2015-01-01 Norms For The Health Cadre - Sri Lanka

Norms for the Health Cadre
Planning Unit
Ministry of health
2015
Table of Contents
Page No.
1. Norms for Medical Officers ....……………………………………………………2
2. Norms for PSM Categories

2.1 Radiographers ………..………………………………..………………………..…….8
2.2 Physiotherapists ………..………………………………………………….............…13
2.3 Occupational Therapists .…………………………………………………………….15
2.4 Pharmacists ………..…………………………………………………..………..……20
2.5 Medical Laboratory Technicians ……………………………………………….…...28
3. Norms For Other Paramedical Categories

3.1 Cardiographers……………………………………………..………………………..40
3.2 EEG Recordists……………………………………………………………………...43
3.3 Ophthalmic technologists and Orthoptists ………………………………….............45
3.4 Public health Inspectors……………………………………………………………..47
3.5 Entomological Assistants……………………………………………………………49
3.6 Public Health Laboratory technicians……………………………………………….51
4. Norms for Middle Level Technical Categories

4.1 Dispensers………………………………………………………………………..…54
4.2 Public Health Field Officers………………………………………………………..55
5. Norms for Nursing Officers …………………………………………….……..57
6. Norms for Midwives …………………………..……………………………….74
7. Norms for Other Categories

7.1 Drivers ……………………………………………………………….…………….79
7.2 Labourers………………………………………………………………..………….80
7.3 Other Staff…………………………………………………………..………………82
1
1. Norms for Medical Officers

Estimations of HRH requirements
Some methods for estimating HRH
Population ratios: ratios of providers to the entire population;
Health needs: based on known health needs of a population;
Demands for services or targets for services: based on quantitative goals, which are
then translated into HRH requirements
Job-based: based on estimating the number of staff belonging to specific cadres

(doctors, nurses, etc.) required to serve a given number of patients;
Task- or function-based: based on analyzing a task;
Staffing norms based on work load indicators for staffing needs. eg (WISN)
Expert consultation
Some Work Measurement Techniques
Direct Time Study (DTS)- for repetitive tasks
Predetermined Motion Time systems (PMTS)
Standard Data Systems (SDS)
Work Sampling- for multi tasking
Other factors need to be considered
Future expansion of health care facilities
Epidemiological and demographic transitions
Technological advancements
Advancement of medicine and further specialization
Situations specific to country
Economic considerations
Political commitment
2
Anaesthesia
For one theatre suite

Morning shift 2
Evening shift 1
Night shift 1
For night off 1
For leave & other 1
TOTAL 6
Intensive care/Critical care

( Include ICU/CCU/SICU/PBU/SCBU/SICU etc.)
For 5 beds
Morning shift - 2
Evening shift - 2
Night shift - 2
For night off - 2
TOTAL - 8
A & E Units
Emergency rooms (Level 4)

Morning shift 1
Evening shift 1
Night shift 1
For night off 1
TOTAL 4
3
A & E Unit
Level 3 (B H A&B )
Triage 1
Resus area 1
Treatment area( 1) 1
Treatment area (2) 1
Sub Total 5
For 3 shifts 15
Night off 5
TOTAL 20
A& E Unit
Level 3 (DGH)
Triage 1
Resus area 2
Sub Total 6
For 3 shifts 18
Night off 6
TOTAL 24
4
A & E Unit
APEX centre (PGH & TH)
Triage 2
Resus area 2
Sub Total 10
For 3 shifts 30
Night off 10
TOTAL 40
Major Specialties (Medicine, Surgery, Peads,O&G)

Criteria
Beds - Male 40
Beds- Female 40
Admissions per day <80
For the above criteria - minimum of 4 MO's will be provided
? Clinic patients- one MO per 150 clinic patients per week
If more than 80 admissions per day, one MO per every 20 admissions
Calculation – clinic patients
5 min per patient
Number of patients can be seen in one hour - 12. For six hours – 72
As ward MO s assisting and clinics are not functioning 7 days
One MO for 150 clinic patients per week
Finer Specialties (with in ward patients)

Criteria
Beds - Male 20
Beds- Female 20
Admissions per day <40
For the above criteria - minium of 4 MO's will be provided
Clinic patients- one MO per 100 clinic patients per week
If more than40 admissions per day, one MO per every 10 admissions
5
RDHS Office
MO- MCH 1 - (one additional MO if more than 10 MOH areas)
MO- Epid (RE) 1- (one additional MO if more than 10 MOH areas)
MO- (E&OH)
MO- ( Q & S)
MO- (Planning)
MO- (NCD)
MO- Health Informatics
MO- MH
PDHS Office
MO-Planning ( ?Provincial CCP Planning)
MO- HI
Medical Officer of Health

Status quo to remain
Anti Filariasis
One MO per RDHS area for highly endemic areas
STD/AIDS
One MO per STD clinic
Additional MO if more than 25 patients /day
TB Control
DTCO – 1 per district
Chest clinic – one MO per 25 patients / day
MO/ IC chest clinic
Divisional Hospitals
Criteria
Based on bed strength
Based on Performance
Based on cluster system
Based on “2500 cluster village” system
6
Performance based allocation
Out door , indoor ,clinic patiants & medical officer

strength of divisional hospitals - 2014
no of
Approved
Out Clinic medical
# Institute In door medical
door attendance officers For out For For
officers
(available) door indoor clinic Total
1 Dh Aranayaka 122132 7113 40272 7 4 7 (50:1) 1(20:1) 1(75;1) 9
2 Dh Rambukkana 132969 12663 58696 10 8 7(50;1) 2(20;1) 2(75;1) 11
3 Dh Undugoda 60630 4595 25428 7 3 3 (50;1) 1(20;1) 1(75;1) 5
4 Dh Daraniyagala 63974 5444 26904 7 4 4(50;1) 1(20;1) 1(75;1) 6
Dh Kithulgala 73604 5520 25408 6 3
Proposed
Criteria
One MO per 50 OPD patients / per day

One MO per 75 Clinic patients / per day
One MO per 20 Admissions / per day
7
2. Norms for PSM Categories

2.1 Radiographers
Norms for Radiographers is based on risk exposure, quality of work, workload & the type of
investigation. Requirement is given for Radiotherapy Centres & Specialized Units of the
hospitals.
By mid-2010, there were 383 Radiographers attached to Line Ministry Institutions while 119
were employed in Provincial level. Eighty six Radiographers have been absorbed to the
Department of Health during 2010. Currently 42 Radiographers are undergoing training.
2.1.1. Duty hours: In keeping with international recommendations for radiation workers,
total duty hours for one Radiographer have been considered as 6 hours per day for 5 working
days (30 hours) per week with covering up of 7 days including public holidays.
Normal duty : From 8 a.m. - 12 noon
From 2 p.m.- 4 p.m ,
On call service : From 12 noon - 2 p. m.
From 4 p.m.- 8 a.m.
2.1.2. Norms for Radiographers per x-ray machine

The following factors were also considered when deciding cadre norms
1. Risk exposure of the officers
2. Nature of work
3. Work load of the hospital
For each functional static X-ray machine

 First 2 machines - 03 Radiographers per machine
 One machine - 02 Radiographers per machine
 From 3rd machine onwards - 02 Radiographers per machine
For each portable X-ray machine - Minimum of 01 Radiographer
2.1.3. Norms of Radiographers for Radiotherapy centres

2.1.3.1. Radiotherapy centres
Radiotherapy centres were categorized according to the available facilities for the purpose of
deciding norms for Radiographers.
8
Category I Radiotherapy centre
Centres with Basic facilities, such as
 Cobalt Teletherapy unit 1
 Iodine 131 therapy 1
 Mould room technology 1
 Registration room 2
Category II Radiotherapy centre

Centres with middle level facilities. Currently Cancer Institute Maharagama is in this
category.
 Iodine131 therapy 1
 Megavoltage unit 1
 Conventional Simulation unit 1
 Brachytherapy unit 1
 CT Simulation unit 2
 Registration room 2 per centre
Category III Radiotherapy centre

Centres with advanced facilities. No Institution up to the standard by 30.9.2010. This
category will include following facilities.
 Iodine131 therapy unit 1
 Megavoltage unit 1
 Conventional Simulation unit 1
 Brachytherapy unit 2
 CT Simulation 2
 Teaching/ Education/Research unit 1
 Registration room 2
9
2.1.3.2. Norms of Radiographers according to the category
Radiotherapy Description No. of Units No. of
centre Radiographers
Cobalt Teletherapy unit 01 03
Calculation/ Planning 01 01
Mould room 01 02
Category I Registration room/ Administration and 01 01
Management
Radioactive Protection & Quality 01 01
Assurance
Registration room 01 02
Total 07 12
Relief Radiographers 02
Cobalt Teletherapy unit 02 06

Megavoltage unit 01 04
Calculation/ Planning 01 03
Mould room 01 02
Category II Conventional Simulation unit 01 02
Brachytherapy Unit 01 02
Administration and Management 01 02
Assurance unit
Treatment Planning Unit 01 02
CT Simulation Unit 01 02
Total 28
10
Radiotherapy Description No. of Units No. of

centre Radiographers
Mould room 02 04
Conventional Simulation unit 01 02
Category III CT Simulation unit 01 01
cont. Brachytherapy Unit 02 04
Administration and Management 02 03
Teaching, Education, Research unit 01 01
Assurance unit
Treatment planning unit 01 02
Mregavoltage Unit 01 04
Total 35
2.1.3.3. Norms of Radiographers for Specialized Units

Unit No. of Radiographers per Relief officers
Unit
Automatic Processing Unit & Quality 01 --
Assurance
Screening Unit 02 --
Cardiac Catheterization Lab 04 01
CT Unit 04 01
MRI Unit 04 01
Nuclear Imaging unit 04 01
Computer Radiography Unit 02 --
Digital Subtraction Angiography Unit 04 01
Mammography Unit 04 --
C-arm Unit 02 --
Dental Unit 02 --
Dental Institution /Colombo 04
11
2.1.4. Cadre Norm for Radiation Safety Officers
At least 01 Radiation Safety Officer is needed for Hospital with a radiation related unit. If
number of radiation related workers are less than 40, a senior radiographer shall function as
the Radiation Safety Officer in addition to the normal duty. In other situations a Radiation
Safety Officers should be appointed as follows.
40 (permanent staff) Radiation related workers = 1 Radiation Safety Officer
Cardiac Catheterization Lab = 1 Radiation Safety Officer
Places where a Physicist is available, radiation safety will be his/her responsibility. Promotion
of the senior radiographers ‘supra special’ grade will be discussed in the future.
Committee Members
Dr. J. M. W. Jayasundara Bandara – DDG (Planning)

Dr. Sunil De Alwis – DDG – ET & R
Dr. S. R. U. Wimalaratne – Director (Training)
Dr. W. A. A. Tissera – Director (Training)
Dr. I. N. Lekamge – Consultant Radiologist - NHSL
Mr. E. Dharmakeerthi – Secretary – Government radiological technologists association
Mr, S, S. Jayasinghe - Chief radiographer – NHSL
Mr. H. P. A. Premalal – Chief radiographer – LRH
Mr. W. A. S. Sanjaya - Therapeutic radiographer – NCI Maharagama
Mr. C. P. K. Adikari - Therapeutic radiographer – NCI Maharagama
12
2.2 Physiotherapists
Physiotherapists treat patients with physical difficulties resulting from illness, injury,
disability or ageing. They work with patients to identify and improve their movement and
function. They assist the rehabilitation process by developing and restoring body systems, in
particular the neuromuscular, musculoskeletal, cardiovascular and respiratory systems.
There are 258 Physiotherapists attached to Line Ministry Institutions while 65 are employed
in Provincial level by mid-2010. Seventy six Physiotherapists have been absorbed to the
Department of Health during 2010. Currently 60 Physiotherapists are undergoing training.
2.2.1. Norm : One Physiotherapist spends 30 minutes per patient, & it is expected that they
manage 12 patients per day.
2.2.2. Duty hours : Monday to Friday - From 8 a.m. to 4 p.m.

