Indian Public Health Standards (IPHS) For 51 to 100 Bedded Sub-District/Sub-Divisional Hospitals
Directorate General of Health Services Ministry of Health & Family Welfare Government of India
1. Introduction 2. Objectives of IPHS for Sub-District Hospitals 3. Definition of Sub-District Hospital 4. Grading of Sub-District Hospital 5. Functions 6. Essential Services 7. Physical Infrastructure 8. Manpower 9. Equipment 10. Laboratory Services 11. Recommended allocation of bed strength at various levels 12. List of Drugs 13. Capacity Building 14. Quality Assurance in Services 15. Rogi Kalyan Samities / Hospital Management Committee 16. Citizen’s Charter Annexure – I: Guidelines for Bio-Medical Waste Management Annexure – II: Reference Laboratory Networks List of Abbreviations References 3 4 4 4 5 5 26 36 39 52 55 56 67 67 68 68 78 82 87 88
Sub-district (Sub-divisional) hospitals are below the district and above the block level (CHC) hospitals and act as First Referral Units. Specialist services are provided through these sub-district hospitals. These hospitals should play an important referral link between the Community Health Centres, Primary Health Centres and sub-centres. They have an important role to play as First Referral Units in providing emergency obstetrics care and neonatal care and help in bringing down the Maternal Mortality and Infant Mortality. It also saves the travel time for the cases needing emergency care and reduces the workload of the district hospital. In some of the states, each district is subdivided in to two or three sub divisions. A subdivision hospital caters to about 5-6 lakhs people. In bigger districts the sub-district hospitals fills the gap between the block level hospitals and the district hospitals. There are about 1200 such hospitals in the country with a varying strength of number of beds ranging from 50 to 100 beds or more. The Government of India is strongly committed to strengthen the health sector for improving the availability, accessibility of affordable quality health services to the people. In order to improve the quality and accountability of health services a set of standards need to be there for all health service institutions including sub-district hospitals. Standards are a means of describing the level of quality that health care organizations are expected to meet or aspire to. The key aim of standard is to underpin the delivery of quality services which are fair and responsive to client’s needs, which should be provided equitably and which deliver improvements in health and well being of the population. Standards are the main driver for continuous improvements in quality. The performance of Sub-district hospitals can be assessed against a set of standards. There has been effort to set standards for 30 and 100 bedded hospitals by the Bureau of Indian Standards (BIS). However, these standards are considered very resource intensive and lack the process to ensure community involvement, accountability and citizens charter issues that are important for public hospitals. Under the National Rural Health Mission (NRHM), the concept of Indian Public Health Standards (IPHS) for the Health Centres/ Hospitals functioning in the country. IPHS for CHC, PHC and Sub-centres have been finalized available on the ministry’s website www.mohfw.nic.in. The current effort is to prepare Indian Public Health Standards for the Sub-district Hospitals. Reference has been made to the BIS Standard for 100 bedded hospitals; Rationalisation of Service Norms for Secondary Care Hospitals prepared by Govt. of Tamil Nadu; District Health Facilities, Guidelines for Development and Operations, WHO, 1998 and Indian Public Health Standards (IPHS) for Community Health Centres.
Setting standards is a dynamic process. This document contains the standards to bring the Sub-district Hospitals to a minimum acceptable...