatrics)/
1
DNB/
Anaesthetist MD(Anesthesia)/DNB/ Essential for utilization of the
DA/ LSAS trained MO surgical specialities. They may
1 be on contractual appointment
or hiring of services from
private sectors on per case basis.
Public Health MD (PSM)/MD
Manager (CHA)/MD Community
1 Medicine or Post
Graduation Degree with
MBA/DPH/MPH
Eye surgeon 1 (1 for MD/MS/DOMS/DNB/( 1 for every 5 CHCs as per
every five Ophthal) Vision 2020 approved Plan of
CHCs) Action.
Dental Surgeon 1 BDS
General Duty 6 (at least 2 MBBS
Medical Officer female
doctors)

Specialist of Post Graduate in

1
AYUSH AYUSH
General Duty Graduate in AYUSH
Medical Officer 1
of AYUSH

15
Part time Cancer To be provided under May be provided under PPP
Surgeon/Physicia 1 programme mode
n
Total 15/16 17/18

Note:- As a short term arrangement, MBBS doctors who have received short term training
or having experience of at least two years in the particular speciality can be utilized against
the spciality post. However, in such cases a specific order after posting such doctors must
be issued.

Support manpower:

Personnel Essential Desirable

Staff Nurse 15@ +3
Lady Health Visitor 1
Public Health Nurse (PHN) 1
ANM 1
Pharmacist/compounder 3
Pharmacist – AYUSH 1
Lab. Technician 3
Radiographer 2
Dietician 1
Ophthalmic Assistant 1
Dental Assistant 1
Cold Chain & Vaccine Logistic Assistant 1
Dresser (certified by Red Cross/ St. Johns 2
Ambulance)
Ward Boys / Nursing Orderly 5
Sweepers* 5
Chowkidar* 5
Dhobi* 1

16
 Mali* 1
Aya* 5
Peon* 2
OPD Attendant* 1
Registration Clerk 2
Statistical Assistant/Data Entry Operator 2
Trained cooks as per hospital dietary 2
recommendations
Account / Admin Assistant 1
OT Techinician 1
Multi-Rehabilitation Worker / Community 1 +1
Based Rehabilation worker
Counseller 1
Driver* 3
Total 65 75
* outsourced
@
for providing round the clock service at OT, Labour Room & casualty, male ward and
female ward along with provision of leave reserve.
Note: One of the Class IV employees can be identified as a helper to Cold Chain & Vaccine
Logistic Assistant and trained as Cold Chain Handler
Central government shall periodically review the staffing norms and modify it somewhat if
required. States shall as per provision under NRHM explore keeping part time / contractual staff
wherever deficient. Outsourcing of services may be done as per State’s policy.

Equipment

• The list of equipment provided under the CSSM may be referred to as they are deemed to
be adequate for providing all services in the CHC (Annexure 9. Before ordering new
sets, the existing equipment should be properly assessed.
• For ophthalmic equipment wherever the services are available, Annexure no.6 may be
referred to.
• Maintenance of equipment. It is estimated that 10-15% of the annual budget is necessary
for maintenance of euipments.

17
 • Refrigerators [3(Essential), 4(desirable)], one for each ward, one for OT, One for
laboratory, should be available in the CHC. No Sharing of Refrigerator with the lab
should be done.
• Appropriate standards for equipments are already available in the Bureau of Indian
Standards. If standards for any equipment are not available, technical specifications for
the equipment may be prepared by the technical committee of the State for the process of
tendering and procurement.

Drugs:

The list of essential drugs and emergency drugs are provided as Annexure 10.
Programme specific drugs are detailed in the Guidelines under each programme. AYUSH drugs
are being included.

Investigative facilities at the CHC:

• In addition to the lab facilities and Xray, ECG should be made available in the CHC with
appropriate training to a nursing staff.
• All necessary reagents, glass ware and facilities for collecting and transport of samples
should be made available.

Physical Infrastructure:
The CHC should have 30 indoor beds with one Operation theatre, labour room, X-ray facility
and laboratory facility. In order to provide these facilities, following are the guidelines:

Location of the centre: All the guidelines as below under this sub-head may be applicable only
to centres that are to be newly established and priority is to be given to operationalise the
existing CHCs.
• To the extent possible, the centre should be located at the centre of the block headquarter
in order to improve access to the patients.
• The area chosen should have the facility for electricity, all weather road communication,
adequate water supply, telephone etc.
• Disaster Prevention Measures: (For all new upcoming facilities in seismic zone 5 or other
disaster prone areas )

Desirable

18
 For prevention of

Earhquake,
Flood
and Fire

Building structure and the internal structure should be made disaster proof especially
earthquake proof, flood proof and equipped with fire protection measures.

• Quake proof measures– structural and non-structural should be built in to withstand

quake as per geographical/ state govt. guidelines. Non-structural features like fastening
the shelves, almirahs, equipments etc are even more essential than structural changes in
the buildings. Since it is likely to increase the cost substantially, these measures may
especially be taken on priority in known earthquake prone areas.

CHC should not be located in low lying area to prevent flooding.

Fire fighting equipments – fire extinguishers, sand buckets, etc. should be available and
maintained to be readily available when needed.

All health staff should be trained and well conversant with disaster prevention and
management aspects

• Infrastructure should be made for water harvesting, use of solar energy / Power back-up,
and horticulture services including herbal medicine garden.
CHC should be away from garbage collection, cattle shed, water logging area, etc.

The building should have areas/space marked for the following:

Entrance zone:
Signage

Prominent display boards in local language providing information regarding the services
available and the timings of the institute.

Barrier free access environment for easy access to non-ambulant (wheel- chair,
stretcher), semi-ambulant, visually disabled and elderly persons as per “Guidelines and
Space Standards for barrier-free built environment for Disabled and Elderly Persons” of
CPWD/ Min of Social Welfare, GOI.

Ramp as per specification, Hand- railing, proper lightning etc must be provided in all
health facilities and retrofitted in older one which lack the same.

19
 • Registration counters
• Pharmacy for drug dispensing and storage
• Clean Public utilities separate for males and females
• Suggestion / complaint boxes for the patients/ visitors and also information regarding the
person responsible for redressal of complaints.

Outpatient department:
• Clinics for Various Medical Disciplines - These clinics include general medicine, general
surgery, dental (optional), obstetric and gynaecology, paediatrics and family welfare.
Separate cubicles for general medicine and surgery with separate area for internal
examination (privacy) can be provided if there are no separate rooms for each. The
cubicles for consultation and examination in all clinics should provide for doctor'
s table,
chair, patient'
s stool, follower'
s seat, wash basin, examination couch and equipment for
examination.
• Room shall have, for the admission of light and air, one or more apertures, such as
windows and fan lights, opening directly to the external air or into an open verandah. The
windows should be in two opposite walls.
• Family Welfare Clinic - The clinic should provide educative, preventive, diagnostic and
curative facilities for maternal, child health, school health and health education.
Importance of health education is being increasingly recognized as an effective tool of
preventive treatment. People visiting hospital should be informed of personal and
environmental hygiene, clean habits, need for taking preventive measures against
epidemics, family planning, etc. Treatment room in this clinic should act as operating
room for IUCD insertion and investigation, etc. It should be in close proximity to
Obstetric & Gynaecology. Family Welfare counselling room should be provided.

• Waiting room for patients

• The Pharmacy should be located in an area conveniently accessible from all clinics. The
dispensary and compounding room should have two dispensing windows, compounding
counters and shelves. The pattern of arranging the counters and shelves shall depend on
the size of the room. The medicines which require cold storage and blood required for
operations and emergencies may be kept in refrigerators.

20
 • Emergency Room/ Casualty: At the moment, the emergency cases are being attended in
OPD during OPD hours and in inpatient units afterwards. It is recommended to have a
separate earmarked emergency area to be located near the entrance of hospital preferalbly
having 4 rooms (one for doctor, one for minor OT, one for plaster/dressing) and one for
patient observation (At least 4 beds).

Treatment Room:
• Minor OT

• Injection Room and Dressing Room

• Observation room

Wards: Separate for males and females

• Nursing Station- The nursing station shall be centered such that it serves all the clinics from
that place. The nursing station should be spacious enough to accommodate a medicine chest /
a work counter (for preparing dressings, medicines), hand washing facilities, sinks, dressing
tables with screen in between and colour coded bins , (As per standard biomedical waste
disposal guidelines) to hold soiled material. It should have provision for Needle cutter and
syringe destroyers.
• Examination and dressing table
• Patient Area:
• Enough space between beds.
• Toilets; separate for males and females.
• Separate space/ room for patients needing isolation
• Ancillary rooms:

Nurses rest room

There should be an area separating OPD and Indoor facility

Operation theatre/ Labour room:
• Patient waiting Area
• Pre-operative and Post-operative (recovery) room
• Staff area
• Changing room separate for males and females

21
 • Storage area for sterile supplies
• Operating room /Labour room
• Scrub area
• Instrument sterilization area
• Disposal area
• New Born care Corner (Annexure 1)

New Born care Stabilization Unit: Annexure 1A

Public utilities: Separate for males and female; for patient as well as for paramedical & Medical
staff. Disabled friendly, WC with basins wash basins as specified under Guidelines for disabled
friendly environment should be provided.

Physical infrastructure for Support services:

• Central Steritization supply depot (CSSD)
• Sterilization and Sterile storage
• Laundry:
• Storage: separate for dirty linen and clean linen
• Outsourcing is recommended after appropriate training of washer man regarding
segregation and separate treatment for infected and non-infected linen.
• Services: Electricity / telephones / water / civil Engineering may be outsourced.
Maintenance of proper sanitation in toilets and other public utilities should be given
utmost attention. Sufficient funding for this purpose must be kept and the services may
be outsourced.
Water Supply - Arrangements shall be made to supply 10,000 litres of potable water per day to
meet all the requirements (including laundry) except fire fighting. Storage capacity for 2 days
requirements should be on the basis of the above consumption. Round the clock water supply
shall be made available to all wards and departments of the hospital. Separate reserve emergency
overhead tank shall be provided for operation theatre. Necessary water storage overhead tanks
with pumping/boosting arrangement shall be made. The laying and distribution of the water
supply system shall be according to the provisions of IS: 2065-1983*. Cold and hot water supply
piping should be run in concealed form embedded into wall with full precautions to avoid any
22
seepage. Geyser in O.T. / L.R. and one in ward also should be provided. Wherever feasible solar
installations should be promoted.
Emergency lighting - Emergency portable / fixed light units should also be provided in the
wards and departments to serve as alternative source of light in case of power failure. Generator
back-up should be available in all facilities. Generator should be of good capacity. Solar energy
wherever feasible may be used.
Generator- 5 KVA with POL for Immunization Cold Chain maintenance
Telephone: minimum two direct lines with intercom facility should be available.
Administrative zone: Separate rooms should be available for
Office
Stores
Residential Zone
Minimum 8 quarters for Doctors
Minimum 8 quarters for staff nurses/paramedicals
Minimum 2 quarters for ward boys
Minimum 1 quarter for driver
If the accommodation can not be provided due to any reason, then the staff may be paid house
rent allowance, but in that case they should be staying in near vicinity of CHC so that they are
available 24x7 in case of need.

Function & Space Requirement for Community Health Centre

It is suggested considering the land cost & availability of land, CHC building may be
constructed in two floors

Function & Space Requirement for different zones

Zone Functions Size for each sub-function Total Areas in Sq

in Mtrs. Mtrs

Entrance Registration & Record storage, Registration /Record Room 20.48 Sq Mtrs
Zone Pharmacy (Issue 3.2X 3.2 X 2
counter/Formulation/Drug
Queue area outside
storage) Public utilities & 10.5 Sq. Mtrs
registration room 3.5X3
circulation space

23
 Pharmacy cum store 6.4X3.2 20.48 Sq Mtrs

Pharmacy cum store for

20.48 Sq Mtrs
AYUSH 6.4X3.2

Ambulatory Examination & Workup Space for 4 general Doctor

Zone (OPD ) (Examination Room, sub Room 3.2 X 3.2 X4 40.96 Sq Mtrs
waiting), Consultation Space for 2 AYUSH
(consultation room Toilets, sub doctors Room 3.2 X 3.2 X2 20.48 Sq Mtrs
waiting) Nursing station 8 specialist room with attach
(Nurses desk, clean utility, dirty toilets = 3.7X 3.2 X 8 94.72 Sq Mtrs
utility, treatment rooms, Treatment room 3.7 X 3.2 11.84 Sq Mtrs
injection & dressing room), Refraction room 3.2X3.2 10.24 Sq Mtrs
Cold Chain, Vaccines and Nursing Station 6.4 X 3.220.48 Sq Mtrs
Logistics area, ECG (sub Casualty 6.4 X 6.4 40.96 Sq Mtrs
waiting, Casualty/Emergency, Dress Room 3.2 X 3.2 10.24 Sq Mtrs
public utilities, circulation Injection Room 3.2 X 3.2 10.24 Sq Mtrs
space Female injection room 10.24 Sq. Mtrs
3.2X3.2
Public Utility / Common 9.5 Sq Mtrs
Toilets
Waiting Area 31.5 Sq Mtrs
Cold Chain Room 3.5x3 10.5 Sq. Mtrs.
Vaccine and Logistics Room 10.5 Sq. Mtrs
3.5x3
Diagnostic Pathology (Optional) Laboratory, Area specification is 180 Sq Mtrs
Zone sample collection, bleeding recommended
room, washing disinfections
storage, sub waiting. Imaging
(radiology, radiography, ultra-
sound) Preparation, change,
toilet, control, Dark room,

24
 treatment room sub waiting
public utilities

Zone Functions Area requirement for each Total Areas in

sub-function Sq Mtrs
Intermediate Nursing station(Nurse Nursing station 6.4 X 6.4 40.96 Sq Mtrs
Zone desk,clean utility , treatment 4 wards each with 6 beds ( 2 153.76 Sq Mtrs
(inpatient room , pantry ,store, sluice male wards & 2 female wards)
Nursing room ,trolly bay) patient size (6.2 X 6.2 ) X 4
units) area(bed space, toilets, Day 4 private room (2 each for for
space, Isolation Space) male & females) with toilets 79.36 Sq Mtrs
s rest 6.2 X 3.2 X 4 2
Ancillary rooms (Doctor'
room, Nurses duty room, Public
isolation rooms with toilet (one
utilities ,circulation space. 39.68 Sq Mts
each for male & female) 6.2 X
3.2 X 2

Critical Zone Patient area (Preparation, Area specification is 240 Sq Mtrs

(Operational Preanaesthesia, post operative recommended
Theater/Labo resting ) Staff area (Changing
ur room Resting ) Supplies area (trolley
bar, equipment storage ,sterile
storage) OT/LR area (Operating
/Labour room, scrub, instrument
sterilization, Disposal) public
utilities, circulation space
Service Zone Dietary (Dry Store, Day Store, Services like Electrical Area specification
Preparation, Cooking, Delivery, engineering /Mechanical is recommended
pot wash, Utensil wash, Utensil engineering & civil
store, trolley park) C.S.S.D. engineering can be privately
(Receipt, wash, assembly, hired to avoid permanent
sterilization, sterile storage, space in the CHC building

25
 Issue) Laundry (Receipt, weigh,
sluice/wash, Hydro extraction,
tumble, calender, press)
Laundry (clean storage, Issue),
Civil engineering (Building
maintenance, Horticulture,
water supply, drainage and
sanitation) Electrical
engineering (sub station &
generation, Illumination,
ventilation) Mechanical
engineering, Space for other
service like ,gas store,
Telephone intercom fire
protection , waste disposal,
Mortuary.
Administrativ General Administration, general Area specification is 60 Sq Mtrs
e zone store, public utilities circulation recommended
space
Total Circulation Area / Corridors 191.15 Sq Mtrs
Total Area 1503.32 Sq Mtrs

Capacity building:

Training of all cadres of worker at periodic intervals is an essential component. Multi skill
training for Staff Nurses and paramedical workers is recommended.