Saturday - From 8 a.m. to 12 noon
On call duty when needed.
2.2.3. Norms for Physiotherapists according to the unit

Unit/ Hospital Description No. of Physiotherapists
1.Rheumatology Units/ NHSL, TH, DGH, BH 01 per 12 referred patients
Out Patients Departments
2. Wards Neuro Surgical, Stroke Unit 01 per 01 unit
Orthopaedic
Medical Wards, Surgical Wards, 01 per 04 units
Paediatric Wards, Neurology
Wards, Other Wards
3. Intensive Care Units Neuro Surgical, Cardio thoracic 01 per 06 beds and
3 times a day
Cardiology, Medical, Paediatric, 01 per 08 beds and
Surgical, Other 3 times a day
4. Specialized Ragama RH, Digana/ Kandegolla/ 01 per 10 inward patients
Rehabilitation Centres Jayanthipura 01 per 12 OPD patients
5. Mental Hospital 02
13
2.2.4. Proposed Areas
Each district is proposed with 01 rehabilitation centre with 02 physiotherapists.
Committee members
Dr.S.C. Wickamaisnghe- Director Planning
Dr. D.T.M Jayawadena - MO/ Planning
Dr. Indra Kumari Fernando - Director/ PCS
Mr. M.V. KAmarasiri - Occupational Therapist
Mrs. Sasanthi Siriwardene - Occupational Therapist
Mr. W.N. Gunasiri - Physiotherapist
Mr. W.A Gunarathne - Physiotherapist
14
2.3 Occupational Therapists

Occupational therapy is a profession concerned with promoting health and well being through
occupation. The primary goal of occupational therapy is to enable people to participate in the
activities of everyday life and be independent. Occupational therapists achieve this outcome
by enabling people to do things that will enhance their ability to participate or by modifying
the environment to support participation.
In this field occupational therapists involve in conditions and services such as,
 Physical Disability
o Rheumatological conditions, Orthopaedic diseases, Neurological problems,
physical injuries (hand injuries, burns) & post surgical complications.
 Mental Health problems
o Neurotic disorders, Psychotic disorders, Learning disability, Stresses,
Personality disorders, alcohol and substance abuse etc.
 Paediatric diseases
Cerebral palsy, Learning disability, Autism, Neuromuscular disorders
 Common conditions in Adult population
o Dementia, Depression, Parkinson disease, Degenerative disorders
 Community Rehabilitation
o MOH area / physical and psychiatry rehabilitation centres/ Day activity centres
 Geriatrics, Cardiac rehabilitation, Forensic psychiatry, Oncology
 Accessibility and environmental modifications
 Special education and childcare services
 Disaster management and accident prevention
 Centres for disabled people, Schools and Universities
 Social services and social work department
 Hostels of residential care homes
 NGOs, charity and voluntary agencies
 Equipment companies
o Assistive Technology Services
 Government agencies
o Housing Departments/ Vocational Rehabilitation Centres
There are 80 Occupational Therapists employed in Line Ministry institutions and 10 are
attached to Provincial Institutions.
15
2.3.1 Norm
 Management of physically injured patients
Less comprehensive therapy procedures which involve 30 minutes per patient for
1st visit and 20 minutes per patient for subsequent visits
 Patients with psychiatric care/ Paediatric patients/ Institution Based

Rehabilitation (IBR)
detailed assessment, setting up implementation criteria and carry out
comprehensive therapy which involves 40 minutes per patient for 1st visit and 30
minutes for subsequent visits
2.3.2 Norms for Occupational Therapists according to the institution
National Hospital of Sri Lanka

Unit No. of Occupational
Therapists
Rheumatology D.R.R. (General) 04
Rheumatology D.R.R. (Special) 04
Neurology 07
Burns 04
Psychiatry 05
Neuro-trauma 03
Accident Service and Orthopaedic 05
Plastic surgery & Hand Therapy 05
General Medical Wards (Physical Disability) 02
16
Special Hospitals
a) Rehabilitation Hospital, Ragama

Section/Unit Description No. of Total
Occupational No.
Therapists
Rheumatology & 02 wards (18 patients) 02 05
Neurology section
OPD (27 clients per day) 03
Pediatric section 01 ward (12 clients per day) 02 04
OPD (24 clients per day) 02
Orthopaedic 02 wards (40 clients per day/ -- 04
Inward)
Spinal Injury 05 wards (60 clients per day -- 07
and specialized unit)
Special Seating Wards & Clinic -- 01
Vocational Rehabilitation -- -- 01
Centre
Total 22
b) Children’s Hospital, Colombo (Lady Ridgeway Hospital)

Section/Unit No. of Occupational Therapists
Rheumatology & Rehabilitation 08
Paediatric Neurology 02
Child Psychiatry 05
Burns 02
Total 17
c) National Institute of Mental Health

Wards including home visits 08
Forensic Unit 02
Geriatric Unit 02
Learning disability Unit 02
Two OT units 04
Total 13
17
d) Other Institutions / Units
Intermediate Care Unit- Mulleriyawa 04

Psychiatry unit – Unawatuna 02
Cancer Institute/ Maharagama 02
Chest Hospital 02
Sirimavo Bandaranayake Hospital for Children 03
STD/ AIDS Control Programme 02
Anti Leprosy Campaign 02
Hospitals according to category

Category of Hospital Section/Unit No. of Occupational
Therapists
Rheumatology Unit 02
Neurology 01
Teaching/ Provincial Orthopaedic 01
General Hospitals Paediatrics (Children with 01
special needs)
Psychiatry 02
Cardiology 01
Total 06
Category of Hospital Section/Unit No. of Occupational

Therapists
District General Hospitals Physical/ Psychiatry 03
Base Hospitals Medical & Surgical care 01
18
Rehabilitation Centres
Category Institution No. of Occupational
Therapists
Digana 04
Physical Jayanthipura 02
Maliban 01
Kendagolla 01
Uhumeeya 01
Deltota 01
Ridiyagama 01
Psychiatry Passara 01
Aluthgama 01
Batticaloa 01
Leliambe 01
Mampitiya 01
Maldeniya 01
Regional divisions
Outreach OT programme 01 per each district
School of PT and OT (Average 25 students)

OT tutor posts 04
Committee members
Dr.Indra Kumari Fernando- Director (PCS)
Dr. D. T. M Jayawadena - MO (Planning)
Mrs. S. C. A. N Samaranayake – Principal / School of PT & OT
Mr. M. V. K Amarasiri- Occupational Therapist
Mr. N. Thileepan – Occupational Therapist
19
2.4. Norms for Pharmacists

The pharmacists shall be in-charge of the Department of Pharmacy which includes following
sections.
• Outdoor Patients’ Department (OPD)
• Indoor Patients’ Department (IPD)
• Drugs Stores/ Medical Stores(DS)
• Surgical Instruments Section (SIS)
The pharmacists are responsible for indenting, receiving, stocking, issuing and accounting of
all drugs, surgical equipments and medical gases.
Pharmacists have to discharge their duties,
• For OPD patients, Clinic patients & Indoor patients
• For Surgical Stores & Drug Stores
• For Reconstitution of Cytotoxics
• Specialized Institutions (CDDA / NDQAL / MSD / NHSL / RMSD / DPDHS Office /
CI Maharagama etc.)
A total of 1249 Pharmacists are currently employed in the government institutions. Out of
them 762 are attached to Line Ministry institutions while 487 Pharmacists serve at Provincial
health institutions. During 2010, 101 new recruitments were carried out. Seventy eight
Pharmacists are undergoing training at present.
2.4.1. Outdoor Patients’ Department (OPD/ CLINICS) - Base Hospital & above
2.4.1.1. Norm :
OPD : A pharmacist works 6 ½ hours per day including the maintenance of records. He
spends 2 minutes with each outdoor patient which includes record keeping. Therefore a
Pharmacist can dispense drugs in the proper way to a maximum of 195 OPD patients only per
day.
Clinic : A Pharmacist must spend at least 05 minutes with each Clinic patient which includes
record keeping time. Therefore a Pharmacist can dispense drugs in the proper way to a
maximum of 78 clinic patients only per day.
2.4.2. Indoor Patients’ Department (IPD/ IDD)

The duties are as follows,
1) In charge (Most senior Pharmacist) of Dangerous Drugs
2) Issuing Medical gases (eg : Oxygen)
3) Issuing drugs for the BHT s (24 hours)
4) Weekly issues for the wards
5) Issuing Surgical Dressings
6) Compounding & preparation of extemporaneous preparations
7) Issuing IV Fluids/ Parenterals
20
Eight units* per Pharmacist must be allocated including maintenance of records.

