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extracted text: I

Indian Mill Hh Standards (M)

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?l to JO bedded Sub-Oistrid/Jub-OivHnol Hospiiols
I

•- I

January
2007

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cn

\Tjfm OPfl'd wma ftn-1

Directorate General of Health Services

Ministry of Health & Family Welfare
Government of India
A..f (^MC

I
I

Foreword
The Government of India is strongly committed to strengthen the whole range of public
health infrastructure including Sub-district/Sub-divisional Hospitals for improving the availability
and accessibility of'affordable quality services to the people. Most of the existing Sub-district/Subdivisional Hospitals require improvement of physical infrastructure as they are mostly located in old
buildings, in towns, where there is no scope for more physical expansion of the building. There is
shortfall of manpower, equipments, drugs and other logistics supply etc. too. Quality management
and quality assurance procedures are also needed to make their functioning more effective,
affordable and accountable.
A Sub-district/Sub-divisional Hospital has an important role to play as the First Referral Unit
in providing emergency obstetrics care and neo-natal care and help in bringing down the maternal
mortality and infant mortality. The National.Rural Health Mission (NRHM) launched by the Hon’ble
Prime Minister of India aims to restructure the health delivery mechanism in the rural areas.
Formulation of Indian Public Health Standards (IPHS) is a step in the direction of achieving the
level of quality that these Hospitals are expected to meet or aspire to.

The Indian Public Health Standards (IPHS) for Sub-district/Sub-divisional Hospitals has
been worked out by constituting Expert Group comprising various stakeholders under the
Chairmanship of Director General Health Services, Ministry of Health & Family Welfare, Government
of India. These Standards have been prepared bed strength-wise for 31-50 beds and 51-100 beds.
The Indian Public Health Standards (IPHS) for'Sub-district/Sub-divisional Hospital has been
prepared, keeping in view the minimum resources available and mention functional level of the
Hospitals in terms of space, manpower, instruments, drugs and other basic health care services.
Constitution of Rogi Kalyan Samittee/Management Committee with involvement of PRIs, Citizen
Charter are expected to make improvement in the functioning and accountability of these Hospitals.
It is emphasized that setting Standards is a dynamic process and will require revision at
regular intervals. It is hoped that this document will be useful to all the stake holders. Any comment
for further improvement is most welcome.

I would like to acknowledge the efforts put in by the Director General of Health Services and
Infrastructure Division in preparing the Guidelines.

A. 'vpL-»
(Naresh Dayal)
Secretary (H&FW)
Ministry of Health & Family Welfare
Government of India

New Delhi.
Dated: 16th May, 2007

in

Preface
Sub-district/Sub-divisional Hospitals act as the First Referral Units for provision of specialist.
services to the population from neighbouring Community Health Centres. They have an important
role to play in providing emergency obstetrics care and neo-natal care and help in bringing down
the maternal mortality and infant mortality. The Government of India through the National Rural
Health Mission is committed to strengthen these Hospitals to a level of Indian Public Health Standards
(IPHS).
Standards are a means of describing a level of quality that health care organizations are
expected to meet or aspire to. The performance of these Hospitals can then the assessed against
the set of Standards prescribed. Currently, the available Standards developed by the Bureau of
Indian Standards (BIS) are short of ensuring community involvement, accountability and rights of
citizens that are important for Public Hospitals. Therefore, for the first time under National Rural
Health Mission (NRHM), an effort has been made to prepare Indian Public Health Standards (IPHS)
for Sub-districts/Sub-divisional Hospitals in the country.

The Standards have been prepared in consultation with the Expert Group constituted for
this purpose and taking in to consideration the minimum functional level needed for providing a set
of assured services.
Setting Standards is a dynamic process and this document is not an end in itself. Further
revision of Standards will occur as and when these Hospitals achieve a minimum functional grade.
The contribution of the Expert Group members, and the efforts made by the Infrastructure Division
of the Ministry of Health & Family Welfare in bringing out the first document of IPHS for Sub-district/
Sub-divisional Hospitals is well appreciated. I hope that this document will be of immense help to
the State governments and other stakeholders in bringing up these Hospitals to the level of Indian
Public Health Standards.

(Dr. R.K. Srivastava)
Director General of Health Services
Ministry of Health & Family Welfare
- Government of India

New Delhi
Dated: 16’h May, 2007

iv

1
IPHS for 31 to 50 Bedded Hospitals

21

Metabolic Disorders

Identify & Refer

22

Hyaline Membrane diseases

Diagnose & refer

23

Neonatal Malaria

Manage/refer if needed

24

Blood disorders

Manage and refer

25

Developmental Delays

CBR

26

UTIs

Manage &refer

27

Failure to Thrive

Manage & Refer

s.

NAME OF THE ILLNESS

RECOMMENDED SERVICE MIX
(SUGGESTED ACTIONS) ’

No
1

I

Infections

Treat

a) Viral - HIV - Verrucca
Molluscum Contagiosa

Identify 7 Treat and refer

Pityriasis Rosea, LGV, HIV

J

b) Bacteria

Treat

Pyoderma
Chancroid

Treat & Refer

Gonorrhea, Leprosy, & Tuberculosis
c) Fungal

Identify/Treat and refer

Sup. Mycosis, Subcut - Mycetoma

d) Parasitic Infestation

Treat

Scabies / Pediculosis/Larva Migrans

2

e) Spirochaetes
Syphilis

Diagnosis and Treat

Papulosquamous
Psoriasis (classical)-uncomplicated/

Treat

Lichen Planus

3
4
5

6

Pigmentary Disorder
Vitiligo

Treat/Refer

Keratinisation Disorder
Ichthyosis/Traumatic Fissures

Refer/Treat
j

Autoimmune
Collagen Vascular DLE, Morphea

Treat / Refer

Skin Tumors, Seb.Keratosis, Soft Fibroma,

Refer

Benign Surface,Tumors / Cysts,
Appendageal Tumors

16

I
IPHS for 31 to 50 Bedded Hospitals

PAEDIATRICS

iI

NAME OF THE ILLNESS

RECOMMENDED SERVICE MIX
(SUGGESTED ACTIONS)

ARI/Asthmatic Bronchitis

Diagnose, Treat & Refer if no improvement

Diarrohoeal Diseases

Diagnose, Treat & Refer if no improvement

Protein Energy Malnutrition and Vitamin
Deficiencies

Diagnose, Treat, & Refer

No

I

2
—

M

Investigate, diagnose, treat & refer if

p Pyrexia of unknown origin
I-5—4 Bleeding Disorders

no improvement

Early Diagnosis and Refer

I Diseases of Bones and Joints

Early Diagnosis and Refer

NEONATOLOG

rNo

NAME OF THE ILLNESS

RECOMMENDED SERVICE MIX
(SUGGESTED ACTIONS)

1

i Attention at birth (to prevent illness)

5 cleans warm chain

2. Hypothermia
a ; Birth asphyxia

Warm chain

4
5
6

Hypoglycemia

Treat

Meconium aspiration syndrome

Treat and Refer

Convulsions (seizures)

- Treat and Refer

7

i Neonatal Sepsis

Treat and refer in necessary

Resuscitation/Refer if Necessary

T' I LBW

1800-1500 gms treat with kangaroo care below
that refer

9 ----------------Neonatal Jaundice
------

Treat and refer if necessary

10 j Preterm

warm chain, feeding, kangaroo care and refer

11 i Congenital malformations

Examine and refer

12 J R.D.S, ARI

Manage and Refer

13

|'ll. l.'.ll’Ul.ri

Identify, first-aid and refer

Dangerously ill baby
1 .■ -•»

•

...

.

.

.........

I 14 . Feeding Problems

Identify and manage

' 15 : Neonatal diarrhea

Diagnosis and manage. Refer if necessary
Minor -manage; major -refer

16 : Birth injury
r

•‘t-'-"------- -- ---

identify and refer

I 17 s Neonatal Meningitis
[ 18 ’ Renal problems/Congenital heart disease/

■

Refer

; Surgical emergencies
[ 1.9 | HIV/AIDS

Refer to ARV Centre

i 20

Manage and Refer

Hypocalcemia

,

•

IS:

15

1
IPHS for 31 to 50 Bedded Hospitals

:'i. ''ViaT',■:

,:5^-

•,

S? NAME OF THE ILLNESS
No

T RECOMMENDED SERVICE MIX

! (SUGGESTED ACTIONS)
- ~-t.

1

Fever -a) Short duration
Fever -b) Long duration

r

(<1 week)
(>1 week)

c) Typhoid
d) Malaria / Filaria
e) Pulmonary Tuberculosis.

—rr

2

3

4

|

5

6

- -

r-- t f-r -

—TT~ii r - i.--im . n ■ 11 .