26
Quality Assurance in Service Delivery

Quality of service should be maintained at all levels.

Standard treatment protocol for all national programmes and locally common diseases should be
made available at all CHCs. Standard Treatment protocol: is the "Heart" of quality and cost
of care. All the efforts that are being made to improved "hardware i.e. infrastructure" and
"software i.e. human resources" are necessary but NOT sufficient. These need to be guided by
Standard Treatment Protocols. Some of the states have already prepared these guidelines. For all
ailments covered by National Health Programmes an agreed treatment/case management
protocol need to be adhered to voluntarily by the physicians.

Diet: Diet may either be outsourced or adequate space for cooking should be provided in a
separate space. The diet within the budget/funds and affordability should be healthy food,
nutritious and full of minerals and vitamins.

CSSD: Adequate space and standard procedures for sterilization and Sterile storage should
be available. A practical protocol for quality assurance of CSSD may be developed with District
Hospital lab developed and implemented to ensure bacterial quality

Laundry:
• Storage: Separate for dirty linen and clean linen
• Outsourcing is recommended after appropriate training of washer man regarding
separate treatment for infected and non-infected linen.

Services: Electricity / telephones / water / civil engineering may be outsourced.

Blood Storage Units: The GOI guidelines as given in Annexure 11 may be referred to.

Waste Disposal: "Guidelines for Health Care Workers for Waste Management and Infection
Control in Community Health Centres" are to be followed. A central storage point should be
made for biomedical waste collected from all points of CHC which should be located away from
OPD & IPD.
27
Charter of Patient Rights: It is mandatory for every CHC to have the Charter of Patient Rights
prominently displayed at the entrance. Details are provided in the Annexure 13.
Quality Control:
Internal monitoring:
Routine Monitoring by District Health Authority.
Social Audit: Through Rogi Kalyan Samitis/ Panchayati Raj Institution etc.
Medical audit
Others like technical audit, economic audit, disaster preparedness audit, etc.
Patient care: This shall include:
• Access to patients
• Registration and admission procedures
• Examination
• Information exchange- complaints & suggestions and their remedical
measures by hospital, authorities.
• Treatment
• Other facilities: waiting, toilets, drinking water
Indoor patients:
Linen/ beds
Staying facilities for relatives with respect to Diet, drinking water and Toilets
External Monitoring:
Gradation of the centre by PRI (Zilla Parishad) / Rogi Kalyan Samitis
Monitoring of laboratory:
- Internal Quality Assessment scheme
- External Quality Assessment scheme

Record maintenance:

It is desirable that Computers should be used for accurate record maintenance

Checklist for minimum requirement of CHCs

28
Services Existing Remarks
Population covered
Specialist services available
Medicine
Surgery
OBG
Paediatrics
NHPs
Emergency services
Laboratory
Blood Storage

29
 Infrastructure Existing Remarks
(As per specifications)
Area of the Building
OPD rooms/cubicles
Waiting room for patients
No. of beds: Male
No. of beds: Female
Operation theatre
Labour room
Laboratory
X-ray Room
Blood Storage
Pharmacy
Water supply
Electricity
Garden
Transport facilities

Checklist for Equipment

Equipment (As per available Functional Remarks

list)

30
Checklist for Drugs:
Drugs Existing Remarks

(As per Essential Drug

list)

Checklist for Audit:

Particulars Available Whether functional as per

norms
Patient's charter
Rogi Kalyan Samiti
Internal monitoring
External Monitoring
Availability of
SOPs/STPs*
*Standard Operating Procedures/ Standard Treatment Protocols
Checklist for Monitoring Maternal Health

ANC
Minimum 4 ANC
High Risk pregnancy
Cases with Danger sign and symptoms treated.
No of CS done

PNC Visit
Minimum 3 PNC Visits within 1st week of delivery i.e. on 0,
3,7th day.

Are deliveries being monitored through Partograph?

31
 Annexure - 1

New Born Care Facilities at CHC

Newborn Corner in OT/ Labour Room

Delivery rooms in Operation Theatres (OT) and in Labour rooms are required to have separate
resuscitation space and outlets for newborns. Some term infants and most preterm infants are at
greater thermal risk and often require additional personnel, equipment and time to optimize
resuscitation. An appropriate resuscitation/stabilization environment should be provided as
provision of appropriate temperature for delivery room resuscitation of high-risk preterm infants
is vital to their stabilization.

Services at the Corner

This space provides an acceptable environment for most uncomplicated term infants, but may not
support the optimal management of newborns who may require referral to SNCU. Services
provided in the Newborn Care Corner are;

• Care at birth
• Resuscitation
• Provision of warmth
• Early initiation of breastfeeding
• Weighing the neonate

Configuration of the corner

• Clear floor area shall be provided for in the room for newborn corner. It is a space within
the labour room, 20-30 sq ft in size, where a radiant warmer will be kept.

• Oxygen, suction machine and simultaneously-accessible electrical outlets shall be

provided for the newborn infant in addition to the facilities required for the mother.
Clinical procedures: administration of oxygen, airway suctioning.

• Resuscitation kit should be placed in the radiant warmer.

• Provision of hand washing and containment of infection control if it is not a part of the
delivery room

• The area should be away from draught of air, and should have power connection for
plugging in the radiant warmer.

Equipments and Renewable required for the Corner

32
Item Item Description Quantit

Mechanica
Installatio
No y

Electrical
Desirable
Essential

Training

Civil
n

l
Open care system: radiant warmer, fixed height, with
1. E 1 X X X X X
trolley, drawers, O2-bottles
Resuscitator (silicone resuscitation bag and mask
2. E 1 X
with reservoir) hand-operated, neonate, 500ml
3. Weighing Scale, spring E 1 X
4. Pump suction, foot operated E 1 X
5. Thermometer, clinical, digital, 32-34 0C E 2
6. Light examination, mobile, 220-12 V E 1 X X
7. Hub Cutter, syringe E 1 X
Renewable consumables
8. I / V Cannula 24 G, 26 G E
9. Extractor,mucus,20ml,ster,disp Dee Lee E
10. Tube,feeding,CH07,L40cm,ster,disp E
11. Oxygen catheter 8 F, Oxygen Cylinder E
12. Sterile Gloves E

33
 Annexure - 1 A

NEWBORN CARE STABILIZATION UNIT

Setting of Stabilization Unit at First Referral Units

Every first referral unit, whether or not care of sick babies is undertaken, must have clearly
established arrangements for the prompt, safe and effective resuscitation of babies and for the
care of babies till stabilized, either in the maternity ward or by safe transfer elsewhere.

Services at the Stabilization Unit

FRUs are not intended to provide any intensive care, a newborn that has problems identified
immediately after birth, or who becomes ill subsequently, may have a requirement for one or
more of the following services. These should therefore be available to ensure safe care of the
baby prior to appropriate transfer:

• Provision of warmth
• Resuscitation
• Supportive care including oxygen,drugs,IV fluids
• Monitoring of vital signs, including blood pressure
• Breast feeding/ feeding support
• Referral Services

Configuration of the Stabilization Unit

• Stabilization unit should be located within or in close proximity of the emergency ward
where sick and low birth weight newborns and children can be cared .

• Space of approximately 40-50 sq ft per bed is needed, where 4 radiant warmers will be
kept.

• Provision of hand washing and containment of infection control

34
Equipments and Renewable required for the Stabilization Unit

Item Item Description Quantit

Mechanica
Installatio
No y

Electrical
Desirable
Essential

Training

Civil
n

l
Open care system: radiant warmer, fixed height, with
1. E 4 X X X X X
trolley, drawers, O2-bottles
Resuscitator, hand-operated, neonate and child,
2. E 2 X
500ml
3. Laryngoscope set E 2 X
4. Scale, baby, electronic, 10 kg <5kg> E 1 X
5. Pump suction, foot operated E 1 X
6. Thermometer, clinical, digital, 32-34C E 4
7. Light examination, mobile, 220-12 V E 4 X X
8. Hub Cutter, syringe E 1 X
Renewable consumables
9. I / V Cannula 24 G, 26 G E
10. Extractor,mucus,20ml,ster,disp Dee Lee E
11. Tube,feeding,CH07,L40cm,ster,disp E
12. Oxygen cylinder 8 F E
13. Sterile Gloves E
14. Tube, suction, CH 10, L50 cm, ster, disp E
15. Cotton wool, 500g, roll, non-ster E
16. Disinfectant, chlorhexidine, 20% E

Human Resource:

Staffing:

ONE STAFF NURSE SHOULD PROVIDE COVER FOR NEONATES AND CHILDREN ROUND
THE CLOCK Additional nursing staff may be required for newborn care at the Stabilization Unit.
Pediatrician posted at FRU will be in charge of the Stabilization Unit.

Training:
Doctors and Nurses posted at Stabilization Unit will undergo Facility based care training .

Referral Services
Each Unit accepting neonatal and sick child referrals should have, or have access to, an appropriately
staffed and equipped transport service.

35
 Annexure 2

Requirements with regard to Revised National TB Control Programme for Indian Public
Health Standards at CHC Level.

Diagnostic services

A Microscopy Centre (MC) is established for 1,00,000 population. For hilly, tribal and difficult
areas MC is established for 50,000 populations. The Microscopy Centres are established at PHC,
CHC or District Hospital.

Inputs
a. RNTCP has provided inputs to upgrade the infrastructure through minor civil works of
the existing laboratories to be able to come up to the minimum standard required to
carry out sputum microscopy. At present, entire country is covered under RNTCP.
b. Manpower: Existing Laboratory Technicians (LTs) are provided training and they
function as LTs to carry out sputum microscopy. For up to 20% of the requirements of
the LTs at designated Microscopy Centres at the District level, LTs are provided by
RNTCP on contractual basis.
c. Equipment: Binocular Microscopes are provided to the Microscopy Centres for sputum
microscopy.
d. Laboratory Consumables: Funds are provided to the District TB Control Societies for
procurement and supply of all the consumables required to carry out sputum
microscopy. For list of Laboratory consumables, reefr to RNTCP guidelines.

Treatment Services

i. Medical Officers: All Medical Officers are trained in RNTCP to suspect chest
symptomatics, refer them for sputum microscopy and be able to categories the patients
and handle side effects of anti TB drugs.

36
 ii. DOTS Centres: All sub-centres, PHCs, CHCs and District Hospitals work as DOTS
Centres. In addition, the community DOTS providers are also trained to deliver DOTS.
A room of the CHC is used to function as DOTS centre. Facilities for seating and
making available drinking water to the patients for consumption of drugs are provided
under the Programme.
iii. DOTS Providers: The Multi Purpose Workers (MPWs), Pharmacists and Staff Nurses
are trained in to monitor consumption of anti TB drugs by the patients.
iv. All the DOTS providers to deliver treatment as per treatment guidelines. All the doctors
to categories patients as per treatment guidelines (refer Technical Guidelines).
v. Drugs in patient wise boxes and loose drugs are provided at DOT Centres through
District TB Centre (DTC). Details of the drugs given in RNTCP guidelines.
vi. Recording and reporting to be done as per Operational Guidelines (refer Operational
Guidelines).

Treatment of complicated cases

1. For patients who require admission (Pleural Effusion, Emphysema etc.) drugs are
provided in the form of prolongation pouches through District TB Centre for indoor
treatment.
2. The common complications of TB can be treated by the Medical Officers/ Specialists
at CHC and side effects of drugs can also be handled by the doctors at CHC.

Quality Assurance

I. Diagnosis: The diagnostic services are supervised by Senior TB Laboratory

Supervisor (STLS) for all the Microscopy Centres at the sub-district level
(5,00,000 population or 2,50,000 population in the hilly, difficult and tribal
areas).

II. Treatment: All major drugs procured at the Centre through World Bank
recommended procedures and provided to the States, thereby assuring quality of
the drugs.

37
 Annexure 3

NATIONAL AIDS CONTROL PROGRAMME: HIV GUIDELINES

At present the preventive and care interventions for the control of HIV/AIDS are being
provided below district level through integrated Health Care System using the available staff.
There is also a provision of training of health care providers and generating awareness through
intensive IEC campaign. The programme is being further strengthened by converging the
activities under NACP with RCH programme, which is underway. The following activities are
being proposed to be integrated at CHC level.

S.No Activities Proposed

1. STI clinic: RTI / STD management Expansion of services up to CHC & 24 hours
services PHC. Basic screening test for RTI/STD to be
made available at the CHCs.
2. Integrated Counseling and Testing Expansion of services up to CHCs in all
Centre (ICTC);, Link ART States
Centre & youth information centres
3. Prevention of parent-to-Child Services to be provided at all CHCs
Transmission (PPTCT)
4. Behaviour Change Communication Joint communication strategy messages &
(BCC) medium development to be done
5. Condom promotion Joint condom procurement & distribution of
condoms to meet the needs of sexually active
women and men as a method of dual
protection
6. Blood safety Blood storage centres planned at FRUs will
procure blood from licensed blood banks but
will be supported by RCH

38
 7. Trainings A specific plan will be developed jointly by
both the departments to train the peripheral
staff at CHC
8. Management Information System All facilities to report service performance on
RTI/STI, ICTC, Link ART services, PPTCT
as a part of routine reporting
9. Operationalisation A convergence facilitator to be appointed
under NACP to ensure coordinated inputs
between the activities implemented by NACP
and RCH

Consumables/Logistics
3000 Nos Whole Blood Finger Prick HIV Rapid Test and STI Screening Test each; STI
syndromic drug kit,
IEC/Job aids
Counseling Flip Chart, Posters etc
Reporting
Registers and Monthly formats as per NACO guidelines

39
 Annexure – 4

NATIONAL VECTOR BORNE DISEASE CONTROL PROGRAMME

The National Vector Borne Disease Control Programme (NVBDCP), erstwhile National Anti
Malaria Programme (NAMP) is the countries most comprehensive and multi-faceted public
health activity. Directorate of NVBDCP is the nodal agency for prevention and control of major
vector borne diseases of public health importance namely Malaria, Filariasis, Japanese
Encephalitis (JE), Kala-Azar, Chikungunya and Dengue.