(*Unit = Wards, Operation theatres, Intensive Care Units, Injection room, Laboratories,
Radiology Department etc.)
For night services (24 hours) of Pharmacy at IDD in Teaching Hospitals, 03 additional
Pharmacists are required.
2.4.3. Medical Stores (Drug Stores)
The duties are as follows,
1) Issuing drugs to the OPD
2) Issuing drugs to the IDD
3) Issuing drugs to the Clinics
4) Issuing Special items
5) Annual Estimation of Drugs
6) Duties related to the MSD
7) Condemning
8) Collect & Auction of Containers
9) Local purchasing of drugs
10) Functioning Institutional Drug Therapeutic Committee (DTC)
Financial allocation for the institution, number of items, quantity or average number of indoor
and outdoor patients can be used to decide on number of Pharmacists required for drug stores.
Norm : One Pharmacist for stores per 07 Indoor and Outdoor Pharmacists in the hospital
2.4.4. Surgical Instruments Section (Surgical Stores)

The following factors were considered.
 Responsibilities
 Values of the pharmaceuticals
 Number of Units
Surgical Stores can be further divided into 2 sections according to its nature of duties.
Surgical Consumable Surgical Inventory

Ward issues surgical inventory
Theatre issues special intents
Receiving from MSD repairing, condemning
Annual estimation Spare parts
21
2.4.4. 1 Norm : Surgical Consumable section = 20 units* per pharmacist

(*Unit = Wards, Operation theatres, Intensive Care Units, Injection room,
Laboratories, Radiology Department etc.)
Surgical Inventory & special items

Teaching, Provincial, District General and District Base hospitals = 2 pharmacists
per hospital
Repairing, condemning & spare parts = 1 pharmacist per hospital (all hospitals)
2.4.5. Norms for Government Pharmaceutical Service

Area Norm
Each Teaching and Provincial Hospital 01 Special grade Pharmacist

(Superintendent Pharmacist)
Each hospital except TH and PGH Chief Pharmacist - In charge of 04
sections (OP/IDD/DS/SIS) Above
Divisional hospitals
Relief Duty – TH/ PGH/ DGH/ DBH One Pharmacist per six Pharmacists
Divisional Hospital (Type A) 02 Pharmacists
Divisional Hospital (Type B) 01 Pharmacist

Pharmacist as a Stock Control Officer Two SCO per RMSD
Provincial Pharmacist (Chief DP) 01 in each Province (Most senior DP)
Divisional Pharmacists (DP) 02 DP per district -Kandy/ Colombo/
Gampaha/ Gall/Kurunegala/Rathnapura
and 01 DP each for other districts
Reconstitution Unit for the Cytotoxic Six preparations per hour per pharmacist
Drugs
Drug information pharmacists (Medicine 02 pharmacists per TH/PH & 01
information Pharmacists) pharmacist per DGH/ DBH
Anti Malaria Campaign 02 Pharmacists
Anti Filariasis Campaign 02 Pharmacists
Anti Leprosy Campaign 02 Pharmacists
Epidemiology unit, Colombo 02 Pharmacists
(Central vaccine stores)

Family Health Bureau, Colombo 02 Pharmacists
National Institute of Dental Sciences, 02 Pharmacists
Maharagama
22
National Blood Transfusion Services, 02 Pharmacists
Narahenpita
National Poison Information Centre 02 Pharmacists
Chief Divisional Pharmacist (Sp Grade) - 01 Pharmacist
Ministry of Health
Dental Institute, Colombo 04 Pharmacists
2.4.6. Cadre for National Drug Quality Assurance laboratory

Area / Description No. of Pharmacists
Chief Pharmacist (Special Grade) 01
Technical Unit 03
Chemical Division 14
Microbiological Division 05
Biological Division 05
Devices & Cytotoxic Division 02
Standards & Calibration Division 02
Total 32
2.4.7. Cadre for Cosmetic Devices and Drugs Authority / Drug Regulatory
Authority
Area / Description No. of Pharmacists
Clinical Trails 03
Evaluation of Drugs 12
Evaluation of Devices 03
Evaluation of Cosmetics 02
Adverse Drug Reactions 01
Nutraceuticals/ Border line products/ 02

Advertisements
23
Drug Information (Data base updating, 02

Collecting information, Maintenance of
Web site, Publishing of data)
Total 26
2.4.8. School of Pharmacy, NHSL, Colombo

Description Number
Senior Lecturer/ Tutor in Pharmacy 02

(Special Grade)
Tutor in Pharmacy 01
Demonstrator (Pharmacist) 01
Total 04
2.4.9. Medical Supplies Division (MSD)

The areas where pharmacists have to discharge their duties in the MSD are as follows.
1. Receiving National estimates and justifications/ clarifications
2. Forecasting National estimate
3. Order placing
4. Communicating with SPC/SPMC/Suppliers/End users
5 Feeding data into the system and analysis of data
6. Distribution process
7. Stock management and controlling
8. Duties assigned by circular, 01/ 04/ 2008
2.4.9.1. Cadre for Medical Supplies Division

Area / Description Number
Head/ SCU – Pharmaceuticals 01
Head/ SCU – Surgical 01
Stock Control Officers - Pharmaceuticals 12
Stock Control Officers – Surgical 15
Monitoring & Re- distribution Unit 02
24
Information Unit 02
Formulary Revision Unit 02
SCO’s for bulk ware houses 50
Total 86
2.4.10. Cancer Institute, Maharagama

Required number of Pharmacist must be allocated to OPD, IDD, DS and SIS according to
the criteria given.
2.4.10.1. Central unit for Reconstitution of Chemotherapeutic Drugs (CRCD) is newly

established in the CI Maharagama.
The areas where pharmacists have to discharge their duties in the CRCD are as follows.
1. Follow the safety methods and precautions
2. Check the prescription
3. Calculate the required doses - 1st time
4. Calculate the required doses - 2nd time
5. Recording
6. Reconstitute with suitable diluents
7. Set with IV infusion
8. Re- checking
9. Dispensing
Norm : Reconstitution of Cytotoxic Drugs in proper way within 24 hours - Hundred
preparations per day per eight Pharmacists
2.4.10.1. a. Cadre for CRCD

Senior Pharmacist (In charge) 01
CRCD 24
Total 25
2.4.11. National Hospital of Sri Lanka (NHSL)

Since NHSL is the largest hospital in Sri Lanka, three pharmacy sections; ie : OPD, IDD
and SIS were considered as separate institutions. Therefore, norms were developed
seperately for this hospital.
25
2.4.11.1. Cadre for Superintendent Pharmacists

Chief Superintendent Pharmacist 01
Superintendent Pharmacist - OPD 01
Superintendent Pharmacist - IDD 01
Superintendent Pharmacist - SIS 01
Total 04
2.4.11.2. Out Patients’ Department / NHSL

Area / Description Functioning Time Number
Inquiries 07.30 am- 6.00 pm 02
Counselling 07.30 am- 6.00 pm 03
Night service for out patients 24 Hours 04
Sub stores (Drugs) 8.00 am – 4.00 pm 02
mall scale manufacturing unit 8.00 am – 4.00 pm 03
Total 14
Norm : A pharmacist should dispense drugs in the proper way* to 78 patients only per
day for the outdoor patients.
*Reading the prescription/ Counting the drugs/ Packetting/ Labelling/ Dispensing/
giving instructions for use
2.4.11.3. Drug Stores / NHSL

Financial allocation for the institution, number of items, quantity or average number of
Indoor and Outdoor patients can be used to decide on number of pharmacists required for
drug stores.
Since it is a complicated process, the number required for Indoor and Outdoor pharmacies are
calculated based on number of patients, number of drug utilizing units.
26
Norm : One Pharmacist for the Stores per 07 Indoor and Outdoor Pharmacists
Relief duty : One Pharmacist per Six Pharmacists
1.4.11.4. Indoor Patients’ Department / NHSL
Norm : 01 Pharmacist per Eight units* including maintenance of records
Relief duty : One Pharmacist per six Pharmacists
2.4.11.5. Surgical Instruments Section / NHSL

01 Pharmacist per 20 Units* including maintenance of records.
In addition to the above allocation, 01 Pharmacist per 40 Units* should be assigned to
cover up the duties of surgical Inventory and special Items.
One Pharmacist should be allocated to cover up the duties of Repairing, Condemning
and Spare parts.
(*Unit = Wards, Operation theatres, Intensive Care Units, Injection room, Laboratories,
Radiology Department etc.)
Committee members
Dr. Wimal Jayantha - DDG / Planning

Dr. Kamal Jayasinghe – Director/ MSD
Dr. (Mrs) H.M.P. Samaratunga - Deputy Director /Eye Hospital
Mr. Ajith Priyadarshana - Director / NDQAL
Mr. Harendra Kuruppu - Senior Tutor Pharmacist/ Dept of Pharmacy, Faculty Of
Medicine, Colombo
27
2.5 Medical Laboratory Technologists

Medical Laboratory Technologists (MLT s) belong to Professional Supplementary to
Medicine and are supposed to perform activities that are essential for patient management in
most diseases by means of assisting either in diagnosis, treatment or rehabilitation. The
quality of work delivered by these officers directly affects the quality of the performance of
Medical Officers hence affecting the quality of life of the patients. Therefore they are bound
to follow the directions of Medical Officers, in order to be reliable, accurate, timely and up to
date as far as the technique is concerned.
The Special Grade MLT s designated as ‘Superintendent Medical Laboratory Technologists’

are responsible to the Head of the Laboratory for supervision and administration of all MLTT
and have been assigned to Teaching Hospitals, Special Hospitals, Provincial and District
General Hospitals and District Base Hospitals (Type A). MLT s have been assigned to
National Blood Transfusion Services, Medical Research Institute, Training Institutions,
Public Health Campaigns, Provincial and District level centres in addition to curative care
institutions.
Staff needed for each unit in hospitals was based on the bed strength and workload in the
areas of Biochemistry, Haematology, Microbiology, Histopathology, Clinical Pathology,
Laboratory in Out Patient Department and Quality Assurance.
As per mid-2010, 932 MLT s were employed at Line Ministry level while 446 were serving
in Provincial Health Institutions. There are 140 MLT s undergoing training at present and 162
MLT s have been appointed to Department of Health during 2010.
28
2.5.1. Norms for Medical Laboratory Technologists (MLT s)
Institution Category/ Unit No. of MLT s

>1200 <1200
Teaching Hospitals/ beds beds
Provincial General
Hospitals Superintendent MLT 1 1
Biochemistry 11 8
Haematology 9 7
CSTH, CNTH, Batticaloa, Microbiology 10 6
Jaffna, Histopathology 6 4
Anuradhapura, Clinical Pathology 2 1
Ratnapura OPD Lab 6 4
Stores 1 1
Quality Assurance/ Biosafety 1
Total 47 32
Pap smear cytology TH- Anuradhapura (2), Batticaloa (1),
(under FHB) Mahamodara (2), SBMCH Peradeniya(2),
Jaffna(1), PGH-Badulla(2), Kurunegala(3),
Ratnapura (2),CSTH (2), CNTH(2), Matara (2)
Superintendent MLT(1 per section) 4

Chief MLT 1
Biochemistry 22
NHSL Haematology 20
Microbiology 14
Histopathology 14
OPD Lab 9
Stores 2
Quality Assurance(01 for each speciality- 4
Haematology, Microbiology, Biochemistry
and Histopathology
Total 90
National Centres RIA 8

(Located at NHSL) Immuno-Histochemistry 4
Nephrology Unit 4
Neurotrauma 4
Total 20
TH Kandy Superintendent MLT 1
Chief MLT 1
Biochemistry 14
29
TH Kandy RIA/Immunoassays 2
Haematology 15
Microbiology 12
Histopathology 11
OPD Lab 5
Dialysis Unit 4
Total 65
Superintendent MLT(1 per section) 4