-

I Refer to Gr-I / G-ll District
I Diagnose and Treat refer if necessary

I

~ Diagnose and refer to Gr-li Sub district
Diagnose and treat - Emergencies Refer to
Gr-HSDH

HAEMATOLOGY
"-~"

b) Bleeding disorder

8

---

GI TRACT
....................... ........................... '
a) G I Bleed / Portial hypertension i
—1 Emergencies - Ref. to Gr-li / Gr-I - District Hospital
Gallblader disorder
b) AGE / Dysentry / Diarrhoreas
I •
jJTreat ~
NEUROLOGY
IO
a) Chronic Hpeadache
Ref. To Gr -1 sub district
b) Chronic Vertigo/CVA/TIA/Hemiplegia/
Ref. To Gr -17 G-li district
Paraplegia
a) Anaemia

7

- -

Sputum +ve - Treat Sputum -ve - Ref to
Gr-ll-SDH
Mild icterus, Short duration - Treal/ Long duration?
Severe icterus- Refer to Gr-ll-SDH
Refer to Gr-I / G-lTDisTrict level

f) Viral Hepatitis
g) Leptospirosis / Menningitis and
Haemorrhagic fever
h) Malignancy
COMMON RESPT ILLNESSES:
Bronchial Asthma / Pleuraleffusion /
Pneumonia / Allergic Bronchitis/COPD
COMMON CARDIAC PROBLEMS
a) Chest pain (IHD)
b) Giddiness (HT)

. irti-

; Basic investigation and Treatment
Investigation and treatment-Refer if necessary
; Treat uncomplicated I Complicated cases refer to Gr-ll - SDH
"J Treat-

c) Malignancy
COMMUNICABLE DISEASES
Cholera, Measles, Mumps, and Chickenpox
PSYCHOLOGICAL DISORDERS
Acute psychosis / Obsession / Anxiety
neurosis

Basic investigation and Treatment
Refer if necessary
| Emergencies - Ref. to Gr-I7SDH otherwise
Ref. To Tertiary
Ref. To Gr -1 / G-ll district

Treat
7' y
Screening, emergency care and referral

I
RECOMMENDED aB?s ICB X (SUGGESTED ACTIONS) FOR DIFFgf ENT
CONCERNING DIFFERENT SPECIALITIES:
Obstetric & Gynecology
S. nameofTheillness

RECOMMENDED SERVICE MIX
(SUGGESTED ACTIONS)
Diagnose,Treat
Diagnose .Treat
Diagnose .Treat & refer
Yes
Refer

No
1
Bleeding during first trimester
2 ’

3

Bleeding during second trimester
Bleeding during thirdTrimester

4 ' Normal Delivery
5 ~ Abnormal lablour (Mai presentation,
.... ............. ......... .

mu .. ,

-------------------------

6

prolonged labour, PROM, Obstructed labour)
PPH

7

Puerperal Spesis

8 ””

9
10
11

■■■—W

Ectopic Pregnancy
Hypertentive disorders
Septic abortion
Medical disorders complicating pregnancy

.H,,

(heart disease, diabetes, hepatitis)
12 Bronchial asthma
Gynaecology .
1 pRTI /STI
2“

F3

Obstetric fisrt aid -IV line /oxytonic Drip
SOS / Inj. Ergometrine
IV /Inj. Prostaglandin IM and refer Mesopros
First Aid, IV parentral antibiotics and refer
May refer
Diagnose and refer
Diagnose and IV parentral antibiotics and refer
Diagnose and refer
......................

I I H

——------------------------ ---------------- ------- -----

....

.

...........................................................

[ JJiagnose, first aid and refer

Treat and refer if necessary
Refer D & C medical management

DUB

in»^

Benign disorders (fibroid, prolapse,
ovarian masses)

- w. A/*»,

.

r..,u

Initial Investigations and refer

Initial investigation at PHC / Gr III level
4 Breast Tumors
5 Cancer Cervix screening
Initial investigation at PHC / Grade III level
6
Cancer cervix/ovarian Initial
investigation at PHC / Grill level
7 Infertility
Prevention of MTCT
9* MTP / MVA services
To Tubectomy
11 Pap Smear
’12" PPTCT Counseling
lirri |-tini-j-i-.n.ii-irn»^ 1.11

----

Refer
Initial Investigations, Collection of PAP SMEAR
and refer
Diagnose and refer

-fr'jr'ni-r*.-rr.-

Basic Workout & Semen Analysis & Refer
Refer
~MVA~

Yes
Yes
Yes

urunmaaL^r

vr. u. _

ISMMMMHSMSBsaaj j

IPHS for 31 to 50 Bedded Hospitals

Tic
;

:■ ■ .-Ta»»»a»■—fwrmriM--nirg

Fractures
1.1

Open reduction int, fixation of femur, tibia, B. Bone, Forearm Humerus inter-condylar fracture
of humerus and femur and open reduction and int. Fixation bimaleola'r fracture and fracture
dislocation of ankle montaggia fracture dislocation

1.2

Medial condyle of humerus fracture lateral condyle of humerus Olecranen fracture, head of
radius lower end of radius, medial malleolus patella fracture and fracture of calcaneum talus
single forearm, bone fracture

1.3

Ext. fixation of hand & foot bones

1.4

Tarsals, Metatarsals, Phalanges carpals, Metacarples, excision head fibula, lower and of Inia
------------------------------------

-

..

-------------------------------------------------------- -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------

-------------------- ------------------....................................................................................................................................................................................................................................................................

1.5

Interlocking nailing of long bones

1.6

Debridement & Secondary closure

1.7

Percutaneous Fixation (small and long bones)

............................................................................................................... ........................... ■

1

■

'

i C-w®ad Bedudfem
2.1

Hand, Foot bone and cervicle

2.2

Forearm or Arm, Leg, Thigh, Wrist, Aknle

2.3

Dislocation elbow, shoulder, Hip, Knee

2.4

Closed Fixation of hand / foot bone

________ _ _________ _

i Opsn Reduction

3.1

Shoulder dislocation, knee dislocation

3.2

Acromiocalvicular or sternoclavicular Jt. Clavicle

3.3

Wrist dislocation on intercarpal joints

3.4

MP & IP Joints

3.5

Debridement of hand/foot

3.6

Fibula Radius Ulna (Clavicle) and Wrist, Ankle, Hand foot

3.7

Amputation (Thigh or arm, leg or forearm, feet or hand, digits)

3.8

POP Aplication (Hip Spica, Shoulde spica POP Jacket; A-K/A-E POP; B-K/B-E POP)

3.9

Patellectomy

IPHS for 31 to 50 Bedded Hospitals

13

Excision carbuncle

______

- ---

14

Ingroving Toe Nail

—

15

1 Diabetic Foot And carbuncle

Urology
'

.

1
<2

?

■ I

,

Pyelolithotomy
'■

Nephrolithotomy

3

Uretrolithotomy
'

.......I

'

■'

■■■

4

Open Prostectomy

5

Cystolithotomy Superopubic

6

-

Dialatition of stricture urethra under GA
<

•.>'

;■

I!“1*11

'

■

- .................................................. ..........................................................................................................................................-

................................... - ■

,

,

7

Dialation of stricture urethra without anaesthesia

8

Meatotomy

9

Trocar Cystostomy

Plastic Surgery
1

i

Burn Dressing Small, medium (10% to 30%), large 30% to 60%, extensive > 60%
.■

•

III. ______________ _ ____________ _______________________ __ __________________________________________________ _________________ _____________________________________________

2

Ear lobules repair one side

3

Simple wound

_____ \
-

B

4

Complicated wound

5

Simple injury fingers

6

Crush injury hand

.

Polio Surgery

7

8

■

Surgery concerning disability with Leprosy

■y Surgery concerning with TB

IPHS for 31 to 50 Bedded Hospitals

■

1

9

Haemorroidectorny

10

Anal Sphincter Repair after injury

I

Testes, Scrotum
1"“....... 1---------------------- ------- —
1
I Circumcision
2

Partial amputation of Penis

3

Total amputation of Penis

1------- L----------------------------

i 4

Orchidopexy (Unilateral & Bilateral)

I 5

Orchidectomy (Unilateral & Bilateral)

I 6

Hydrocele (Unilateral & Bilateral)

i 7

; Excision of Multiple sebaceous cyst of scrotal skin

J 8

Reduction of Paraphimosis

I

; Other Procedures
_]------------------ -----------------------------

! 1
L—

' Suture of large laceration

2

Suturing of small wounds

! 3

Excision of sebaceous cyst

. 4

--------------------------------------

.. ;-------------- ---------------------------

Small superficial tumour

i 5

i Repair torn ear lobule

i!
k

(

i

Incision and drainage of abscess
----------------- -

Injection Haemorrhoids/Ganglion/Keloids

I
!

8

Removal of foreign body (superficial)

* 9

Removal of foreign body (deep)

! 10

Excision Multiple Cysts

11I
12

; Tongue Tie

Debridment of wounds

isiaggi 10

IPHS for 31 to 50 Bedded Hospitals

Appendix

1

Emergency Appendisectomy

2

Interval Appendisectomy

’3

Appendicular Abscess Drainage

Small fntestjne

1

Resection and Anastomosis

"l

□

Multiple Resection and Anaestomosis
■

3

Intestinal Performation

I

Liver
1

Open Drainage of liver abscess

2

Drainage of Subdia, Abscess/Perigastric Abscess

i

Biliary System

1

Cholecystostomy

2

Cholecystectomy

3

Cholecystectomy and Choledocholithotomy

I

-1
Coion, Rectum sai As

1

Fistula in anus low level

2

Catheters

3

IV Sets

4

Colostomy Bags

5

Fistula in ano high level

6

Perianal Abscess

7

Ischiorectal Abscess

8

Ileostomy or colostomy alone

*

> -J ®a«l 9 Ki

1
SMI

IPHS for 31 to 50 Bedded Hospitals

| 4

iiil? ■ ■

Fissurotomy or fistulectomy

__

'-------

i 5

Hemorrohoidectomy

b

Circumcision

Herniorraphy

_________________

i 9

Suprapubic Cystostomy

_________________

■

| 6

■v. ' K- -

. . .
-

Hydrocele surgery

,

-

________________ ___

■'

_________________

_____________

■

8

i—

I

I';

10

Vasectomy

11 ,

Cysts and Benign Tumour of the Palate

i 12

"
.
■ IB
-------------------- -—

Excision Submucous Cysts

' _____ . __

I Breast
i

1

/

.

■

! Excision fibroadenoma - Lump
..