Following are the strategy for control of these diseases:-

1. Malaria:
• Early Diagnosis and prompt treatment of malaria cases
• Integrated vector control
• Early Detection and Containment of malaria outbreak
• Information, Education and Communication (IEC) for personal protection and
community involvement for malaria control
• Training and Capacity Building of Medical and Para-medical workers
• Monitoring and evaluation of Efficient Management Information System (MIS)
2. Dengue:
• Epidemiological Surveillance of Dengue cases
• Entomological surveillance of Aedes aegypti mosquitoes
• Clinical management of reported cases
• Control of mosquitoes through Integrated Vector Management including source
reduction, use of larvivorous fishes, impregnated bednets and selective fogging with
Pyrethrum
• Behaviour change communication to change behavior of the community about
prevention of breeding of mosquitoes

40
3. Kala-azar:
• Early diagnosis & complete treatment through Primary Health Care System
• Interruption of transmission through vector control by undertaking residual insecticidal
spraying in affected areas
• Health Education and community participation
4. Japanese Encephalitis:
• Vector control by insecticidal spraying with appropriate insecticide for outbreak
containment
• Early diagnosis and prompt clinical management to reduce fatality
• Health Education
• Training of Medical Personnel and Professionals
5. Filariasis:
For elimination of Lymphatic Filariasis following are the strategies:-
• Annual Mass Drug Administration (MDA) with single dose of DEC to all eligible
population at risk of Lymphatic Filariasis
• Home based management of Lymphodema cases and
• Hydrocelectomy

The diagnosis, treatment and examination are performed at CHCs as per the pattern of PHC. In
addition, CHCs are the first referral units for treatment of severe and complicated malaria cases.
Services to be provided are:
• Diagnosis of malaria cases, microscopic confirmation and treatment
• Cases of suspected JE and Dengue to be provided symptomatic treatment, hospitalization
and case managements.
• Complete treatment to Kala-azar cases in Kala-azar endemic areas
• Complete treatment of micro-filaria positive cases with DEC and participation &
arrangement for Mass Drug Administration (MDA) along with preparedness of
management of side reactions.

Standards:

41
The CHC Medical Officer should be well-trained in prevention and control of the Vector Borne

Diseases and should carry out the following activities:-

• He will refer all fever cases to malaria laboratory for blood smear collection and
examination before giving final prescription/medicines.
• He will supervise all Malaria Cinics and PHC laboratory in his area, see the quality of
blood smear collection, staining, efficiency microscopic examination and check
whether the stain is filtered daily.
• He will also ensure/supervise that all positive cases get radical; treatment within 48
hours of examination.
• He will also ensure that sufficient stocks of Anti-malarials including Quinine tablets
and injectable Quinine and Artemisenine are available in CHC and also PHCs
• He will ensure that malaria laboratory is kept in proper condition along with
microscope and other equipments.
• He will provide referral services to severe cases of malaria
• He will refer severe and complicated cases to District Hospital in case of emergency
and drug failure.
• He will also ensure that Filaria cases are managed at CHC and the Hydrocele cases are
operated.

1. Drugs:

Chloroquine, Primaquine, Sulphadoxin Pyremethamine Combination, Artemisinine

Derivatives, Quinine Injections, Quinine tablets and 5% Dextrose saline And DEC tablets

2. Equipment:

Microscope, Slides, Pricking Needles, Cotton, Stains, Staining Jars, Filter paper, Glass
marking pencil, Lint cloth and Glasswares for preparation of stains and storage.

42
3. IEC Material:
• Display material like posters, banners and permanent hoardings etc.
• Distribution material like handbills, pamphlets, booklets display cards etc.
• Training Materials like Guidelines on programme strategies, dose-schedule cards etc.

Diagnosis and Manageemnt of Vector borne Diseases is to be done as per NVBDCP

guidelines for PHC/CHC

43
 Annexure-5

National Leprosy Eradication Programme

Minimum services to be available at Community Health Centres (CHC)

• Diagnosis of Leprosy
• Treatment
• Management of Reactions
• Counselling of patient on treatment, possible side effects & lepra reactions.
• Advise to Patient on prevention of disabilities and self care.

Manpower required
• Medical Officer trained in leprosy diagnosis
• Pharmacist to issue medicine and manage MDT Stock
• Health Worker trained in identification of leprosy lesions, its complications and maintenance
of records/reports

Diagnosis, classification and treatment of Leprosy should be made according to programme

guidelines.

Standard MDT Regimens

MDT should be is available in separate blister packs for MB (Adult), MB (Child), PB (Adult)
& PB (Child). Each Blister Pack contains treatment for 4 weeks.

44
 Annexure – 6
NATIONAL PROGRAMME FOR CONTROL OF BLINDNESS

Standards at Community Health Centres

1. Physical Structure for Eye Care at CHC

a. Refraction Room
b. Eye OT with Eye Ward (number of beds based on workload)

2. Equipment

For IOL Surgery

Operating Microscope
A-Scan Biometer
Keratometer
Slit Lamp
AutoRefractometer
Flash Autoclave
Streak Retinoscope
Tonometers (Schiotz)
Direct Ophthalmoscope
For primary Eye Care & Vision Testing
Tonometers (Schiotz)
Direct Ophthalmoscope
Illuminated Vision Testing Drum
Trial Lens Sets with Trial Frames
Snellen & Near Vision Charts
Battery Operated Torch (2)

45
 Drugs
Eye Ointments
Atropine (1%)
Local antibiotic: Framycetin/Gentamicin etc.
Local antibiotic steroid ointment
Ophthalmic Drops
Xylocaine 4% (30ml)
Local antibiotic: Framycetin/Gentamicin etc.
Local antibiotic steroid drops
Pilocarpine Nitrate 2%
Timolol 0.5%
Homatropine 2%
Tropicamide 1%
Injections
Xylocaine 2% (30 ml)
Inj Hyalase (Hyaluronidase)
Gentamycin
Betamethasone/Dexamethasone
Inj. Maracaine (0.5%) (For regoinal anesthesia)
Inj. Adrenaline
Ringer Lacate (540 ml) from reputed firm
Surgical Accessories
Gauze
Green Shades
Blades (Carbon Steel)
Opsite surgical gauze (10x14 c.m.)
Double needle Suture (commodity asstt. GOI)
Visco-elastics from reputed firm

46
 Annexure 7
INTEGRATED DISEASE SURVEILLANCE PROJECT
Services and Standards at Community Health Centres CHC will function as peripheral
surveillance unit and coallate, analyse and report information to District Surveillance Unit as per
IDSP reporting format at Annexure 7A, 7B and 7C. In out-break situations, appropriate action
will also be initiated.

47
Annexure 7 A

48
Annexure 7B

49
Annexure 7 C

50
 Annexure 8

Facility Based Maternal Death Review Form

NOTE:
This form must be completed for all deaths, including abortions and ectopic gestation related deaths, in pregnant
women or within 42 days after termination of pregnancy irrespective of duration or site of pregnancy
Attach a copy of the case records to this form
Complete the form in duplicate within 24 hours of a maternal death. The original remains at the institution where
the death occurred and the copy is sent to the person responsible for maternal health in the State

For Office Use Only:

FB-MDR no: Year:

GENERAL INFORMATION:

Address of Contact Person at District and State:

Residential Address of Deceased Woman:

Address where Died:

Name and Address of facility:

Block:

District: State:

2. DETAILS OF DECEASED WOMAN:

i. Name: / Age( years) : /Sex: / Inpatient Number:
ii Gravida: / Live Births(Para): / Abortions: / No. of Living children:
iii Timing of death: During pregnancy / during delivery / within 42 days of delivery /
iv Days since delivery/abortion:
v Date and time of admission:
vi Date /Time of death:

3. ADMISSION AT INSTITUTION WHERE DEATH OCCURRED OR FROM WHERE IT

WAS REPORTED ;

51
i . Type of facility where died:
PHC 24x7 SDH/RURAL DISTRICT MEDICAL PRIVATE PVT OTHER
PHC HOSPITAL HOSPITAL COLLEGE/TERTIARY HOSPITAL CLINIC
HOSPITAL

ii. Stage of pregnancy /delivery at admission:

Abortion Ectopic Not in labour In labour Postpartum
pregnancy

iii. Stage of pregnancy /delivery when died:

Abortion Ectopic Not in labour In labour Postpartum
pregnancy

iv Duration of time from onset of complication to admission:

v. Condition on Admission: Stable / Unconscious / Serious / Brought dead /
vi. Referral history: Referred from another centre ? How many centres?
Type of centre?

4.ANTENATAL CARE: Received Antenatal care or not/

Reasons for not receiving care/
Type of ante-natal care provided/

High risk pregnancy : aware of risk factors? / what risk factors?

5.DELIVERY, PUERPERIUM AND NEONATAL INFORMATION:

i.Details of labor : / had labor pains or not / stage of labor when died / duration of
labor
ii. Details of delivery: / undelivered / normal / assisted (forceps or vacuum) /
surgical intervention (C-section)

iii.Puerperium: / Uneventful / Eventful (PPH /Sepsis etc.)

Comments on labour ,delivery and puerperium: (in box below)

iv. Neonatal Outcome : / stillborn / neonatal death immediately after birth / alive at birth / alive at
7 days /

Comments on baby outcomes( in box below)

6. INTERVENTIONS: Specific medical/surgical procedures / rescuscitation procedures

undertaken

7.CAUSE OF DEATH :

52
 a. Probable direct obstetric (underlying) cause of death: Specify:

b. Indirect Obstetric cause of death: Specify:

c. Other Contributory (or antecedent) cause/s: Specify:

d. Final Cause of Death:(after analysis)

8.FACTORS (other than medical causes listed above)
a. Personal/Family

b. Logistics

c. Facilities available

d. Health personnel related

9. Comments on potential avoidable factors, missed opportunities and substandard care

10. AUTOPSY: Performed / Not Performed

If performed please report the gross findings and send the detailed report later
11.CASE SUMMARY: (please supply a short summary of the events surrounding the
death):

12. Form filled by:

13.Name
14.Designation
15.Institution and location
16.Signature and Stamp
17.Date :

53
 Annexure - 9

LIST OF EQUIPMENTS IN CHC

Standard Surgical Set - I (Instruments) FRU (Essential)

1 Tray, instrument/dressing with cover, 310 x 200 x 600 mm-ss 1

2 Gloves surgeon, latex sterilizable, size 6 12
3 Gloves surgeon, latex sterilizable, size 6-1/2 12
4 Gloves surgeon, latex sterilizable, size 7 12
5 Gloves surgeon, latex sterilizable, size7-1/2 12
6 Gloves surgeon, latex sterilizable, size 8 12
7 Forceps, backhaus towel, 130 mm 4
8 Forceps, sponge holding, 228 mm 6
9 Forceps, artery, pean straight, 160 mm, stainless steel 4
10 Forceps hysterectomy, curved, 22.5 mm 4
11 Forceps, hemostatic, halsteads mosquito, straight, 125 mm-ss 6
12 Forceps, tissue, all/is 6x7 teeth, straight, 200 mm-ss 6
13 Forceps, uterine, tenaculum, 280 mm, stainless steel 1
14 Needle holder, mayo, straight, narrow jaw, 175 mm, ss 1
15 Knife-handle surgical for minor surgery # 3 1
16 Knife-handle surgical for major surgery # 4 1
17 Knife-blade surgical, size 11, for minor surgery, pkt of 5 3
18 Knife-blade surgical, size 15 for minor surgery, pkt of 5 4
19 Knife blade surgical, size 22, for major surgery, pkt of 5 3
20 Needles, suture triangular point, 7.3 cm, pkt of 6 2
21 Needles, suture, round bodied, 3/8 circle No. 12 pkt of 6 2
22 Retractor, abdominal, Deavers, size 3, 2.5 cm x 22.5 cm 1
23 Retactor, double-ended abdominal, Beltouis, set of 2 2
24 Scissors, operating curved mayo-blunt pointed 170mm 1

54
25 Retractor abdominal, Balfour 3 blade self-retaining 1
26 Scissors, operating, straight, blunt point, 170 mm 1
27 Scissors, gauze, straight, 230 mm, stainless steel 1
28 Suction tube, 225 mm, size 23 F 1
29 Clamp intestinal, Doyen, curved, 225 mm, stainless steel 2
30 Clamp intestinal, Doyen straight, 225 mm, stainless steel 2
31 Forceps, tissue spring type, 160 mm, stainless steel 2
32 Forceps , tissue spring type, 250 mm, stainless steel. 1

Standard Surgical Set – II (Essential)

1. Forceps, tissue, 6 x 7 teeth, Thomas-Allis, 200 mm- ss 1

2. Forceps, backhaus towel, 130 mm, stainless steel 4
3. Syringe, anaesthetic (control), 10 ml, luer-glass 1
4. Syringe, hypodermic, 10 ml glass, spare for item 3 4
5. Needles, hypodermic 20G x 1-1/2" box of 12 1
6. Forceps, tissue, spring type, 145 mm, stainless steel 1
7. Forceps, tissue spring type 1 x 2 teeth, Semkins, 250 mm 1
8. Forceps, tissue spring type, 250 mm, stainless steel 1
9. Forceps, hemostat curved mosquito halsteads, 130 mm 6
10. Forceps, artery, straight pean, 160 mm, stainless steel 3
11. Forceps artery, curved pean, 200 mm, stainless steel 1
12. Forceps, tissue, Babcock, 195 mm, stainless steel 2
13. Knife handle for minor surgery No. 3 1
14. Knife blade for minor surgery No. 10, pkt of 5 8
15. Needle holder, straight narrow-jaw Mayo-Heger, 175 mm 1
16. Needle suture straight, 5.5 mm, triangular point, pkt of 6 2
17. Needle, Mayo, % circle, taper point, size 6, pkt of 6 2 2
18. Catheter urethral Nelaton solid-tip one-eye 14 Fr 1
19. Catheter urethral Nelaton solid-tip one-eye 16 Fr 1
20. Catheter urethral Nelaton solid-tip one-eye 18 Fr 1

55
 21. Forceps uterine tenaculum duplay dbl-cvd, 280 mm 1
22. Uterine elevator (Ranathlbod), stainless steel 1
23. Hook, obstetric, Smellie, stainless steel 1
24. Proctoscope Mcevedy complete with case 1
25. Bowl, sponge, 600 ml, stainless steel 1
26. Retractor abdominal Richardson-Eastman, dbl-ended, set 2 1
27. Retractor abdominal Deaver, 25 mm x 3 cm, stainless steel 1
28. Speculum vaginal bi-valve graves, medium, stainless steel 1
29. Scisssors ligature, spencer straight, 130 mm, stainless steel 1
30. Scissors operating straight, 140 mm, blunt/blunt ss 1
31. Scissors operating curved, 170 mm, blunt/blunt ss 2
32. Tray instrument curved, 225 x 125 x 50 mm, stainless steel 1
33. Battery cells for item 24 2

IUD Insertion Kit (Essential)