Chief MLT 1
Biochemistry 15
TH Karapitiya Haematology 15
Microbiology 12
Histopathology 11
OPD Lab 6
Accident and Emergency 5
Stores 1
Total 70
District General Hospitals Superintendent MLT 1

and Base Hospitals (Type A) Biochemistry 8
Haematology 7
Microbiology 6
Histopathology 4
OPD Lab 4
Stores 1
Quality Assurance/ Biosafety
Total 31
Ampara (1), Kegalle (1),Polonnaruwa (1),
Chilaw (2), Vavuniya (2), Monaragala (2),
Pap smear cytology N'Eliya (2), Gampaha (1), Negambo (1),
Hambantota (2), Matale (1), Avissawella (1),
(under FHB) Homagama (1), Horana (1), Wathupitiwela (1),
Trincomalee (1), Embilipitiya (1), Mahiyanganaya (1)
Chief MLT 1
Biochemistry 4
Base Hospitals Heamatology 4
(Type B & C) Microbiology 3
Histopathology 3
OPD Lab 3
Stores 1
Quality Assurance 1
Total 20
30
Divisional Hospitals Senior MLT and Co-ordination of Satellite 1
system
Type A (>100 beds) Haematology 1
Chemical Pathology 1
Clinics/ OPD 1
Total 4
Divisional Hospitals Laboratory (routine) and Co-ordination of

Satellite System 1
Type B (100-50 beds) Laboratory (Clinics) 1
Total 2
Divisional Hospitals Clinics and Co-ordination of Satellite System 1

Total 1
Superintendent MLT 1
Chief MLT 1
Biochemistry 7
Cancer Institute Tumour markers 2
Maharagama Haematology 10
Bone marrow test 4
OPD lab 6
Histology 7
Immuno histo-chemistry 4
Cytology 3
Microbiology 6
Stores 1
Quality Assurance/Bio safety 1
Public Relation officer 1
Total 54
Superintendent MLT 1
Chief MLT 1
Biochemistry 7
Lady Ridgway Haematology 7
Hospital
for Children Microbiology 10
Histology 5
OPD Laboratory 6
Quality Assurance/Bio safety 1
Stores 1
Public Relation/Teaching Co-ordination 1
Total 40
31
Chief MLT 1
Haematology 1
Eye Hospital Microbiology 2
Histology 2
PAP smear 1
Biochemistry 2
OPD 1
Quality Assurance /Stores 1
Total 11
Dental Hospital Colombo
& Chief MLT 1
Peradeniya Haematology 1
Biochemistry 2
OPD/ Quality Assurance 1
Total 5×2
Maternity Superintendent MLT 1

Hospitals Biochemistry 4
Haematology 4
Castle Street Hospital for Microbiology 2
Women Histology 5
& De Soyza Maternity Hospital Clinical Pathology 2
Andrology 1
Stores 1
Quality Assurance 1
Public relation/Teaching Coordination
Total 21
National Institute of
Mental Health Chief MLT 1
& Biochemistry 4
BH Mulleriyawa Haematology 4
Microbiology 2
Quality Assurance /Bio Safety 1
Public relation /Teaching Coordination
Total 12
Infectious Disease Chief MLT 1

Control Hospital Biochemistry 4
(IDH) Angoda Haematology 4
Microbiology 2
Quality Assurance /Bio Safety 1
Public relation /Teaching Coordination
Total 12
32
National Institute of Health

Sciences / Kalutara Public health, PAP, lipid profile, FBS etc 4
Service Lab & other Microbiology 6
Services (Outside tests, generates Total 10
money)
Food Labs* Chemical Pathology 2

NIHS Microbiology 3
Anuradhapura
Kuruneagala Total 5
(*Generate money)
STD/AIDS Superintendent MLT 1

Control Programme Chief MLT(Regional Centres coordination) 1
Public Relation/Teaching coordination 1
PCR Laboratory 3
HIV Laboratory 7
HSV Culture Laboratory 2
GC Culture 3
Serology Laboratory 5
General Laboratory 2
Microscopy 4
PAP screening 2
Quality Assurance 1
Bio safety 1
Stores 1
Total 34
22 Regional Centres 1 per
STD Clinics each
(Regional)
Total 22
National Blood Transfusion Superintendent MLT 1

Service Chief MLT(Regional Centre coordination) 1
Quality Assurance 1
National Blood Centre Stores 2
Teaching Lab Coordinator 1
Histocompatibility Laboratory 4
National Reference Laboratory 3
Quality Control Laboratory 3
Reagent Preparation Laboratory 2
Nucleic Acid Testing 2
Cord Blood Banking 2
33
Frozen Red Cells 2
Processing Laboratory 25
{Component (12)/TTI (5)/Grouping
Laboratories (3)}
Total 49
Regional Centres Kandy / Anuradhapura / Kamburugamuwa / 6x4

Kurunegala
Karapitiya/ Maharagama/ Jaffna 4x3
Ampara/ Badulla/ Rathnapura 4x3
Vauniya/ Trincomalee/ Peradeniya/ Ragama/ 3x5
Polonnaruwa
Baticoloa/ NHSL/ CSHW/DMH/LRH/CSTH/ 1x7
SJGH/
Total 70
Kalutara/Avissawella/ Wathupitiwala/ 1x
Collecting & Storage Gampaha/ 23
Centres Horana/Chilaw/ Negombo/ Kethumathie/
Mathale / Nuwaraeliya/ Nawalapitiya/
Kuliyapitiya/ Mathara/ Hambanthota/
Mahamodara/ Kegalle / Embilipitiya
Dehiattakandiya/ Kahawatta/ Monaragala/
Mahiyanganaya/Kilinochchi/ Kalmunei
Total 23
Superintendent MLTT 4
Residential MLTT 3
Medical Research Institute Haematology 5
Histopathology 5
Immunology 4
Bio Chemistry 10
Animal House 1
Food & Water 13
Pharmacology 3
Entomology 1
Rabies & Vaccines 4
Nutrition 3
Virology 15
Molecular Biology 3
Mycology 4
Microbiology 11
Parasitology 3
Electron Microscopy 2
Natural Products 2
Total 96
34
Training Schools Principal 1

Total 01×
MRI-Colombo 03
TH-Peradeniya Lecturers (Tutors)
Microbiology & virology 2
NIHS-Kalutara
Histopathology & lab Management 2
Haematology 2
Parasitology 2
Bio chemistry 2
Demonstrator 1
Total 11×3
Food and Water
Laboratory Senior MLT 1
Anuradhapura Chemical 2
Kurunegala Microbiology 3
Rathnapura
Kaluthara Total 6×4
NPTCCD Superintendent MLT 1

Gen. Microbiology, TB Culture & 12
National Reference DST and identification
Laboratory Microscopy 4
Quality Assurance 2
Stores, Training & Research 2
Total 21
Chest Hospital, Welisara Chief MLT 1

Public Relation/Quality Assurance 1
Haematology 3
Bio Chemistry 3
OPD 2
Microbiology 2
Histopathology 1
Total 13
Central Chest clinic, Microscopy & EQA (for Chest Clinic) 5
Colombo other tests 3
for the rest of the district 10
Total 18
Chest Clinic , Gampaha for Chest Clinic 2
for the rest of the District 7
Total 9
35
Provincial and District Chest Clinics Chief MLT 1

Quality Assurance/Public Relation 1
Kandy/ Jaffna/Galle/ Vavuniya/ Borella/ 5
TB culture
Kurunegala/ Anuradhapura
Microscopy 3
10×
Total
7
Ampara 2
Anuradhapura 3
District Chest Clinics
Badulla 4
Batticalo 3
Galle 3
Hambanthota 3
Jaffna 4
Klmunei 3
Kaluthara 3
Kandy 8
Kegalle 3
Kilinochchi 3
Kurunegala 5
Mannar 3
Matale 3
Mathara 3
Moneragala 3
Mullathiv 3
Nuwara Eliya 2
Polonnaruwa 2
Puttalam 3
Rathnapura 4
Trincomalee 3
Vavuniya 3
Microscopy Centres Total ( 1 per each centre) 1x

24
Microscopists have to be absorbed as MLT s
Family Health Bureau (FHB) Chief MLT 1

Coordinating/Quality officer
Central Lab Central Gov. Hospitals 1
Provincial Council Hospitals 1
Special Institutions 1
Service Laboratory 4
Total 8
36
Attached to Teaching TH –Anuradhapura (2), Batticaloa (1),

Hospitals Mahamodara (2),
SBMCH Peradeniya (2), Jaffna (1), PGH –
Badulla (2), Kurunegala (3), Ratnapura (2),
Total 15
Attached to General Ampara (1), Kegalle (1), Matara (2),
Hospitals Pollonaruwa (1),Chilaw (2), Vauniya (2),
Moneragala (2),N’Eliya (2), Hambantota (2),
Matale (1)
Total 16
Gampaha (1), Avissawella (1), Mathale (1),
Attached to Base Horana (1), Homagama (1), Wathupitiwela (1),
Hospitals Trincomalee (1), Embilipitiya (1),
Mahiyanganaya (1)
Total 9
National Nephrology Chief MLT 1
Centres Public Relation/Quality Assurance 1
Maligawatte/ Kandy
Anuradhapura Haematology 1
Biochemistry 1
Clinical Pathology 1
Special Test 1
Total 07x3
National Cardiology Centres Chief MLT 1

Colombo / Kurunegala/ Public Relation/Quality 1
Karapitiya Assurance
Haematology 1
Biochemistry 2
Special Test 1
Total 06x3
National Thalassaemia Chief MLT 1

Centres Public Relation/Quality Assurance
Kurunegala
Anuradhapura Haematology 3
Ragama Biochemistry 1
Special Test 1
Total 06x3
Chief MLT(Management for regional 1
Anti Malaria Campaign services)
Reagent and Stores 1
Regional Campaigns 01
each
37
Anti Filariasis Campaign Chief MLT(Management for regional 1

services)
each
Anti Leprosy Campaign Chief MLT(Management for regional 1
services)
each
Senior MLT/Stores 1
Judicial Medical Laboratory Biochemistry 1
Haematology 1
Colombo, Kandy,
Microbiology 1
Karapitiya
Histology 1
Total 05x3
Prison Hospitals Senior MLT/Stores 1
Colombo/Kandy/Galle Biochemistry 1
Haematology 1
Microbiology 1
Histopathology 1
Total 05x3
Medical Supplies Division Chief Coordinator 1
Coordination - Provincial councils 2
Coordination - Central Government Hospitals 2
Coordination - Special Institutions 2
Total 7
Ayurvedic Hospitals Senior MLT/Stores 1
Biochemistry 1
Rajagiriya, Nawinna, Haematology 1
Microbiology 1
Pallekele
Histopathology 1
Total 05x3
Provincial Provincial Superintendent MLT 1

Councils Under PDHS (Applicable for each Province)
office
Total 9
Under RDHS office Divisional Chief MLT 1
(Applicable for each divisional Provincial
Councils)
Total 25
38
Ayurvedic Hospitals Senior MLT/Stores 1