; Hernia

■

—-

fB“ Ingunial Hernia repair reinforcement
ii 2

■

- iii

Femoral Hernia repair

r

Strangulated Ventral or Incisional Hernia/lngunial

3

t

■

Abdomen
*

Exploratory Laparotomy

1

■

2

Gastrostomy or Jejuncstomy

3

Simple Closure of Perforated Ulcer

•'•H ,/ • y

-i

. j '•

. ■;

----- :--------------■■

Pancreas

_____

I 1

I Drainage of Pseudopancreatic Cyst

L2

I_________________________ ——

Retroperitoneal Drainage of Abscess

T

_

_________

—

IPHS for 31 to 50 Bedded Hospitals

;

8

Bartholin Cyst Excision

9

Suturing Perineal Tears

10

Assisted Breech Delivery

11

Cervical Cautery

12

Normal Delivery

13

EUA

14

Retained Placenta & MRP

15

Suturing Cervical Tear

16

Assisted Twin Delivery

Dental Services

1

Dental Caries/Dental Abcess/Gingivitis

2

Minor Surgeries, Impaction, Flap

—i

3

Trauma including Vehicular Accidents

4

Sub Mucus Fibrosis (SMF)

5

Scaling and Polishing

6

Root Canal Treatment

7

Extractions

8 .

Amalgum Filling (Silver)
----------- - ---------------------- --- .j. —...

9

Intra oral X-ray '

10

Complicated Extractions (including suturing of gums)

i

SURGICAL

1

Abcess drainage including breast & perianal

2

Wound Debridement

3

Appendicectomy

7

Isa

1
1PHS for 31 to 50 Bedded Hospitals ■

1.4

- Foreign Body Removal (Corneal)

1.5

- Epilation

1.6

- Suture Removal
3 '

1.7

- Subconj Injection

1.8

- Retrobular Injection (Alcohol etc.)

1.9

- Tonometry

1.10

- Pterygium Excision

1.11

- Syringing & Probing

1.12

-1 & C of chalazion

•' B
• *

fi—
- HI I

... .................

1.13

- Stye

1.14

- Conjuctival Resuturing

1.15

- Corneal Scraping

I

,..

.... -■

■

''I

_______
—

' <f, & "

.. .

— — -. «——

~

- - ■ - W»..

• • >■

1.16

-1 & D Lid Abscess

1.17

- Uncomplicated Lid Tear

1.18

- Indirect Opthalmoscopy

1.19

- Retinoscopy

—

& Gynecology Specialist Services

;

1

Episiotomy

2

Forceps delivery

—
—

-------------------------- —
■’ i--

-

.

________
■

3

Craniotomy-Dead Fetus/Hydrocephalus

4

Caesarean section

5

Female Sterilization ( Mini Laparotomy & Laparoscopic)

————

6

7

1 D&C

________________

——

________

MTP

_________________

I

MW

MM IPHS for 31 to 50 Bedded Hospitals

Paediatric Procedures

~1
i—-------------------------------------------------------------------------- I

1

Immunization (BCG, QPV, DPT, Measles, DT) / Children Ward/ORT corner

2

2.1

Services related to new borne care + All procedures as mentioned in IMNCI
———
„------_____-------------------------------------------- only cradle

2.2

- Incubator Nebulization equipment

----- 1

___

2.3

- Radiant Heat Warmer

2.4

- Phototherapy

________
pc
215

--------- j

J

- Gases (oxygen)

2.6
-v,
.

........................................... ,

’

- Cut down
j

Cardiology Procedures and Diagnostic Tests
1

ECG

2

Defibrillator Shock

______ _______ _________

■

Physiotherapy Services
1

With Electrical Equipments
T ■

1.1

Short wave diathermy

1.2

- Ultra Sonic Therapy

1.3

- Infra Red Lamp (Therapy)

_______

1

_______

1.4

- Electric Vibrator
.....

Eye Specialist Services (Opthalmology)
1

OPD Procedures

1.1

- Refraction (by using snellen’s chart)
- Prescription for glasses using Trial frame.
»a

1.2

- Syringing and Probing

1.3

- Foreign Body Removal (conjunctival)

r

'

•. 'MSM

1
...

1
IPHS for 31 to 50 Bedded Hospitals

SERVICE MIX OF PROCEDURES IN MEDICAL AND SURGICAL SPECIALITIES
• .••v.r :

•

s-

•..-jrvt • 'n.^rAv»iTTVTr««FK’y.<rxa?’^<ww^Av^v^rjwr7at—riunaji^iuwjiw-BW-U.—w—wtu un.-to/^afw .ora ww*jabim«j*-

; MEDICAL
Pleural Aspiration

1

----------------------- --------------------------------------------------------------------------------------------------- -------------------- *------------------------------------------------------------------------------------------------------------------------------------- —---------------------------------------------------------

i 2

I 3
4

; Lumbar Puncture

Skin scraping for fungus / AFB
Skin Biopsies

'

'

’’

■

■'.

_

------- ---—

—

I Abdominal tapping
; 5
}—
| OPD Procedures (Including IPD)

_______
_____

WBBk;

'

Dressing (Small, Medium and Large)

1

'VC -'.

'

f
:

2

i Injection (l/M & l/V)

■ h,....irii-in-.irii. l.iniurr-r-ini.jiiixn tit. '

3

: Catheterisation

j.—

I 4

Steam Inhalation

LI

i Cut down (Adult)

6

/

/ if r:': . ,r..

------- -

'OW
■

____

i Enema

' 7
I---i 8

I Stomach Wash

; 9

j Sitz bath

_____

■

Douche

•— —I-----------------------------

i

10

Blood Transfusion

I 11 ■ Hydrotherapy
L-------- 4--------------------—
I 12 i Bowel Wash

ZZ

■

.

(---- 1-------------i Skits Procedures

.

j.

1

| 2

4

L

■

■

■

Chemical Cautery

! Electro Cautery
1

3

.

—

Ii Intra Lesional Injection
Biopsy

'J

■'

—

IPHS for 31 to 50 Bedded Hospitals

serves. I
Secondary level health care services
‘ ies froregarding following specialties will be assured at
motions aospital:
' isolation
’ 5 day?
Consultation, services with following
rict havinspecialists:

Security services
Housekeeping and Sanitation

<■

Inventory Management

Waste management

Office Management (Provision should be
made for computerized medical records with
anti-virus facilities whereas alternate records
should also be maintained)

i o0 beds

’"'"t varieGeneral Medicine
norms
o
s per th(^enera Sur9ery
Obstetric & Gynecology

Counseling services for domestic violence,
gender violence, adolescents, etc. Gender
and socially sensitive service delivery be
assured.

' Pediatrics
-OfSUl

funder Anesthesia

Orthopedics
* Subject to location at District Headquarter.

ENT

Fmanci

ollowing Rac*'0'09'st anc^ Ultrasonologist
Ophthalmology

Medical Superintendent to be authorized to
incure and expenditure up to Rs. 15.00 lakhs for
repair/upgradating of impaired equipments/
instruments with the approval of executive
committee of RKS. Financial accounting and
auditing be carried out as per the rules along with
timely submission of SOEs/UCs.

♦
Community Health
althcare
t Jalist Dermatology and Venerology (Skin & VD) RTI/STI

^for a Denta| care
cipation
! i the AYUSH
covers
Diagnostic and other Para clinical services
isional
) ation regarding:

No equipment/instruments should remain
non-functional for more than 30 days. It will amount
to suspension of status of IPHS of the concerned
institutions for absence period.

Lab, X-ray, Ultrasound, ECG, Blood
Dublic transfusion and storage, and physiotherapy
'raiuka

•: res,
itres.

rnary ♦

r im

Outsourcing of services like laundry,
ambulance, dietary, housekeeping and sanitation,
waste disposal etc. to be arranged by hospital itself.
Manpower and outsourcing work could be done
through local tender mechanism.

Support Services: Following ancillary
services shall be ensured:

Medico legal/postmortem*

♦

Ambulance services

♦

Dietary services

♦

Laundry services

Following services mix of procedures in
medical and surgical specialties would be available:

nd

3

IPHS for 31 to 50 Bedded Hospitals

scope of further expansions. As far as possible,
States should not dislocate the said hospitals to a
new location (in case of dislocating to a new location,
the original client group will not be able to have same
access to the desired health facilities)

Objectives of indian Public Health
Standards (IPHS) for Sub-District
Hospitals:
The overall objective of IPHS is to provide
health care that is quality oriented and sensitive to
the needs of the people of the district. The specific
objectives of IPHS for Sub District Hospitals are:
i.

ii.

iii.

To provide comprehensive secondary health
care (specialist and referral services) to the
community through the Sub District Hospital.
To achieve and maintain an acceptable
standard of quality of care.

The minimum functional requirement (
district hospitals (31-50 bedded) is given a j
5.

The term Sub District / Sub Divisional
Hospital is used here to mean a hospital at the
secondary referral level responsible for the Sub
District / Sub Division of a defined geographical area
containing a defined population.

Categorizing of Sub District
hospitais

The size of a sub district hospital is a function
of the hospital bed requirement, which in turn is a

■M 2

“uractsons

A sub district hospital has the fr
functions:
1.

It provides effective, affordable he’7'1*!
services (curative including spec
services, preventive and promotiv.,
defined population, with their full part'^c
and in co-operation with agencies ii
district that have similar concern. Ii i
both urban population (sub divisi
headquarter town) and the rural popul
of the sub division.

2.

Function as a referral centre for th.;
health institutions below th’e tehseel' ♦<•
level such as Community Health Cer
Primary Health Centres and Sub-ct )i

3.

Provide education and training for r,i
health care staff.

To make the services more responsive and
sensitive to the needs of the people of the
district and act as the First Referral Unit
(FRU) for the hospitals/centers from which
the cases are referred to the Sub District
hospitals

Debnstion of Sub District hospitals

A

function of the size of the population it se'v
India the population size of a sub district vanei
1,00,000 to 5,00,000. Based on the assum, i
the annual rate of admission as 1 per 50 pop1
and average length of stay in a hospital as o
the number of beds required for a sub distrii i
a population of 5 lakhs will be around 100-150
However, as the population of the sub distriw'
a lot, it would be prudent to prescribe n ’■
categorizing the size of the hospitals as pc
number of beds.

Essential Services (Minnr '
Assured Services)
Services include OPD, indoor
emergency services.

IPHS for 31 to 50 Bedded Hospitals

1.

Introduction

continuous improvements in quality. The
performance of Sub-district hospitals can be
assessed against a set of standards.

Sub-district (Sub-divisional) hospitals are
below the district and above the-block level (OHO)
hospitals and act as First Referral Units for the Tehsil
/Taluk /block population in which they are
geographically located. Specialist services are
provided through these sub-district/district hospitals
and they receive referred cases from neighboring
CHCs. These hospitals should play an important
referral link between the Community Health Centres,
Primary Health Centres and sub-centres. They have
an important role to play as First Referral Units in
providing emergency obstetrics care and neonatal
care and help in bringing down the Maternal
Mortality and Infant Mortality. It also saves the travel
time for the cases needing emergency care and
reduces the workload of the district hospital. In some
of the states, each district is subdivided in to two or
three sub divisions. A subdivision hospital caters to
about 5-6 lakhs people. In bigger districts the sub
district hospitals fills the gap between the block level
hospitals and the district hospitals. There are about
1200 such hospitals in the country with a varying
strength of number of beds ranging from 50 to 100
beds or more.

There has been effort to set standards for
30 and 100 bedded hospitals by the Bureau of Indian
Standards (BIS). However, these standards are
considered very resource intensive and lack the
process to ensure community involvement,
accountability and citizens charter issues that are
important for public hospitals.

The National Rural Health Mission (NRHM)
has given the opportunity to set Indian Public Health
Standards(IPHS) for various health institutions at
different levels right from Sub-centre to District
Hospital level including Sub-district/Sub-divisional
Hospitals.
The current effort is to prepare Indian Public
Health Standards for the Sub-district Hospitals.
Reference has been made to the BIS Standard for
100 bedded hospitals; Rationalisation of Service
Norms for Secondary Care Hospitals prepared by
Govt, of Tamil Nadu; District Health Facilities,
Guidelines for Development and Operations, WHO,
1998 and Indian Public Health Standards (IPHS)
for Community Health Centres. Setting standards
is a dynamic process. This document contains the
standards to bring the Sub-district Hospitals to a
minimum acceptable functional grade with scope
for further improvement in it. These standards are
flexible as per the requirements and resources
available to the concerned State/UT Government.
The timeframe for implementation and achievement
of these Standards could be extended for five years
and to be done in phases.

The Government of India is strongly
committed to strengthen the health sector for
improving the availability, accessibility of affordable
qiiafity health services to the people. In order to
‘ improve the quality and' accountability of health
services a set of standards need to be there for all
health service institutions including sub-district
hospitals.
Standards are a means of describing the
level of quality that health care organizations, are
expected to meet or aspire to. The key aim of
standard is to underpin the delivery of quality
services which are fair and responsive to client’s
needs, which should be provided equitably and
which deliver improvements in health and well being
of the population. Standards are the main driver for

Most of the existing hospitals below district
level (31-50 Bed category) are located in older
buildings in urbanized areas / towns as compared
to most Primary Health Centres / Sub-centres. The
expansions already done have resulted in
construction touching the boundaries walls with no

1

■' t:

■

.

'

. ■

■

'■

Contents
1.

< ww

Introduction

'

■

■■

2.

Objectives of IPHS for Sub-District Hospitals

2

Definition of Sub-District Hospital

2

••■■■.■■■■

V

"■■■

\

JL IK'

Aa

AX

a

■.

2

I Jiak A aMk |A

I

___

2

I a.

2
■

■</

P. ssential Services

2

E’

6‘

u-: '

Physical Infrastructure

7.

_

.

W ■ ■

L •; A. '

A '

8-

Manp°wer

30

A*

s

'O a'<

I:

32

9_jw«2L___

a.;'

a. ■>

•■<a:a'. <;.

<■

1°A-

•

Lab^Senta.

,A

■ vA-Va'. a ■

43

■ a-

■

'

'

' ■

.A

allocation of bed strength at various levels
11. ^ Recommended
Rscc
*

23

. A'

AX A^V

L

l

—~~

.5- Ful1al°ns
•

A A Im.

Categorizing of Sub-District Hospital

■ 4.

1

/■

AAA

44

:/'a y;

'■ ■■■<:

.,2-

USIOID^S

13.

Capacity Buildirtg

45
. ...
■ B.

■

■III... ■

<b...BB-. -B'-b a.B'?

■

61

b

14.

Quality Assurance In Services

61

15.

ROQI Kalyan SamiUes / Hospital Management Committee

61

16.

Citizen's Charter

61

Annexure -1: Guidelines for Bio-Medical Waste Management

67

Annexure - II: Reference Laboratory Networks

71

__________________________________________________________________________________________________________________ ___________________________________________________________________________________________________________________________

.■•,

A

74

List of Abbreviations
.

References

■

75

vii

Acknowledgements
Indian Public Health Standards (IPHS) for the Sub-district/Sub-divisional Hospitals fulfill ■
the needs of secondary referral care which may be useful as a referral document for the delivery of
quality health care. The document is the result of efforts put in by both the government and non
government organizations. As the population and geographical size of the Sub-division varies in
different States and UTs, an attempt has been made to formulate IPHS for hospitals having
different bed strengths such as 31 -50, and 51-100 bedded hospitals. This document contains the
Standards set for 31-50 bedded hospital at Sub-district / Sub-divisional level.

I gratefully acknowledge the valuable contribution made by all the members of the Expert
Group constituted to formulate Indian Public Health Standards (IPHS) for the Sub-district/Subdivisional Hospitals. I am thankful to them individually and collectively.
I also gratefully acknowledge the initiative, encouragement and guidance provided by Dr.
R.K. Srivastava, Director General of Health Services and Smt. S. Jalaja, Additional Secretary. The
help and encouragement provided by Shri Amarjeet Sinha, Joint Secretary(H&FW), M/o Health &
Family Welfare, Government of India is also gratefully acknowledged.
I would specifically like to thank Dr. R.N. Salhan, Addl D.G. and Medical Superintendent
(Safdarjang Hospital), Dr. Shivlal, Additional D.G. and Director (NICD) and Shri S. Majumdar, Chief
Architect, Bureau of Design, Ministry of Health & Family Welfare for their valuable contribution and
guidelines in formulating the IPHS for the Sub-district/Sub-divisional Hospitals.
The preparation of this document has been made possible by the assistance provided by
Smt. Sushma Rath, Under Secretary (ID/PNDT) and the secretarial and typing assistance provided
by Sh. Brij Mohan Singh Bhandari. The assistance provided by the staff of Rural Health Section of
the M/o Health & Family Welfare is duly acknowledged.

u
(Dr. S.K. Satpathy)
Member Secretary - Expert Group
Director
Central Health Education Bureau
Directorate General of Health Services
Ministry of Health & Family Welfare
Government of India

New Delhi
Dated: 16,h May, 2007

V

»

IPHS for 31 to 50 Bedded Hospitals

fl.

17 J Miscellaneous
‘
Treat

a) Acne Vulgaris, Miliaria, Alopecia,
I

!

Nail disorder,Toxin induced

J

b) Leprosy - Resistant/
Complications / reaction

Allergy - EMF / SJS / TENP soriasis/

Treat /

I Collagen Vascular/Auto immune Disorders

Refer

c) Deep Mycosis, STD Complications

Treat / Refer

d) Genetically Determined Disorders

Refer

I

CHEST PISE?

RECOMMENDED SERVICE MIX

' j S. I NAME OF THE ILLNESS

(SUGGESTED ACTIONS)

No'

T

Fever

Investigation and Treatment Refer if necessary

2

Cough with Expectoration / Blood Stained

Treatment and refer if necessary

3

Hemoptysis

First Aid, Start blood transfusion and refer

4

Chest Pain

ECG Symptomatic treatment Refer

.....

r5 | Wheezing
- ----Breathlessness
6

Investigation, Symptomatic treatment if necessary
'' Investigation, Treatment and Refer if necessary,

X-ray
PSYGHI’Apf

S.

RECOMMENDED SERVICE MIX

NAME OF THE ILLNESS

No

(SUGGESTED ACTIONS)

- 1

Schizophrenia
......- -----2
Depression

Screening and Refer

' 3

i Mania

Screening and Refer

4

Anxiety Disorders

Screening and Refer

5

Mental Retardation

Screening and Refer

Other Childhood Disorders

Screening and Refer

7

Alcohol and Drug Abuse

Screening and Refer

8

Dementia

Screening and Refer

iHRfl

Screening and Refer

1':

■■ s 17

IPHS for 31 to 50 Bedded Hospitals

"

DSASETOLOGY
S. NAME OF THE ILLNESS

RECOMMENDED SERVICE MIX
(SyG^ESTED ACTIONS)

NO ;

1

Screening for Diabetes

2

Gestational Diabetes/DM with Pregnancy

Diagnose and Treat
Diagnose and Treat

3

DM with HT

Diagnose and Treat

Nephropathy/Retinopathy
p_4_^
5

Neuropathy with Foot Care

6

Emergency
i) Hypoglycemia
ii) Ketosis
iii) Coma

!

Diagnose and Refer

Investigate, Diagnose & Treat

Diagnose first and refer

NEPHROLOGY
S. NAME OF THE ILLNESS
No ’
~ _______________

RECOMMENDED SERVICE MIX
(SUGGESTED ACTIONS)

1

Uncomplicated UTI

Treat

2

Nephrotic Syndrome - Children/
I Acute Nephritis

Refer to SD-II

3

Nephrotic Syndrome Adults

4

HT, DM

Annual followup / refer to Gr-ll-SD

5

Asymptomatic Urinary Abnormalities>

Refer to the District

6

Nephrolithiasis

Refer to District Hospital

7

Acute renal Failure/ Chronic Renal Failure

Suspect / Refer to District level

8

Tumors

_

HEMRO MED8CINE AND NEURO SURGERY
I S. I NAME OF THE ILLNESS

No
. 1 Epilepsy

J^£!?L!2.^elt'ary care _

Refer to Tertiary

RECOMMENDED SERVICE MIX
(SUGGESTED ACTIONS) ’
First Aid, Referral and Follow up of already
diagnosed cases

2

CX A.

First Aid and Referral

3

Infections

Referral ’

4 : Trauma

First Aid and Referral

5

Chronic headache

Referral

6

Chronic Progressive Neurological disorder

Referral

ISIS

IPHS for 31 to 50 Bedded Hospitals

.

GENERAL SURGERY

"s7
Nd

1,
•»

Basic
Techniques

*

■

2

Elective
Surgeries

3

Emergency
surgeries

NAME OF THE SURGICAL
PROCEDURE/ILLNESSES ___________
a. Minor Cases
under LA Abcess l&D/Suturing, Excision
of Lipoma / Ganglion / Lymph Node,
Seb-Cyst / Dermoid / Ear Lobe Repair /
Cjrcumcision_____________________
b. Breast Lumps, Lymph nodes Swelling

RECOMMENDED SERVICE
MIX (SUGGESTED ACTIONS)

Treat

Diagnosis and Refer
Treat

a. Genitourinary tract Hydrocele, Hernia,
Circumcision, Supra pubic cystostomy'
b. Gastrointestinal disorder
Appendicitis/Anorectal abscesses /
Treat
Hemorrhoids/Fistula ______________
Assault injuries/Bowel injuries/
Head injuries/Stab injuries/Multiple injuries/ Diagnose, treat & refer
Perforation/lntestinal obstruction________

4"

Benign/
Malignant
SO Diseases

Breast/Oral/GI tract/Genitourinary (Penis,
Prostate, Testis)

Diagnose & refer

_5__ Others

Thyroid, Varicose veins

Diagnose & Refer

6

Burns

Burns
<15%

7

Medico legal

Treat first and then Refer

: ■

>15%______________
a) Assault / RTA

AR entry / Treat Refer if
necessary__________'

b) Poisonings

AR entry/Treat Refer if
necessary__________

c) Rape

AR entry/Treat Refer if
necessary__________
Done

d) Postmortem

I

19

r
IPHS for 31 to 50 Bedded Hospitals

OPTHALMOLOGY________

S. NAME OF THE ILLNESS
No.

RECOMMENDED SERVICE
MIX (SUGGESTED ACTIONS)

2_ Superficial Infection______________________

Treatment with drugs ______
First aid and refer_________
Treat__________________

2

Deep Infections_________________________
_________________
3_ Refractive Error
4_ Glaucoma __________________________

5
6
7
8

Eye problems following systemic disorders______
Cataract_____ __ _____________________

9

Malignancy/Retina Disease________________
Paediatric Opthalmology

10

Foreign Body and Injuries__________________
Squint and Amblyopia/Corneal Blindness (INF, INJ,
Leucoma)/ Oculoplasty
________________

Diagnosis and refer________
Refer___________________

Screening and refer________
First aid and refer ________
Refer
Refer
Refer

EAR, NOSE, THROAT
tAR

S. NAME OF THE ILLNESS
No.
j_ ASOM/SOM/CSOM
2_ Otitis External / Wax Ears

4

Polyps_____________
Mastoiditis

5

Unsafe Ear

■3_

RECOMMENDED SERVICE
MIX (SUGGESTED ACTIONS)

Treat_______________ _
Treat__________________
Diagnose and Refer_______
Treatment
(Medical)_____________ _
Diagnose and Refer
THROAT

2
2
3
4

Tonsillitis/Pharyngitis/Laryngitis
Quinsy_________________
Malignancy Larynx________

Treat__________
Diagnose and Refer
Diagnose and Refer
Diagnose and Refer

Foreign Body Esophagus

NOSE

2
2
3
4
5

Epistaxis_____
Foreign Body

First aid & Refer______________
Treat (Removal) And refer if needed
Refer___________ ,
Treat (Medical)______________ _
Treat (Symptomatic)

Polyps______
Sinusitis_____
Septal Deviation

20

F

IPHS for 31 to 50 Bedded Hospitals

ORTHOPADICS_________
S. NAME OF THE ILLNESS
No.
Osteomyelitis'_____________
1
Rickets /Nutritional Defeciencies
2
3
4

I

Poliomyelitis with residual
Deformities/JRA/RA
RTA/Polytrauma

.

RECOMMENDED SERVICE
MIX (SUGGESTED ACTIONS)
X-ray / Antibiotics POP/refer
Detection/ Refer
Nutritional Mgt______________
Prevention / Detection / Antibiotics/
Anti inflammatory for JRA
Stabilize and Refer

_

UROLOGY
CHILDREN
S- NAME OF THE ILLNESS
No.
Hydronephrosis__________
1
Urinary Tract Injuries______
2
3 PUVZ Posterior Urethral Valve
Cystic Kidney___________
4
Urinary Obstruction_______
5
Undesended Testis_______
6
Hypospadias and Epispadias
7
Mega Ureter____________
8
Extrophy______________
9
10 Tumours - Urinary Tact

RECOMMENDED SERVICE
MIX (SUGGESTED ACTIONS)
Diagnose and refer___________
Diagnose and refer
Diagnose and refer
Diagnose and refer
Urethral Catheter Insertion Referral
Diagnose and refer
Diagnose and refer
Diagnose and refer
Diagnose and refer
Diagnose and refer

ADULT___________________ __
All above and_______________
Stricture Urethra_____________
1
2 Stone Diseases__________ _
3 Cancer - Urinary and Genital Tract
4 Trauma Urinary Tact
5 GUTB __________________

Diagnose and refer
Diagnose and refer
Diagnose and refer
Diagnose and refer
Diagnose and refer

OLD AGE
1 / Prostate Enlargement and Urinary Retention
Stricture Urethra__________________ _
2
Stone________________
3
4 Cancer
(Kidney, Bladder, Prostate, Testis, Penis and
Urethra)
5 Trauma Urinary Tract

21
!

..A.

Urethral Catheter Insertion Referral
Diagnose and refer
Diagnose and refer

Diagnose and refer

Diagnose and refer

[1

IPHS for 31 to 50 Bedded Hospitals

DENTAL SURGERY_______

s.

NAME OF THE ILLNESS

RECOMMENDED SERVICE
MIX (SUGGESTED ACTIONS)

Dental Caries/Dental
Abcess/Gingivitis______

Treatment
Extraction and Filling

2

^-♦Cleaning
Periodontitis
________ ^~~~*Surgery _________

Treat by Cleaning

3

Minor Surgeries, Impaction, Flap

Treat and Refer if necessary

4

Malocclusion

Diagnose and Refer__________

5

Prosthodontia (Prosthetic Treatment)

Diganose and Refer

6

Trauma

Treated - First aid with drugs and refer

_7

Maxillo Facial Surgeries__________

Refer_____________________

8

Neoplasms

Refer

No.

1

HEALTH PROMOTION & COUNSELLING

s.

NAME OF THE ILLNESS

T- CHD/M.I.

RECOMMENDED SERVICE
MIX (SUGGESTED ACTIONS)
Counseling / Diet advice Safe Style
changes

2

Diabetes

Safe Style Changes / Physiotherapy

3

Substance Abuse

Vocational Rehabilitation Safe Style

No.

COMMUNITY HEALTH SERVICES:
S. NAME OF THE ILLNESS
No.

■

I
i

T- Communicable & Vaccine Preventable Diseases

Health Promotional Activities like ORT
Canon, Immunization Camps
Epidemic Health Investigation, Promotion
& Counseling Activities

2

Non-communicable Diseases

3

Adolescent & School Health

Adolescent & school health promotional
activities

4

Family Planning

Counseling services, camps, follow up of
contraceptive users

5

HIV/AIDS

Counseling, ART

22

-

RECOMMENDED SERVICE
MIX (SUGGESTED ACTIONS)_______

i

IPHS for 31 to 50 Bedded Hospitals

7.

Physical Infrastructure

7.1

Size of the hospital

rain fall and data on weather and climate. Hospital
Management Policy should emphasize on quake
proof, fire proof and flood proof buildings.
Infrastructure should be eco-friendly and disabled
(physically and visually handicapped) friendly.
Provision should be made for water harvesting,
generating back-up, solar energy / power back-up,
and horticulture services including herbal garden.
Local agency Guidelines and By-laws should strictly
be followed. A room for horticulture to store garden
implements, seeds etc will be made available.

The size of a district hospital is a function of
the hospital bed requirement which in turn is a
function of the size of the population serve. In India
the population size of a district varies from 50,000
to 15,00,000. For the purpose of convenience the
average size of the district is taken in this document
as one million populations. Based on the
assumptions of the annual rate of admission as 1
per 50 populations. And average length of stay in a
hospital as 5 days. The number of beds required
for a district having a population of 10 lakhs will be
as follows:

7.4

The location may be near the residential
area.

The total number of admissions per year
= 10,00,000 x 1/50 = 20,000

I

Too old building may be demolished and
new construction done in its place.

Bed days per year = 20,000 x 5 = 100,000

It should be free from dangers of flooding; it
must not, therefore, be sited at the lowest
point of the district.

Total number of beds required when
occupancy is 100% = 100000/365 = 275
Total number of beds required when
occupancy is 80% = 100000/365 x 80/100

. t

I

7.2

I
I
•

♦

It should be in an area free of pollution of
any kind, including air, noise, water and land
pollution.

Area of the hospital

It must be serviced by public utilities: water,
sewage and storm-water disposal,
electricity, gas and telephone. In areas
where such utilities are not available,
substitutes must be found, such as a deep
well for water, generators for electricity and
radio communication for telephone.

An area of 65-85 m2 per bed has been
considered to be.reasonable. The area will include
the service areas such as waiting space, entrance
hall, registration counter, etc. In case of specific
rbcfuirement of a hospital, flexibility in altering the
area be kept.
, •'
7.3.

Factors to be considered in locating a
district hospital

Necessary environmental clearance will be
taken.

Site information

Disability Act will be followed.

Physical description of the area which
should include bearings, boundaries, topography,
surface area, land use.d in adjoining areas, limitation
of the site that would affect planning, maps of vicinity
and landmarks or centers, existing utilities, nearest
city, port, airport, railway station, major bus stand,

7.5

Site selection criteria

A rational, step-by-step process of site
selection occurs only in ideal circumstances. In

23

D

IPHS for 31 to 50 Bedded Hospitals

Floor Height

some cases, the availability of a site outweighs other
rational reasons for its selection, and planners arid
architects are confronted with the job of assessing
whether apiece of land is suitable for building a
hospital. In the case of either site selection or
evaluation of adaptability, the following items must
be, considered: size, topography, drainage, soil
conditions, utilities available, natural features and
limitations.

7.6

The room height should not be less than
approximately 3.6 m measured at any point from
floor to floor height.
Entrance Area
Physical Facilities

Ambulatory Care Area (OPD)

In the already existing structures of a
district hospital

Waiting Spaces

It should be examined whether they fit into
the design of the recommended structure
and if the existing parts can be converted
into functional spaces to fit in to the
recommended standards.

♦

Registration, assistance and enquiry counter
facility be made available in all the clinics.

Main entrance, general waiting and
subsidiary waiting spaces are required adjacent to
each consultation and treatment room in all the
clinics.

If the existing structures are too old to
become part of the new hospital, could they
be converted to a motor pool, laundry, store
or workshop or for any other use of the
district hospital.

♦

If they are too old and dilapidated then they
must be demolished. And new construction
should be put in place.

7.7

Building and Space Requirements

Clinics
The clinics should include general, medical,
surgical, ophthalmic, ENT, dental, obsetetric and
gynaecology, paediatrics, dermatology and
venereology, psychiatry, neonatology, orthopaedic
and social service department. The clinics for
infectious and communicable diseases should be
located in isolation, preferably, in remote corner,
provided with independent access. For National
Health Programme, adequate space be made
available.

Administrative Block:
Administrative block attached to main
hospital along with provision of MS Office and other
staff will be provided.

I •»

Nursing Services

Various clinics under Ambulatory Care Area.
require nursing facilities in common which include
dressing room, side laboratory, injection room, social
service and treatment rooms, etc.

Circulation Areas
Circulation areas like corridors, toilets, lifts,
ramps, staircase and other common spaces etc. in
the hospital should not be more than 55% of the
total floor area of the building.

Nursing Station: On an average, one
nursing station per ward will be provided. However,
24

>

I
IPHS for 31 to 50 Bedded Hospitals

)

it should be ensured that nursing station caters to
about 40-45 beds. Out of these half will be for acute
and chronic patients.

Intermediate Care Area (Inpatient Nursing Units)
General
Nursing care should fall under following
categories:

Diagnostic Services

Imaging

General Wards: Male / Female

l

. I

I

Role of imaging department should be radio
diagnosis and ultrasound along with hire facilities
depending on the bed strength. The department
should be located at a place which is accessible to
. both OPD and wards and also to operation theatre
department. The size of the room should depend
on the type of instrument installed. The room should
have a sub-waiting area with toilet facility and a
change room facility, if required. Film developing
and processing (dark room) shall be provided in the
department for loading, unloading, developing and
processing of X-ray films. Separate Reporting Rbom
for doctors should be there.

Private Wards

Wards for Specialities

Depending upon the requirement of the
hospital and catchment area, appropriate beds may
be allowed, for private facility. 10% of the total bed
strength is recommended as private wards beds.
Location

Location of the ward should be such to
ensure quietness and to control number of visitors.

Clinical Laboratory

Ward Unit

For quick diagnosis of blood, urine, etc., a
small sample collection room facility shall be
provided.

The basic aim in planning a ward unit should
be to minimize the work of the nursing staff and
provide basic amenities to the patients within the
unit. The distances to be traveled by a nurse from
bed areas to treatment room, pantry etc. should be
kept to the minimum. Ward unit will include nursing
station, doctors’ duty room, pantry, isolation room,
treatment room, nursing store along with wards and
toilets as per the norms. On an average one nursing
station per ward w ill be provided. It should be ensure
that nursing station caters to above 40-45 beds,
out of which half will be for acute and chronic
patients.

Separate Reporting Room for doctors
should be there.

Blood Bank
Blood bank shall be in close proximity to
pathology department and at an accessible distance
to operation theatre department, intensive care units
and emergency and accident department. Blood
Bank should follow all existing guidelines and fulfill
all requirements as per the various Acts pertaining
to setting up of the Blood Bank.

Private ward: Depending upon the
requirement of the hospital and catchment area
appropriate beds may be allocated for private
facilities. However, 10% of the total bed strength is
recommended as private wards beds.

Separate Reporting Room for doctors
should be there.

25

A*
IPHS for 31 to 50 Bedded Hospitals

departments, such as, X-ray and pathology so that
the staff and ancillaries could be shared. Easy and
convenient access from emergency and accident
department is also essential. This unit will also need
all the specialized services, such as, piped suction
and medical gases, uninterrupted electric supply,
heating, ventilation, central air conditioning and
efficient life services. A good natural light and
pleasant environment would also be of great help
to the patients and staff as well.

Pharmacy (Dispensary)
The pharmacy should be located in an area
conveniently accessible from all clinics. The size
should be adequate to contain 5 percent of the total
clinical visits to the OPD in one session.

Pharmacy should have component of
medical store facility for indoor patients and separate
pharmacy with accessibility for OPD patients.

ICU and High Dependency Wards: Number
of beds for both the units will be restricted to 5% of
the total bed strength. Out of these, they can be
equally divided among ICU and High Dependency
Wards. For example, in a 500 bedded hospital, total
of 25 beds will be for critical care. Out of these 13
may be ICU beds and 12 will be allocated for high
dependency wards.

Intensive Care Unit & High Dependency Wards
General

In this unit, critically ill patients requiring
highly skilled life saving medical aid and nursing care
are concentrated. Critically ill patients may be kept
for supportive therapy at this hospital and as soon
as they are stabilized, they may be expeditiously
transferred to tertiary care centres. These should
include major surgical and medical cases, head
injuries, severe haemorrhage, acute coronary
occlusion, kidney and respiratory catastrophe,
poisoning etc. It should be the ultimate medicare
the hospital can provide with highly specialized staff
and equipment. The number of patients requiring
intensive care may be about 2 to 5 percent total
medical and surgical patients in a hospital. The unit
shall not have less than 4 beds not more than 12
beds. Number of beds will be restricted to 5% of the
total bed strength. Out of these, they can be equally
divided among ICU and High Dependency Wards.
For example, in a 500-bedded hospital, total of 25
beds will be for Critical Care. Out of these, 13 may
be ICU beds and 12 will be allocated for High
Dependency Wards. Changing room should be
provided for.

Facilities
Nurses Station
Clean Utility Area

Equipment Room
Critical Care Area (Emergency Services)
It should .preferably have a distinct entry
independent of OPD main entry so that a very
minimum time is lost in giving immediate treatment
to casualities arriving in the hospital. There should
be an easy ambulance approach with adequate
space for free passage of vehicles and covered area
for alighting patients.

Therapeutic Services
Operation Theatre

Location

Operation theatre usually have a team of
surgeons anesthetists, nurses and sometime
pathologist and radiologist operate upon or care for

This unit should be located close to
operation theatre department and other essential

26

4

vf

IPHS for 31 to 50 Bedded Hospitals

destroyed. Dirty linen is sent to laundry through a
separate exit. The room should be provided with
sink, slop sink, work bench and draining boards.

the patients. The location of Operation theatre
should be in a quite environment, free from noise
and other disturbances, free from contamination and
possible cross infection, maximum protection from
solar radiation and convenient relationship with
surgical ward, intensive care unit, radiology,
pathology, blood bank and CSSD. This unit also
need constant specialized services, such as, piped
suction and medical gases, electric supply, heating,
air-conditioning, ventilation and efficient life service,
if the theatres are located on upper floors. Zoning
should be done to keep the theatres free from micro
organisms. There may be four well defined zones
of varying degree of cleanliness namely, Protective
Zone, Clean Zone, Aseptic or Sterile Zone and
Disposal or Dirty Zone. Normally there are three
types of traffic flow, namely, patients, staff and
supplies. All these should be properly channelized.
An Operation Theatre should also have Preparation
Room, Pre-operative Room and Post Operative
Resting Room. Operating room should be made
dust-proof and moisture proof. There should also
be a Scrub-up room where operating team washes
and scrub-up their hands and arms, put on their
sterile gown, gloves and other covers before
entering the operation theatre. The theatre should
have sink / photo sensors for water facility. Laminar
flow of air be maintained in operation theatre. It
should have a central air conditioning facility. It
should have a single leaf door with self closing
device and viewing window to communicate with
the operation theatre. A pair of surgeon’s sinks and
elbow or knee operated taps are essential.
Operation Theatre should also have a SubSterilizing unit attached to the operation theatre
limiting its role to operating instruments on an
emergency basis only.

Delivery Suite Unit

The delivery suit unit be located near to
operation theatre.
The delivery Suit Unit should include the
facilities of accommodation for various facilities as
given below:

Reception and admission
Examination and Preparation Room

Labour Room (clean and a septic room)
Delivery Room
Neo-natal Room
Sterilizing Rooms

Sterile Store Room
Scrubbing Room
Dirty Utility

Physiotherapy

The physiotherapy department provides
treatment facilities to patients suffering from crippling
diseases and disabilities. The department is more
frequently visited by out-patients but should be
located at a place which may be at convenient
access to both outdoor and indoor patients with
privacy. It should also have a physical and electro
therapy rooms, gymnasium, office, store and toilets
separate for male and female. Normative standards
will be followed.
Hospital Services

Theatre refuse, such as, dirty linen, used
instruments and other disposable / non disposable
items should be removed to a room after each
operation. Non-disposable instruments after initial
wash are given back to instrument sterilization and
rest of the disposable items are disposed off and

Hospital Kitchen (Dietary Service)
The dietary service of a hospital is an
important therapeutic tool. It should easily be

27

IPHS for 31 to 50 Bedded Hospitals HWI

accessible from outside along with vehicular
accessibility and separate room for dietician and
special diet. It should be located such that the noise'
and cooking odours emanating from the department
do not cause any inconvenience to the other
departments. At the same time location should
involve the shortest possible time in delivering food
to the wards.

Central Sterile and Supply Department
(CSSD)
As the operation theatre department is the
major consumer of this service, it is recommended
to locate the department at a position of easy access
to operation theatre department. It should have a
provision of hot water supply.

Hospital Laundry

It should be provided with necessary
facilities for drying, pressing and storage of soiled
and cleaned linens.
Medical and General Stores
There are of medical and general store
should have vehicular accessibility and ventilation,
security and fire fighting arrangements.
Mortuary

It provides facilities for keeping of dead
bodies and conducting autopsy. It should be so
located that the dead bodies can be transported
unnoticed by the general public and patients.
Engineering Services

Electric Engineering

Sub Station and Generation
Electric sub station and standby generator
room should be provided.

Illumination

The illumination and lightning in the hospital
should be done as per the prescribed standards.
Emergency Lighting

Shadow less light in operation theatre and '
delivery rooms should be provided. Emergency
portable light units should be provided in the wards
and departments.

k

Call Bells
Call bells with switches for all beds should
be provided in all types of wards with indicator lights
and location indicator situated in the nurses duty
room of the wards.

Ventilation

I

The ventilation in the hospital may be
achieved by either natural supply or by mechanical
exhaust of air.
Mechanical Engineering
i

Air-conditioning and Room Heating in
operation theatre and neo-natal units should be
provided. Air coolers or hot air convectors may be
provided for the comfort of patients and staff
depending on the local needs.

Hospital should be provided with water
coolers and refrigerator in wards and departments
depending upon the local needs.

i
!

Public Health Engineering

Water Supply

Arrangement should be made for round the
clock piped water supply along with an overhead

!

I
\WS to,

water storage tank with pumping and boosting
arrangements. Approximately 10000 litres of potable
water per day is required for a 100 bedded hospital.
Separate provision for fire fighting and water
softening plants be made available.

'BedAed Wp\'.a\s

Cooking Gas: Liquefied petroleum gas
(LPG)
Laboratory Gas: Liquefied petroleum gas
(LPG) and other specified gases.

Drainage and Sanitation

Building Maintenance: Provision for
building maintenance staff.and an office-cum store
will be provided to handle day to day maintenance
work

The construction and maintenance of
drainage and sanitation system for waste water,
surface water, sub-soil water and sewerage shall
be in accordance with the prescribed standards.
Prescribed standards and local guidelines shall be
followed.

Parking: Sufficient parking place as per the
norms will be provided

Waste Disposal System

Administrative Services: Two sections
(i) General section to deal with overall upkeep of
the hospital and welfare of its staff and patients (ii)
Medical Records section.

National guidelines on Bio-Medical Waste
Management and a Notification of Environment and
Forests are at Annexure -1.

Committee Room: A meeting or a
committee room for conferences, trainings with
associated furniture.

Trauma Centre

I

to

Guidelines to be followed
Fire Protection

Residential Quarters: All the essential
medical and para-medical staff will be provided with
residential accommodation.

Telephone and Intercom

Medical Gas

29

1

IPHS for 31 to 50 Bedded Hospitals

8.

MANPOWER REQUIREMENT

8.1.

Man Power - Doctors

S. No

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15

Staff
Hospital Superintendent1____________
Medical Specialist_________________
Surgery Specialists________________
O&G specialist____________________
Dermatologist / Venereologist________
Paediatrician_____________________
Anesthetist______________________
Opthalmologist____________________
Orthopedician____________________
Radiologist_______________________
Casualty Doctors / General Duty Doctors
Dental Surgeon___________________
Forensic Specialist_________________
ENT Surgeon_____________________
AYUSH Physician2_________
Total

Sub District Hospital
31-50 bedded
1
gii ; >
1
1
1
1
1
1
1
1
1
.7
1
1
1
2
22

1 May be a Public Health Specialist or management specialist trained in public health.
2 Provided there is no AYUSH hospital / dispensary in the district headquarter.

8.2.

Man Power - Para Medical

S. No

Staff

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15

Staff Nurse______________________________
Hospital worker (OP/ward +OT+ blood bank) ■
Sanitary Worker_________________
Ophthalmic Assistant / Refractionist _________
ECG Technician__________________________
Laboratory Technician* ( Lab + Blood Storage Unit)
Laboratory Attendant (Hospital Worker)_________
Radiographer_____________________________
Pharmacist1______________________________
Matron__________________________________
Physiotherapist___________________________
Statistical Assistant________________________
Medical Records Officer / Technician___________
Electrician_______________________________
Plumber_________________________________

Total
* Must have MLT qualification.

’ One from AYUSH.

30l

Sub District Hospital
31-50 bedded
18
5
5

1

I

1
5 (3+2)
2
2
4
1
1
1
1

________ 1_______ |
________ 1________
49

I
IPHS for 31 to 50 Bedded Hospitals

8.3.

Manpower- Administrative Staff

S. No

I

i

Sub District Hospital
31-50 bedded

Staff

1

Office Superintendent

1

2

Accountant

2

3

Computer Operator

6

4

Driver

1

5

Peon

2

6

Security Staff*

2

Total

14

_____________

Note: Drivers post will be in the ratio of 1 Driver per 1 vehicle. Driver will not be required if outsourced

* The number would vary as per requirement and to be outsourced.

8.4.

Man Power- Operation Theatre

S. No.

Sub District Headquarters Hospital
31-50 Bedded

Staff

I

Emergency / FW OT

■few

Ii

Staff Nurse

2

2

OT Assistant

2

3

Sweeper

g ___

1

_

5

Total

8.5.

Man Power - Blood Storage
S.No

Blood Storage

Staff

1

Staff Nurse

1

2

MNA/FNA

1

3

Blood Bank Technician

1

4

Sweeper

1
)S
)./

31

s4-

Bl
LU

ii r

s’. ' //

F

IPHS for 31 to 50 Bedded Hospitals

9

i

EQUIPMENT
■

S.
No.

_______________ I Imaging Equipment
Name of the Equipment

31-50 bedded
Sub District Hospital

1

100 M.A. X-ray machine______________

|

2

Dental X-ray machine____________

1

3

Ultra Sonogram (Obs & Gyne. department
should be having a separate ultra-sound
machine of its own)

I

1 +1

____________II X-Ray Room Accessories

S.
No.

Name of the Equipment

31-50 bedded
Sub District Hospital

J_

X-ray developing tank

_______ 1_

2__

Safe light X-ray dark room

___ i

_3__

Cassettes X-ray_______

________ 4

4 __

X-ray lobby single______

________ 2

5 __

Lead Apron__________

1

6

Intensifying screen X-ray

1

S.
No.

III Cardiac Equipments
Name of the Equipment

31-50 bedded
Sub District Hospital

1

ECG machine ordinary

2

Cardiac Monitor________

1

3

Pulse Oximeter________

1 ,

4

Infusion pump_________

____ 2_

5
6

B.P,apparatus table model
B.P.apparatus stand model

________ 6_
4

7

Stethoscope

_______ 1_
_______

2

32

i

IPHS for 31 to 50 Bedded Hospitals

_______ IV Labour ward & Neo Natal Equipments

Name of the Equipment

31-50 bedded
Sub District Hospital

__ L

Baby Incubators_____________

________ 1_______

2

Phototherapy Unit____________

_______ 1_______

~V

' Emergency Resuscitation Kit-Baby

_______ 2_______

;

Radiant Warmer

_______

_______ 1_______

S.
No.

A
5
6
7
8
___ 9

2_______

Room Warmer______________
Foetal Doppler______________

_______ 1_______

Delivery Kit________________

_______ 2_______
1_______

Episiotomy kit______________

Forceps Delivery Kit__________

_______ 1_______

10

Vacuum extractor metal________

_______ 1_______

11
12
13
14
15

Silastic vacuum extractor______

1_______

Pulse Oximeter baby & adult

_______ 1_______

Cardiac monitor baby_________

_______ 1_______

Nebulizer baby______________

_______ 1_______

Weighing machine adult_______

2

16
17

Weighing machine infant_______

2

18

Arc

CTG Machine

_______________ V Eye Equipments
S.
No.

Name of the Equipment

31-50 bedded
Sub District Hospital

1

Opthalmoscope - Direct

_______ 1_______

2

Slit Lamp__________

_______ 1_______

3

Retino scope

_______ 1_______

4

Perimeter__________

1_______

5

IOL Operation set

1

33 Hi

IPHS for 31 to 50 Bedded Hospitals

S.
No.

______________ VI Dental Equipments
Name of the Equipment

31-50 bedded
"Sub District Hospital

1

Air Rotor

1 'fiii

2

Dental Unit with motor for dental OP

i

3

Dental Chair

4

Dental Kit

9

1

1
■

S.
No.

__________ VII Operation Theatre Equipment
Name of the Equipment

i

31-50 bedded
Sub District Hospital
.