1 Setal sterilization tray with cover size 300 x 220 x 70 mm, S/S, 1
Ref IS:3993
2 Gloves Surgeon, latex, size 6-1/2 Ref. 4148 6
3 Gloves surgeon latex, size 7-1/2 Ref. 4148 6
4 Bowl, metal sponge, 600 ml, Ref. IS: 5782 1
5 Speculum vaginal bi-valve cusco'
s graves small ss 1
6 Forceps sponge holding, straight 228 MMH Semken 200 mm 1
7 Sound uterine simpson, 300 mm graduated UB 20 mm 1
8 Forceps uterine tenaculum duplay DBL-CVD, 280 mm 1
9 Forceps tissue - 160 mm 1
10 Anterior vaginal wall retractor stainless 1
11 Torch without batteries 1
12 Gloves surgeon, latex, size 7, Ref: 4148 6
13 Gloves surgeon, latex size 6 Ref. IS: 4148 6
14 Battery dry cell 1.5 V '
D'Type for Item 7G 1
15 Speculum vaginal bi-valve cusco'
s/Grea Ves Medium ss 1

56
 16 Forceps artery, straight, Pean, 160 mm 1
17 Scissors operating, straight, 145 mm, Blunt/Blunt 1
18 Forceps uterine vulsellum curved, Museux, 240 mm 1
19 Speculum vaginal double-ended sime size #3 1

CHC Standard Surgical Set – III (Essential)

Tray, instrument/dressing with cover, 310 x 195 x 63 mm 1

Forceps, backhaus towel, 130 mm, stainless steel 4
Forceps, hemostat, straight, Kelly, 140 mm, stainless steel 4
Forceps, hemostat, curved, Kelly, 125mm, stainless steel 2
Forceps, tissue Allis, 150 mm, stainless steel, 4 x 5 teeth 2
Knife handle for minor surgery No. 3 1
Knife blade for minor surgery, size 11, pkt of 5 10
Needle hypodermic, Luer 22G x 11/4", box of 12 1
Needle hypodermic, Luer 250G x 3/4", box of 12 1
Needle, suture straight 5.5 cm, triangular point, pkt of 6 2
Needle, suture, Mayo % circle, taper point No. 6, pkt of 6 2
Scissors, ligature, angled on flat, 140 mm, stainless steel 1
Syringe anaesthetic control, Luer - 5 ml, glass 4
Syringe 5 ml, spare for item 13 4
Sterilizer, instrument 200 x 100 x 60 mm with burner ss 1
Syringe, hypodermic, Luer 5 ml, glass 4
Forceps, sterilizer, Cheatle, 265 mm, stainless steel 1
Normal Delivery Kit (Essential)

Trolley, dressing carriage size 76C, long x 46 cm wide and 84 cm high. 1

Ref. IS 4769/1968
Towel, trolley 84 cm x 54 cm 2
Gown, operation, cotton 1
Cap. operation, surgeon'
s 36 x 46 cm 2

57
Gauze absorbent non-sterile 200 mm x 6 m as per IS: 171/1985 2
Tray instrument with cover 450 mm (L) x 300 mm (W) x 80 mm (H) 1
Macintosh, operation, plastic 2
Mask, face, surgeon'
s cap of rear ties: B) Beret type with elastic hem 2
Towel, glove 3
Cotton wool absorbent non-sterilize 500G 2
Drum, sterilizing cylindrical - 275 mm Dia x 132 mm, ss as per IS: 2
3831/1979
Table instrument adjustable type with tray ss 1

Standard Surgical Set – IV (Essential)

Vaccum extractor, Malastrom 1

Forceps obstetric, Wrigley'
s, 280 mm, stainless steel 1
Forceps, obstetric, Barnes-Neville, with traction, 390mm 1
Forceps, sponge holding, straight 228 mm, stainless steel 4
Forceps, artery, Spencer-Wells, straight, 180mm-ss 2
Forceps, artery, Spencer-Wells, straight, 140mm-ss 2
Holder, needle straight, Mayo-Hegar, 175 mm-ss 1
Scissors, ligature, Spencer, 130 mm, stainless steel 1
Scissors, episiotomy, angular, Braun, 145 mm, stainless steel 1
Forceps, tissue, spring-type, 1 x 2 teeth, 160 mm-ss 1
Forceps, tissue, spring-type, serrated ups, 160mm-ss 1
Catheter, urethral, rubber, Foley'
s 14 ER 1
Catheter, urethral, Nelaton, set of five (Fr 12-20) rubber 1
Forceps, backhaus towel -130 mm-ss 4
Speculum, vaginal, Sim'
s, double-ended # 3-ss 1
Speculum, vaginal, Hamilton-Bailey 1

Standard Surgical Set – V (Essential)

58
Forceps, obstetric, Neville-Barnes, W/traction 390 mm 1
Hook, decapitation, Braun, 300 mm, stainless steel 1
Hook, crochet, obstetric 300 mm, Smellie, stainless steel 1
Bone, forceps, Mesnard 280 mm, stainless steel
Perforator, Smellie, 250 mm, stainless steel 1
Forceps, cranial, Gouss, straight, 295 mm-ss 1
Cranioclast, Braun, stainless steel, 365 mm long 1
Scissors ligature Spencer 130 mm, stainless steel 1
Forceps sponge holding, 22.5 cm straight - ss 1
Forceps, tissue, spring-type, 1 x 2 teeth, 160 mm, stainless steel 1
Forceps, tissue, spring-type, serrated tips, 160 mm-ss 1
Forceps, artery, Spencer-Wells, straight, 180 mm-ss 2
Forceps, artery, Spencer-Wells, straight, 140 mm-ss 2
Forceps, scalp flap, Willet'
s 190 mm -ss 4
Forceps, Vulsellum, duplay double curved, 280 mm-ss 4
Forceps, Vulsellum, duplay double curved, 240 mm-ss 1
Catheter, urethral, 14 Fr. solid tip, one eye, soft rubber 3
Holder, needle, Mayo-Hegar, narrow jaw, straight, 175 mm-ss 1
Speculum vaginal bi-valve, Cusco-medium, stainless steel 1
Speculum, vaginal sim'
s double-ended, size # 3-ss 1
Forceps, backhaus towel, 130 mm, stainless steel 4
Standard Surgical Set – VI (Essential)

Forceps, sponge holding, straight, 225 mm, stainless steel 4

Speculum, vaginal, Sim'
s double-ended size # 3 - ss 1
Speculum, vaginal, weighted Auvard, 38 x 75 mm blade - ss 1
Forceps, tenaculum, Teale'
s, 230 mm-ss 3x42
Sound, uterine, Simmpson, 300 mm with 200 mm graduations 1
Dilator, uterine, double - ended hegar, set of 5 - ss 1
Curette, uterine, sim'
s blunt, 26 cm x 11 mm size # 4-ss 2

59
Curette, uterine, sim'
s sharp, 26 cm x 9 mm size # 3-ss 2
Forceps, artery, Spencer-Well'
s straight, 140 mm-ss 1
Forceps, tissue, spring-type, serrated tips, 160 mm-ss 1
Forceps, ovum, Krantz, 290 mm, stainless steel 1

Miscellaneous
NSV Kit 2
Laproscope 1

Equipment for Anaesthesia (Essential)

Facemask, plastic w/rubber cushion & headstrap, set of 4 4

Airway Guedel or Berman, autoclavable rubber, set of 6 2
Laryngoscope, set with infant, child, adolescent blades 3
Catheter, endotracheal w/cuff, rubber set of 4 3
Catheter, urethral, stainless steel, set of 8 in case 2
Forceps, catheter, Magill, adult and child sizes, set of 2 1
Connectors, catheter, straight/curved, 3, 4, 5 mm (set of 6) 3
Cuffs for endotracheal catheters, spare for item 4 4
Breathing tubes, hoses, connectors for item 1, anti-static 4
Valve, inhaler, chrome-plated brass, Y-shape 3
Bag, breathing, self inflating, anti-static rubber, set of 4 2
Vaporiser, halothane, dial setting 2
Vaporiser, ether or methoxyflurane, wick type 2
Intravenous set in box 6
Needle, spinal, stainless set of 4 2
Syringe, anesthetic, control 5ml Luer mount glass 2
Cells for item 3 2

Equipment for Neo-natal Resuscitation (Essential)

Catheter, mucus, rubber, open ended tip, size 14FR 2

60
 Catheter, nasal, rubber, open tip, funnel end, size 8Fr 2
Catheter, endotracheal, open tip, funnel end rubber, 12Fr 3
Stilette, curved, for stiffening tracheal catheter SS 1
Catheter, suction, rubber, size 8Fr 3
Laryngoscope, infant, w/three blades and spare bulbs. 1
Lateral mask, with ventillatory bag, infant size 2
Resuscitator, automatic, basinet type 1
Lamp, ultra-violet (heat source) with floor stand 1
Cells for item 6 (Laryngoscope) 2
Oxygen Cylinders 1
Nasal Prongs 5
Thermometers 5
Infantometer: Measuring range 33-100 cm 2
Stadiometer: Measuring range 60-200 cm 1
Phototherapy Unit 1
Radiant warmers 2
Dextromsticks 100 sticks
Nebulisers/MDI 1
IV Canulas (22G and 24 G) 100 each
Scalp vein set No. 22 and 24 100 each
Nasogastric tube ( 8,10,12 FG) 20
Oropharyngeal airway (000-4 Guydel size)
Plastic/disposable syringes including tuberculin 100
IV infusion sets (adult and pediatric) 100

Materials Kit for Blood Transfusion (Essential)

Bovine albumin 20% testing agent, box of 10 X 5 ml vials 5
Centrifuge, angle head for 6 X 1 5 ml tubes, 240 volt 1
Bath, water, serological, with racks, cover, thermostate, 240 v 1
Pipette, volumetric, set of six 1 mol/2 ml/3 ml/5 ml/10 ml/20 ml 1
Test-tube without rim 75 X 12 mm HRG 12

61
Test-tube without rim 1 50 X 16 mm, HRG 12
Cuff, sphygmomanometer, set of two sizes – Child/Adult 1
Needle, blood collection disposable, 1 7 g X 1-1/3 box of 100 1
Ball, donor squeeze, rubber, dia, 60 mm 1
Forceps, artery, Spencer-Wells, straight 140 mm, stainless steel 1
Scissors, operating, straight 140 mm, blunt/jpoints, ss 1
CPDA anti-coagulent, pilot bottle 350 mil for collection 20
Microscope, binocular, inclined, 10 X 40 X 100 X magnificent 1
Illuminator for item 14 (microscoper) 1
Slides, microscope, plain 25 X 75 mm, clinical, box of 100 1

Equipment for operation Theatre (Essential)

Diathermy machine
Dressing drum all sizes
Lamps shadowless:
Ceiling lamp
Portable type
Sterilizer
Suction Apparatus
Stand with wheel for single basin
Table operation, hydraulic:
Major
Minor
Trolley for patients
Trolley for instruments
X-ray view box
Wheel chairs

Equipment for Labour Room

Aprons rubber
Cradles baby
Wheel Chair

62
Cabinet Insturment
Dressing drum
Shadowless lamps
Table for
Obstetric labour
Examination
Trolley for
Patients
Dressing
Torch (flash light)
Trays
Vacuum Extractor
Weighing machine baby
Wheel chairs
Equipment for Radiology
Aprons lead ribber
Diagnostic X-ray Unit 20C7300mA with automatic device
Dark room accessories
Dark room timer
Film clips
Lead sheets
X-ray view box
X-ay protection screen
X-ray film processing tank

Immunization Equipments (Essential)

ILR (Large) & DF(Large) with Voltage Stabilizer
1. Assuming 30,000 population directly served by CHC, 25/1000 live birth,19.5 mixed
antigens, 25% wastage& 25% buffer stock, 80.6 cubic cm per child, and 33% space for air
circulation, the ILR storage volume required is =11.4 L
2. Ice pack making by DF
3. Stabilizer to protect the CC Equipments from voltage fluctuation

63
4. However considering contigency plan Large ILR & ILR DF may be provided to the CHC
Cold Boxes ( Large& Small):
Small- one, Large – two
Vaccine Carriers with Icepacks
Two per SC (maximum 2 per booth) + 1 for CHC: Transport of vaccines to session sites.
For campaign, more vaccine carrier will be required
Spare ice pack box
8, 25 & 60 ice pack boxs per vaccine carrier, 5L cold box & 20L cold box respectively
Room Heater/Cooler for immunization clinic with electrical fittings
Thermometers Alcohol (stem) 2
AD syringes AD syringes (0.5 ml & 0.1 ml) - need based
Reconstitution syringes Reconstitution syringes(5ml) - need based
Full size steel Almirah for FW Clinic For storage of registers and reports and Logistics
Freeze Tag :Monitoring Freezing of vaccine
Waste disposal twin bucket, hypochlorite solution/bleach
Chair for new staffs proposed-4
Dustbin with lid-2
Water receptacle-1
Hub cutters-2
Computer with Modem with UPS, Printer with Internet connection
Immunization schedule printed on a tin plate
Posters/Paintings on key messages

Records and reports

Immunization register-1
Vaccine stock & issue register-1
Tally sheets
Temperature monitoring registers/chart
AD syringes, Reconstitution syringes, other logistic stock & issue register
Monthly UIP reports
RI Monitoring Chart
Weekly surveillance reports (AFP, Measles)

64
Serious AEFI reports
Outbreak reports
Tracking Bag and Tickler Box

Equipments and Renewable required for the New Born Corner and New Born
Stabilization Unit (Essential): given in Annexure 1 and 1A respectively

Equipment required for Non- Communicable Diseases (Essential wherever the programme
is being implemented)

NPPCD • Head Light • For screening of patients

• Ear specula of hearing impairment /
• Ear Syringe deafness
• Otoscope • For diagnosis of common
• Jobson Horne Probe ear Problems
• Tuning fork • For early detection of
Noise Maker hearing loss
• Removal of foreign body
from ear and nose
NCCP • Consumables for screening of For early detection of
cervical cancer common cancers
• Disposable tongue depressor
• PAP smear kit PAP smear
Programme on ECG machine ordinary 1 For screening of patients
Prevention and Cardiac Monitor with defibrillator 1 For diagnosis and early detection
Control of Pulse Oximeter 1 of CVD DM,Stroke
Diabetes, CVD and Infusion pump 1
Stroke Ophthalmoscope (direct) 1
Slit Lamp 1
B.P.apparatus table model 4
Stethoscope 4

PMR 1.Shot wave diathermy

2.Ultra sound therapy As PMR services would be
3. Infra-red lamp (therapy) provided with the posting of
qualified paramedical these
1.Neuromuscular Stimulator are all required equipment
2.Pocket TENS
3.Paraffin Wax bath
4. Hot packs with hydro collators.
5. Exercise Table – 2 nos
6. Static Cycle
7. Shoulder Wheel

65
 8. Cervical & Lumber traction
9. Medicine ball
10. Quadriceps Exerciser
11. Coordinator board
12. Hand grips strength
measurement kit.
13. Kit for Neuro- Development
assessment.
14. CBR Manuals
15. Assorted toys like sound making /
colourful gadgets / building blocks /
peg boards / pictorial charts and
manuals

Oral Health Dental Unit consisting of Equipment Necessary for dental care
for dental examination and services
management
Dental Chair, Dental Unit and set of
dental Equipment for examination,
extraction and management of gum
problems.

