Essential community health service

MEANING
 A essential basic health service is
understood to be a network of coordinated,
peripheral and intermediate health units
capable of performing effectively a selected
group of function essential to the health of
an area and assuring the availability of
completed professional and auxillary
personnel to perform these functions.

Purpose
 To improve the health status of the
population and environment.

BROAD AGREEMENT THAT
HEALTH SERVICES SHOULD
BE
A. COMPREHENSIVE
B. ACCESSIBLE
C. ACCEPTABLE
D. PROVIDE SCOPE FOR COMMUNITY
PARTICIPATION
E. AVAILABLE AT A COST THE
COMMUNITYAND COUNTRY CAN
AFFORD

GOAL
 To reduce the mortality and morbidity
 To increase in expectation of life
 To decrease the population growth rate
 To improve the nutritional status
 To provide basic sanitation
 To workout adequate trained manpower requirements in
various dept.
 To provide adequate support in resources development
 -agriculture
 -food production
 -literacy rate
 -housing/shelter
 -small scale industry for economic development etc.

HEALTH CARE SERVICES AT
COMMUNITY LEVEL
 1. PUBLIC HEALTH SERVICES
 2.PRIVATE SECTORS
 3.INDEGENEOUS SYSTEM OF
MEDICINE
 4.VOLUNTARY HEALTH AGENCIES
 5. NATIONAL HEALTH PROGRAM
 6. INTERNATIONAL HEALTH
AGENCIES SERVICES.

SUGGESTED NORMS FOR
HEALTH PERSONNEL

MANPOWER AT PRESENTLY
WORKING IN COMMUNITY
SET UP

ESSENTIAL AREA FOCUS AT
COMMUNITY SERVICES
 1. COMMUNICABLE DISEASE
 2. NON COMMUNICABLE DISEASES
 3. NUTRITIONAL PROBLEMS
 4.MATERNALAND CHILD HEALTH
SERVICES
 5.POPULATION STABILIZATION
 6. ENVIRONMENTAL SANITATION
 7.CHILD HEALTH SERVICE

continued
8. FAMILY PLANNING/CONTRACEPTION/
COUNSELLING SERVICE
9. ADOLESCENT HEALTH SERVICE
10.HEALTHPROMOTION/MAINTANANCE/SCREENING/PRIMODIA
L PREVENTION
11.TEACHING/TRAINNING/CONTINUING /INSERVICE
EDUCATION
12.CO-ORDINATION SERVICES WITH OTHER AGENCY
13.DISEASESURVEY/SURVEILLANCE/MONITORING/
IMPLEMENTATION/FOLLOWUP/NEWPOLICY/REASSESSMENT
14.PROMOTION OF AYUSH SERVICES AT COMMUNITY

continued
 15.RECORDS AND REPORTS OF VITAL
EVENTS
 16.CO-ORDINATION AND MONOTORING
THE SERVICES OF HEALTH WORKERS
 17.OUT-REACH AND FILED SERVICES
 18.REFERRAL SERVICES.
 19.BASIC LABORATORY SERVICES
 20 NATIONAL HEALTH SCHEME
AWARENESS PROGRAM.

COMMUNICABLE
DISEASES
 ESSENTIOAL SERVICES:
 Survey periodically
 Early identification, diagnosis and treatment
 Counseling and follow-up
 Referral services
 Health promotion
 IEC services for prevention
 Health education

NON COMMUNICABLE
DISEASES
ESSENTIAL SERVICES:
 Detections of high risk cases early through
survey.
 Promote healthy life style
 Diagnosis, management and referral service
 Follow-up services.
 Counseling
 IEC activities /health education/awareness
program.
 Statistical reports based on the condition

MCH SERVICES
ESSENTIAL SERVICES:
 ANTENATAL SERVICES:
 Early registration
 Minimum 4 ANC visit
 Immunization
 Basic laboratory test /general examination
 Detect the high risk mothers as early
 Appropriate referral services tie-up
 Personal hygiene/diet/rest/sexual life/care
 Counseling for FP/identify suspected STD/RTI
 Vital statistical

INTRA NATAL SERVICES
ESSENTIAL SERVICES:
 Promotion of institutional services
 Skilled attendant at home deliveries when called for
 Appropriate and timely referral services for high risk
cases.
 Managing the labour with using of partograph
 Identification and management of danger sign during
labour
 Proficient first aid treatment for PPH
 Safe delivery/equipment/hands/environment/birth
canal
 Breast feeding within 30 minutes initiazation

POST NATAL SERVICES
 ESSENTIAL SERVICES:
 Exclusive breast Feeding
 Post natal home visit(3,7,42 day)
 Incase of LBW visit to be(14,21,28th day)
 Immunization continue
 Care of mother/baby/ in perineum observation of lochia /care of
breast
 Examination of newborn for sign of sickness/congenital
abnormalities as IMNCI guidelines.
 Counseling on
diet/rest/hygiene/contraception/feeding/sign/symptom of
RTI/STD/HIV/AIDS
 Tracking of missed and left PNC cases
 documentation

CHILD HEALTH SERVICES
 New born care(temperature/KMC/maintain
airway/breathing/initiate BF/infection protection/personal
care/card care as per guidelines
 Counseling of EBF up-to 6 months
 Complementary feeding including BF till 2 years
 Assess the growth and development
 Immunization services
 Vitamin A prophylaxis till 5years
 Prevention and control of childhood disease.
 Indentification of high risk cases/referral /documentation

ADOLESCENT HEALTH
SERVICES
 ESENTIAL SERVICES:
 Adolescent friendly clinic for 2 hours once a week on a fixed day.
 Provide comprehensive care(promotive,preventive,curative and
referral services)
 Information regarding change in reproductives health ,counseling,
 Services related sexual
concerns,pregnancy,contraceptions,abortion,menstrual problems,
 Services for tetanus immunization
 Nutritional counselling for prevention of anemia.
 Prevention and control ,screening about RTI/STD management
 Referral services for VCTC and PPTCT
 OUT REACH SERVICES:
 Periodic health checkup and health education activities.
 National health program awareness,drugs,alcohol,substance abuse etc
 Encourage the co-curricular activities.

