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Delivery of Community Health Services - Anand Ync

The document discusses urban health services in India. It notes that over 377 million people live in urban areas in India, including 97 million living in urban poverty. It outlines the health challenges facing urban poor populations, including those living in slums. It then describes the various levels of India's urban health system, including health posts and urban primary health centers that provide primary care services to slum communities, as well as urban family welfare centers and specialty clinics that offer other services. Community health workers called USHAs and community groups called Mahila Arogya Samities are involved in healthcare delivery and health promotion in slum areas.

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233 views37 pages

Delivery of Community Health Services - Anand Ync

The document discusses urban health services in India. It notes that over 377 million people live in urban areas in India, including 97 million living in urban poverty. It outlines the health challenges facing urban poor populations, including those living in slums. It then describes the various levels of India's urban health system, including health posts and urban primary health centers that provide primary care services to slum communities, as well as urban family welfare centers and specialty clinics that offer other services. Community health workers called USHAs and community groups called Mahila Arogya Samities are involved in healthcare delivery and health promotion in slum areas.

Uploaded by

Anand gowda
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© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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You are on page 1/ 37

https://www.yenepoya.edu.

in
09/16/21 16:50 Yenepoya Nursing College 1
(
09/16/21 ANANDA.S ASST.PROFESSOR YNC 2
LEARNING OBJECTIVE
At the end of the class the students will be able
to:-
 Explain in detail about urban organization

09/16/21 16:50 (NAME) 3


Organization, staffing and functions
of urban health services

09/16/21 ANANDA.S ASST.PROFESSOR YNC 4


URBAN HEALTH SERVICES

In India 377 million people live in urban places, out of


which an estimated 97 million people live in urban
poverty.
 Rapid urbanization and the significant growth of
urban poor population in absolute numbers already
have new demands on the available infrastructure
and service delivery mechanisms.

09/16/21 ANANDA.S ASST.PROFESSOR YNC 5


• The urban poor are a mix of people living in slums and
the homeless.
• Urban poverty is characterized by food insecurity,
varied morbidity pattern, poor access to drinking
water and sanitation, high costs of living and job
insecurity.
• All these aspects affect the health seeking behavior of
the urban poor and in general the health.

09/16/21 ANANDA.S ASST.PROFESSOR YNC 6


SLUMS

• Nearly one-third of India’s urban citizens

live in crowded informal settlements or


slum communities.
• UN-HABITAT has estimated that by the

year 2020, India’s total slum population

will cross 200 million people.

09/16/21 ANANDA.S ASST.PROFESSOR YNC 7


What are slums?

Habitations located on disputed as well as unused


government, municipal and private land and
characterized by a serious lack of basic amenities and
sanitation with dense and overcrowded housing
conditions.

09/16/21 ANANDA.S ASST.PROFESSOR YNC 8


City slums are characterized by poor access to clean

 water and adequate sanitation, the basic
requirements for maintaining good hygiene and
health.

09/16/21 ANANDA.S ASST.PROFESSOR YNC 9


Health Delivery System in Urban
Slums
 The government of India appointed the Krishnan
Committee in 1982 to address the problems of urban
health.
• The health post scheme was devised for urban areas
based on the recommendations of the Krishnan
Committee. Its report specifically outlines which
services have to be provided by the health post .

09/16/21 ANANDA.S ASST.PROFESSOR YNC 10



These services have been divided into outreach,
preventive, family planning, curative, support (referral)
services and reporting and record keeping.

09/16/21 ANANDA.S ASST.PROFESSOR YNC 11


• Outreach services include population
education, motivation for family planning,
and health education.
• In the present context, very few outreach
services are being provided to urban slums.

09/16/21 ANANDA.S ASST.PROFESSOR YNC 12


• There are four types of health posts (A, B, C and D)
according to population size (as per GoI guidelines).
• According to the Krishnan Committee
recommendations, the health post was to be located
‘in’ slum areas.
• The committee had recommended one voluntary
health worker (VHW) per 2,000 population.

09/16/21 ANANDA.S ASST.PROFESSOR YNC 13


• The health post (HP) scheme was launched in 1983-
84. A deputy director and joint director were
assigned to urban health, but functioned chiefly to
promote family planning goals.

09/16/21 ANANDA.S ASST.PROFESSOR YNC 14


Urban Revamping Scheme
• Urban revamping scheme was introduced following
recommendations by Krishnan committee 1983 .
• To provide primary health care, family welfare,
service delivery outreach and MCH services in urban
areas.

09/16/21 ANANDA.S ASST.PROFESSOR YNC 15


HEALTH POSTS:

• There are 871 health posts functioning in 10 States


and 2 UTs.