Biochemistry 1
Rajagiriya, Nawinna, Haematology 1
Microbiology 1
Pallekele
Histopathology 1
Total 05x3
Committee members
Mr.Ravi Kumudesh - President/ MLT Union

Mr. Mohan Premaratne - Secretary/ Association of MLT s
Dr. Arunananda - DD/ Chest Hospital
Dr. Alf Rahman - MS/ AMH, Kalmunei
Dr. B.A.P.R. Balasooriya - SR/Medical Administration,MOH
Administrative Committee
Dr.R.Wimal Jayantha - DDG/ Planning
Dr.S. Yoganathan - DDG/ Medical Services II
Dr. Kapila Kannangara - PDHS /Sabaragamuwa
Dr.S.C. Wickramasinghe - D/Planning, MOH
Dr. Vineetha Pannila - D/ Lab Services, MOH
Dr. Ajith Priyadarshana - D/ NDQAL
Dr. Kamal Gamini - D/ Medical Supplies Division
Dr. Champa Aluthweera - D/ NCD, MOH
39
3. Norms for other Paramedical Categories

3.1 Cardiographers
Currently there are 228 Cardiographers functioning in the public sector institutions. Of them
167 are attached to Line Ministry Institutions while 61 are employed at Provincial level. No
Cardiographers have been absorbed to the Department of Health during 2010. Fifty students
are to be recruited for training during 2011.
3.1.1. Duty hours : From 8.00 a.m. to 4.00 p.m. on week days
From 8.00 a.m. to 12.00 noon on Saturday
The Cardiographer should be on call for duty when requested by the authority, outside normal
working hours.
He/ she should attend to all procedures pertaining to Electro Cardiography under the
instructions of Medical Officer/ Specialist/ In-charge of unit/ Institution.
3.1.2 Norm : One Cardiographer must take 40 ECG s of inward patients per day.
Sixty (60) ECG s per day should be taken from OPD/ Clinic patients.
3.1.3 Superintendent Cardiographer

(01 Superintendent per 25 cardiographers)
School of Cardigraphy 01
NHSL 02 (Cardiology 01, Main ECG Department 01)
TH Karapitiya 01
TH Kandy 01
Total 05
3.1.4 Norms for Cardiographers according to Institution/ Unit

3.1.4.1. National Hospital of Sri Lanka
01 cardiographer per 05 Medical wards (Inward)
01 cardiographer per 10 Surgical wards and other wards (Inward)
04 cardiographers per OPD (Estimating that 240 patients need ECG per day)
02 cardiographers for Accident Service/ Neurotrauma Unit
02 cardiographers per ETU (24 hour service)
40
3.1.4.1. a. Cardiology Unit

02 cardiographers per lab x 03 Cardiac Catheterization Labs 06
01 Pace maker x 01 cardiographer 01
01 cardiographer per machine × 2 Halter Monitor 02
02 cardiographers for Stress ECG 02
03 cardiographers for Electro Physiology 03
Cardiology wards (4) 03
CCU (1), ICU (1) 02
Total 19
Off/ Leave 02
3.1.4.1. b. Cardio-Thoracic Unit

02 cardiographers per one Operating Theatre × 04 OT s 08
Relief duty 02
3.1.4.2. Teaching Hospitals/ Provincial Hospitals/ DGH

Wards 01 cardiographer per 07 wards
ICU 02 cardiographers per 12 ICU beds
ETU/PCU 02 cardiographers
Clinics 02 cardiographers
Exercise ECG 02 cardiographers per machine
Halter monitoring (1 monitor) 01 cardiographer per machine
Catheterization Lab 02 cardiographers
Cardio-thoracic unit 01 cardiographer per operating theatre bed
Off/ Leave 01 cardiographer
3.1.4.3. Base Hospitals

Wards 02 cardiographers
OPD/Clinic 02 cardiographers
Total 04
3.1.4.4. Divisional Hospitals

More than 100 beds 01 cardiographer
41
3.1.4.5. School of Cardiography

Principal 01 cardiographer
Tutors 04 cardiographers
Total 05
Committee members
Dr. S. C. Wickramasinghe Director/ Planning, MDPU, Ministry of Health
Dr. D. L. S. Liyanagama Senior Cardiographer
Mr. H. I. A. Gunarathne In Charge of Cardiographers
Mr. H. I. S. Senarath Cardiographer
Mr. U. G. S. Hasitha Cardiographer
Mr. B. M. A. B. Wijerathna Cardiographer
42
3.2. Norms for EEG Recordists

By mid 2010, 47 EEG recordists are working in Public Sector institutions and none has been recruited
during the year of 2010. Their duties include obtaining routine EEG, Video EEG, performing
Sleep studies (MSLT, Polysomonography), ICU monitoring, Electrocortiography, and
Neurophysiology tests (VEP, BSER, SEP, ERG).
3.2.1. Normal duty hours: From 8.00 a.m. to 4.00 p.m. on week days
From 8.00 a.m. to 12.00 noon on Saturday
3.2.2. Norms according to Institution/ Unit
3.2.2.1. National Hospital of Sri Lanka

Neurology unit 02 EEG recordists per Neurologist
Neurophysiology unit 02 EEG recordists per Neurophysiologist
Neurosurgery units 01 EEG recordist
Relief/ leave/ off 01 EEG recordist
3.2.2.1. a. Specialized units

Video EEG Units 02 EEG recordists (7 a.m. - 8 p.m.)
Neurotrauma & ICU Monitoring 03 EEG recordists (24 hr duty)
Supervisory functions 01 special grade EEG recordist
3.2.2.2. Teaching Hospitals

Neurology unit 02 EEG recordists per Neurologist
Neurosurgery unit 01 EEG recordist
Medical/ Paediatric units 01 EEG recordist per 03 Paediatric / Medical Units
Relief/ leave 01 EEG recordist
3.2.2.3. Provincial General Hospitals/ District General hospitals

Similar to cadre norms for TH
If no Neurologists/ Neurosurgeons 01 EEG recordist/ 2 Physicians
Leave/ Relief / off 01 EEG recordist
43
3.2.2.4. Specialized Hospitals
05 Paediatric/ 05 Physician Units 01 EEG recordist
Neurology Unit 02 EEG recordist per Neurologist/ Paediatric
Neurologist
Leave/ Relief / off 01 EEG recordist
3.2.2.5. National Institute of Mental Health

01 EEG Recordists per 3 Psychiatrists in institutions performing ECT
3.2.2.6. Base Hospitals

01 EEG recordist
Leave/ Relief/ off 01 EEG recordist
3.2.2.7. EEG Recordist Training School

Prinicipal 01 Special Grade EEG recordist
Tutors 02 EEG recordists (Class I / Grade IIA)
Committee Members
Mr. H. S. Fernando DDG/ A1, Ministry of Health
Mr. Nilantha Piyarathna Secretary/ Government Electroencephalographers Union
Mr. Lathika Fernando President/ Government Electroencephalographers Union
44
3.3 Ophthalmic technologists & Orthoptists

3.3.1 Ophthalmic Technologists
The Ophthalmic Technologist is a Technical Officer in the Department of Health, who is

trained to perform ophthalmic procedures under the direct or indirect supervision of an
Ophthalmologist. He/ she will be attached to the Eye Unit of the Teaching/ Provinial/ Base
hospital. He/ she may extend his/ her services at the primary eye care clinics held in the
Primary Healthcare Institutions or other locations.
Currently, there are 152 Ophthalmic Technologists employed in Line Ministry Institutions
and Provincial Health Institutions.
3.3.1.1. Duty Hours: 6½ hrs per day
3.3.1.2. Rationale on cadre :

Routine refractions 10 min. per one patient and Post Operative refractions 10-15 min. per one
patient
One Ophthalmic Technologist shall perform 40-50 refractions per day.
Paediatric refractions 25-30 min per one patient
3.3.2. Orthoptists
Orthoptists assist Ophthalmologists in managing patients with abnormal eye movements,
visual problems and conduct screening programmes for school children. Currently, three
Orthoptists function in the state sector.
Paediatric / Neuromuscular - 30 min per one patient
Other - 20 min per one patient
3.3.3. Cadre
3.3.3.1 National Eye Hospital

Conducts daily OPD and clinics for patients with eye problems. Seven Units consisting 07
Ophthalmologists (Eye Surgeons) are available.
a) Ophthalmic Technologists
Biometry 02
Visual Field (30 – 45 min per one patient) 02
Electro Diagnostic Testing 01
(CCT, OCT, ERG, EOG, VEP, FFA)
Auto Refractor 01
Mobile Unit 03
45
04 OT s per one Ophthalmologist = Total 28
b) 03 Orthoptists for National Eye Hospital
3.3.3.2 TH Kandy
04 OT s per one Ophthalmologist = Total 12
3.3.3.3 Other TH/ Provincial Hospitals/ District General Hospitals

No daily clinics or separate daily OPD for eye problems
02 OT s per one Ophthalmologist
3.3.3.4 Base Hospitals

02 per hospital with an Ophthalmologist
At least 01 per BH with an Ophthalmologist or cadre for an Ophthalmologist is
available
3.3.3.4 Orthoptists
One Orthoptist per Province
3.3.4. School of Ophthalmic Technologists/ Tutorial Staff
Principal. -01
Tutors -04
3.3.4. Necessary Posts to be created

The Superintendent OT
Provincial Incharge OT
Low vision Practitioners
46
3.4. Public Health Inspectors
3.4.1. Norms for the Range
01 Public Health Inspector (PHI) per 10,000 population

01 Supervising Public Health Inspector (SPHI) per Medical Officer of Health area
01 Supervising Public Health Inspector of District (SPHI/ D) per District
01 Supervising Public Health Inspector of Province (SPHI/ P) per Province
3.4.2 .Norms for the Institutions and Specialized Campaigns
3.4.2.1. Ministry of Health

01 Principal PHI
02 PHII
3.4.2.2. National Institute of health Sciences

01 Public Health Senior Tutor
09 Public Health Tutors
01 SPHI/ D
02 SPHII
16 PHII
3.4.2.3. Norms for other Institutions and Specialized Campaigns
Campaign/ Institution No. of PHII No. of SPHI Total

National Blood Transfusion Service 36 01 37
STD/AIDS Control Programme 22 01 23
Airport Health Office 08 01 09
Sea Port Health Office - Colombo, 02 -- 02
Galle
National Programme for TB Control and 11 01 12
Chest Diseases
Public Health Veterinary Service 03 -- 03
47
National Cancer Control Programme/ 02 -- 02
Cancer Institute
Malaria Control Programme 02 -- 02
Family Health Bureau 02 -- 02
Health Education Bureau 01 -- 01
Filariasis Control Programme 02 -- 02
Leprosy Control Programme 01 -- 01
Medical Research Institute 08 01 09
Dengue Control Programme 01 -- 01
Epidemiological Unit 02 -- 02
National Institute of Mental Health 01 -- 01
Each TH/ PGH/ DGH 01 -- --
48
3.5. Norms for Entomological Assistants (EA)