Equipments under National Health Programmes (as listed under each NHP) and Blood Storage
equipment as at Annexure - 11.

66
List of Drugs Annexure 10

Emergency Obstetric Care Drugs Kit for CHC/ FRU (Essential)

Sl.No Name of the Drug / Form Dosage Quantity/

Kit
1 Containing 0.01 % w / w thymol
Halothane BP 5 Bottles
IP; 200 ml in each Bottles
2 Atropine Sulphate IP 600µg / ml; 50
Atropine Injection IP
02 ml in each ampoule ampoules
3 Each vial containing Thiopentone
Thiopentone Injection IP Sodium IP 500 mg ; Capacity of 100 Vials
vial 20 ml
4 Bupivacaine Hydrochloride IP eq.
to Bupivaine hydrochloride
Bupivacaine Injection IP 50 vials
anhydrous 5 mg / ml; 20 ml in each
vial
5 Lignocaine Hydrochloride IP 5 % 50
Lignocaine Injection IP
w / v; 02 ml in each ampoule ampoules .
6 Lignocaine Hydrochloride IP 2% w
Lignocaine Injection IP 50 vials
/ v; 30 ml in each vial
7 Diazepam IP 5 mg / ml; 2 ml in 100
Diazepam Injection IP
each ampoule ampoules.
8 Pentazocine Lactate IP eq. to
100
Pentazocine Injection IP Pentazocine 30 mg / ml; 01 ml in
ampoules .
each ampoule
9 Dexamethasone Sodium Phosphate
IP eq. to Dexamethasone 100
Dexmethsone Injection IP
Phosphate, 4 mg / ml.; 02 ml in ampoules .
each ampoule
10 Promethazine hydrochloride IP, 25 50
Promethazine Injection IP
mg / ml; 02 ml in each ampoule ampoules.
11 500
Nifedipine Capsules IP Nifedipine IP10 mg
capsules
12 Dopamine Hydrochloride USP 40
Dopamine Injection USP 25 vials
mg / ml; 05 ml in each vial
13 500
Digoxin Tablets IP Digoxin IP 250 µg / tab
tablets
14 Methyldopa IP eq. to Methyldopa 500
Methyldopa Tablets IP
anhydrous 250 mg tablets
15 500
Frusemide Tablets IP Frusemide IP 40 mg
tablets
16 Frusemide IP 10 mg / ml; 02 ml in 100
Frusemide Injection IP
each ampoule ampoules

67
17 Ampicillin Sodium IP eq. to
Ampicillin Injection IP 1000 vials
Ampicillin anhydrous 250 mg /vial
18 Gentamycin Sulphate eq. to
Gentamycin Injection IP gentamycin 40 mg / ml; 02 ml in 1000 vials
each vial
19 Amoxycylline Trihydrate IP eq. to 2000
Amoxycillin Capsules IP
amoxycylline 250 mg capsules
20 Norfloxacin Tablets IP Norfloxacin IP 400 mg 2000
tablets

21 Doxycycline Hydrochloride eq. to 1000

Doxycycline Capsules IP
Doxycycline100 mg capsules
22 2000
Metronidazole Tablets IP Metronidazole IP 400 mg
tablets
23 Methylergometrine Injection Methylergometrine maleate IP, 0.2 500
IP mg /ml; 01 ml in each ampoule ampoules
24 Oxytocin IP 5.0 I.U. / ml; 02 ml in 500
Oxytocin Injection IP
each ampoule ampoules
25 Etofylline BP plus Anhydrous Etofylline BP 84.7 mg / ml &
Theophylline IP Combination Theophylline IP eq. to 100
Injection (As per standards Theophylline anhydrous, 25.3 mg / ampoules
provided) ml; 02 ml in each ampoule
26 Hydrocortisone Acetate Hydrocortisone Acetate IP 25 mg /
100 vials
Injection IP ml; 02 ml in each vial
27 Salbutamol sulphate eq. to 1000
Salbutamol Tablets IP
Salbutamol 2 mg tablets
28 0.18% w/v of Adrenaline Tartrate
or Adrenaline Tartrate IP eq. to 100
Adrenaline Injection IP ?
adrenaline 1 mg / ml; 01 ml in each ampoules
ampoule
29 Succinylcholine Chloride IP 50 mg
Succinylcholine Injection IP 30 vials
/ ml; 10 ml in each vial
30 Ketamine Hydrochloride eq. to
Ketamine Injection IP Ketamine base 10 mg / ml; 10 ml in 50 vials
each vial
31 250
Diazepam Tablets IP Diazepam IP 5 mg
tablets
32 Vecuronium Bromide
Vecuronium Bromide USP 4 mg 500
Injection (as per standards
per ampoule ampoules
provided)
33 Pancuronium Bromide Pancuronium Bromide BP 2 mg / 500
Injection BP ml; 02 ml in each ampoules ampoules
34
Neostigmine methylsulphate 500
Neostigmine Injection IP
0.5mg/ml (??); 01 ml in each ampoules
ampoule

68
35 Benzylpenicillin Sodium IP eq. to
Benzylpenicillin Injection IP 2000 vials
Benzylpenicillin 300 mg / vial..
36 Procaine Penicillin IP 300 mg and
Fortified Procaine Penicillin Benzylpenicillin Sodium/Potassium
1000 vials
Injection IP salt IP eq. to Benzylpenicillin 60mg
per vial
37 Benzathine Penicillin Injection Benzathine penicillin IP 450mg (6
100 vials
IP lakh units) / vial
38 Trimethoprim & Trimethoprim IP 80mg / 5000
Sulphamethoxazole Tablets IP Sulphamethoxzole IP 400mg tablets
39 Phenoxymethylpenicillin Phenoxymethylpenicillin Potassium 3000
Potassium Tablets IP 250 mg tablets
40 Fluconazole Tablets (as per 1500
Fluconazole USP 150 mg
the standards provided) tablets
41 Cloxacillin Injection IP Cloxacillin Sodium IP 250 mg / 100 vials
vial
42 Metronidazole Injection IP (IV Metronidazole IP 5 mg / ml: 100 ml 100
infusion) in each bottle bottles
43 2000
Ergometrine Tablets IP Ergometrine maleate IP 250 mcg
tablets
44 150
Phenytoin Tablets IP Phenytoin Sodium IP100 mg
tablets
45 Hydroxyprogestrone Injection Hydroxyprogesterone Hexanoate IP
100 vials
IP 250 mg /ml; 02 ml in each vial
46 Norethisterone Acetate Tablets 1000
Norethisterone Acetate BP 5 mg
(as per the standards provided) tablets
47 Insulin IP (porcine/bovine/human)
Insulin Injection IP 20 vials
40 units / ml; 10 ml in each vial
48 Insulin Zinc Suspension eq. to
Insulin Zinc Suspension
Insulin 40 units / ml; 10 ml in each 10 vials
Injection IP
vial
49 Sodium Bicarbonate Injection Sodium Bicarbonate 7.5 % w/v; 10 100
IP ( IV infusion) ml in each ampoule ampoules
50 Magnesium Sulphate Injection Magnesium Sulphate 50% w/v ; 02
50 vials
IP ml in each vial
51 Phenytoin Sodium IP 50 mg / ml; 50
Phenytoin Injection BP
02 ml in each ampoule ampoules.
52 Medical Oxygen in steel or
2
Oxygen IP aluminium, cylinder (10 litres water
Cylinders
cap).with gas specific PIN system
53 1000 FFS
Sodium Chloride Injection IP ( Sodium Chloride IP 0.9 % w/v; 500 pouches /
I.V. Solution) ml in each bottle/pouch BFS
bottles
54 250 FFS
Dextrose Injection IP ( Dextrose eq. to Dextrose anhydrous
pouches /
I.V.Solution) 5 % w/v
BFS

69
 bottles
55 Medical Nitrous Oxide B Type in
steel or aluminium, Cylinder (10 2
Nitrous Oxide Gas IP
litres water cap.) with gas specific Cylinders
PIN system
56 Dextran 40 Injection IP
Dextrans 10 w/v; 500 ml in each
(Plasma Volume expander) 10 bottles
bottle
57 1000
Sterile Water for injections IP 05 ml in each ampoule
ampoules
58 IV set with hypodermic needle 21G
Infusion Equipment BIS 900 nos.
of 1.5” length
59 Intracath Cannulas for Single
Gauze 18, length 45 mm, Flow rate
use (Intravascular Catheters) 12 nos.
90 ml/minute
BIS
60 Intracath Cannula for Single 12 nos.
Size 22, Length 25 mm, Flow rate
use (Intravascular Catheters)
35 ml/minute
BIS

61 Hypodermic Syringe for

Cap. 2 ml +_1.5% 500 nos.
Single use - 2ml BP/BIS
62 Hypodermic Syringe for
Cap.5 ml +_1.5% 500 nos.
Single use - 5 ml BP/BIS
63 Hypodermic Syringe for
Cap. 10 ml +_1.5% 500 nos.
Single use - 10 ml BP/BIS
64 Hypodermic Syringe for
Cap. 50 ml +_1.5% 20 nos.
Single use - 50 ml BP/BIS
65 Hypodermic Needle fir Single
Length, 25 +1/-2 550 nos.
use – Gauze 22 BIS
66 Hypodermic Needle for Single
Length, 25 +1/-2 500 nos.
use – Gauze 23 BIS
67 Hypodermic Needle for Single
Length, 25 +1/-2 500 nos.
use – Gauze 24 BIS
68 0.24 % V/V of Lactic Acid ( eq. to
0.32% w/v of Sodium Lactate), 0.6 1000 FFS
Compound Sodium Lactate % w/v Sodium Chloride, 0.04 % pouches /
Injection IP w/v Potassium Chloride and 0.027 BFS
% w/v Calcium Chloride; 500 ml in bottles
each bottle/pouch.
69 Surgical Gloves, Sterile BIS Size 6 500 pairs.
70 Surgical Gloves, Sterile BIS Size 6.5 500 pairs
71 Surgical Gloves, Sterile BIS Size 7 100 pairs.

70
DRUG KIT FOR SICK NEW BORN & CHILD CARE - FRU/CHC

1. Diazepam Inj. IP 5 mg per ml Inj. 2 ml Ampoule 60 Ampoules (For per

rectally use only)
2. Inj. Cefotaxime 1 gm Vial 100 Vial
3. Inj. Cloxacillin 1 gm Vial 100 Vial
4. Dexamethasone 4 mg per ml Inj. 2 ml ampoule 300 Ampoules
Sodium Phosphate
inj. IP
5. Aminophylline Inj. 25 mg per ml Inj. 10 ml Ampoule 60 Ampoules
BP
6. Adrenaline 1 mg per ml Inj. 1 ml Ampoule 60mpoules
Bitartrate Inj. IP ? (1:1000
dilution)
7. Ringer Lactate 500 ml 500 ml plastic pouch 300 Pouches
8. Doxycycline dispersible Tablets 300 Tablets
Hydrochloride
9. Vit. K3 (Menadione Inj. 10 mg per Inj. 1 ml ampoule 100Ampoules
Inj.) IP ml
10. Phenytoin 50 mg per ml Inj. 2 ml Ampoule 60 Ampoules
11. Dextrose Inj. IP I.V. 5% Inj. 500 ml plastic 60 Plastic pouches
Solution pouch
12. Inj. Gentamycin 10 mg/ml Ampoule 150Ampoules
13. Water for injection 2 ml/ 5 ml Ampoule 300Ampoules
14. Inj. Lasix 20 mg/2ml 2 ml Ampoule 300Ampoule
15. Inj. Phenobarbitone 100mg/ml 2 ml Ampoule 60Ampoule
16. Inj. Quinine 150 mg/ml 2 ml Ampoule 60 Ampoule
17. Normal Saline 500 ml 500 mg Plastic pouch 60 Plastic pouches
18. Inj. Ampicillin 500mg/ 5ml Vial 150 Vial
19. Inj. 1 gm/10 ml Vial 150 Vial
Chloramphenicol
20. Inj. Calcium 10% 10 ml Ampoule 60 Ampoules
Gluconate
21 Ciprofloxacin 100mg Tablet 500 tablets
dispersible
22 Nebulisable 15 ml 100 Nebuliser
Salbutamol nebusol equipment to be
solution (to be used provided with
with nebuliser) Nubulisable Salbutamol
23. Inj. Dopamine 200 mg/5 ml Ampoule 20 Ampoule
24. Needles 23G 750
25. Disposable Syringe 1ml/2ml/5 ml 1ml-200
2ml-500
5ml-500

71
 LIST OF OTHER ESSENTIAL DRUGS FOR CHC

S.No. Name of the Drug Route of Strength

administration/
dosage form
1 Lignocaine Hydrochloride Topical Forms 2-5%
2 Acetyl Salicylic Acid Tablets 75mg, 100 mg 300
mg 350 mg
3 Ibuprofen Tablets 200 mg, 400 mg
4 Paracetamol Injection 150 mg / ml
Syrup 125 mg / 5ml
Tablets 500 mg
5 Chloroquine Phosphate Tablets 150 mg
Injection 40 mg/ml
Syrup 50 ml/5 ml
6 Chlorpheniramine Maleate Tablets 4 mg
7 Prednisolone Tablets 5 mg, 10 mg
8 Promethazine HCL Tablets 25 mg
9 Phenobarbitone Tablets 30 mg. 60 mg
10 Phenytoin Sodium Capsules or Tablets 50 mg,100 mg
Syrup 25 mg / ml
11 Albendazole Tablets 400 mg
Suspension 200 mg/ 5 ml
12 Amoxicillin Powder for suspension 125 mg / 5 ml
13 Ciprofloxacin Hydrochloride Tablets 250 mg,500 mg
Suspension 40 +200 mg / 5 ml
14 Clotrimazole Pessaries 100 mg, 200 mg
Gel 2%
15 Sulfadoxine +Pyrimethamine Tablets 500 mg +25 mg
16 Ferrous Salt Tablets 60 mg
Oral solution 25 mg

72
17 Folic Acid Tablets 1 mg, 5 mg
18 Isosorbide Mononitrate/Dinitrate Tablets 10 mg, 20 mg
19 Amlodipine Tablets 2.5 mg, 5 mg,10 mg
20 Digoxin Injection 0.25 mg / ml
Elixir 0.05 mg / ml
21 Benzoic Acid +Salicylic Acid Ointment or Cream 6% + 3%
22 Miconazole Ointment or Cream 2%
23 Neomycin +Bacitracin Ointment 5 mg + 500 IU
24 Silver Sulphadiazine Cream 1%
25 Benzyl Benzoate Lotion 25%
26 Acriflavin+Glycerin Solution
27 Gentian Violet Paint 0.5%, 1%
28 Hydrogen Peroxide Solution 6%
29 Povidone Iodine Solution 5%, 10%
30 Bleaching Powder Powder
31 Potassium Permanganate Crystals for solution
32 Aluminium Hydroxide + Tablet
Magnesium Hydroxide Suspension
33 Domperidone Tablets 10 mg
Syrup 1 mg / ml
34 Local Anaesthetic,Astringent and Ointment
Antiinflammatory Medicine /suppository
35 Dicyclomine Hydrochloride Tablets 10 mg
Injection 10 mg / ml
36 Oral Rehydration Salts Powder for solution As per IP
37 Ciprofloxacin Hydrochloride Drops/Ointment 0.3%
38 Tetracycline Hydrochloride Ointment 1%
39 Alprozolam Tab 0.25 mg
40 Salbutamol Sulphate Tablets 4 mg
Syrup 2 mg / 5 ml
Inhalation 100 mg / dose