FAMILY
PLANNING/POPULATION
STABILIZATION
ESSENTIAL SERVICES:
 Full range of family planning services including
IEC,counseling,provision of adequate supply of
contraceptives etc
 Permanent family planning method as per
family norms completed(NSV/laboroscopy
sterilization and follow up services,incentives)
 Safe abortion services
 Avoid unwanted pregnancy
 Health education/awareness program
 documentation

ENVIRONMENTAL
SANITATION
 Basic water facilities/quality monitoring/adequate supply
 Drainage facilities
 Precaution for local endemic disease
 Housing facilities
 Road facilities/electricity /transportation/communication etc
 Recreational facilities like park, sport,play ground,telecast
,news paper etc.
 Spiritual facilities like temple/majid/church/sikkim etc
 Facilities for domestic animals/pet animals/street animals
 Polluted free environment
 Make green environment/sapling tree/agriculture forming etc

NUTRIONAL SERVICES
 Prepare the type of dietary pattern
 Select always fruits, vegetables fresh /seasonal base .
 Cook always iron base utensil
 Take always balnced diet(protein,CHO,fat,vitamin,
minerals equal)
 Take adequate water 2500 ml/day
 Avoid fast food /more fatty food /preservatives food
 Screening for nutritional problems periodically.
 Better to take germination food like sprout gram

SCHOOL HEALTH
SERVICES:
 Screening for general health assessment of
anemia/nutritional status/visual acuity/hearing /dental
checkup/physical disabilities/learning
disorder/behavioural problems etc
 Screening for communicable /non
communicable/endemic/skin diseases
 Treatment for minor ailments
 Immunizationa as per period/schedules
 Provide midday meals /supplementary nutrition/special
micronutrients
 Provide prophylaxis for filaria/malria/worm infestation.

OCCUPATIONAL HEALTH
SERVICES
 Nutritional services(canteen facilities,balanced diet at low cost )
 Control of communicable diseases measures(early
diagnosis,treatment,prevention and rehabilitation)
 Evnironmental sanitation measures(water ,food,toilet ,general plant
cleanliness,sufficient space,lighting,ventilation,work safety
measure,residence facilities )etc
 Mental health measure(promote health/happiness,reduce the
stress/emotion,screen the mental health illness,
counseling,rehabilitation,follow-up )
 Measure for women and children(maternity leave,MCH
services,creches , sickness leave ,no child can work under14 yrs )
 Health education
 Family planning method to be adopted for small family norm.

NURSING EDUCATION
 ANM
 GNM
 B.SC
 P.B.SC
 M.SC
 PH.D
 BRIDGE COURSE IN ALL PROGRAM
 SKILLED TRANNING FOR ASHA, USHA,
DAI,SBA/TBA ETC.

TRAINING PROGRAM
 Exclusive community area to post like
 Urban area
 Rural area
 Health centre
 Industrial area
 Rehabilitation centre.
 Old age home
 Maternity centre
 Proper trainning material
 Proper trainning faculty
 Proper return demonstration/simulation and
performance skills assessment
 Proper evaluation system

COMMUNITY SERVICES
 Follow proper guidelines like
WHO,CDC,MOH&FW,GOI in clinical
service.
 Daily inventory/demand/stockout/essential
things adequate supply
 Assessment
 Implementation to public health service
 Policy review as per guidelines
 Maintaining of records/report to submission

Health education to community
service
 Sanitation
 Personal hygiene
 Environmental sanitation
 Economic development
 Primary/secondary/higher education as
needed
 Rest
 Proper sleep
 Balanced diet

CONTINUED
 Medication/spiritual practice
 Screening for communicable/non
communicable/hereditary/congenital/genital
defect etc
 Recreational facilities
 Vaccination/Immunization
 Work safety
 Personal safety
 Public awareness about the
pandemic/endemic/epidemic diseases

COMMUNITY RESEARCH
 THE STEPS TO IMPLEMENTATION MIGHT
BE
 Assemble a broad-based, inclusive, participatory
coalition or coordinating council to guide the CHIP
process, if one does not already exist.
 Do your research.
 Identify the issue(s) you’re going to work on, if you
haven’t started with a specific issue in mind.
 Analyze the issue(s) carefully.
 Take stock of potential resources, particularly those
already available in the community.

CONTINUED
 Develop a strategic plan and action plans to
carry it out.
 Agree on who will be accountable for which
parts of the plan.
 Work out how accountability will be monitored.
 Implement your strategy.
 Monitor both the process and the outcomes of
your effort.
 Maintain your gains.
 Start the cycle again, with another issue.

Summary
 We discussed the essential community
services like meaning.goal,purpose,area
,manpower,norm,tranning,teaching,rese
arch,policy,implementation,achievement
and reassessment in health services of
individual, family , community and
society.

conclusion
 Till now we discussed essential
community health services in health
care delivery system. I hope you all can
perform essential community services to
the society with help of this knowledges
in present and future.

Essential community health service

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Essential community health service