A total of 112 Entomological Assistants are currently employed in health institutions and 50
students are scheduled to be recruited and trained during the year 2011.
3.5.1. Line Ministry Institutions

Control of epidemic situations, co-ordination of all island activities with provincial health
authorities, special projects, assisting implementation of new methods of vector management
are some of their functions.
3.5.1.1. Norm : 02 EA per one Entomological team
Medical Research Institute 10 (08 in position)

Malaria Control Programme 10 (06 in position)
Anti Filariasis Campaign 05 (02 in position)
National Dengue Control Unit 10 (02 in position)
Training School for Entomologists 01 Principal
02 Tutors
Epidemiology Unit 01 Chief Entomological Assisstant
Total 39 (18)
3.5.2. Provincial Level

3.5.1.2. Norm : 01 EA per each Province
01 EA per each District attached to RDHS office
01 Supervisory EA per each District attached to RDHS office
01 EA per each Municipal Council area
01 EA per Regional Malaria office
01 EA per each MOH area
49
3.5.1.3. Distribution of EA
01 EA per MOH area

01 EA per Municipal
01 per RDHS office
01 EA per RMO
Supervisory EA
Provincial EA
Council area
Province
Office
Western 01 03 07 03 38
Southern 01 03 03 03 46
North Western 01 02 01 02 27
Sabaragamuwa 01 02 01 02 28
Central 01 03 03 03 45
North Central 01 02 01 02 26
Uva 01 02 01 02 23
Eastern 01 03 02 03 41
Northern 01 05 01 05 16
Total 09 25 20 25 290
Committee Members
Dr. Premakumara Medical Officer/ AFC
Mr. K.D. N. Sumanasena Secretary/ Health Service Entomological Assistant Officers
Union
Mr. T. Dharmasiri National Co-ordinator/ Health Service Entomological
Assistant Officers Union
50
3.6. Norms for Public Health Laboratory Technicians (PHLT s)

A total of 356 Public Health Laboratory Technicians (PHLT s) are currently employed in health
institutions and will be absorbed to MLT service.
3.6.1. Norms and cadre for Anti Malaria campaign

Preparation of staining, cross checking, drug-sensitivity tests, conducting mobiles and mass
blood surveys, special surveys, purchasing, preparation and distribution of lab reagents and
equipments, maintenance of buffer stocks, in-service training
Monocular and serological diagnosis for NHSL, TH, PGH,
3.6.1.1. Central Laboratory : 10 PHLT s
3.6.1.2. Regional Labs

Preparation of staining, cross checking, conducting mobiles and mass blood surveys, special
surveys, maintenance of buffer stocks
02 per each laboratory in endemic areas
3.6.1.3. Blood Banks and Mobile Malaria Clinics

80-100 blood smears per day + urgent ones
Maintenance of records and stocks
3.6.1.4. Hospitals
Hospital Endemic areas Non-endemic areas
NHSL - 02
TH 02 02
BH-Type A 01 01
BH-Type B 01 01
DH- Type A 01 --
DH- Type B 01 --
DH- Type C 01 --
Primary Medical Institution 01 --
51
3.6.2. Anti Filariasis Campaign

Three types of labs at the central level : PCR labs, parasitological labs, entomology labs
PCR lab - Specimen examination, quality assessment, training activities, special surveys
Parasitology lab - Specimen examination, quality assessment, training activities, special
surveys, reagent preparation
Entomology lab- mosquito dissection, quality assessment, training activities, special
surveys, reagent preparation
Entomological investigation by molecular and serological testing
PCR Lab 2 PHLT s

Parasitology Lab 4 PHLT s
Entomology Lab 2 PHLT s
3.6.2.1. Regional Labs

Seven regional laboratories
Colombo, Kalutara, Gampaha, Galle, Matara, Kurunegala, Puttlam
1 PHLT per FA for microscopy examination
1 PHLT per EA for mosquito dissection
3.6.3. STD/Aids Control Programme

3.6.3. 1. Central lab - Specimen examination, reagent preparation, quality assurance,
demonstrations, refresher training programmes
07 PHLT s
3.6.3. 2. District STD/AIDS Clinics
03 PHLT s per clinic at TH/ PGH
02 PHLT s per clinic at GH/ BH
3.6.4. National Programme for Tuberculosis Control and Chest Diseases

3.6.4.1. Central lab - Smear examination, quality assessment, training activities, culture
smear preparation, refresher training
04 PHLT s
3.6.4.2. District Chest Clinic
01 PHLT for 40 smears per day
52
3.6.4.3. Microscopy Centers
01 PHLT per clinic centre
Leprosy
Identification by Smear examination, molecular biological technique and serological
technique, Preparing smears and reagent
Committee Members
Mr. P.D. Gamini Public Health Laboratory Technician
Mr. A. W. P. M. de Silva Public Health Laboratory Technician
Mr.W. M. K. Gunatunga Public Health Laboratory Technician
53
4. Norms for Middle Level Technical Categories
4.1. Norms for Dispensers

Currently, 1375 Dispensers are employed in the public sector institutions. One hundred and
thirty six Dispensers have been absorbed to the Department of Health during 2010. Forty six
students for estate sector are undergoing training at present.
3.1.1. Duty hours : 8 a.m. to 4 p.m. on week days
8 a.m. to 12 noon on Saturday
Institution Details Cadre Norm
TH Approved cadre to be
remained
PGH
DGH
BH Type A & B
Divisional hospitals Type A 5
Type B 3
Type C 2
Primary care health -- 1
institutions
RDHS office Relief Dispensers 5
Ministry of Health Office of Chief Divisional 2
Pharmacist
Ante-Leprosy campaign 3
Respiratory Disease Control Colombo (at MRI) 3
Program - Clinics
Other clinics 1
Training Centers Narahenpita 4
Kadugannawa 3
Kurunegala 3
Committee members
Mr. Udeni Dasanayaka Dispenser
Mrs. N. D. Rathuwithana Dispenser
Mr. W. A. A. Gajaweera Dispenser
Mr. D. M. G. G. Dissanayaka Dispenser
Mr. R. U. Hettigama Dispenser
54
4.2. Public Health Field Officer (PHFO)

Examination of blood films - 900 per month
4.2.1. Anti Filariasis Campaign

A. Centre (Head Office, Narahenpita)
1 PHFO
B. Districts- Only Endemic areas (Western, Southern and North Western Provinces)
Regional Office
04 PHFO
Duties 1.Cover the special works in District
2. All Filarial Clinics
3. Stores and recording
C. MOH area
01 PHFO for 10,000 population in endemic areas (10,000 blood filming/ year)
04 PHFO per MOH for the non endemic areas to cover the 10000 blood flims/one
year and controlling the other mosquito born diseases
Duties : Health Education, Blood Filming
01 PHFO / spraying unit

One spraying unit in all MoH areas
4.2.2. Anti Malaria Campaign
A. Center – Head Office

06 PHFO - for 3 Entomology Teams (2 PHFO/Entomology Team)
04 PHFO - for Office duties recording work and other duties
Total 10 PHFO
B. Districts
04 PHFO - RMO Office (2 Entomology Teams)
06 PHFO - For Dengue activities and other duties
01 PHFO per Medical Institution (Base, Rural and Districts Hospitals)
55
Duties – Blood filming of all fever patients and health education
C. MOH Office
02 PHFO per MOH for endemic MOH areas
01 PHFO per non endemic MOH area to support Dengue activities
Duties – Spraying, fever surveying, fogging, health education and other controlling
methods of mosquito born diseases
Committee Members
Mr.J. Sunil Shantha Public Health Field Officer

Mr. A.G.Piyasena Public Health Field Officer
Mr. R. K. P. Hewanayakage Public Health Field Officer
56
5. Nursing Officers
5.1. Nursing Officers for Units of Major Speciality
Required No. Nurses

Unit /
Hospital
Ward
M E N Total
Admission 2 2 2
Critically Ill 3 3 2
High
1 1 2
Dependency care
Acute 3 2 1
Non Acute &
2 1 0
Isolation
Diarrhoea
Paediatric TH, PGH, DBH 1 1 1 42
Treatment Unit
Chronic Cases 1 1 0
Baby Room 1 1 1
Ward
1 1 0
Management
Specimen &
2 0 2
Report
Sister Incharge 1 0 0
Total 18 12 11
Ratio
57
Required No. Nurses

Unit /
Hospital
Ward
M E N Total
Admission/
1 1 1
Discharge
Critically Ill/Post
3 3 2
Op.
High Dependency
1 1 0
care
Acute 3 2 1
Surgical TH, PGH, DBH Non Acute 1 1 1 28
Ward
Management & 1 1 1
Specimen Report
Dressing 2 0 0
Total 13 9 6
Ratio 4 3 2
Admission 2 2 1
Critically Ill/Post
2 2 1
Op.
Acute 2 2 1
Non Acute &Pre
Gynaecolog 1 1 1
TH,PGH,DBH Op 26
y
Ward
Management & 2 2 1
Specimen Report
Dressing 1 0 0
Total 11 8 4
Ratio 5 4 2
58
Required No. Nurses

Unit /
Hospital
Ward
M E N Total
Admission/
2 2 1
Discharge
Critically Ill-02
1 1 1
Beds
Acute- 10 Beds 2 2 1
High Risk
Mothers - 15 5 5 2
Beds
Ante Natal TH,PGH,DBH Ward 31
Management &
2 1 1
Non Acute - 10
Beds
Isolation - 3 Beds 1 0 0
Total 13 10 6
Ratio 6 5 3
Admission /
1 1 1
Discharge
Post Op & Post
3 3 2
Delivery Mothers
Brest Feeding 1 1 0
Birth
Registration & 1 1 0
Discharges
Post Natal TH, PGH, DBH 23
Ward
Management & 3 1 1
Non Acute
Immunization &
1 1 0
Health Education
Total 11 8 4
Ratio 5 4 2
59
5.1.1. Summary of the Major Specialities
Unit M E N Total
Paediatric Unit 16 12 6 42
Medical 13 9 6 28
Surgical 13 9 6 28
Gynaecology 11 8 4 26
Antenatal 13 10 6 31
Postnatal 11 8 4
60
5.2. Nursing Officers for Units of Subspecialties
Proposed Norm
Discipline Hospital Norms Beds Beds M E N Total

Critical 20 3 3 2
Moderate 20 2 2 1
Self care 40 2 2 0
Other
activities 1 1 0
Neurology
NHSL, TH Total 8 5 3 19
Critical 5 3 3 2
Provincial
General Moderate 15 3 2 1
Hospital Self care 20 40 2 2 1
Other
activites 1 1 1
Cardiology Total 9 7 4 22
Critical 10 3 3 2
Provincial
General Moderate 10 2 2 1
Hospital Self care 20 40 2 2 0
Other
activities 1 2 0
Oncology Total 8 5 3 20
Self Care 3 2 1
Moderate
care 4 3 2
Rheumatology Total 40 7 5 3 15
Self Care 3 2 1
Moderate
care 40 4 3 2
Dermatology Total 7 5 3 15
61
Proposed Norm