73
41 Glucose Injection 50% hypertonic
42 Glucose with Sodium Chloride Injection 5% + 0.9%
43 Ringer Lactate Injection
44 Ascorbic Acid Tablets 100 mg, 500 mg
45 Calcium salts Tablets 250 mg, 500 mg
46 Multivitamins(As per Schedule V) Tablets
47 Atenolol Tablets 50 mg
48 Fluoxetine Tablets 20 mg
49 Amitryptiline Hcl Tablets 25 mg
50 Bisacodyl Tablets 05 mg
51 Tinidazole Tablets 300mg,
52 Daonil Tablets 5 mg
53 Haloperidol Tablets 1, 2, 5 mg
54 Sulpacetamide eye drops Drops
55 Tab.Metoprolol Tablets 12.5, 25 mg, 100 mg
Hydrochlorthiazide
56 Tab Captopril Tablets 25 mg

57 Glyceryl Trinitrate Inj Inj

58 Carbamazepine tabs, syrup 100mg, 200 mg

59 Tab.Methyldopa Tablets 250 mg

60 Tab.Enalapril Tablets 2.5/5mg

61 Atorvastatin Tab Tablets 10mg

62 Inj.Streptokinase 15lac vial Inj 15lac vial

Inj.Streptokinase 7.5lac vial Inj 7.5lac vial

63 Inj.Heparin sod.1000IU Inj 1000 IU

64 Inj.Insulin Regular Inj

Insulin Intermediate Inj

65 Tab. Metformin Tablets 500 mg

74
 66 Inj. Crocin Inj
67 Inj. Potassium chloride Inj
68 Inj. Buscopan Inj
69 Inj. Duvadilan Inj
70 Inj. Chlormycetin Inj
71 Inj. Manitol Inj
72 Inj. Chloroquine Inj
73 Inj. Pethidine Inj
74 Inj. Chlorpromazine Inj
75 Inj. Pheniramine (Avil) Inj
76 Inj. Dextrose (10%) Inj
77 Inj. Salbutamol MDI Inj

Apart from drugs mentioned above, Drugs under various National Health Programmes and
Vaccines as under Immunization Programme are to be provided.

75
 LIST OF AYURVEDIC MEDICINES FOR CHCs

1. Sanjivani Vati
2. Godanti Mishran
3. AYUSH-64
4. Lakshmi Vilas Rasa (Naradeeya)
5. Khadiradi Vati
6. Shilajatwadi Louh
7. Swas Kuthara rasa
8. Nagarjunabhra rasa
9. Sarpagandha Mishran
10. Punarnnavadi Mandura
11. Karpura rasa
12. Kutajaghan Vati
13. Kamadudha rasa
14. Laghu Sutasekhar rasa
15. Arogyavardhini Vati
16. Shankha Vati
17. Lashunadi Vati
18. Kankayana Vati
19. Agnitundi Vati
20. Vidangadi louh
21. Brahmi Vati
22. Sirashooladi Vajra rasa
23. Chandrakant rasa
24. Smritisagara rasa
25. Kaishora guggulu
26. Simhanad guggulu
27. Yograj guggulu
28. Gokshuradi guggulu
29. Gandhak Rasayan
30. Rajapravartini Vati

76
31. Triphala guggulu
32. Saptamrit Louh
33. Kanchanara guggulu
34. Ayush Ghutti
35. Talisadi Churna
36. Panchanimba Churna
37. Avipattikara Churna
38. Hingvashtaka Churna
39. Eladi Churna
40. Swadishta Virechan Churna
41. Pushyanuga Churna
42. Dasanasamskara Churna
43. Triphala Churna
44. Balachaturbhadra Churna
45. Trikatu Churna
46. Sringyadi Churna
47. Gojihwadi kwath Churna
48. Phalatrikadi kwath Churna
49. 54.Maharasnadi kwath Churna
50. Pashnabhedadi kwath Churna
51. Dasamoola Kwath Churna
52. Eranda paka
53. Haridrakhanda
54. Supari pak
55. Soubhagya Shunthi
56. Brahma Rasayana
57. Balarasayana
58. Chitraka Hareetaki
59. Amritarishta
60. Vasarishta
61. Arjunarishta
62. Lohasava

77
63. Chandanasava
64. Khadirarishta
65. Kutajarishta
66. Rohitakarishta
67. Ark ajwain
68. Abhayarishta
69. Saraswatarishta
70. Balarishta
71. Punarnnavasav
72. Lodhrasava
73. Ashokarishta
74. Ashwagandharishta
75. Kumaryasava
76. Dasamoolarishta
77. Ark Shatapushpa (Sounf)
78. Drakshasava
79. Aravindasava
80. Vishagarbha Taila
81. Pinda Taila
82. Eranda Taila
83. Kushtarakshasa Taila
84. Jatyadi Taila/Ghrita
85. Anu Taila
86. Shuddha Sphatika
87. Shuddha Tankan
88. Shankha Bhasma
89. Abhraka Bhasma
90. Shuddha Gairika
91. Jahar mohra Pishti
92. Ashwagandha Churna
93. Amrita (Giloy) Churna
94. Shatavari Churna

78
95. Mulethi Churna
96. Amla Churna
97. Nagkesar Churna
98. Punanrnava Churna
99. Dadimashtak Churna
100. Chandraprabha Vati.
101. Dhanwantara Taila
102. Balaswagandhadi Taila
103. Mahanarayana Taila
104. Sahacharadi Taila
105. Ksheerabala Taila
106. Kaseesadi Taila
107. Kolakulatthadi Udvarthana Churna
108. Jatamayadi Udvarthana Churna
109. Upanaha Churna
110. Shadpala Ghrita

111. Panchthiktha Guggulu Ghrita

112. Panchagavya Ghrita
113. Madanapippali Churna
114. Saindhava Lavana
115. Madhu
116. Pippali Churna
117. Shuddha Ghrita
118. Trivrit Leha
119. Dashmoola or Ransnadi Kwath Churna

120. Manibhadra Guda

121. Gandharvahastadi Kwath Churna

122. Balaguluchyadi Kwath Churna

79
 123. Aragwadadi Kwath Churna

124. Pure Ghrita

125. Icchabhedi Rasa

LIST OF UNANI MEDICINES FOR CHCs

1. Arq-e-Ajeeb
2. Arq-e-Gulab
3. Arq-e-Kasni
4. Arq-e-Mako
5. Barshasha
6. Dawaul Kurkum Kabir
7. Dawaul Misk Motadil Sada
8. Habb-e-Aftimoon
9. Habb-e-Bawasir Damiya
10. Habb-e-Bukhars
11. Habb-e-Dabba-e-Atfal
12. Habb-e-Gule Pista
13. Habb-e-Hamal
14. Habb-e-Hilteet
15. Habb-e-Hindi Qabiz
16. Habb-e-Hindi Sual
17. Habb-e-Hindi Zeeqi
18. Habb-e-Jadwar
19. Habb-e-Jawahir
20. Habb-e-Jund
21. Habb-e-Kabid
Naushadri
22. Habb-e-karanjwa

80
23. Habb-e-Khubsul
Hadeed
24. Habb-e-Mubarak
25. Habb-e-Mudirr
26. Habb-e-Mumsik
27. Habb-e-Musaffi
28. Habb-e-Nazfuddam
29. Habb-e-Nazla
30. Habb-e-Nishat
31. Habb-e-Raal
32. Habb-e-Rasaut
33. Habb-e-Shaheeqa
34. Habb-e-Shifa
35. Habb-e-Surfa
36. Habb-e-Tabashir
37. Habb-e-Tankar
38. Habb-e-Tursh Mushtahi
39. Itrifal Shahatra
40. Itrifal Ustukhuddus
41. Itrifal Zamani
42. Jawahir Mohra
43. Jawarish Jalinoos
44. Jawarish Kamooni
45. Jawarish Mastagi
46. Jawarish Tamar Hindi
47. Khamira Gaozaban Sada
48. Khamira Marwareed
49. Kushta Marjan Sada
50. Laooq Katan
51. Laooq Khiyarshanbari
52. Laooq Sapistan
53. Majoon Arad Khurma

81
54. Majoon Dabeedulward
55. Majoon Falasifa
56. Majoon Jograj Gugal
57. Majoon Kundur
58. Majoon Mochras
59. Majoon Muqawwi-e-
Reham
60. Majoon Nankhwah
61. Majoon Panbadana
62. Majoon Piyaz
63. Majoon Seer Alwikhani
64. Majoon Suhag Sonth
65. Majoon Suranjan
66. majoon Ushba
67. Marham Hina
68. Marham Kafoor
69. Marham Kharish
70. Marham Quba
71. Marham Ral Safaid
72. Qurs Aqaqia
73. Qurs Dawaul Shifa
74. Qurs Deedan
75. Qurs Ghafis
76. Qurs Gulnar
77. Qurs Habis
78. Qurs Kafoor
79. Qurs Mulaiyin
80. Qurs Sartan Kafoori
81. Qurs Zaranbad
82. Qurs Ziabetus Khaas
83. Qurs Ziabetus Sada
84. Qurs-e-Afsanteen

82
85. Qurs-e-Sartan
86. Qutoor-e-Ramad
87. Raughan Baiza-e-Murgh
88. Raughan Bars
89. Raughan Kahu
90. Raughan Kamila
91. Raughan Qaranful
92. Raughan Surkh
93. Raughan Turb
94. Roghan Luboob Saba
95. Roghan Malkangni
96. Roghan Qust
97. Safoof Amla
98. Safoof Chutki
99. Safoof Dama Haldiwala
100. Safoof Habis
101. Safoof Muqliyasa
102. Safoof Mustehkam
Dandan
103. Safoof Naushadar
104. Safoof Sailan
105. Safoof Teen
106. Sharbat Anjabar
107. Sharbat Buzoori Motadil
108. Sharbat Faulad
109. Sharbat Khaksi
110. Sharbat Sadar
111. Sharbat Toot Siyah
112. Sharbat Zufa
113. Sunoon Mukhrij-e-
Rutoobat
114. Tiryaq Nazla

83
115. Tiryaq pechish
116. Zuroor-e-Qula

LIST OF SIDDHA MEDICINES FOR CHCs

1. Amai otu parpam -For diarrhoea in children and

indigestion
2. Amukkarac curanam - For general debility, insomnia
3 Anna petic centuram - For anaemia
4. Antat Tailam For febrile convulsions
5. Appirakac centuram - Diabetes mellitus
6. Arakkut Tailam - Headache and sinus infection
7. Arumukac Centuram - Arthritis
8. Atotataik kuti nir - cough and cold
9. Atatotai manappaku cough and cold
10. Atatotai nei cough and wheeze
11. Aya jampirac karpam anaemia
-
12. Aya Kantac centuram aneamia
-
13. Canku parpam - anti allergic
14. Cantamarutac arthritis
Centuram
15. Canta cantirotayam fevers and jaundice
16. Carapunka Vilvati nervine tonic
ilakam
17. Cati Campirak Nausea and vomiting
Kulampu -
18. Cempu Parpam - peptic ulcer
19. Cilacattu Parpam Urinary infection, white discharge
20. Cilntil Curanam Diabetes mellitus
21. Ciropara Nivarana Headache and sinus

84
 Tailam
22. Cirra Muttit Tailam Neuritis, uterine problems
23. Civanar Amirtam Anti-allergic, bronchial asthma
24. Comput Tinir Indigestion, loss of appetite
25. Cukkut Tailam Headache and earache
26. Cuvacakkutori Asthma and cough
mathiral
27. Elatic curanam Allergy, fever in primary complex
28. IIaku Viamuttit Hemiplegia
Tailam
29. Impural IIakam Bleedings
30. Impural Vatakam Blood vomiting
31. Inicic Curanam Indigestion, flatulence
32. Iraca Kanti Meluku Skin infections, venereal infections
33. Iti Vallati Venereal uncer
34. Kaiyan Tailam Cough with expectoration
35. Kantaka Racayanam Skin diseases and urinary infections
36. Kapa Curak Kutinir Fevers
37. Karappan Tailam Eczema
38. Karunai Ilakam Piles
39. Kasturik karuppu Fever, cough, allergic bronchitis
40. Kauri Cintamanic Liver disorders, fever, fistula
Centuram
41. Kecari Ilakam Dropsy, amoebic dysentery
42. Kilanellit Tailam Jaundice, giddiness, neuritis
43. Kilincil Meluku Cracks on the heel and sole
44. Korocanai mattirai Sinus, fits
45. Kunkiliya parpam Urinary infection, white discharge
46. Kunkumappu Mattirai Peptic unlcer, habitual constipation
47. Kunkiliya Vennay External application for piles and scalps
48. Kumak Kutori Peptic ulcer
49. Kuntarikat Tailam Swelling and inflammation

85
50. Man Kompup Parpam Chest pain
51. Manturati Ataik Anaemia
Kutinir
52. Mattan Tailam Ulers, carbuncle and gangrence
53. Matulai Manappaku Nausea, vomiting, anaemia
54. Mayanat Tailam Swelling, inflammation
55. Mayilirakatic Hiccup
Curanam
56. Mekanatak Kulikai Constipation
57. Murukkan Vitai Intestinal worms
Mattirai
58. Muttuc cippi Parpam Diarrhea in children
59. Naciroka Nacat Nasal problems
Tailam
60. Naka Parpam Diuretic
61. Nantukkal Parpam Diuretic
62. Nattai Parpam Bleeding piles
63. Nellikkai Ilakam Tonic
64. Neruncik Kutinir Diuretic
65. Nilavakaic Curanam Constipation
66. Nila Vempuk Kutinir Fever
67. Noccit Tailam Sinus
68. Omat Tinir Indigestion
69. Palacancivi mattirai Fever in children, indigestion
70. Palakarai Parpam Anti-allergic
71. Panca Lavana Parpam Hyper acidity
72. Parankip pattaic Skin diseases
Curanam
73. Paankip Pattai Skin diseases
Iracayanam
74. Parankip Pattaip Skin diseases
Patankam

86
75. Patikara parpam Urinary infection, stomatitis
76. Pattuk karuppu DUB, painful menstruation
77. Pavala Parapam Cough and fever
78. Peranta Parpam No.1 Fits
79. Pinacat tailam Sinus
80. Pirami Ney Nervine tonic
81. Pirammanta pairavam Fevers
82. Punkat Tailam Injury and ulcers
83. Talampu mattirai Toxic fever
84. Talicati Vatakam Cough
85. Tayirc Cuntic Diarrhea, used as ORS
Curanam
86. Terran kottai Ilakam Tonic, used in bleeding piles
87. Tiripalaic Curanam Styptic and tonic
88. Tipplili Iracayanam Cough
89. Uluntut Tailam Musclar atrophy, deafness
90. Vacanta Fever, cough, and cold in child
Kucumakaram
91. Veti Anna Petic Dropsy
Centuram
92. Vilvati Ilakam Tonic
93. Visnu Cakkaram Pleurisy

Patent & Proprietary Drug

1. 777 Oil - for Psoriasis

87
 LIST OF HOMEOPATHY MEDICINES FOR CHCs

S.No Name of Medicine Potency

1 Abrotanum 30
2 Abrotanum 200
3 Absinthium Q
4 Aconite Nap. 6
5 Aconite Nap. 30
6 Aconite Nap. 200
7 Aconite Nap. 1M
8 Actea Racemosa 30
9 Actea Racemosa 200
10 Aesculus Hip 30
11 Aesculus Hip 200
12 Aesculus Hip 1M
13 Agaricus musca. 30
14 Agaricus musca 200
15 Allium cepa 6
16 Allium cepa 30
17 Allium cepa 200
18 Aloe soc. 6
19 Aloe soc. 30
20 Aloe soc. 200
21 Alumina 30
22 Alumina 200
23 Ammon Carb 30
24 Ammon Carb 200
25 Ammon Mur 30
26 Ammon Mur 200
27 Ammon Phos 30

88
28 Ammon phos 200
29 Anacardium Ori. 30
30 Anacardium Ori. 200
31 Anacardium Ori. !M
32 Angustura vera Q
33 Anthracinum 200
34 Anthracinum 1M
35 Antim Crud 30
36 Antim Crud 200
37 Antim Crud !M
39 Antimonium Tart 3X
40 Antimonium Tart 6
41 Antimonium Tart 30
42 Antimonium Tart 200
43 Apis mel 30
44 Apis mel 200
45 Apocynum Can Q
46 Apocynum Can 30
47 Arg. Met 30
48 Arg Met. 200
49 Arg. Nit. 30
50 Arg. Nit. 200
51 Arnica Mont. Q
52 Arnica Mont 30
53 Arnica Mont 200
54 Arnica Mont !M
55 Arsenicum Alb. 6
56 Arsenicum Alb. 30
57 Arsenicum Alb. 200
58 Arsenicum Alb. 1M
59 Aurum Met. 30

89
60 Aurum Met. 200
61 Bacillinum 200
62 Bacillinum 1M
63 Badiaga 30
64 Badiaga 200
65 Baptisia Tinct. Q
66 Baptisia Tinct 30
67 Baryta Carb. 30
68 Baryta Carb. 200
69 Baryta Carb. 1M
70 Baryta Mur. 3X
71 Belladonna 30
72 Belladonna 200
73 Belladonna 1M
74 Bellis Perennis Q
75 Bellis Perennis 30
76 Benzoic Acid 30
77 Benzoic Acid 200
78 Berberis Vulgaris Q
79 Berberis Vulgaris 30
80 Berberis Vulgaris 200
81 Blatta Orientalis Q
82 Blatta Orientalis 30
83 Blumea Odorata Q
84 Borax 30
85 Bovista 30
86 Bromium 30
87 Bryonia Alba 3X
88 Bryonia Alba 6
89 Bryonia Alba 30
90 Bryonia Alba 200

90
91 Bryonia Alba 1M
92 Bufo rana 30
93 Carbo veg 30
94 Carbo veg 200
95 Cactus G. Q
96 Cactus G. 30
97 Calcarea Carb 30
98 Calcarea Carb 200
99 Calcarea Carb 1M
100 Calcarea Fluor 30
101 Calcarea Fluor 200
102 Calcarea Fluor 1M
103 Calcarea Phos 30
104 Calcarea Phos 200
105 Calcarea Phos 1M
106 Calendula Off. Q
107 Calendula Off 30
108 Calendula Off 200
109 Camphora 6
110 Camphora 200
111 Cannabis Indica 6
112 Cannabis Indica 30
113 Cantharis Q
114 Cantharis 30
115 Cantharis 200
116 Capsicum 30
117 Capsicum 200
118 Carbo Animalis 30
119 Carbo Animalis 200
120 Carbolic Acid 30
121 Carbolic Acid 200

91
122 Carduus Mar Q
123 Carduus Mar 6
124 Carduus Mar 30
125 Carcinosinum 200
126 Carcinosinum !M
127 Cassia sophera Q
128 Caulophyllum 30
129 Caulophyllum 200
130 Causticum 30
131 Causticum 200
132 Causticum !M
133 Cedron 30
134 Cedron 200
135 Cephalendra Indica Q
136 Chamomilla 6
137 Chamomilla 30
138 Chamomilla 200
139 Chamomilla !M
140 Chelidonium Q
141 Chelidonium 30
142 Chin Off. Q
143 Chin Off 6
144 Chin Off 30
145 Chin Off 200
146 Chininum Ars 3X
147 Chininum Sulph 6
148 Cicuta Virosa 30
149 Cicuta Virosa 200
150 Cina Q
151 Cina 3X
152 Cina 6

92
153 Cina 30
154 Cina 200
155 Coca 200
156 Cocculus Indicus 6
157 Cocculus Indicus 30
158 Coffea Cruda 30
159 Coffea Cruda 200
160 Colchicum 30
161 Colchicum 200
162 Colocynthis 6
163 Colocynthis 30
164 Colocynthis 200
165 Crataegus Oxy Q
166 Crataegus Oxy 3X
167 Crataegus Oxy 30
168 Crataegus Oxy 200
169 Crotalus Horridus 200
170 Croton Tig. 6
171 Croton Tig. 30
172 Condurango 30
173 Condurango 200
174 Cuprum met. 30
175 Cuprum met. 200
176 Cynodon Dactylon Q
177 Cynodon Dactylon 3X
178 Cynodon Dactylon 30
179 Digitalis Q
180 Digitalis 30
181 Digitalis 200
182 Dioscorea 30
183 Dioscorea 200

93
184 Diphtherinum 200
185 Drosera 30
186 Drosera 200
187 Dulcamara 30
188 Dulcamara 200
189 Echinacea Q
190 Echinacea 30
191 Equisetum 30
192 Equisetum 200
193 Eupatorium Perf. 3X
194 Eupatorium Perf. 30
195 Eupatorium Perf. 200
196 Euphrasia Q
197 Euphrasia 30
198 Euphrasia 200
199 Ferrum Met. 200
200 Flouric Acid 200
201 Formica Rufa 6
202 Formica Rufa 30
203 Gelsimium 3X
204 Gelsimium 6
205 Gelsimium 30
206 Gelsimium 200
207 Gelsimium 1M
208 Gentiana Chirata 6
209 Glonoine 30
210 Glonoine 200
211 Graphites 30
212 Graphites 200
213 Graphites 1M
214 Guaiacum 6

94
215 Guaiacum 200
216 Hamamelis Vir Q
217 Hamamelis Vir 6
218 Hamamelis Vir 200
219 Helleborus 6
220 Helleborus 30
221 Hepar Sulph 6
222 Hepar Sulph 30
223 Hepar Sulph 200
224 Hepar Sulph 1M
225 Hippozaenium 6
226 Hydrastis Q
227 Hydrocotyle As. Q
228 Hydrocotyle As. 3X
229 Hyocyamus 200
230 Hypericum Q
231 Hypericum 30
232 Hypericum 200
233 Hypericum 1m
234 Ignatia 30
235 Ignatia 200
236 Ignatia 1m
237 Iodium 30
238 Iodium 200
239 Iodium 1m
240 Ipecacuanha Q
241 Ipecacuanha 3X
242 Ipecacuanha 6
243 Ipecacuanha 30
244 Ipecacuanha 200
245 Iris Tenax 6

95
246 Iris Veriscolor 30
247 Iris Veriscolor 200
248 Jonosia Ashoka Q
249 Justicia Adhatoda Q
250 Kali Bromatum 3X
251 Kali Carb 30
252 Kali Carb 200
253 Kali Carb 1M
254 Kali Cyanatum 30
255 Kali Cyanatum 200
256 Kali lod 30
257 Kali lopd 200
258 Kali Mur 30
259 Kali Mur 200
260 Kal Sulph 30
261 Kalmia Latifolium 30
262 Kalmia Latifolium 200
263 Kalmia Latifolium 1M
264 Kreosotum Q
265 Kreosotum 30
266 Kreosotum 200
267 Lae Defloratum 30
268 Lae Defloratum 200
269 Lac Defloratum 1M
270 Lac Can 30
271 Lac Can 200
272 Lachesis 30
273 Lachesis 200
274 Lachesis 1M
275 Lapis Albus 3X
276 Lapis Albus 30

96
277 Ledum Pal 30
278 Ledum Pal 200
279 Ledum Pal 1M
280 Lillium Tig. 30
281 Lillium Tig. 200
282 Lillium Tig. 1M
283 Lobella inflata Q
284 Lobella inflata 30
285 Lycopodium 30
286 Lycopodium 200
287 Lycopodium 1M
288 Lyssin 200
289 Lyssin 1M
290 Mag.Carb 30
291 Mag.Carb 200
292 Mag Phos 30
293 Mag Phos 200
294 Mag Phos 1M
295 Medorrhinum 200
296 Medorrhinum 1M
297 Merc Cor 6
298 Merc Cor 30
299 Merc Cor 200
300 Merc Sol 6
301 Merc Sol 30
302 Merc Sol 200
303 Merc Sol 1m
304 Mezerium 30
305 Mezerium 200
306 Millefolium Q
307 Millefolium 30

97
308 Muriatic Acid 30
309 Muriatic Acid 200
310 Murex 30
311 Murex 200
312 Mygale 30
313 Naja Tri 30
314 Naja Tri 200
315 Natrum Ars 30
316 Natrum Ars 200
317 Natrum Carb 30
318 Natrum Carb 200
319 Natrum Carb 1M
320 Natrum Mur 6
321 Natrum Mur 30
322 Natrum Mur 200
323 Natrum Mur 1M
324 Natrum Phos 30
325 Natrum Sulph 30
326 Natrum Sulph 200
327 Natrum Sulph 1M
328 Nitric Acid 30
329 Nitric Acid 200
330 Nitric Acid 1M
331 Nux Vomica 6
332 Nux Vomica 30
333 Nux Vomica 200
334 Nux Vomica 1M
335 Nyctenthus Arbor Q
336 Ocimum Sanctum Q
337 Oleander 6
338 Petroleum 30

98
339 Petroleum 200
340 Petroleum 1M
341 Phosphoric Acid Q
342 Phosphoric Acid 30
343 Phosphoric Acid 200
344 Phosphoric Acid 1M
345 Phosphorus 30
346 Phosphorus 200
347 Phosphorus 1M
348 Physostigma 30
349 Physostigma 200
350 Plantago Major Q
351 Plantago Major 6
352 Plantago Major 30
353 Platina 200
354 Platina 1M
355 Plumbum Met 200
356 Plumbum Met 1M
357 Podophyllum 6
358 Podophyllum 30
359 Podophyllum 200
360 Prunus Spinosa 6
361 Psorinum 200
362 Psorinum 1M
363 Pulsatilla 30
364 Pulsatilla 200
365 Pulsatilla 1M
366 Pyrogenium 200
367 Pyrogenium 1M
368 Ranunculus bulbosus 30
369 Ranunculus bulbosus 200

99
370 Ranunculus repens 6
371 Ranunculus repens 30
372 Ratanhia 6
373 Ratanhia 30
374 Rauwolfia serpentina Q
375 Rauwolfia serpentina 6
376 Rauwolfia serpentina 30
377 Rhododendron 30
378 Rhododendron 200
379 Rhus tox 3X
380 Rhus tox 6
381 Rhus tox 30
382 Rhus tox 200
383 Rhus tox 1M
384 Robinia 6
385 Robinia 30
386 Rumex crispus 6
387 Rumex crispus 30
388 Ruta gr 30
389 Ruta gr 200
390 Sabal serreulata Q
391 Sabal serreulata 6
392 Sabina 3X
393 Sabina 6
394 Sabina 30
395 Sang.can 30
396 Sang.can 200
397 Sarsaprilla 6
398 Sarsaprilla 30
399 Secalecor 30
400 Secalecor 200

100
401 Selenium 30
402 Selenium 200
403 Senecio aureus 6
404 Sepia 30
405 Sepia 200
406 Sepia 1M
407 Silicea 30
408 Silicea 200
409 Silicea 1M
410 Spigellia 30
411 Spongia tosta 6
412 Spongia tosta 30
413 Spongia tosta 200
414 Stannum 30
415 Stannum 200
416 Staphisagria 30
417 Staphisagria 200
418 Staphisagria 1M
419 Sticta pulmonaria 6
420 Sticta pulmonaria 30
421 Stramonium 30
422 Stramonium 200
423 Sulphur 30
424 Sulphur 200
425 Sulphur 1M
426 Sulphuric acid 6
427 Sulphuric acid 30
428 Syphilinum 200
429 Syphilinum 1M
430 Tabacum 30
431 Tabacum 200

101
432 Tarentula cubensis 6
433 Tarentula cubensis 30
434 Tellurium 6
435 Tellurium 30
436 Terebinthina 6
437 Terebinthina 30
438 Terminalia arjuna Q
439 Terminalia arjuna 3X
440 Terminalia arjuna 6
441 Thuja occidentalis Q
442 Thuja occidentalis 30
443 Thuja occidentalis 200
444 Thuja occidentalis 1M
445 Thyroidinum 200
446 Thyroidinum 1M
447 Tuberculinum bov 200
448 Uran.Nit 3X
449 Urtica urens Q
450 Urtica urens 6
451 Ustilago 6
452 Verat alb 6
453 Viburnan opulus 6
454 Viburnan opulus 30
455 Viburnan opulus 200
456 Vipera tor 200
457 Vipera tor 1M
458 Verat viride 30
459 Verat viride 200
460 Viscum album 6
461 Wyethia 6
462 Wyethia 30

102
463 Wyethia 200
464 Zinc met 200
465 Zinc met 1M
466 Zink phos 200
467 Zink phos 1M
468 Globules 20 no.
469 Sugar of milk
470 Glass Piles 5 ml
471 Glass Piles 10 ml
472 Butter Paper
473 Blank Sticker Ointments 1/2*3/2 inch
474 Aesculus Hip
475 Arnica
476 Calendula
477 Cantharis
478 Hamamelis Vir
479 Rhus tox
480 Twelve Biochemic Medicines 6x & 12x
481 Cineraria Eye Drop
482 Euphrasia Eye Drop
483 Mullein Oil ( Ear Drop )

103
 Annexure 11

Extracts from National Guidelines on Blood Storage Facilities at FRUs

1. Requirements
Space: The area required for setting up the facility is only 10 square meters, well-lighted, clean
and preferably air-conditioned.

