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1 GOVERNMENT of ANDHRA PRADESH ABSTRACT Public Health System Strengthening

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1 GOVERNMENT of ANDHRA PRADESH ABSTRACT Public Health System Strengthening GOVERNMENT OF ANDHRA PRADESH ABSTRACT Public Health System Strengthening - Revitalisation of the Primary Health System – Establishment of Three Hundred and Sixty (360) Community Health and Nutrition Clusters (CHNCs) – Orders – Issued. MEDICAL, HEALTH AND FAMILY WELFARE (F1) DEPARTMENT G.O.Ms.No. 209 Dated: 18.08.2010 Read the following:- 1. G.O.Ms. No. 92 of H.M & F.W (F1) Dept Dated: 23-04-2010. 2. Memo. No. 12231/F1/2008 dated 23-04-2010 ORDER: 1. The Government’s endeavour is to strengthen the public health care system for effective prevention and efficient management of diseases; provision of universal and comprehensive reproductive and child health services; strengthening the referral system; and improving the quality of hospital care in conformity with the Indian Public Health Standards (IPHS). 2. In this direction, the Government have ordered for conversion of two-hundred and three (203) Government Dispensaries (GDs), Government Civil Hospitals (GCHs), Subsidiary Health Centres (SHCs) and Mobile Medical Units (MMU) into Primary Health Centres (PHCs) / Community Health Centres (CHCs) in the reference first cited. This measure has contributed to the creation of a rational primary health structure in the rural areas of the state characterised by three inter-related and hierarchically organised institutions of health care, i.e., sub-centre, primary health centre and community health centre / Area Hospital. 3. In continuation of the process of primary health institutions’ rationalisation, the Government have decided to establish Three Hundred Sixty (360) Community Health and Nutrition Clusters (CHNCs) across the state with a view to provide comprehensive health services to population ranging from one to three lakhs through a network of four to ten proximate PHCs and a Referral Hospital – a CHC / Area Hospital / District Hospital / Teaching Hospital ; in order to achieve the following objectives: a) strengthen preventive, promotive, curative and referral health services through rational deployment of human, material and infrastructure resources available with the CHNC area; 1 b) strengthen first referral units (FRUs) – CHCs and Area Hospitals – and provide them with comprehensive emergency obstetric and neonatal care service facility (CEmONC); c) strengthen the Primary Health Centres by ensuring they function round the clock throughout the year by providing additional human resources, infrastructure, etc. d) strengthen the referral system, i.e., the linkage between the village, Sub-centre, PHC, CHC / Area Hospital and the District / Teaching Hospitals; e) establish an effective planning, coordination, facilitation and monitoring system for a cluster of four to ten PHCs; and f) strengthen community outreach through fixed day visit to sub-centres and villages by the medical and para-medical staff; and 4. Accordingly, the Government hereby orders for the establishment of three hundred and sixty CHNCs as per the list of CHNCs, PHCs and FRUs detailed in Annexure-A of this Order. The Government orders that the Community Health and Nutrition Cluster Office (CHNCO) be established in the CHNC headquarters with responsibilities for supervision, monitoring, and coordination of all health activities – health prevention, promotion, treatment and referral services – of all health institutions within the CHNC area, in the premises of the Cluster Hospital. 5. The Government orders that each CHNC shall be headed by a Deputy Civil Surgeon who is hereby designated as the ‘Senior Public Health Officer’ (SPHO), supported by the following staff, who shall be positioned through redeployment: a) Community Health Officer; b) Deputy Para-Medical Officer (DPMO - Leprosy); c) Public Health Nurse (PHN); d) Health Educator; e) MPHEO / Sub unit officer (Malaria); f) Ophthalmic Officer; g) LD Computer; and h) one Senior Assistant. 6. In order to ensure effective operationalisation of the CHNCs, the Government orders the following: a) Every CHNC Referral Hospital shall be provided with comprehensive emergency obstetric and neonatal care (CEmONC) facilities by positioning a gynaecologist, paediatrician and anaesthetist by appropriate redeployment of specialists from the Directorate of Public Health establishment to APVVP, as necessary. b) Sixty three (63) CHCs, each with a bed strength of 30 or less that are currently under the control of Commissioner APVVP, which are listed at Annexure-B, are hereby transferred to the control of Directorate of Public health. All specialist posts in these Hospitals, however, shall remain with APVVP and shall be filled by the Commissioner of Health and Family Welfare in consultation with APVVP and Director of Public Health. 