Self Care 3 2 2
Moderate
care 40 4 3 2
Respiratory Total 7 5 4 16
Critical 2 1 1
Moderate 40 5 4 3
Self Care 5 4 3
Psychiatry Total 12 9 7 28
Critical Care 20 10 8 10
Moderate 20 5 4 3
Self 40 0 0 0
Other 2 1 0
Neuro Surgery Total 17 13 13 43
Moderate 15 5 4 3
Self 20 40 3 2 1
Cardio Other 1 0 0
Thoracic Total 12 8 6 26
Critical Care 2 1 1
Moderate 8 6 4
Self 40 0 0 0
Other 2 0 0
Orthopaedic Total 12 7 5 24
Moderate 40 6 5 3
Other 1
Eye Total 7 5 3 15
62
Proposed Norm

Moderate 10 3 3 2
Self 25 40 2 2 1
Other 1 0 0
ENT + OMF Total 8 7 4 19
Moderate 10 3 2 1
Self 20 40 2 1 0
Other 1 1 0
Onco Surgery Total 11 8 5 25
Moderate 10 2 1 1
Self 22 40 1 1 1
Other 1 0 0
Plastic Total 8 5 3 16
Moderate 40 5 3 2
Self 20 3 2 1
Other 1 0 0
Total 9 5 3 17
63
5.3. Nursing Officers in Specialized units

Required No. Nurses
Discipline/Unit Hospital Norms Nurses M E N Total

Nurse Incharge 1
Shift Incharge 1
Assisting Nurse 2
Running Nurse 2
Recovery Nurse 2
OT (With 2 TH,
Helping Nurse 2 13 12 6 29
beds) PGH,DBH
Sterilising 2
Receiving
Patients public
relation &
documentation 1
Drug Nurses 1
Recap 2
Transplant TH,
Theatre PGH,DBH
Refusion 2 16 15 31
TH,
PGH,DBH
Sister Incharge 1
Shift Incharge 1
ICU, CCU, NICU
Patient Care 1x5
Sterilize supply
nurse 1 8 6 6 25
Drug Nurse 1
TH, Total care
PGH,DBH feeding,
Premature Baby Phototherapy,
Unit Cannulation,
Maintenance of
incubator 8 6 6 20
64
Required No.
Nurses
Same as
General ICU 8 6 6
TH,PGH,
Cardiac ICU 29
DBH
Baloon Pump 1 1 1
CRRT 2 2 2
TH,PGH,
DBH
Nurse Incharge 1
Assisting&
Monitoring 1 3 3 3
Supplies
Labour Rooms &Equipments 1 1 1 1 23
Documentation 1 1 1 1
& Staff
Education
Deliveries 3 3 2
DH & RH 2 2 2 6
Nurse Incahrge 1
TH,PGH,
X ray & Radiology CT 1
DBH
MRI 1
DSA 4
IVP X ray 1 8
65
Required No.
Nurses

Assisting 1
Sample
TH,PGH Preparing 1
Sample &
report
Medical handling 1 3
Investigation Unit
Assisting 1
Sample
Preparing &
DBH handling 1 2
Nurse In
charge 1
NH,TH, Assisting 1
Endoscopy Unit
PGH Recovary 1
Sterilization 1 4
Sister /Nurse
incharge 1
TH, Shift incharge 1
High Dependency U.
PGH,DBH Critical Care 8
Drugs Nurse 1
Sterlize supply
nurse 1 8 6 6 23
Sister /Nurse
incharge 1
Critical Care
TH, Sterlize supply
Isolation Unit
PGH,DBH nurse
Specific
Investigations
& Treatments 4 3 2 9
66
Required No.
Nurses
Sister incharge 1
Shift incharge 1
TH,
Dialysis Unit Critical Care 5
PGH,DBH
Drugs Nurse 1
Sterlize supply
nurse 1 8 6 6 20
Sister Incharge 1
Duty Area 3
Clean Area 4
NH, TH Sterile Area 1 8 8 3 19
Sister Incharge 1
CSSD Duty Area 1
Clean Area 2
PGH Sterile Area 1 4 4 2 10
Sister Incharge 1
Duty Area 1
Clean Area 1
Sterile Area 1
DBH 3 3 1 7
67
Required No.
Nurses

Sister Incharge 1
Donor Section
Registration 2
Bleeding from
Donors 2
Issuing Blood
& Component 2
Registration
NH Room 4
Plasma
Blood Bank Exchange 2
Special Mobile
Team 4
Documentation 1
Relief Blood
Bank 2
Night Duty 2 21
Special Mobile
TH,PGH & relief 2 5 3 2 12
DBH 2 2 1 5
68
Special Unit – Summery
Type of
Unit Hospital Proposed Norm
Incharge M E N Total
OT 1 12 11 6 29
ICU 1 8 6 6 20
PBU/SCBU 1 8 6 6 20
Neuro ICU 1 8 6 6 20
CSSD 1 8 8 3 19
CCU 1 8 6 6 20
TH,PGH,DBH
Cardiac ICU 1 11 9 9 29
Isolation Unit 1 4 3 2 9
Blood Bank 1 29
Radiology Dep. 1 10
Pathology 1 5
Endoscopy Unit 1 5
Dialysis Unit 1 8 6 6 20
High Dependency
Unit 1 8 6 6 20
Blood Bank 1 29
CSSD TH,PGH 1 3 3 1 10
Endoscopy /Path 5
Blood Bank 1 2 2 2 6
Labour Room 1 2 2 2 6
69
5.4. Nursing Officers for Other Areas
Proposed Cadre
Area Hospital Norms M E N Total

Dressing 4 7 0
Injection 3 5 0
Blood Drawing 4 4 0
Special
Procedures 3 6 1
Vaccinations 3 5 0
OPD Reception 1 1 1
Incharge
Officer 1 1 1
Day OT 4 4 0
Observation (4
beds) 3 2 1
TH HDU 1 1 1
Orthopaedic 6/200
Gynaecology 4/500
Obstetrics 4/150
Neonatology 4/50
Medical 4 /600
Surgical 4/ 400
Cardiac 8/300
Oncology 8 /250
ENT 4/100
Clinics
Skin 4/200
Eye 4/200
Chest 4/ 200
Psychiatry 4/200
Neurology 4/200
STD 4 /200
Rheumatology
Family
Planning
Diabetic
70
Proposed Cadre

Ward
Management
Nebulizing
Special IM/IV
procedures
Suturing
Serum
ETU administration 1/Bed/Shift
Invesigations
BT/CT, ECG etc.
Monitoring of
patients
Total Nursing
care
Accompany
Transfer
Dental
Strelization
Injections
Suturing
Extraction
Fillings
Nurve Filling
I&D 1/Chair
Minor + 1 In
procedures charge
71
Proposed Cadre

Reception 1 1 1
Examination 1 1 1
Resuscitation 2 2 2
Injection 2 1 1
Dressing 4 3 3
Accident Mini OT 4 3 3
Service Observation 3 2 3
Plaster Room 4 3 3
In- Charge 1 1 1
Supply &
equipment 1 1 1
ETU 2 2 2
NHSL 4
PGH,
Health Prom. Special H 3
DGH 2
Small Hos 1
NHSL 20
PGH &
Infection Con. Special H 5
DGH 3
Small Hos 2
72
5.5. Nursing Officers for Divisional Hospitals
Proposed
Hospital Norms Cadre
OPD Incharge 1
Clinics Incharge 1
Injection & Dressing 2
Divisional H. -
A Health Promotion/Infection Control 1
ETU/ Direct Patient Care 5
Ward 24
OPD & Clinic Incharge 1
Divisional H. -
B Health Promotion/Infection Control 1
ETU/ PCU 5
Ward (4 wards) 12
OPD & Clinic Incharge 1
Divisional H. -
C Health Promotion/ Infection Control 1
ETU/ PCU 5
Ward 10
6. Norms for Midwives
73
There are 6568 Midwives attached to hospitals and Provincial level by mid-2010. Currently
500 Midwives are undergoing training and another 500 will be recruited for training during
2011.
6.1. Midwives in Hospitals

6.1.1. Teaching, Provincial and Base Hospitals
Norm : One Midwife per 10 deliveries

Antenatal ward - 7 .00 a.m. - 1.00 p.m. - 04
(40 beds per unit) 1.00 p.m. - 7.00 p.m. - 04
7.00 p.m. – 7.00 a.m. - 03
Total - 11
(additional 01 per 10 floor patients)
Postnatal ward - 7.00 a.m.- 1.00 p.m. - 04

(40 beds per unit) 1.00 p.m.-7.00 p.m. - 04
7.00 p.m. – 7.00 a.m. - 03
Total - 11
(additional 01 per 10 floor patients)
Labour Room
(06 Beds per Unit) 7.00 a.m.- 1.00 p.m. - 03
1.00 p.m.-7.00 p.m. - 03
7.00 p.m. – 7.00 a.m. - 03
Total - 09
Clinic Services for 100 Patients

7a.m.- 3.00 p.m. - 03
Ambulance Duty - 02
24 Hrs OPD services for Women’s Hospitals - 03
Established Lactation Management Centre - 01
74
6.1.2. District Hospitals
20 Beds Maternity Units with a labour room (02 beds). Bed occupancy rate approx. 35%
7.00 a.m.- 1.00 p.m. - 02
1.00 p.m.-7.00 p.m. - 02
7.00 p.m. – 7.00 a.m. - 02
Total - 06
6.1.3. Peripheral & Rural Hospitals

15 Beds and a labour room (02 beds). Bed occupancy rate 15%
7.00 a.m.- 1.00 p.m. - 01
1.00 p.m.-7.00 p.m. - 01
7.00 p.m. – 7.00 a.m. - 01
Total - 03
5.1.4. Justification
Antenatal Wards
7 a.m. – 1.00 p.m. 1. Admission – urine, temperature, pulse, FHS, checking
2. Bed making
3. Perineal care if necessary
4. Preparation of the patient for labour or LSCS
5. Helping the doctors to examine the patient on admission
6. Accompanying the VOG during ward round
7. Accompanying the mother to O.T
8. Health Education
9. Accompanying the mother for referral
10. Handing over and taking over
11. FHS Checking
1.00 p.m.-7.00 p.m. All the activities given in above except health education
7.00 p.m. – 7.00 a.m.

