Ministry of Health and Family Welfare Government of India

National Standard Treatment Guidelines

(A Work in Process Report)

September 9, 2011

Developed by Department of Health and Family Welfare Nirman Bhawan, New Delhi

Foreword
Providing 'Quality Healthcare for All' has been a key challenge for the Government in the recent time. It has been recognised that Health sector in India has remained unorganized to a large extent. There has been a concerted effort on part of the Ministry of Health and Family Welfare, Government of India and some of the proactive State Governments to introduce guidelines to streamline the sector. National Rural Health Mission (NRHM) has been one of the most successful programmes by the Central Government in its effort to reach out to the rural population in the country. The recent legislation of Clinical Establishments (Registration and Regulation) Act, 2010 is yet another milestone achieved by the Government towards Health Reforms. It is hoped that implementation of the Clinical Establishments Act-2010 will pave the way for a new paradigm in healthcare in India. This new ecosystem would have various categories of health facilities classified on the basis of services and procedures available, thus leading to more predictable outcomes. It is envisaged that adoption of Standard Treatment Guidelines (STGs) by health facilities registered in the country would ensure delivery of a certain standard of quality health care to All. Keeping this in view, a Core Committee of Experts was constituted by the Deptt. of Health and Family Welfare to undertake this important exercise. The Committee identified 20 Specialties and Group leaders for development of National Guidelines. The task of coordination was entrusted to the Federation of Indian Chambers of Commerce (FICCI) owing to its previous experience of developing STGs for 20 conditions for common cases of hospitalization from the health insurance perspective. The aim of the exercise is to lay down procedures for standardization of treatment, ensure more predictability of outcomes and contain costs to the extent possible by reducing unnecessary treatment and investigations. The first phase of the exercise is focused on the overall objective of creating a ready reference for clinical experts across the country at secondary and at more developed tertiary facilities so that standard procedures can be followed keeping in mind the prevalent diverse practices and varied costs of procedures across the country. I would like to congratulate the clinical experts involved in the development of the Guidelines for the successful completion of phase one. I would also like to acknowledge and appreciate the efforts of the FICCI in coordinating this exercise on behalf of the Ministry of Health & Family Welfare. As a work in Process (WIP) Report towards the National Guidelines, we are happy to release the ten Specialties documents in the areas of 'General Surgery', 'Gastroenterology', 'Cardiovascular', 'Interventional Radiology', 'Lab Medicine', 'Pediatrics', 'Endocrinology', 'Gynecology & Obstetrics', 'Organ Transplant' and 'ENT' for dissemination. We look forward to the release of the final report with all the Specialties Guidelines later this year.

New Delhi September 5, 2011

SD/ L C Goyal Additional Secretary & Director General (CGHS)

Table of Content
Cardiovascular . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Endocrinology. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ENT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Gastroenterology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . General Surgery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Interventional Radiology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Lab Medicine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Obstetrics and Gynecology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Organ Transplant . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Pediatrics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .