UNIT 6 VOLUNTARYAND

INTERNATIONAL HEALTH
AGENCIES
Structure
6.0 Objectives
6.1 Introduction
6.2 Voluntary Health Agencies
6.21 Functions
6.2.2 Voluntary Health Agencies in India
6.3 International Health Agencies
6.4 Let Us Sum Up
6.5 Answers to Check Your Progress
6.6 Further Readings

6.0 OBJECTIVES
After going through this unit, you should be able to:
discuss the importance of voluntary, and International health agencies in Health
Care system;
describe various voluntary Health agencies operating in India for betterment of
people's health in India; and
discuss the role of International health agencies collaborating in Health Care
Systems of India.

6.1 INTRODUCTION
As you have learnt that the healthy people are vital to economic and social
dev~:lopment.Although the country has made significant progress in improving the
health of its population, the statistics on Inpia's fertility rates, HlV and infectious
disease burden and child survival issues point towards the need for continued
investments to expand programs, identify new models of inteirventions and develop
approaches to ensure sustainability. Failure to address the uhmet needs for family
planning and reproductive health, increasing HIV transmissiaas, and a significant
burclen of child mortality could plunge India into a downward spiral of political
instability, decreased economic growth, environmental degratdation and an
unmanageable burden of disease.
The capacity of the public sector to meet the health cafe ne:eds remain severely
limiled. Thus a global collaborative net work is essentially required for the
advancement of health and quality of life of all inankind. India's voluntary
heallh agencies have achieved important results over the la~stthree decades.
Intetnational Health agencies are closely associated with 'hdia's health programmes
and i%ey are the specific donors on number of issues and providing economic support
for various health programmes. In this unit we shall focuc: an various voluntary health
agencies and Lnternational health agencies contributing in the health care delivery
system.
Community Health
Nursing Administration 6.2 VOLUNTARY HEALTH AGENCIES
The Voluntary health agencies occupy an important place in community health
programmes. "A voluntary health agency may be defined as an organization that is
administered by an autonomous board which holds meetings, collects funds for its
support chiefly from private services and expends money, whether with or without
paid workers, in conducting a programme directed primarily to promote public Health
by providing health service or health education or by advancing research or legislation
for health, or by a combination of these activities".

6.2.1 Functions
The types of service rendered by voluntary health agencies have been classified as
follows.

a) Supplementing the Work of Government Agencies: It is well known that

government agencies cannot provide complete service because they operate
under financial and statutory restrictions. The voluntary health agencies can help
strengthen the work of government agencies by lending personal, or by
contributing funds for special equipment, supplies or services
Z
b) Pioneering: The voluntary health agencies are in a position to explore ways and
means of doing new things. Research is one form of pioneering. When the efforts
succeed and bear fruit, the government agencies can step in and take over the
project for the benefit of the larger numbers.. The family planning programme in
India is an example of pioneering by the voluntary agencies which first
spearheaded the movement in the face of much opposition. When the importance
of family planning was realized, the government accepted family planning as
national policy.

C) Education: There is unlimited scope for health education in India. The

govenunent agencies cannot cope with the problem, unless it is supplemented by
voluntary effort on the part of the people.

d) Demonstration: By putting up demonstrations and experimental projects, the

voluntary health agencies have advanced the cause of public health. The
'
demonstration of bore-hole latrines by the Rockefeller Foundation to solve the
problem of hookworm in India is a case in point. The bore-hole latrine and its
modifications have since become an essential part of the environmental sanitation
programme in India.

e) Guarding the Work of Government Agencies: By setting a good example the

voluntary health agencies can always guide and criticize the work of government
agencies.

f) Advancing Health Legislation: The voluntary agencies can also mobilize public
opinion and advance legislation on health matters for the benefit of the whole
community.

6.2.2 Voluntary Health Agencies in India

The various voluntary health agencies are discussed below:

1) Voluntary ~ealth~~ssocintion
of India (VHAI)
VHAI is a non-profit, registered society formed in the year 1970. It is a federation of
24 state voluntary health associations, linking together more than 4000
,
health care
institutions and grass-root level community health programs spread across the country. Voluntary and Interriational
Health Agencies
Objective%
V,HA17sPrimary objective is to make health a reality for the people of India by
promotirlg comnunity health, social justice and human rights related to the provision
and distribution of health services in India.
VI-IAI tries to achieve these goals through campaigns, policy research and advocacy,
need basea training, media, parliament interventions, publications and audio-visuals,
dissemination of information and running of health and development project in some
difficult areas.
VHAI walks for people centered policies and their effective implementation. It
se~lsitizesthe general public on important health and development issues for evolving
sustainable health movement in the country with due emphasis on its rich health and
cultural heritage.

2) Indian Red Cross Society (IRCS)

Th: Indian Red Cross is a voluntary humanitarian organization having a network of
ovt:r 700 branches throughout the country, providing relief in times of disasters,
emergencies and promotes health and care of the vulnerable people and communities.
It i s a leading member of the largest humanitarian organization in the World, the
International Red Cross and Red Cross Crescent movement.
The mission of the Indian Red Cross is to inspire, encourage and initiate at all times all
fonns of humanitarian activities so that human sufferings can be minimized and even
prevented and thus contribute to creating more congenial climate for peace,
Indian Red Cross Society (IRCS) was established in 1920 under the Indian Red
Cross society Act and incorporated under Parliament Act XV of 1920. The act
was last amended in 1992 and rules were framed in 1994.
The IRCS has 35 statelunion territories branches with their more than 700
districts and sub-district branches.
His Excellency The President of India is the President and Hon'ble Union Health
Minister is the Chairman of the Society.
. The Vice Chairman is elected by the members of the managing body.
The National managing body consist of 19 members.
The chairman and 6 members are nominated by the President. The remaining 12
members are elected by the state and union territory branches through an
electoral college.
The Managing body is responsible for the governance and supervision of the
functions of the society through number of committees
The Secretary General is the Chief Executive of the Society.

The Seven fundamental Principles of Red Cross are:

Humanity
Impartiality
Neutrality
Independence
Voluntary service
TJnity
0 ' 1Jniversality.
Community Health Red Cross on a white background is the Emblem of Red Cross, recognized in
Nursing Administration 1864 as the distinctive sign for Medical relief teams on the battle field.
During the General Assembly and the Council of Delegates in November 2005 at
Geneva,Red Crystal has been adopted as another emblem for the Red Cross Red
Crescent movement. National Headquarter of IRCS is in New Delhi, (Web site:
www.indian redcross.org).
3) Hind Kusht Nivaran Sangh (Indian beprosy Association)
There are about 40 lakh leprosy patients in India. The scourge and agony of the
disease is very well known and it is for this reason that the Mass Scale Treatment and
Rehabilitation programme of leprosy affected persons was launched with the
establishment of Hind Kusht Nivaran Sangh, on all India level in the year 1949. It acts
as a useful bridge between the Government and non-Governmental organization
engaged in leprosy elimination, to strengthen collaboration and co-ordination for a
'common goal i.e. prevention and treatment of leprosy and rehabilitation of the cured
person.
At the National level, Hon'ble President of India is the President of the Sangh and
union Health Minister is the Chairman.
Main Objectives
a) To control leprosy and provide relief and assistance to the afflicted person and
their family.
b) To collaborate and co-ordinate with other organization already working for the
control and elimination of leprosy and also with the organizations working for
orthopaedicallyhandicapped.
c) To promote social research into the cause and treatment of Leprosy.
d) To devise means whereby the result of such risearch may be communicated
effectively to the social workers, medical professionals and the public.
e) To establish and maintain institutions for the treatment of patients by up-to-date
scientific methods, extension of existing institutions or establishing new ones.
f) To educate the public opinion with regards to the disease of leprosy and its control
through latest medicines

g) To establish children homes for healthy and non-affected children of the leprosy
affected parents.
h) To establish residential institution for cured people on subsidized bases
i) To establish training centers for leprosy and paramedical workers.
j) To establish centers for occupational therapy, physio-therapy and medicinal
therapy.
The following economic rehabilitation programmes were started for cured leprosy
affected persons:
i) Production of Mandloom cloth

ii) Physiotherapy unit q d plastic surgery

iii) Poultry fanning
iv) Cultivation of vegetables
v) Sewing Centre
vi) Farming, etc.
In pursuance of the above objectives, the Delhi Branch of the Hind Kusht Nivaran VoIuntary m d International
Sangh established a colony "Anand Gram" comprising of 400 leprosy affected Healttl~Agencies
people in the year 1961. 1 18 pucca tenements are constructed for the inmates of
Anand Gram. Above mentioned economic rehabilitation programmes are also in
operation in Anand.Gram.After 18 years of its establishment Anand Gram was
handed over 10 the Delhi Government. This is a Joint venture of Departments of
Social welfare, Delhi Government and Hind Kusht Nivaran Sangh Delhi. The Delhi
~Govt.has included this project in its five year plans. This will be a unique institution of
North India where diagnosis, different types of test, treatment, and social research and
rehabilitation aspects will be covered.

4) Indian Council for Child Welfare (ICCW)

Indian Cour~cilfor child welfare is a voluntary organization working for the
development of disadvantaged children in child rights issues like child labour, female
infanticide, child abuse, early child hood care and education through direct intervention
programmes with children training, advocacy and action-oriented research. The
c~mncilwas established in 1952. It is affiliated with the international Union for Child
Welfare. Since its formation, the ICCW has built up a network of state councils and
district councils all over the country. The services are devoted to secure for Indian
Children those opportunities and facilities, by law and other means which &e
necessary, to enable them to develop physically, mentally, morally, spiritually and
socially in a healthy and normal m,anner and in conditions of freedom and dignity.

5) fiberculosis Association of India

The Tuberculosis Association of India was formed in 1939. It has branches in all
states in India. The activities of this association comprise organizing a TB Seal
Campaign every year to raise funds, training of doctors, health visitors and social
workers in antituberculosis woik, promotion of health, education and promotion of
consultations and conferences. The following institutions are under the management of
the Association.
The New Delhi Tuberculosis centre,
The Lady Linlithgow Sanatorium in Kasauli,
The King Edward VII Sanitation at Dharampur, and
Tuberculosis Hospital at Mehrauli.
6) Bharat Sevak Samaj (BSS)
The Barat Sevak Samaj is a non-political and non-official organization established in
1952,. One of the prime objectives of the Bharat Sevak Samaj is to help people to
achic:ve health by their own actions and efforts. The BSS. has branches in all the
states and in nearly all the districts. Improvement of sanitation in villages is one of the
important activities of the B.S.S. Self help group's self development initiatives of BSS
have made a significant difference to the lives of poorest community.
7) Central Social Welfare Board (CSWB)
Central social welfare Board is an apex organization for the welfare of women,
children and the disadvantaged groups. The CSWB was set up in 1953 with the
objec~ivesof promoting social welfare activities and implementing welfare
progrlunmes for women and children through voluntary organizations. The CSWB is
unique in the sense that it was the first organization in post independence era to
achieve people's participation for implementation of welfare programmes for women
and children through NGOs. The CSWB within the broad objectives of empowering
women and providing for the needs of children is implementing the following
programmes/activities.
L

Community Health Condensed Courses of Education and Vocational Training to Needy and
Nursing Administration Deserving Women through voluntary organizations. The grant is given to the
voluntary organization to conduct courses of a 2 years duration to enable women of
the age 15 plus to pass Matricl Secondary, middle and primary level examination. The
training is given in different vocation such as Draft, designing, Computer cohrses, type
setting, Batik, Handloom weaving, Nursery Teacher Training, Stenography etc.
Awareness Generation Programme for Rural and Poor Women
The aim of this programme is to create awareness among rural and poor women on
various social issues so that they can realize their importance in the family and society.
Socio Economic Programme (SEP)
Under this programme, voluntary organizations are given financial assistance to take
up variety of income generating activities which include the handlooms, handicrafts,
agro-based activities such as animal husbandry, sericulture and fishery and self
employment ventures like vegetables or fish vending etc. ,
Support Services
The programme of cr&chesfor children of working and ailing mothers provide day
care services to the children of mothers from lower income group families who are
working or ailing. Assistance is given to voluntary organizations to run working women
Hostels also.
Voluntary Action Bureau and Family Counseling Center
The Centre provides preventive and rehabilitative services to women and children who
are victims of family maladjustment and atrocities.
Mahila Mandals Programme
This programme is the decentralized programme of Board and is being run by the
state Boards. This programme was started in 1961-62 in those areas where there are
no voluntary organizations to take up welfare services for women and children. These
groups of women function essentially like NGOs and they fdnn the entry point for
comprehensive welfare services to be taken to the grass-root level.
Balwadi Nutrition Programme
Under the Scheme supplementary food, health education and recreation facilities are
provided to children for 3-5 years belonging to low income families.
Welfare Extensions and the Border area projects
These are the multipurpose projects which extend services such as pre-primary school
education, craft activities, Maternity services and recreational facilities in rural areas.
The other activities includes family counseling, monitoring and evaluation of schemes
being implemented in states and publication of Monthly Journals, namely 'Social
Welfare' (English) and 'Samaj Kalyan' (Hindi)
8) The Kasturba Memorial Fund
Created in Commemoration of Kasturba Gandhi, after her death in 1944, the fund
was raised with the main object of improving the lot of women, especially in the
villages, through gram sevikas. The trust has nearly a crore of rupees and is actively
engaged in various welfare projects in the country.
9) Family Planning Association of India (FPAI)
The family planning Association of India was formed in 1949 with its head quarter at
Bombay. It has done pioneering work in propagating family planning in India. The
Association has branches all over the country. These branches are running family Voluntary and International
planning clinics with grant-in-aid from the Government. It aims to promote family Health Agencies -
planning as a basic human right and the norm of a two-child family on voluntary basis
ant1 to achieve a balance between population and resources. It also prepares young
people for responsible attitudes in human sexuality and to provide education and
services in underserved areas of country. It generates awareness about small family
norms through seminars, conferences and media and also by organizing artfiteracy
competitions. The Association has trained several hundred doctors, health visitors, and
social workers.
10) All India Women's Conference (AIWC)
It is India's Pioneer Women's Voluntary organization, and one of the oldest
Organization for women in the country founded in 1927 by Margaret cousins, an Irish
lady, who had made India her home. Its original concern was women's education but
gradually it took up various social and economic issues concerning women such as
purdah, child marriage, trafficking, women's property rights etc. Today, AIWC has
over 100000 members in 500 branches all over the country. It is recognized as a
premier organization working for women's development and empowerment. Most of
the branches are running MCH clinics, medical centers, adult education centers, milk
centers and family planning clinics.
11) All India Blind Relief Society
The All India Blind relief society was established in 1946 with a view to coordinate
different institutions working for the blind. It organizes eye relief camps and other
measures for the relief of the blind.
12) :Professional Bodies
The Indian Medical Association, All India Licentiates Association, All India Dental
Association, the Trained Nurses Association of India are all voluntary agencies of men
and women who are qualified in their respective specialties and posses registerable
qualifications. These Professional bodies conduct annual conferences, publish journals,
arrange scientific sessions and exhibitions, foster research, set up standards of
professional education and organize relief camps during period of natural calamities
and clisasters.
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6.3 INTERNATIONALHEALTHAGENCIES
A large number 6f International health organizations of various sizes provide
international health aid for provilng long term health care to the developing countries.
They provide aid to victims of war, famine and natural disasters. Research and pilot
programs sponsored by agencies from Industrial developed nations have generated
many of the best ideas for improving health in developing countries. Also, the
international health organizations are a major source of expert technical advice and
training for local health professionals. These organizations produce the major text
books in tropical health, as well as the most important manuals for health care
workers.

We will discuss major International health agencies which are contributing for health
care delivery system in India.

1) The World Health Oganisation (WHO)

The World Health Organization is the united Nations specialized agency for health. It
was established on 7th April 1948. WHO'S objectives as set out in its constitution, is
the attainment by all people of the highest possible level of health. Health is defined in
WHO constitution as a state of complete physical, mental and social well-being and
not merely the absence of disease or infirmity.
WHO is governed by 192 Member States through the world Health Assembly. The
Health Assembly is composed of representatives from WHO member states.

WHO has three main divisions:

i) World Health Assembly

ii) Executive Board

iii) Secretariat
World Health Assembly is the governing body. It meets once in a year to approve
the budget and decide on major matters of health policy. All the 192 member nations
send delegations. The World Health Assembly elects 31 members nations to
designate health experts for Executive Board which meets twice a year and serve
as the liaison between Assembly and the Secretariat. Secretariat carries on the day
to day work of the WHO. The secretariat has staff of about 4500, with 30% of the
employees at headquarters in Geneva, 30% in six regional field offices, and 40% in
individual countries, either as country wide WHO representatives or as
representatives of special WHO programs.
The principle work of WHO is directing and co-coordinating international health
activities and supplying technical assistance to countries. It develops norms and
standards, disseminates health information, promotes research, provides training in
international health, collects and analyses epidemiologic data, and develops systems
for monitoring and evaluating health programmes.

WHO has a biannual budget. Assessed Contribution from member nations constitutes
the regular budget.
 2) The World Bank Voluntary and Intemat-ional
Health Agencies
The World Balk. is the other major Intergovernmental agency related to the UN
heavily involved in international health. The World Bank loans money to poor countries
on advan~agrunstemls not available in commercial markets. The amount of money
loaned to developing countries for human resources development i.e. Health,
- ed~cation,nursilion and population activities.

3) United Nations International Children Emergency Fund (UNICEF)

UNICEF i q one of the specialized agencies of united nations and was set up in 1946
by rhe UN General Assembly as a temporary agency. It deals with rehabilitation of
children affected by war. UN decided to continue the agency after the war. was over.
Its focus was broadened to welfare of children all over the world by addressing
variety of programmes and activities. In 1953, it became a Permanent organization of
United Nation Assembly and new name was given i.e."UN Children's Fund" but the
original name UNICEF was retained.
UNLCEF works in co-operation with WHO and other specialized agencies of UN
such as the United Nations Educational Scientific and Cultural Organization
(UNESCO), the Food and Agriculture Organization (FAO), the United Nation
Development Programme (UNDP), United Nations Population Fund (UNPF), World
Food Programme (WEP), International Labour Organization (ILO), the Joint United
Nations Programme on HIV/AID(UNAIDS). The Headquarter is in New York,
USA.
UNICEF Contribution in India
The Government of India and UNICEF worked out a master of operations 2003-
200;' for women & children in order to further their mutual agreement and co-
operation for realizing the goals specified in India's 10th five year plan (2003-2007)
and fulfilling the right of children to survival, protection, participation and development.
The major areas of operations are:
:Reproductive and Child Health
Child Development and Nutrition
Child environment
IZlementary education

Child P~.tdection
Planning, Monitoring and Evaluation of Children's programme
The estimated budget for all the above programme for the period 2003-07 was
approved by UNICEF Executive Board.
4) Food and Agricultural Organisation (FAO)
FA0 is one of the specialized agencies of the United Nations formally fonned in 1945
with headquarter in Rome. The main functions of FA0 are given below:
- T'3help nations to raise their living standards.
- TI>improve nutrition level of people of all countries.
- To secure improvement of production and dist4bution of all food and Agricultural
products.
- To improve conditions of rural population.
- To increase the efficiency of farming, fisheries and forestry. 01
Community Health The main activity of this agency is to promote production of food to keep pace with
Nursing Administration the rising world population. The Joint WHOFA0 expert committee provides the base
for many co-operative activities such as nutritional surveys, training courses, seminars,
and related research programmes.

5) United Nations Development Programme (UNDP)

UNDP was established in 1965 with the objectives to help poorer nations develop their
own human and natural resources to the fullest extent. WHO is the executing agency
of the UNDP in Public Health promotions.
The main aims of UNDP are as follows:
Increased production and processing of food, timber and other agricultural
commodities.
Expansion and modernization of industry, power generation, transport and
communication.
Improvement of basic essential facilities for education, health care, housing,
employment and administrative and social services.
The growth of more suitable trade and other advances towards the goals of
establishing a new International economic order.
Progress in integrated rural development, comprehensive urban renewal, equal
participation of women in development and other pioneering fields.
The role of UNDP is to act as catalyser of new Ideas to develop countries to solve
their problems. UNDP is financed by voluntary contributions from various
Governments.
6) International Red Cross
Red Cross is a non political, non official, international humanitarian voluntary
organization devoted to the service of mankind in peace and war. It was founded by
Swiss businessman Henry Dunant when traveling through North Italy in 1859 and saw
the neglect of thousands of wounded and dying soldiers in the Battle of Solferino.
Dunant recruited volunteers from near by villages to help to relieve sufferings of
wounded soldiers. At Dunant's plea the first Geneva Convention took place in 1864
and treaty was signed for the relief of wounded and sick in the field. International
committee of Red Cross are independent, neutral institution and has branches all over
the world.
In 1919 the League of the Red Cross society was created with its headquarter in
'
Geneva to Co-ordinate the work of national societies. The role of Red Cross is to
provide humanitarian services to victims of wars, natural disasters i.e. flood,
earthquake, service to armed forces, first aid, home nursing, health education,
maternal and child welfare services.
7) Colombo Plan
Colombo plan was drawn when common wealth foreign minister of six common
wealth nations met in January, 1950 at Colombo. The Colombo plan assists in industrial
and agricultural development with some support to health promotions giving
fellowships. The aim of Colombo plan is to seek improvement in living standards of the
people by reviewing development plans and co-ordinating development assistance.
8) United States Agency for International Development (USAID)
USAID is technical Co-operative Mission. India has received assistance in: Malaria
Control and eradication programme, control of Filaria, Medical education, national
water supply and sanitation, agriculture support and family planning programmes.
9) Cooperative for American Relief Everywhere (CARE) Voluntary anld International
Health Agencies
CARE is nonsectarian, non-governmental organization established in 1946 for the
immediate purpose of sending food from American donors to people in war
devastated Europe. When post-war emergency programmes completed, CARE
extended programmes to other countries. In India operation began in 1950. It has been
helping lndia in Midday School Meal Programme, in primary school children since
1961. It has given help in the field of Medicine, literacy vocational training and
agriculture. It also helps schools by providing garden tools, pumps and improved seeds
to grow more food. CARE has provided mobile medical X-ray machines, diagnostic
equipments, eye glasses "and frames, medical books, medicines and vitamins.

10) ~dckfellerFoundation (RF)

The Rockefeller foundation (RF) is founded by Mr. John D. Rockefeller in 1913. Its
aim is to promote the wellbeing of mankind throughout the World. In its early days the
foundation was very active in public health and medical education and later on induced
in advancement of life sciences, the social sciences, the humanities and agricultural
sciences.

In 1920, Rockefeller Foundation started a scheme for the Control of hookworm

infestation in Madras Presidency. All India Research Institute at Pune is financed by
Rockefeller Foundation. RF has trkned many persons in teaching and research work
by giving them financial help.

12) International Labour Organization (ILO)

ILO was established in 1919 as an affiliate of the league of Nations to improve the
working and Living Conditions of the working population all over the world. The main
objectives of ILO are:

To contribute to the establishment of lasting peace by promoting Social Justice.

To improve through International action, Labour conditions and living standards.

To promote economic and social stability.

13) Port/Airport Health Organizations

The Port and Airport health organization in accordance with the International Health
regulation 1969, Indian Port Health Rules 1955 and Aircraft Rules 1954 implement all
the measures to prevent international spread of communicable diseases and prevent
entry of yellow fever into the country through passengers coming from or transiting
through notified yellow fever endemic countries.
 6.4 LET US SUM UP
Voluntary and International Health agencies have a long history of active involvement
in the promotion of human welfare and well-being. They are the private enterprises
for social progress. Voluntary action is the soul of democracy as this medium secures
the active involvement of the people from policy making to implementation of social
services. Their programmes covers a diverse range of functions embracing human to
welfare in the field of health. The programmes of Voluntary organizations have direct
relevance to health care administration which includes: projects to improve nutrition,
food production, housing, potable water, promote literacy, provide educational and
instructional material, enhance community development, improve environmental
sanitation, child and women welfare etc. Thus they are helping to create conditions for 1
the protection, promotion and maintenance of health and the prevention of illnesses. !

Community Health nurse being a key person in the Community health team needs to
be well oriented with the groups interested in promoting the welfare of the people
such as voluntary and International health agencies. !
International Co-operative efforts for health were felt necessary by the whole world
and WHO was established in 1946 after the 2nd World War. Various International
health organizations and United Nation Agencies have come up as a result of
international co-operative efforts for health. These include UNICEF, UNDP, UNFPA,
ILO, Red Cross Society, World Bank, FAO, CARE, Rockefeller Foundation and Port
and Arport Health Organizations.

6.5 ANSWERS TO CHECK YOUR PROGRESS

Check Your Progress 1
1) a) Voluntary Health Association of India
b) Indian Red Cross Society
c) All India Women's Conference
d) Hind Kusht Nivaran Sangh
e) Indian Council for Child Welfare

2) To Control leprosy and provide relief and assistance to the afflicted persons
and their family.
To promote social research into the cause and treatment of leprosy
II
To educate the public with regards to the disease of Leprosy and its control
I
To establish and maintain institution for treatment of patients
I
To establish children home for healthy and non-affected children of leprosy
affected parents
fi
94 To establish residential Institutions for cured people on subsidized basis
 To establish training centres for paramedical workers Voluntrrry and International
Health Agencies
To establish centres for occupational therapy, physio-therapy and meditational
therapy

3) To make health a reality for people of India by promoting community health,

social Justice and human rights related to the provision and distribution of
health services.
Organize campaigns, policy research, advocacy, need based training, media,
audio visuals, publication and disseminate information.
Formulate people centered policies and their effective implementation.
Sensitizes general public on important health and developmental issues.
4) Humanity
Impartiality
Neutrality
Independence
Voluntary Service
Unity
Universality.

Check Your Progress 2

I) - Directing and Co-coordinating international health activities and supplying
technical assistance to countries.
- Develops norms and standards, disseminates health' information, promote
.research, and provides training in International health.
- Collects and analyses epidemiological data, develops system for data and
develops system for monitoring and evaluating health programmes.
2) - Reproductive and child health
- Child development and nutrition
- Child environment
- Elementary Education

- Child Protection
- Planning, monitoring and evaluation of children's programme.

3) The main functions of FA0 are:

To increase the efficiency of farming, fisheries and forestry
To help people to raise their living standard
.
To improve nutritional level of all countries
To secure improvement of production and distribution of all foods and agricultural
products
To improve conditions of Rural People. 95
Community Health
Nursing Administration 6.6 FURTHER READINGS
Central Health Education Bureau (1965). Swasth Hind, 9,196

Chadha, M.S. (1963). Report of the Special committee on the Preparation for entry of
the NMEP into the Maintenance Phase, Ministry of Health, Govt. of India.

Govt. of India (1946). Report of the Health Survey and Development Committee,
Govt. of India Press, Sirnla.

Govt. of India (1962). Report of the Health Survey and planning Committee, Ministry
of Health, New Delhi.

Govt. of India (1967). Report of the Committee on Integration of Health Services,

Dorectorate General of Health Services, Ministry of Health, New Delhi.

Govt. of India (1973). Report of the committee on ~ u l t i ~ u r ~Workers

o s e Under health
and Family Planning Programme, Department of Family Planning, Ministry of
Health and Family Planning, New Delhi.

Govt. of India (1976). Swasth Hindi, 20,233

Govt. of India (1981). Report of the Working Group on Health for all by 2000 Ad,
Ministry of health and Family Welfare.

Govt. of India (1987). Annual Report 1986-87, Ministry of Health and Family Welfare,
New Delhi.

Govt. of India (1990), Modules for continuing Education of Health Assistant (Male and
Female ) and Health worders (Male and Female), Ministry of Health and Family
Welfare, New Delhi.
-
Govt. of India (2000). Annual Report 1999-2000, Ministry of Health and Family
Welfare, New Delhi.

Govt, of India (2002) National Health Policy-2002. Department of Health, Ministry of ,

Health and Family Welfare, New Delhi.

Govt. of India (2003), Health Information of India 2000-2001, Ministry of Health and
Family Welfare, New Delhi.

Govt. of India (2004). Annual eeport 2003-2004. Ministry of Health and Family
Welfare, New Delhi.

Govt. of India (2005) RUMHealth Mission Document.

Govt. of India Bulletin on Rural Health Statistics in India June 1993, DGHS, New
Delhi.

Govt. of India Planning Commission (1974). Draft Fifth Five Year Plan, 1974-79, Vol I
& I1 Controller of Publications, Delhi.

Govt. of India, Ministry of Health and Family Planning (1975). Report of Group on
Medical Education and support hanpower, New Delhi.

Govt. on India (2001). Census of India 2001, Series 1, Provisional Population Totals,
REgistrar General and Census commissioner, Inclia.

Govt. on India (2002). Bulletin on Rural Health statistics in India, June 2002, Rural
Health Division, DGHS, Ministry of Health and Farmly Welfare, New Delhi
K..Park 2005 Text book of Preventive and Social Medicine Bhanarasi Das Banot Voluntary and International
Health A#:encies
India: Jabalpur.

Mtdcherjee, B. (1966). Report on Reorganisation of Family Planning Services

Administration and Basic Health Services, Ministry of Health Govt. of India.

UNDP (2003), the World Health Report 2003, Millennium Development Goals: A
compact among nations to end human poverty.

UNICEF (1975), UNICEF- A GUIDE. Current Policies and Working Methods,

UNICEF-WHO Joing Committee on Health Policy, 1987

UNlCF (2004), The State of World's Children 2004.

WHO (1963). World Health , March, 1963

WHO (1967). Techn. Rep. Ser., No. 350

WHO (1969). WHO Chaonicle, 23,16

WHO (1971). Planning and Programing for Nursing Services, Public Health

WHO (1971). Techn. Rep. Ser., No.472

WHO1 (1972). Approaches to National Health Planning, Public Health Papers 46.

WHO (1973). Application of Modem Management Methods and Techniques for the
inlproved delivery of Health Services, SEAfPHM120, WHO New Delhi.

WHO (1974). Modem Management Methods and the Organisation of Health

Services. Public Health papers 55.

WHO (1976). Intorducing WHO.

WHO (1977). WHO Chronicle, 31,479

WHO (2003),The World Health Report 2003, Shaong the future.

WHO (2,904), Health Development in South-East Asia Region: An Overview, Edited by
Dr. Uton Muchtar Rafei.
I

\inr0, SEARO (1984). Health Planning and Management Glossary, SEAR0 Reg. Health
Papers No.2, New Delhi.

97
 Appendix I
Roles and Functions of Community Health Nursing Personal
~ u n c t i oof
i Nursing Team
Nursing is uniqueness lying in the close and individualized service to the patient, the
service may vary with his state of health dependence in which the nurse performs for
him, what he cannot do for himself through supportive and rehabilitative care,
physical and emotional to self-direction of own health.
The health care service on community health are based on public health team Fig. 1.
All members of the health team outcome of people. As there have been changes in
health care delivery system, the public health team has also been changing'for time to
time.

The community health nursing team consists of District Public Health Nurse
(Supervisor/Director) at district level.

Public Health Nurse-supervisory as well as clinical nurse at PHCICHC level

1
LHVIHealth Supervisor (Male and Female) PHC
1
ANM/Health worker
(Male and Female) - Sub-centre level

AWW, TBAs and C W - at community level

AWW - Anganwadi Worker

TBA - Traditional Birth Attendant
CHV - Community Health VolunteerNillage Health GuideIASHA

(HA) LHV DPHN

rc - L
ANM (HA) PHN

DISTRICT PUBLIC HEALTH NURSE @PHN)

The district Public Health Nurse is responsible for planning organizing and directing
the public health programme of jurisdiction where she is appointed.
Praticipates in policy making activities in regard to health care.
She need to learn and understand the organization and administration and states
public health progrtammes are affected by quantity and quality of public health
nursing service available in rural areas.
Evaluation of nursing services is done by District public nurse who plans for
continuously improving the quality of client care.
 The district public health nurse is attached to the district health office. She is directly
responsible to the district health off~cerand delegates the responsibilities to all
nursing personnels in the district community health field is., PHC, SC, family
planning and all national health programmes. She is supervised by nursing officer at
dirc:ctorate level.
District public health nurse works in close co-ordination with community health
nursing, nursing tutors and hospital administration and other health workers. .

Responsibilities as an Administrator
Responsible for efficient implementation of policies and programmes relating to
nursing in public health.
Will make recommendations to district health officer on:

a) Requirements of nursing staff in public health field.

b) Staff development programmes for educational promotional awareness.

c) Any indiscipline occurrence in the community or nursing personnels.
Determine the need for supply and equipment for her section, take part in
budgetary planning.
Submit monthly report to District Health Officer at directorate level.
Field visits at least four times a day to each staff member in sub-centres and
Primary health certres and ensures the quality care, submit annual complete
standard report for all primary health centrea and sub-centres visits paid and
recommendations for improvement of public health services.

S~qwrvisoryResponsibilities
Conducting regular meeting and solving official as well as personal problems in
best possible way.
Encourage initiative and help in promoting professional growth of staff.
~nterpretationsof policies, plans and rules to the staff so as to regulate and
develop the services.
Advice on organizing and planning of work, helping the individual staff
members to evaluate the qeeds of their particular areas and to select priority for
her work.
Help in improving the quality and quantity of health services by establishing
good patterns of procedures and techniques.
Guidance to staff regarding use of records, report and the collection of statistical
data and record keeping system.
Ensure that public health nursing personnel have job descriptions, standing
orders and understand their interpretations in the area of their work.

E:ducational Responsibilities .

, r Organize the in-service education programme. for all nursing staff.

Initiate and assist in planning and organizing the orientation programme for new
staff.
(11 Participate in community health field experience organized for nursing students .
of schools or colleges.
Appendices - Suggest in selection of areas for practical experience.

- Provide facilities and resources to students and staff.

- Guide students during field experience.

Help to supervise and guide the traditional birth attendants (TBAs).

Keep her knowledge updated by reading attending professional seminars and ,

meetings etc.

ROLES AND RESPONSIBILITIES OF

COMMUNITY HEALTH NURSE
Community health nurse represents the mist numerous of professional workers in the
public health field and nursing service are employed to implement or support
virtually of the services offered to community.

Community health nurse participates in planning, development and evaluation of

the agency programme as a whole and advisement of technical knowledge of
nursing have a big contribution to make in relation to determining the care and
content of public health programme.

Application of nursing practice in public health field involves the use not only of
technical and administration skills with which the people are familiar but also
the nursing skills of inter-personal and organizational in character. Nurse not
only provides homely, comforting services, treatment provided for the care of the
sick or groups toward better health care. She uses epidemiologic as well as
physiologic bases in her observation of the health status of the family or
community.
She uses administrative as well as clinical skills in organizing clinics and
recruiting and training volunteers.
Community health nurse considers the family as a service unit rather an
individual; hence care is an important component of her functions.
She plans her work and evaluates its effectiveness in term of community as a
whole.
Provides nursing care to non-hospitalized sick, direct care or teaches the family
member to give care to sick.
Medical supportive activities: Assisting with medical procedures, identifying,
and reporting significant conditions or symptoms, providing inspectional
services, e.g., examination of school students, during high incidence of
communicable disease, routine observation of industrial workers exposed to
specific occupational hazards and interpreting home or community factors. She
prefers diagnostic testing procedures that can be done safely without medical
supervision, e.g., collect specimens and blood slides.
Health counseling and teaching: Family health counseling and teaching in all
aspects of family care. Health counseling is the action taken to assist individual
to make and carry out his own plans to meet health problems. Teaching may be a
part of counseling and involves provision of information in such a way that
family or individual learns how to apply this information in this own situations
and gains a semed heath care.
Control of environmental health hazard is an integral part of public health
nursing observation and teaching help to control the accidents, hazards at home,
1 00 school and industries prev6nt unnecessary exposure to injury or infection.
 s Kesponsibli- for organizing and conducting the heaiih clin~is.e.g., well baby
clinic. antenatal clinic, family welfare aqd gcnel-a1 clinics. t:!:-.
e Supcrxiilng. organizing and plann~ngb o ~ n c1 i k ~ t sfor subordinate nurses and
.cne wggebtionh for improvement.
o Organ~ze'ind encourage the educational activit~esfor improving quality care.
o Will interpret the need of she nursing and health service to medical officer.

Administrative

' Rzsponsibilities for the efficient implementation and prograninie

L e Outline thz nursing requirements for nursing services and training programmes.

I o Responsible for ascertaining the need for supplies and equipments in her section
and arrange for adequate maintenance.

I1
Supervisory
Promote harmony and efficiency within the team to improve the quality of work.
Promote the professional growth of other staff and encourage initiative

II
a Will interpret the staff policies, plans and ruleh laid down for develop~ngand
regulating the service.
o Review the use of records, reports and collection of statistical data and advlse
wherever necessary.
o Describe each staff member's job description and interpret In the area of her own
work.
e Home visit as per schedule to supervise the staff.
Arrange orientation programme of all new staff posted to training unit area to
acquaint them with them geography of the area. set-up, policies, and duties of
different staff and channels of communication.
Plan and carryout continuous and effective in-servlce training programme, arranging
monthly meetings for all nursing staff.

I
Practical nurse are prepares to provide simple nursing care under the direction of a
professional nurse of physician. They have been proved as useful in providing home
care to the long-term illness and as assistants in clinics, where they relieve the
professional staff for more existing work. In such cases community health nurse takes
the responsibility of providing more complex service and delegates the task to
practical nurse which they can do competently.

Nurse's Aids
They have been used in increased numbers in clinics. They are generally trau:ed <)n
jobs and work under close supervision of'professional nurse. They assist in activities
which do not require skills, e.g., setting up clinics, equipments, carry-out for supply,
assisting in doing procedures controlling the people gathering.

Lady 'Health VisitorsDIealth Assistant/Supervisor (Female)

They have been trained lo provide specified health care in cor11:-nunityhealth nur-ins
Tht: multi-pu1l3ose workers health schzlrle was desigfiatztl !.I4?:< as heaith
I
Appendices supervisors (female). They have been given a special training of 6 months to promote
as health supervisors are usually placed in primary health center. Their job
responsibilities have been listed as below:
%

Job Responsibilities of Health AssistanVSupenisor (Female)

Under the Multipurpose Workers Scheme as health assistant female is expected to
cover a population of 30,000 (30,000 in tribal and hilly areas) in which threw are six
subcentre, each with one health worker female. The health assistant female will
canyout the following duties:

a) Supervise and guide the health worker female, Dais and female health guide in
the delivery of health care Services to the community.

.b) Strengthen the knowledge and skills of the health worker female.
c) Help the health worker female in improving her skills in working in the
community.
Help and guide the health worker female in planning and organizing her
programme of activities.
Visit each sub-centre at least once a week on a fixed day to observe and guide
the health worker female in her day-to-day activities.
Assess fortnightly the progress of work of the health worker female and submit
an assessment report to the medical officer of the primary health programme.
Carryout supervisory visits in the area of the health worker female with respect
to their duties under various National Health Programmes.
Supervise referral of all pregnant women for Venereal Disease Research
Laboratory (VDRL) testing to Community Health Centre (CHC)lSub-divisional
hospital.
Team Work
Help the health workers to work as part of the health team.
Co-ordinate her activities with those of the health assistant male, ~d other health
personnel including the9ais and health guides.
Co-ordinate the health activities in her area with the activities of workers of
other department and agencies and attend meeting at primary health cntre (PHC)
leyel.
Conduct regular staff meetings with the health workers in co-ordination with the
health assistant male.
Attend staff meeting at the primary health centre.
Assist the medical officer of the primary health center in the organization of the
different health services in the area.
Participate as a member of the health team in mass camps and campaigns in
health programmes.
Supplies, Equipment and Maintenance of Sub-centres
Collaboration with the health assistant male, check at regular intervals the stores
available at the sub-centre and help in the procurement of suppli'es and
equipments.
Check that the drugs at the sub-centre are properly stored and that the
equipments is well-maintained.
 Ibsure that the health worker female maiqtains her general kit and midqifery kit Appendices
c)
and Dai kit in the proper way.

d) Ensure that the sub-centre is kept clean and is properly maintained.

Records and Reports

a) Scrutinize the n~sintenanceof records by the health worker female and guide her
in their proper maintenance.

b) Maintain the prescribed records and prepare the necessary reports.

c) Review reports received form the health worker female, consolidate them and
submit monthly reports to the medical officer of the primary. health center.

Additional duties where Kala-azar is endemic:

1) Supervise the work of health worker during concurrent visit and will check
whether the worker is performing her duties.

2) Visit minimum 10 per cent of the house in a village to verity that the health
worker female really visited those house and carried her job properly. Her job
of identifying suspected kala-azar cases and ensuring complete treatment has
been done properly.

3) Carry with her the proper record forms, diary and guidelines for identifying
, suspected kala-azar cases.

4) Be responsible along with health assistant male for ensuring complete treatment
of kala-azar patients in his area.
1
'5) Be respo~lsiblealong with health assistant male for ensuring complete coverage
during the spray activities and search operations.

6) Also undertake health education activities particularly through interpersonal

communication, arranging group meetings with leaders and organizing and
conducting training of community leaders with the assistance of health team.

; Specific Duties where Japanese Encephalitis is '~ndemic-FHSwill

I

I 1) Supervise the work of health worker female during concurrent visit and will
check whether the worker is performing her duties.
I

1
2) Check along with minimum 10 per cent of the houses on a.village to verify that
the health work female work really visited those houses and carried her job

I
properly. Her job of identifying suspected kala-azar cases and ensuring complete
treatment has been done pyoperly.

3) Carry the proper record forms, dairy and guidelines for identifying suspected
kala-azar caeses.

4) Be responsible for ensuring complete treatment of kala-azar patients in her area.

5) Be responsible for enstying complete during the spray activities and search
operations.

b) Conduct weekly family planning clinics (along with the MCH clinics) at each
sub-centre with the assistance of the health worker planning. 103
 Maternal and Child Health
a) Conduct weekly MCH clinics at each sub-centre with the assistance of the health
worker female and Dais.
b) Respond to call from the health worker female. the health worker male111the
helth guidcs and the trained Dais and render the necessary help.

C) Conduct deliveries when required at primary helath centre levle and provide
dimiciliary and ~nidwifcryservices.
Family Planning and Medical Termination of Pregnancy-She will
a) Ensure through spot checlung that health worker female maintains up-to-date
eligible couple registers all the times.
b) Conduct weekly tanlily plann~ngclinics (along with the MCH clinics) at each
sub-centre w ~ t hthe assistance of the health worker female.

c) Personally rnot~vateresistant case for family planning.

d) Provide informat~onor1 the availabil~tyof services for medical tenninat~onof
pregnancy and for sterilizat~on.Refer suitable cases for MTP to the approved
~nstitutions.

e) Guide the health worker fexnale in establishing female depot holders for the
distribution of conventional contraceptives and train the depot holders with the
assistarlce of the health worker female.

f) Provide IUD service and their follow-up.

g) Assist medical officers at primary health center (PRC) in organization of family

planning camps and drives.
Nutrition
a) Ensure that all cases of malnutrition among infants and young children (zero to
five years) are g ~ v e the
r necessary treatment and advice and refer serious cases to
the primary health center.

b) Ensure that iron and folic acid and vitamin A are distributed to the beneficiaries
as prescribed.

C) Educate the expectant mother regarding breastfeeding.

Universal Im~nunizationProgramme
a) Supervise the immurliza~~on
of all pregnant women and children (zero to five
years).

b) Guide the health worker (HW) (female) to procure supplies, organize

immunization camps. and provide guidance for maintaining cold chain storage of
vaccines. Health education and also in immunizations.

c) Supervise the inlrnuni7ation of all pregnant w+omenand infants.

d) Follow the dirsctlon5 giver in Manual of Health Worker Female under National
Immunizi!:~on Progr amrne.
Aeute P dspiratory Infectkm ( AR1
1) dnsure early 01' pneurnonk,l i.:w?<

2 ) F'rovidt. \u~tal,lr Ircat~nentt+ !q~ld;mc~deratz

cases oi acute respiratory ~nfectl~:,
(AKI:
'1 En..il~ I , , I CI ~ ( 1 1 lii4 . (3

,
 School Health Appendices

1) Help the medical officers in school health services.

Primary Medical Care

a) Ensye treatment for minor ailments, provide oral rehydration solution (ORS)
and first aid for accidents and emergencies and refer cases beyond her
competence to primary health center or nearest hospital.

Health Education

a) Carry-out educational activities for MCH, .family planning, nutrition and

immunization, control of blindness, dental care and other National Health
Programme like leprosy and tuberculosi: with the assistance of the health worker
female.

b) Arrange group meeting with leaders and involve them in spreading the massage
for various health programmes.

C) Organize and conduct training of women leaders with the assistance of the health
worker female.

d) Organize and utilize Mahila Mandal, teachers and other women in the
community in the family welfare programmes, including integrated child
development scheme (ICDS) personnel.

ROLES AND RESPONSIBILITIES OF ANMIHEALTH WORKER (I!)

r The auxiliary nurse midwives (ANMs) are designated as health worker (F), as
multipurpose worker scheme. They complete 2 years of training. They have been
posted in sub-centres to provide comprehensive health care service to community and
assist the PHN and health supervisor in providing health to defined area. Their main
areas of jobs are:

Job Responsibilities of Health Worker (Female)

Under the multipurpose workers scheme, one health worker female and on ehealth
worker male are posted at each sub-posted at each sub-centre and are expected
ultimately to cover a population of 5,000 (3,000 in tribal and hilly areas). She will
carry-out the following duties:

Maternal and Child Health

.a) Register and provider care to pregnant women throughout the period of
pregnancy.

; 13) Test urine of pregnant women for albumen and sugar and.estimate hemoglobin
level during her hone visits and at the clinic.
i
c) Ensure that all pregnant women get VDRL test done.

1 ) Refer cases of abnormal pregnancy and cases with medical and gynecological
i
b
problems to the health assistant female or the primary in her area.

I i:) Conduct about 50 per cent of total deliveries in her area.

I
f) Supervise deliveries conducted by Dais and assist them whenever called for.

) Refer cases of difficult labour and newborns with abnormalities, help them to get
institutional care and provide follow-up to the patients referred to or discharged
form hospital.
h) Make at least three postnatal visits for each delivery condHcted in her ma and
render advice regarding care of mother and care and feeding of the -born.

i) Assess the growth and development of the infant and take neclcesary a c h
required to rectify the defect.
Educate mothers individually and in groups in beWr family hcakh inchding
j) . .
maternal and child health, f a y planning, nutnition, bmmmabm oodcndof
communicable disease, personnel and environmental hygiccle.
k) Assist medical officer and health assistant femrde in c o n k h g antamtd d
postnatal clinical at the sub-centre.
Family Planning
a) Utilize the information fonn the eligible couple sRd chiid lar Uw family
planning programme. She will be squarely mpasibk Ca m&d&ig e i i
couple registers and updating at all times.
b) Spread the message of family plaHning to dw!ample dd v a t e &an fiu
family planning individual and in wps.
C) Distribute conventional contraceptive and oral cofmq#ives b tke caw#!%
provide facilities and to help prospective accepCocs in getting f d l y p k h g
service, if necessary, by accompanying them a mxmghg fiw Lki lb aooorn~#ulry
them to hospital.
d) Provide follow-up service to female family planning acoepcors, k h & y side
effects and minor complaints and refer h s e cases that rroed P#estioa by t
k
physician to primary health center (PHCyhospitat.
e) Establish female depot holders, help the W t h assh&W feslrPle in M n g tbm
and provide a continuous supply of conventhnal tmmcqCives to $re depot
holders.

f) Build rapport with acceptors, village leaders, health guides, Ibis and d
utilize them for promoting Family Welfare Pmgmmw.

g) Identify women leaders and help the heaith tlssldanE feffiele to train
h) Participate in Mahila Mandat meetings and u t i b such gatkering. Zbr edw%€hg
women in Family Welfare Ikgamme.
Medical Termination of Pmgmmq

a) Identify the women requiring help for medical t e n s h t h d d

refer them to nearest approved institution.

b) Educate community of the consequences of septic abmtim and Wmn &em

about the availability of services for medical termination of m.
Nutrition
a) Identify cases of malnutrition among infants aud young chiibrm (zem to five
years), give the necessary treatment and advice snd refer Beriosls cases to he
primary health center.
b) Distribute iron and folk acid tablets as prescribedto snl ~ t ~ ~ h g
mothers, infants and ymng childten (zero to five y a m ) and family phmbg
acceptors.
C) Administer Vitamin A solution as p s r i b e d to c h i b krwrr 1 fo 15 years
d) Educate community about nutritious diet for molsem3 arnl chWm.
 Universal Immunization P
- Appendices

a) Immunize pregnant with tetanus toxoid.

b) Administer DFT vaccine, oral polio-vaccine to all infants and children.
c) Maintain report of all eligible those vaccinated and follow-up defaulters.
JXmhea Control Pmgmmw
a) Educate mothers regarding home management of diarrhea with ORT.
b) Provide and indent ORS packets.
c) Monitoring of cases of diarrhea, if increase, report to medical officer.
d) Record deaths ctue to diarrhea and give monthly report.
e) Arrange of mother's meeting and work closely with Anganwadi and other health
workers.

a) List Dais in her area. and involve them in promoting family welfare.

I b) Help the health assistant female in the training Programme of Dais.

a) Notify the medical officer PHC immediately about any abnormal increase in
cases of dimheddysentery. Poliomyelitis, neonatal tetanus, fever with rigors,
fever with rash, fever with jaundice or fever with unconsciousness, which she
come across during her home visits, take the necessary measures to prevent their
L
spread, and infonn the health worker male to enable him to take further section.
b) If she come across a case of fever during her home visit, she will take blood
smears administer presumptive treatment and inform health worker for further
action.
c) Identify cases of skin patches, especially if accompanied by loss of sensation,
which she comes across during her home visits and bring them to the notice of
the health worker male for smears.
d) Assist the health worker male in maintaining a record of cases in his area who
are under treatment for tuberculosis and leprosy and check whether they are
taking regular treatment, motivate defaulters to take regular treatment and bring
these cases to the notice of the health worker male or health assistant male.
Give oral dehydration solution to all cases of diarrhea/dysentery/vomiting.
e) Identify and refer all cases of blindness including suspected of cataract to
Medical officer W C .
i
I
f) Where Ma-azar is endemic:
- She will assist health worker male and identifying suspected kaka-azar cases
and guiding them to the nearest diagnostic and treatment center.
t

i - She will endure follow-up of all kala-azar cases in her area for complete
treatment.
g) Where Japanese encephalitis (J.E.) is endemic:
- She will assist the health worker male in identifying suspected encephalitis
cases and guiding to the nearest diagnostic and treatment center.
! - She will ensure follow-up of all the J.E cases in her area.
Appendices Vital Events
Record births and death occurring in her area in the births and deaths registers and
report them to the health worker male.
Record keeping
a) Register
- Pregnant women from three months of pregnancy onward.
- Infants day one to one,year of age; and
- Women aged 15 to 4 4 years.
b) Maintain the prenatal and maternity records and child records.
c) Assist the health worker male in preparing the eligible couple and child register
and maintaining it up to-date.

d) Maintain the records as regards contraceptive distribution, IUD insertion,

couples sterilized, clinics held at the sup-centre and supplies received and issued.

e) Prepare and submit the prescribed monthly reports in time to the health assistant
female.
Primary Medical Care

a) Provide treatment for minor ailments, provide first aid for accidents and
emergencies and refer cases beyond her competence to the primary health canter
of nearest hospital.

Team Activities

a) Attend and participate in stall meeting at primary health center/community

development block or both.

b) Co-ordinate her activities with the health worker male and other health workers
including the health guides and Dais.

c) Meet the health assistant female each week and seek her advice and guidance
whenever necessary.

d) Maintain the cleanliness of the sub-centre.

e) Participate as a member of the team in camps and campaigns.
f) Work as a team with Anganwadi worker in ICDS blockNHGRBA
Expanded Programme on Immunization
Follow the direction given in Manual of Health Worker (Female) under National
Immunization Programme.
Acute Respiratory Infection
8 Ensure early diagnosis of pneumonia cases.
a Provide suitable treatment to mildlmoderate cases of ARI.
a Ensure early referral in doubtfuVsevere cases.

School Health
8 Help the medical officer in school health services.
108
 Non Government Health Personnel Appendices

Due to inaccessibility of health service to the rural people, the need was felt to
provide minimum health care to each individual at their own doorstep, so as maintain
the optimum level of health. The community health volunteers and traditional birth
attendants fare-the community people who gave been selected to provide simple
training to provide health service at root level. There are important ways and means
of giving primary health care.

a) Village Health Guides or Community Health Workers

A village health guide is non-government personnel with an aptitude of social
service, The VHG scheme was initiated in 1977 to encourage people's participation
on the care of their won health and to make them self-reliant in health aspects.
Mostly VHGs are women, who come from and are chosen by the community in
which they work. They are the liaison /link between government and community.
They provide the first contact care to the people.

Criteria for Selection

A person preferably woman:

Should belong to the same community, where helshe is going to provide care

Should be at least sixth standard and is able community people

b Should be able to spare 2to3 hours everyday for community health work.

Should be eady to work without financial gains and provide free health care.

Training

The village health guides (VGHs) undergo a three months training, which is being
conduct in the primary health center (PHCs) or sub-centre (SCs) or a t y suitable
place. During training they receive a stipend of Rs. 2000 per month.

After training each village health guide receives a health manual and kit cmtaining
simple medicines. The duties assigned to health guides include treatment of minor
ailments, first aid, maternal and child health, family planning. health education and
sanitation. The health guide gives instruction of giving medication for minor ailments
and what they can do, and what they are expected to do community health work in
spare time for 2 to 3 hours daily in fixed regular period. Each village health guide
(VHG) is expected to cover a population of 1000 per of a village. If population of
village is more than one thousand another village health guide may be required. Since
training involves expenditure by the government, hence she is expected to work for at
least three years. At percent more than 4 lakh health guides are working in the
i country.

b) Traditional Birth Attendants/Local Dais

'i
In rural areas, most of deliveries are conducted by untrained Dais, who are often only
people immediately available to the women during delivery. More than 70 per cent of

I
the deliveries are conducted by traditional birth attendants (TBAs). The do not
receive andy training but they learn by virtue of their practice in the field or by elders
or seniors who practice and knowledge, the maternal and infant mortality rate is very
high especially in rural areas. Hence been undertaken to train all categories of local
Daisltraditional birth attendants to improve their knowledge in the basic concepts on
maternal and child heath and obstetric skills. They are provided training for 30
working day, twice a qeek and remaining four days they accompany the health
worker to the village preferably in dais own community.
Appendices During training each traditional birth attendant is expected to conduct at least who
deliveries under the guidance and supervision of the health worker (female),
auxiliary nurse midwife (ANM) or health assistance (F). More emphasis is laid on
aseptic technique during the process of delivery which help in lowering the
complications and reducing the maternal and infant mortality rate. They also learn to
identify the high risk cases and appropriate and timely referral and management of
newborn emergencies and referrals.
After successful completion of training each Dai is provided with a delivery provided
the mother is registered at health center, etc. Each infant registered by her, will be
given Rs. 3. These Dais are also expected to play important role in education the
people regarding family planning, nutrition, hygiene and immunization, etc. Each Dai
is expected to cover population of 1000. At present are more than 80 thousand
trained Dais.
c) Anganwadi Workers
The Anganwadi workers are selected form the community they are expected to serve
a population of 1000, under Ministry of Social Welfare. There are about 100
Anganwadi worker in each Integrated Child Development Scheme project. At present
5320 Integrated Child Development scheme blocks are functioning in the country.
Each Anganwadi worker undergoes training in various aspects of health, nutrition
and child development for 4 months. She is a part time worker and is paid an
honorarium of Rs. 250 per month for the services she gives to community, e.g., health
check-up for mothers and children, immunization, supplementary nutrition, health
education non-formal pre-school education and referral services, etc. The services are