1. Admission
2. FHS, monitoring
3. Preparation of the patient for labour or LSCS
75
4. Handing over & Taking over
Post Natal Services

1. Bed Making
2. Post-natal care
3. Care for baby
4. Assisting Breast feeding
5. Health education and counseling
6. Handing over and taking over
Labour Room
1. FHS recording and monitoring the progress
2. Assisting delivery (normal)
3. Observation of delivered mother and baby for 2 hrs- including
dressings, feeding
4. Assist the doctors for suturing of episiotomy
5. Cleaning of labour room instruments
6. Lactation Management
7. Preparation of the bed for delivery
8. Accompany mother and baby to post-natal ward and hand over
6.2. Public Health Midwives (PHM s)

Public Health Midwife is the grass root health worker who reaches each family and delivers
individual and family care.
6.2.1. Duty Hours - 8.00 a.m. – 4.00 .p.m. on week days
8.00 a.m. – 1.00 p.m. on Saturday
7.30 a.m. – 3.30 p.m. on Clinic days
6.2.2. Norm according to the population of the area

01 Midwife per 3000 population
Difficult Geographical areas – 1/2 relief PHM s will be attached to RDHS/PDHS office
6.2.3. Supervisory Public Health Midwives (SPHM)*
76
01 SPHM per 10 PHMM
Each SPHM should do 10 supervisions per month including clinic supervisions
Duty hours - Week Days 8.00 a.m. – 4.00 p. m.
Saturday 8.00 a.m. – 1.00 p. m.
* Selection from grade I Senior PHMM and Training for 3 months
6.2.4. Activities of Public Health Midwife

1. Nutrition / Growth Monitoring
2. Health Promotion and Education
3. Promotion of Brest Feeding & Complementary feeding
4. Distribution of Family Planning Items
5. Counseling & referral with regard to family planning
6. Adolescent health & pre-pregnancy counseling
7. Registration of Eligible Families
8. Home visits – antenatal, postnatal, infant, preschoolers, for pre and post
immunization, subfertile couples, risk families
9. Clinic services (ANC/well baby /postnatal/FP/Well Women Clinic)
10. Record keeping with all the registers
6.2.5. Duties of the SPHM
1. Supervision of the PHMM and clinic activities

2. Field supervision to evaluate PHM services
3. Prepare Consolidated MCH Master sheet
4. Prepare family planning consolidated return
5. Participate for Monthly and Local Conferences
Committee Members
77
01. Mrs. D. Ubeywarna Director Nursing / Public Health Services
02. Dr. Mrs. C.J. Gunasekara Acting Director / CSHW
03. Mrs. K.S.R. Jayasekara Special Grade Nursing Officer / FHB
04. Mrs. J.M.R.S. Priyadarshani Special Grade Nursing Officer / DGH Gampaha
05. Mrs. R.P. Perera Special Grade Nursing Officer / CHSW
06. Mrs. R.S.M. Gunarathna Special Grade Nursing Officer / DMH
07. Mrs. M.K.G Menike PHNS / Mahara
08. Mrs. M.W.J Perera Nursing Sister/ TH Ragama
09. Mrs. Kusuma Dias Union Midwifery/ All Ceylon
10. Mrs. Dulsey Hemalatha Silva Union Midwifery / SLMA
11. Mrs. Deepani Champa Perera PHM / Moratuwa MOH
12. Mrs. M.P.T.R Kumarai PHM/ Kaduwela MOH
78
7. Norms for Other Categories

7.1. Norms for Ambulance Drivers
Institution No. of Drivers Remarks

04 drivers for 03 vehicle Forman, 15 ambulance
National Hospital
ambulances needed
01 per one vehicle
04 drivers for 03 01 Driver Overseer for more than
TH/PGH/ DGH
ambulance 10 Drivers,
01 Driver Overseer for more than
04 drivers for 03
DBH 10 Drivers, Clinical Patient
ambulances
Vehicle
Divisional Hospital Type A/
B/ C/ 01 driver for 01
one driver for one vehicle
Primary Medical Care Units/ ambulance
Estate Hospitals
Veterinary Office 01 driver for one vehicle
PDHS Office 06 Drivers for 5 vehicles
RDHS Office 01 driver for one vehicle
Nursing Training School one driver for one vehicle

Regional Medical Supplies Minimum 03 vehicles –
Division 03 drivers
01 per vehicle, 02
additional drivers for 10
vehicles in the pool, 01
Ministry of Health Driver Overseer for more
than 10 drivers, 02
Formans, 01 Technical
Engineer
79
7.2 Norms for Labourers

Type of
Ward/ Unit No. of Labourers Remarks
Hospital
Morning -10, 5 for 50
TH/PGH/
OPD (with 1000 patients) admissions, 8 for afternoon,
DGH
1 per night
Injection Room/ Mornnig-3 (1 per each
Dressing Room/ Admission 6 station), Afternoon – 2,
Night - 1
Clinics 01 per Clinic
Morning - 15, Evening- 10,
Accident Services Unit 30
Night- 5
Morning -6, Afternoon- 4,
PCU 16
Night - 6
Morning - 1, Afternoon- 1,
ETU (4 beds) 3
Night-1
one per occupied bed for
HDU 1/ bed
each shift
Morning - 4 for one table, 2
for each additional table, 3
OT
for one table after noon, 2
for night,
Morning - 3, After noon- 2,
MICU (6 beds) 7
Night -2
Morning - 3, After noon- 2,
SICU (6 beds) 7
Night - 2
Neuro Surgical Unit (40 Morning - 3, After noon- 2,
6
beds) Night -1
CCU 1 per bed
3 per 5 patients
Dialysis Unit
undergoing dialysis
Laboratory 1 per each section
Blood Bank 1 for shift
Physiotherapy Unit 1 per unit
ECG 2 per 3 technician
1 per machine, 1per
Radiology 3
scanning, 1 per dark room
Dispensary 1
Indoor Pharmacy 1
Out Door Pharmacy 2
Drug Stores -
Exercise ECG 1 per Unit
Speech Therapy Unit 1 per unit
Morning – 3, Afternoon –
Premature Baby Unit 7
3, Night - 1
80
Morning – 2, Afternoon –
Labour Room (10 beds) 4
1, Night - 1
Morning - 6, Afternoon – 4,
Burns Unit (15 beds) 12
Night - 2
Endoscory Unit 3 1 per each shift
CT / MRI Room 6 2 per shift
CSSD 10
Medical Ward (Assume 50 Morning - 3(1 per 15 beds),
06 for 3 shifts
beds) Afternoon – 2, Night - 1
Surgical Ward (30 beds + 15 Morning - 2, Afternoon – 2,
5
Floor patients) Night - 1
Paediatric Ward (30 beds+ Morning - 2, Afternoon – 1,
4
15 Cots ) Night - 1
Gynaecology Ward
3 1 per shift
(20 beds)
Obstetric Unit Morning - 3, Afternoon – 1,
5
(40 beds) Night - 1
Orthopaedic Ward 5
Night - 1
Skin (30 beds) 3 1 per shift
Eye (30 beds) 3 1 per shift
ENT (30 beds) 3 1 per shift
Psychiatric Ward (30 beds) 6
Night - 2
GI Ward (30 beds) 4
Night - 1
Kitchen 2 for shift
Office 1
Garden 2
Other Institutions
Institution No. of Labourers Remarks
Special Campaign 4 per Campaign 7 a.m. to 5 p.m.
Training Centre 1 per floor
Provincial Director of Health
2 7 a.m. to 5 p.m.
Services
Regional Director of Health
3 7 a.m. to 5 p.m.
Services
MOH 2 7 a.m. to 5 p.m.
RMO/AMC 2 7 a.m. to 5 p.m.
STD Clinic 2
Chest Clinic 2
School Dental clinic 1 7 a.m. to 5 p.m.
81
7.3. Norms for other staff
Category Type of Hospital No. of Labourers Remarks
TH/PGH/ DGH 06/ day

Pump Operator
DBH 02/ day
RDHS 3/ day
THH/PGH/ DGH 3
Mason DBHH 1
RDHS 3
Morning – 5,
Cooks TH/PGH/ DGH 10 Afternoon - 3,
Night - 2
Three Wheel Operator TH/PGH/ DGH 1 per vehicle
TH/PGH/ DGH 1
Spray Machine Operator MOH 5
RDHS 6
Electrician TH/PGH/ DGH 2

Carpenter TH/PGH/ DGH 2
82

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Norms for the Health Cadre

1. Norms for Medical Officers ....……………………………………………………2

2. Norms for PSM Categories

3. Norms For Other Paramedical Categories

4. Norms for Middle Level Technical Categories

5. Norms for Nursing Officers …………………………………………….……..57

6. Norms for Midwives …………………………..……………………………….74

7. Norms for Other Categories

1. Norms for Medical Officers

Some methods for estimating HRH

Population ratios: ratios of providers to the entire population;

Health needs: based on known health needs of a population;

Job-based: based on estimating the number of staff belonging to specific cadres

Task- or function-based: based on analyzing a task;

Some Work Measurement Techniques

Direct Time Study (DTS)- for repetitive tasks

Predetermined Motion Time systems (PMTS)

Standard Data Systems (SDS)

Work Sampling- for multi tasking

Other factors need to be considered

Future expansion of health care facilities

Epidemiological and demographic transitions

Advancement of medicine and further specialization

Situations specific to country

For one theatre suite

Intensive care/Critical care

Emergency rooms (Level 4)

Major Specialties (Medicine, Surgery, Peads,O&G)

Finer Specialties (with in ward patients)

Medical Officer of Health

Out door , indoor ,clinic patiants & medical officer

1 Dh Aranayaka 122132 7113 40272 7 4 7 (50:1) 1(20:1) 1(75;1) 9

2 Dh Rambukkana 132969 12663 58696 10 8 7(50;1) 2(20;1) 2(75;1) 11

3 Dh Undugoda 60630 4595 25428 7 3 3 (50;1) 1(20;1) 1(75;1) 5

4 Dh Daraniyagala 63974 5444 26904 7 4 4(50;1) 1(20;1) 1(75;1) 6

Dh Kithulgala 73604 5520 25408 6 3

One MO per 50 OPD patients / per day

2. Norms for PSM Categories

2.1.2. Norms for Radiographers per x-ray machine

For each functional static X-ray machine

2.1.3. Norms of Radiographers for Radiotherapy centres

Category II Radiotherapy centre

Category III Radiotherapy centre

Cobalt Teletherapy unit 02 06

Treatment Planning Unit 01 02

Radiotherapy Description No. of Units No. of

2.1.3.3. Norms of Radiographers for Specialized Units

Dr. J. M. W. Jayasundara Bandara – DDG (Planning)

2.2.2. Duty hours : Monday to Friday - From 8 a.m. to 4 p.m.

On call duty when needed.

2.2.3. Norms for Physiotherapists according to the unit

2.2.4. Proposed Areas

Each district is proposed with 01 rehabilitation centre with 02 physiotherapists.

2.3 Occupational Therapists

 Patients with psychiatric care/ Paediatric patients/ Institution Based

2.3.2 Norms for Occupational Therapists according to the institution

National Hospital of Sri Lanka