Manpower: One of the existing doctors and technicians should be designated for this purpose.
They should be trained in the operation of blood storage centers and other basic procedures like
storage, grouping, cross- matching and release of blood.

The medical officer designated for this purpose will be responsible for overall working of the
storage center.

Electricity: 24 hours supply is essential. Provision of back-up generator is required.

Equipment: Each FRU should have the following:

1. Blood bag refrigerators having a storage capacity of 50 units of blood.

2. Deep freezers for freezing ice packs required for transportation. The deep freezers available
in the FRUs under the Immunization Programme can be utilized for this purpose.
3. Insulated carrier boxes with ice packs for maintaining the cold chain during transportation of
blood bags.
4. Microscope and centrifuge: since these are an integral part of any existing laboratory,
these would already be available at the FRUs. These should be supplied only if they
are not already available.

Consumables: There should be adequate provision for consumables and blood grouping
reagents. The following quantities would suffice the annual requirement of an FRU with up to
50 beds.

Consumables Quantity:
Pasteur pipette 12 dozens / year

104
Glass tubes 7.5 to 10 mm - 100 dozens / year
Glass slides 1" x 2" boxes of 20 or 25 each / year
Test tube racks 6 racks, each for 24 tables
Rubber teats 6 dozens / year
Gloves Disposable rubber gloves 500 pairs per year

Blotting tissue paper As required Marker pencil ( alcohol based) As required

Tooth picks As required
Reagents: All the reagents should come from the Mother Blood Bank.
Anti-A 2-vials each per month
Anti-B 2-vials each per month
Anti-AB 2-vials each per month
Anti-D (Blend of IgM & IgG) 2 vials each per month
Antihuman Globulin 1 vial per month
(Polyclonal IgG & Complement)

Since quality of the reagents is an important issue, the supplies of these should be made from the
same blood bank/center from where blood is obtained. For this purpose, State
Governments/Union Territories should provide the additional budgetary requirements to the
mother blood bank/center.

Disinfectants: Bleach & Hypochlorite Solution - As required

2. Suggested quantities of Whole Blood Units to he available at a Blood Storage Unit

5 units each of A, B, O (Positive)

2 units of AB (Positive)
1 units each of A, B & O (Negative)
This can be modified according to the actual requirement

105
3. Storage & transportation

Cold chain: It is necessary to maintain the cold chain at all levels i.e. from the mother center to
the blood storage center to the issue of blood. This can be achieved by using insulated carrier
boxes. During transportation, the blood should be properly packed into cold boxes surrounded
by the ice packs. Ice, if used should be clean and should not come in direct contact with the
blood bags. The blood should be kept in blood bank refrigerator at 4°-6°c ± 2°c. The
temperature of the blood should be monitored continuously.

Storage: The storage center should check the condition of blood on receipt from the mother
center and also during the period of storage. The responsibility of any problem arising from
storage, cross matching, issue and transfusion will be of the storage center. Any unit of blood
showing hemolysis, turbidity or change in colour should not be taken on stock for transfusion.
Due care should be taken to maintain sterility of blood by keeping all storage areas clean. The
expiry of the blood is normally 35/42 days depending on the type of blood bags used. The
Medical Officer in-charge should ensure that unused blood bags should be returned to the
mother center at least 10 days before the expiry of the blood and fresh blood obtained in its
place. The blood storage centers are designed to ensure rapid and safe delivery cf whole blood in
an emergency. The detail of storage of packed cells, fresh frozen plasma and platelets
concentrate are therefore not given in these guidelines. In case, however, these are required to be
stored, the storage procedures of the mother blood bank should be followed.

4. Issue of blood s

Patients blood grouping and cross matching should invariably be carried out before issue of
blood. A proper record of this should be kept.

First In and First Out (FIFO) policy, whereby blood closer to expiry date is used first, should be
followed.

106
5. Disposal

Since all the blood bags will already be tested by the mother center, disposal of empty blood
bags should be done by landfill. Gloves should be cut and put in bleach for at least one hour and
then disposed as normal waste.

6. Documentation & records

The center should maintain proper records for procurement, cross matching and issue of blood
and blood components. These records should be kept for at least 5 years.

7. Training

Training of doctors and technicians, who will be responsible for the Blood Storage Center,
should be carried out for 3 days in an identified center as per the guidelines. Training will
include:
Pre-transfusion checking. i.e. patient identity and grouping
Cross matching
Compatibility
Problems in grouping and cross matching
Troubleshooting
Issue of blood
Transfusion reactions and its management
Disposal of blood bags

The states will have to identify the institutions where training of the staff responsible for running
the blood bank is to be held. These could be the blood banks at Medical Colleges, Regional
Blood Banks, Indian Red Cross Blood Banks, or any other well setup, licensed Blood Bank,
provided they have the necessary infrastructure for undertaking training.

The training will be for three-days duration during which the Medical Officer and the technician
from the identified FRUs will be posted at the training institution.

107
A "Standard Operating Procedures Manual" (SOPM) has been developed and is part of these
guidelines. This SOPM will be used as the training material. A copy of this SOPM will be made
available to the Medical Officer for use in his Blood Storage Center for undertaking storage,
grouping, cross matching and transfusion.

In addition to the training of the above Medical Staff, it is considered necessary that the
clinicians who will be responsible for prescribing the use of blood are also sensitized on the
various parameters of blood transfusion. For this the "Clinician'
s Guide to Appropriate Use of
Blood" has been developed. It is suggested that one-day sensitization programme for the
clinicians may be organized at the District Hospital/Medical College.

Government of India will make the expenditure for the above-mentioned trainings, available as
per the norms of training under the RCH Programme. This training will, however, be
coordinated by the Training Division of Department of Family Welfare. The states are required
to include training as part of the overall State Action Plan for establishing Blood Storage
Centers.

Equipments for Laboratory Tests & Blood Transfusion

Rod, flint-glass, 1000 x 10 mm dia, set of two 2

Cylinder, measuring, graduated W/pouring lip, glass, 50 ml 2
Bottle, wash, polyethylene W/angled delivery tube, 250 ml 1
Timer, clock, interval, spring wound, 60 minutes x 1 minute 1
Rack, slide drying nickel/silver, 30 slide capacity 1
Tray, staining, stainless steel 450 x 350 x 25 mm 1
Chamber, counting, glass, double neubauer ruling 2
Pipette, serological glass, 0.05 ml x 0.0125 ml 6
Pipette, serological glass, 1.0 ml x 0.10 ml 6
Counter, differential, blood cells, 6 unit 1
Centrifuge, micro-hematocrit, 6 tubes, 240v 1
Cover glass for counting chamber (item 7), Box of 12 1
Tube, capillary, heparinized, 75 mm x 1.5 mm, vial of 100 10
Lamp, spirit W/screw cap. Metal 60 ml 1

108
Lancet, blood (Hadgedorn needle) 75 mm pack of 10 ss 10
Benedict'
s reagent qualitative dry components for soln 1
Pipette measuring glass, set of two sizes 10 ml, 20 ml 2
Test tube, w/o rim, heat resistant glass, 100 x 13 mm 24
Clamp, test-tube, nickel plated spring wire, standard type 3
Beaker, HRG glass, low form, set of two sizes, 50 ml, 150 ml 2
Rack, test-tube wooden with 12 x 22 mm dia holes 1

109
 Annexure - 12
LIST OF DIAGNOSTIC SERVICES
S. No. Speciality Diagnostic Services / Tests

I. CLINICAL PATHOLOGY

a) Haematology
Haemoglobin estimation
Total Leucocyte count
Differential Leucocyte count
Absolute Eosinophil count
Reticulocyte count
Total RBC count
E.S.R.
Peripheral Blood Smear
Malaria/Filaria Parasite
Platelet count
Packed Cell volume
Blood grouping
Rh typing
Blood Cross matching
b) Urine Analysis Urine for Albumin, Sugar, Deposits, bile salts, bile pigments,
acetone, specific gravity, Reaction (pH)
c) Stool Analysis Stool for Ovacyst (Eh)
Hanging drop for V. Cholera
Occult blood
II. PATHOLOGY
a) Sputum Sputum cytology

110
 S. No. Speciality Diagnostic Services / Tests

III. MICROBIOLOGY Smear for AFB, KLB

Grams Stain for Throat swab, sputum etc.

IV. SEROLOGY VDRL
Pregnancy test (Urine gravindex)
WIDAL test
V. BIOCHEMISTRY Blood Sugar
Blood urea
Liver function tests
Kidney function tests
Blood lipid profile

VI. CARDIAC INVESTIGATIONS a) ECG

VII. OPHTHALMOLOGY a) Refraction by using Snellen'
s chart
Retinoscopy
Ophthalmoscopy

IX. RADIOLOGY a) Xray for Chest, Skull, Spine, Abdomen, bones

e) Dental Xray
f) Ultrasonography

(b) Physical Structure for Laboratory at CHC

S.No. Item No. at CHC level

1 Marble/Stone Table Top for Platform 1

2 Wash-basins (Steel/Porcelain) 1
3 Water Taps 1
4 Electric Fittings As per requirement

111
 5 Office Table 1
6 Office Chairs 3
7 Revolving Stools 2
8 Almirah (Steel/Wooden) 1
9 Wooden/Steel Racks 1

(c) Laboratory Equipment

Equipments
1 Binocular Microscope with oil immersion
2. Lancet
3. Ice box
4 Stool transport carrier
5. Test tube rack
6. Table top centrifuge
7. Refrigerator
8. Spirit lamp
9. Smear transporting box
10. Sterile leak proof containers

(d) Laboratory Supplies

Supplies

1. Clean slides

2. Slide markers
3. Gloves
4. Transport medium (Cary Blair)
5. Sterile test tubes
6. Plastic vials
7. Sterile cotton wool swabs
8. Rapid Diagnostic Kit Typhoid
9. Rapid test kit for faecal contamination
10. Blood culture bottles with broth

112
11. Zeil Neelsen Acid fast stain
12. Aluminium Foil
13. Cotton
14. Sealing material
15. Extra plastic vials for

113
 Annexure 13

Model Citizens Charter for CHCs

1. Preamble

Community Health Centres and Primary Health Centres exist to provide health care to
every citizen of India within the allocated resources and available facilities. The Charter seeks to
provide a framework which enables citizens to know.

What services are available.

The quality of services they are entitled to.
The means through which complaints regarding denial or poor qualities of services will be
addressed.

2. Objectives

To make available medical treatment and the related facilities for citizens.
To provide appropriate advice, treatment and support that would help to cure the ailment to
the extent medically possible.
To ensure that treatment is best on well considered judgment, is timely and comprehensive
and with the consent of the citizen being treated.
To ensure you just awareness of the nature of the ailment, progress of treatment, duration of
treatment and impact on their health and lives, and
To redress any grievances in this regard.

3. Commitments of the Charter

To provide access to available facilities without discrimination,

To provide emergency care, if needed on reaching the CHC/ PHC
To provide adequate number of notice boards detailing the location of all the facilities.

114
 To provide written information on diagnosis, treatment being administered.
To record complaints and designate appropriate officer, who will respond at an appointed
time that may be same day in case of inpatients and the next day in case of out patients.

4. Component of service at CHCs.

Access to CHCs and professional medical care to all

Making provision for emergency care after main treatment hour whenever needed

Informing users about available facilities, costs involved and requirements expected of them
with regard to the treatment in clear and simple terms.
Informing users of equipment out of order
Ensuring that users can seek clarifications and assistance in making use of medical treatment
and CHC facility.
Informing users about procedures for reporting in-efficiencies in services or nonavailability
of facilities.

5. Grievance redressal

Grievances that citizens have will be recorded

There will be a designated officer to respond to the request deemed urgent by the person
recording the grievance
Aggrieved user after his/her complaint recorded would be allowed to seek a second opinion
within the CHC
To have a public grievance committee outside the CHC to deal with the grievances that are
not resolved within the CHC.

6. Responsibilities of the users

Users of CHC would attempt to understand the commitments made in the charter
User would not insist on service above the standard set in the charter because it could
negatively affect the provision of the minimum acceptable level of service to another user.

115
 Instruction of the CHC'
s personnel would be followed sincerely, and
In case of grievances, the redressal mechanism machinery would be addressed by users
without delay.

7. Performance audit and review of the charter

Performance audit may be conducted through a peer review every two or three years after
covering the areas where the standards have been specified

116
 Annexure 14

List of Abbreviations

ANM : Auxiliary Nurse Midwife

ASHA : Accredited Social Health Activists
BCC : Behaviour Change Communication
CHC : Community Health Centres
CSSD : Central Sterile and Supply Department
CSSM : Child Survival and Safe Motherhood
DOT : Direct Observed Treatment
DTC : District Tuberculosis Centre
FRU : First Referral Unit
IEC : Information, Education and Communication
Inj : Injection
IPHS : Indian Public Health Standards
IUCD : Intra-urine Contraceptive Devise
JE : Japanese Encephalitis
LTs : Laboratory Technicians
MC : Microscopic Centre
MIS : Management Information System
MO : Medical Officer
MPWs : Multi Purpose Workers
NAMP : National Anti Malaria Program
NLEP : National Leprosy Eradication Program
NRHM : National Rural Health Mission
NHP : National Health Program
NVBDCP : National Vector Borne Disease Control Program
OT : Operation Theatre
PHC : Primary Health Centre
PPTCT : Prevention of Parent to Child Transmission
PRI : Panchayati Raj Institution
117
RCH : Reproductive & Child Health
RNTCP : Revised National Tuberculosis Control Program
RTI / STI : Reproductive Tract Infections / Sexual Tract
Infections
SOPs : Standard Operating Procedures
STPs : Standard Treatment Protocols
STLS : Senior Tuberculosis Laboratory Supervisor
ICTC : Integrated counselling and testing centre

118
 REFERENCES

1. National Rural Health Mission 2005-2012 – Reference Material (2005), Ministry of

Health & Family Welfare, Government of India.

2. Bulletin on Rural Health Statistics in India (2005), Infrastructure Division,

Department of Family Welfare; Ministry of Health & Family Welfare, Government
of India.

3. Guidelines for Operationalising 24x7 PHC (2005) (unpublished), Maternal Health

Division, Department of Family Welfare, Ministry of Health & Family Welfare,
Government of India.

4. Guidelines for Ante-Natal Care and Skilled Attendance at Birth by ANMs and
LHVs (2005), Maternal Health Division, Department of Family Welfare, Ministry of
Health & Family Welfare, Government of India.

5. RCH Phase II, National Program Implementation Plan (PIP) (2005), Ministry of
Health & Family Welfare, Government of India.

6. Guidelines for Setting up of Rogi Kalyan Samiti / Hospital Management Committee

(2005) (unpublished), Ministry of Health & Family Welfare, Government of India.

7. Indian Standard: Basic Requirements for Hospital Planning , Part-1 up to 30

Bedded Hospital, IS: 12433 (Part 1)-1988, Bureau of Indian Standards, New Delhi

8. Indian Public Health Standards (IPHS) for Community Health Centre (April 2005),
Directorate General of Health Services, Ministry of Health & Family Welfare,
Government of India.

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120