2 c) Fifty-nine CHCs currently under the control of APVVP, each with a bed strength of 50 and above, which are detailed at Annexure-C of this order, shall henceforth be called ‘Area Hospitals’, and shall be developed as Secondary Referral Hospitals (SRUs). This would entail that all PHCs and CHCs shall henceforth be under the control of Public Health Directorate, while the Area and District Hospitals shall be managed by APVVP under the overall control and supervision of the Commissioner of Health and Family Welfare. d) All specialist doctors shall remain under the control of APVVP, while MBBS doctors shall be placed under the control of Director of Public Health. The Commissioner of Health and Family Welfare is empowered to redeploy specialists currently working in PHCs and other health facilities under the control of Director of Public Health to CHCs and Area Hospitals and replace them with MBBS doctors working in district and area hospitals, based on the need and workload duly following the counselling method after obtaining orders of the Government. 7. Necessary guidelines with regards to the service area rationalization of the functionaries, integration of fixed day health services through CHNCs, method of repositioning of staff in CHNCs and comprehensive action plan for strengthening the PHCs will be issued separately. Financing for this purpose will be provided under National Rural Health Mission (NRHM). 8. The Commissioner of Health and Family Welfare, Director of Public Health and Family Welfare, the Commissioner of AP Vaidya Vidhana Parishad and the District Collectors shall take necessary action accordingly. 9. This order is issued with the concurrence of Finance Department’s U.O.Note No.9841/153/A1/Exp. M&H-II/10, dated 29 July, 2010 (BY ORDER AND IN THE NAME OF THE GOVERNOR OF ANDHRA PRADESH) Dr. P.V. RAMESH SECRETARY TO THE GOVERNMENT To The Commissioner of Health and Family Welfare The Director of Public Health and Family Welfare The Commissioner of AP Vaidya Vidhana Parishad All District Collector and District Magistrates All District Medical and Health Officers All District Coordinators of Health Services of APVVP All Superintendents of Area and District Hospitals Copy to: 1. The Secretary to Government of India, Ministry of Health and Family Welfare, Nirman Bhavan, New Delhi 3 2. The Secretary to Government of India, Department of Medical Research, Ministry of Health and Family Welfare, Nirman Bhavan, New Delhi 3. The Director-General of Health Services, Ministry of Health and Family Welfare, Government of India, Nirman Bhavan, New Delhi. 4. The Mission Director, NRHM, Nirman Bhavan, New Delhi. 5. The Director, NIHFW, New Delhi. 6. All Special Chief Secretaries / Principal Secretaries and Secretaries to Govt of AP 7. The Principal Secretaries / Special Secretaries to the Chief Minister 8. Director of Medical Education / Director of IPM / Commissioner of AYUSH / Director General of Drug Control Administration / Managing Director of APHMHIDC / Project Director of APSACS / Director of Indian Institute of Health & Family Welfare / Vice-Chancellor of NTR University of Health Sciences / 9. The OSD to Hon’ble Minster ( ME), AP Secretariat, Hyderabad. 10. The OSD to Hon’ble Minster ( H&FW), AP Secretariat, Hyderabad. 11. The OSD to Hon’ble Minster (Aarogyasri, 108,104 & APHMHIDC), AP Secretariat, Hyderabad. 12. All Regional Directors of Health 13. All the DM&HOs / District Coordinator of Health Services (DCHS) 14. All Superintendents of Teaching / District / Area Hospitals 15. Principals of Medical College of the state 16. The Director of Treasury and Accounts, AP Hyderabad. 17. The PS to the Special Chief Secretary to Government, Medical and Health Department 18. Finance (Expr .M &HII) and (SMPC) Depts. 19. All Officers / Sections in HM&FW Dept. 20. Director, SPMU of HM &FW Department 21. Representative, Family Health International Hyderabad 22. Director, Indian Institute of Public Health, Hyderabad //FORWARDED :: BY ORDER // SECTION OFFICER 4 ANNEXURE - A to G.O.Ms.No.209, dated 18.08.2010 DETAILS OF COMMUNITY HEALTH AND NUTRITION CLUSTERS (CHNCs) SN District Name of CHNC Referral Hospital PHCs with in CHNC 12 3 4 5 1 Adilabad Adilabad RIMS Adilabad Gimma Jainath Talamadugu Tamsi Bela Syedpur Bheempur Ankoli Gudihathnoor Boath CHC Boath Sonala Bazarhathnoor Ichoda Narsapur -T Neradigonda Utnoor AH Utnoor Danthanpally Hasnapur Shyampur Indravelly Pittabangaram Jainoor CHC Jainoor Jainoor PHC unit Sirpur-U Lingapoor Nirmal AH Nirmal Mujgi Soan Laxmanchanda Velmalbopparam Narsapur-G Sarangapur Lokeshwaram Dilwarpur Mudhole CHC Mudhole Basar Tanoor Khanapur AH Khanapur Pembi Mamda Dasturabad Kaddam Narnoor CHC Narnoor Jhari Gadiguda Narnoor PHC unit Luxetipet CHC Luxetipet VenkatraoPet Dandepelly Tallapet Jannaram 1 SN District Name of CHNC Referral Hospital PHCs with in CHNC Bhainsa AH Bhainsa
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