09/16/21 ANANDA.S ASST.PROFESSOR YNC 16


USHA

• An Urban Social Health Activist (USHA) will be posted


for every 200-500 households and provide the
leadership and promote the Mahila Arogya Samitee
• The USHA on the lines of ASHA, would preferably be a
woman resident of the slum– married/widow/
divorced, preferably in the age group of 25 to 45 years

09/16/21 ANANDA.S ASST.PROFESSOR YNC 17


• The USHA would actually be the nerve centres for
delivering outreach services in the vicinity of the
door steps of the beneficiaries
• The USHA may be preferably co-located with the
Anganwadi Centres located in the slums

09/16/21 ANANDA.S ASST.PROFESSOR YNC 18


Functions
• Facilitate awareness on essential RCH services,
sexuality and gender equality age at marriage
/pregnancy
• Motivation on contraception adoption, medical
termination of pregnancy, sterilization, spacing
methods
• Distribution of condoms and oral contractive pills.
• Early registration of pregnancies, pregnancy care,
clean and safe delivery, nutritional care during
pregnancy, identification of danger signs during
pregnancy

09/16/21 ANANDA.S ASST.PROFESSOR YNC 19


• Counselling on immunization ANC, PNC, etc. act as a
depot holder for essentail provisions like ORS, IFA,
Chloroquine, Oral pills and condoms etc.
• Identification of target beneficiaries and support the
ANM
• Facilitate access to health related services available
at Anganwadi/Primary Urban health centres.
• Formation and promotion Mahila Arogya samittees
in her slum/community area

09/16/21 ANANDA.S ASST.PROFESSOR YNC 20


• Arrange escort /accompany pregnant and children
requiring treatment to the nearest primary urban
health centre
• Carrying out preventive and promotive health
acticvites with AWW / Mahila Arogya samiti etc

09/16/21 ANANDA.S ASST.PROFESSOR YNC 21


Mahila Arogya Samitee
(MAS)
• The NUHM proposes the creation of Mahila Arogya
Samitee (MAS) a community based federated group of
around 20 to 100 households, depending upon the
size and concentration of the slum population
• MAS - acts as community based peer education group,
involved in community monitoring and referral

09/16/21 ANANDA.S ASST.PROFESSOR YNC 22


• The MAS will have 5-20 members with an an elected
Chairperson and a Treasurer, supported by an USHA.
• This group would focus on health and hygiene
behaviour change promotion, facilitating access to
identified facilities and risk pooling.

09/16/21 ANANDA.S ASST.PROFESSOR YNC 23


Urban Primary Health Centre

• The UPHC may be located preferbly within a slum or a


half kilometer radius
• The UPHC may cater to a slum population between
20000- 30000, with provision for evening OPD,
providing preventive, promotive and non-domiciliary
curative care (including consultation, basic lab
diagnosis and dispensing)
09/16/21 ANANDA.S ASST.PROFESSOR YNC 24
URBAN PHC
Organization
Municipality

Commissioner

Health Officer

Dispensary/Hospital

Medical officer

09/16/21 ANANDA.S ASST.PROFESSOR YNC 25


STAFFING PATTERN AT UPHC

ANM

09/16/21 ANANDA.S ASST.PROFESSOR YNC 26


FUNCTIONS OF UPHC
• Medical care

• MCH and family planning.

• Prevention and control of communicable

diseases.
• Safe drinking water.

• Environmental sanitation.
• Dietary services.

09/16/21 ANANDA.S ASST.PROFESSOR YNC 27


Dispensary

• A dispensary is an office in a school,hospital or other


organization that dispenses medications and medical
supplies.
• In a traditional dispensary set-up a pharmacist
dispenses medication as per prescription or order
form

09/16/21 ANANDA.S ASST.PROFESSOR YNC 28


Staff Pattern

• MO • Pharmacist
• Nurse midwife • Lab technician
• Male health assistant • Store keeper
• Female health assistant • Watchman
• Male health worker • Driver
• Female health worker • Cook

09/16/21 ANANDA.S ASST.PROFESSOR YNC 29


URBAN FAMILY WELFARE CENTRES
• Urban Family Welfare Centers are on ground since
First Five Year Plan to provide family welfare services
in urban areas
• Most of UFWCs are equipped to provide
contraceptive supplies.
• At present 1083 centers are functioning.
• There are three types of Urban Family Welfare
centers based on the population covered by
each centre.

09/16/21 ANANDA.S ASST.PROFESSOR YNC 30


Staffing pattern for Urban Family Welfare Centers

09/16/21 ANANDA.S ASST.PROFESSOR YNC 31


SPECIAL CLINICS

• Special clinic provides advanced diagnostic or treatment


services for specific diseases or parts of the body.
• They provide outpatient clinics, medical and counseling
services for certain specific disorder.
• Specialist doctors and nurses are essential for
conducting these clinics.

09/16/21 ANANDA.S ASST.PROFESSOR YNC 32


Specialty clinics

• A sexual health clinic

• A fertility clinic

• An ambulatory surgery clinic

• An abortion clinic

09/16/21 ANANDA.S ASST.PROFESSOR YNC 33


Summary

09/16/21 16:50 (NAME) 34


Conclusion

09/16/21 16:50 (NAME) 35


Evaluation

• Define Slum
• List the problem of Slum
• Discuss the health organization pattern of
health post
• Explain about Mahila Arogya samiti

09/16/21 16:50 (NAME) 36


THANK YOU

09/16/21 16:50 (NAME) 37

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