1

Auto Clave HP Vertical (2 bin)

2

Operation Table Hydraulic Major

1

3

1

4

Operation table Hydraulic Minor
Operating table non-hydrauliclield type

5

Autoclave vertical single bin

________ 1_

6

Shadowless lamp ceiling type major*

________ 1

7

Shadowless lamp ceiling type minor*

________ 1

8

Shadowless Lamp stand model

________ 1

9

Focus lamp Ordinary

1

10

Sterilizer big (Instrument)

1

11

Sterilizer Medium (Instrument)

_______ 2

12

Steriliser Small (Instruments)

2

13

Bowl Steriliser - big*

________

14

Bowl steriliser - Medium*

_______ 1_

15

Diathermy Machine (Electric Cautery)

16

Suction Apparatus - Electrical

_______ 1
_______ |

—

_____ 1
1

17

Suction Apparatus - Foot operated

_______ 1

18

Ultra violet lamp philips model 4 feet

2

_

-

’ To be provided as per need.

341

1

F
IPHS for 31 to 50 Bedded Hospitals

Vlil Laboratory Equipments

Name of the Equipment

31-50 bedded
Sub District Hospital

Binocular Microscope______________

_______ 2_______

2

Chemical Balances_______________

_______ 1_______

3

Simple balances_____ ___________

_________ |_________

J ^4

Electric Colorimeter_______________

_______ 1_______

5

Micro pipettes (10-100 ml), (200-1000 ml)

6
7
8
9
10
11
12
13
14

Water bath

2(1+1)
________ 1________

15
16
17

S.
No.

__ L
■

18
19
20
21
22
23
24
25
__ 26
__ 27
28
29

_______________

Hot Air oven*_________

_______ _1________

Lab Incubator*___________________

________ 1________

Distilled water Plant_______________

________ 1________

Electricentrifuge, table top___________

________ 1________

Cell Counter Electronic*____________

1

Hot plates______________________

_______ 2_______

Rotor / Shaker

_________________

_______ 1_______

Counting chamber________________

_______ 2_______

PH meter______________________

1_______

Glucometer_____________________

_______ 1_______

Haemoglobinometer______________

_______ 1_______

TCDC count apparatus_____________

_______ 1_______

ESR stand with tubes

________ 1

___________
_____________

________ 3________

Test tube rack*__________________

________ 3________

Test tube holders*________________

________ 3_______

Spirit lamp*_____________________

________ 4________

Timer stop watch_________________

________ 1________

Alarm clock_____________________

________ 1________

Refrigerator____________________

______ 1______

Laboratory Auto Claves____________

2

Test tube stands*

Automatic Processing Unit for Radiology*

Tonometer for Ophthalmology*

* To be provided as per need.

351

i.

[1
IPHS for 31 to 50 Bedded Hospitals

S.
No.
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15

16
17
18
19
20
21
22
23
24
25
26
27
28

____________ IX Surgical Equipment Sets
Name of the Equipment
P.S.set______________________
MTP Set
Biopsy Cervical Set*____________
D & C Set
I.U.C.D. Kit___________________
LSCS set____________________
MVA Kit
Vaginal Hysterectomy___________
Proctoscopy Set*
P.V. Tray*
Abdominal Hysterectomy set______
Laparotomy Set
Formaline dispenser____________
Kick Bucket_____________ ,
General Surgical Instrument Set Piles,
Fistula, Fissure*_______________
Knee hammer_________________
Hernia, Hydrocele*_____________
Vaginal Examination set*_________
Suturing Set*_________________
MTP suction apparatus__________
Thomas Splint_______
Mini Surgery Set*______________
Gl Operation Set*______________
Appendicectomy set *
LP.Tray*
Uretheral Dilator Set____________
Amputation set________________
Crammer wire splints

31-50 bedded
Sub District Hospital
1
1
1
1
_______ 1_
1
1
1
1
11
1'
1
1
1
4
____ 1_

__ 1
____ 1_
____ 2
___ 2
____ 1_
3
1

____ 1
____ 1_
’______ 1_

__ £
6

* To be provided as per need.

S.
No.
1
2

___________ X Physio Therapy Equipments
Name of the Equipment

Skeleton traction set
Short Wave Diathermy

31-50 bedded
Sub District Hospital
_______ 1
1

■

F
IPHS for 31 to 50 Bedded Hospitals

____________ XI Endoscopy Equipments

s.

Name of the Equipment

NoI1

Laparoscope diagnostic and for sterilisation *

31-50 bedded
Sub District Hospital

1

* To be provided as per need.

___________ XII Anaesthesia Equipments

S.
No.

31-50 bedded
Sub District Hospital

Name of the Equipment

1
___ 2^

Anaesthetic - laryngoscope magills with four blades _______ 2_______

___ 3_

Magills forceps (two sizes)_________________ _______ 3_______

4
5

Connector set of six for E.T.T_______________ _______ 3_______

6
7
8
9
10
11
13

Endo tracheal tubes sets_________ ________ _______ 1_______

Tubes connecting for ETT__________________ _______ 4________
4_______
Air way female*_________________________

_______ 8_______
Mouth prop*________________ '
_______ _______ 6_______
Tongue depressors*_______ ______________ _______ 6_______
O? cylyinder for Boyles_____ , -_____________ _______ 6
NPO Cylinder for Boyles_________________ _______ 6_______
Air way male*_______

CO,, cylinder for laparoscope*_______________

2

Boyles Apparatus) with Fluotec and circle absorber

1

* To be provided as per need.

37

1
IPHS for 31 to 50 Bedded Hospitals

S.
No.
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35

_________XIII Furniture & Hospital Accessories
Name of the Equipment

Doctor’s chair for OP Ward, Blood Bank, Lab etc.
Doctor’s Table___________________
Duty Table for Nurses______________
Table for Sterilisation use (medium)
Long Benches(6 1/2' x 1 1/2')_________
Stool Wooden___________________
Stools Revolving_______________
Steel Cup-board__________________
Wooden Cup Board_______________
Racks -Steel - Wooden_____________
Patients Waiting Chairs (Moulded)*
Office Chairs____________________
Office Table_____________________
Foot Stools *____________
Filing Cabinets (for records) *_________
M.R.D,Requirements (record room use) *
Paediatric cots with railings__________
Cradle*________________________
Hospital Cots (ISI Model)___________
Hospital Cots Paediatric (ISI Model)
Wooden Blocks (Set)*______________
Back rest*______________________
Dressing Trolley (SS)______________
Medicine Almairah________________
Bin racks (wooden or steel)*_________
ICCU Cots______________________
Bed Side Screen (SS-Godrej Model)A ■
Medicine Trolley(SS)______________
Case Sheet Holders with clip(S.S.)*
Examination Couch (SS)____________
Instrument Trolley (SS)_____________
Instrument Trolley Mayos (SS)________
Surgical Bin Assorted______________
Wheel Chair (SS)_________________
Stretcher / Patience Trolley (SS)
381

31-50 bedded
Sub District Hospital
12
_______ 3
<
________ 4
________ 4________
________ 10
________ 8
________ 6
;
________ 8________
________ 4
________ 5________
_____10
________ 4
_______ 3
________ 8
________ 4________
________ 1_________
_______ 3
_______ 2
_______ 50______ _
5
_________

t________ 2
_______ 2
_______ 1
3
_________

As per requirement
_________

_______ 40_______ _
________ 2
________ 4

_____L____
________15
_______ 3
2 each.

■

f:

IPHS for 31 to 50 Bedded Hospitals

36
37

Instrument Tray (SS) Assorted

20

Kidney Tray (SS) - Assorted

20

38

Basin Assorted (SS)_____ ______
Basin Stand Assorted (SS)______
__________ (2 basin type)______
__________ (1 basin type)______
Delivery Table (SS Full) ______

20

39

40
41
42
43
44
45
46
47
48
49
50
51
52
__ 53
54
55
56
__ 57
58
59
60
■ 61
i

62
__ 63
64
65
66
__ 67_
68
69

O9 Cylinder Trolley(SS) •________
Saline Stand (SS)
_____
Waste Bucket (SS)____________
Dispensing Table Wooden
Bed Pan (SS)
_____________
Urinal Male and Female ______

Name Board for cubicals________
Waste Disposal - Bin / drums
Waste Disposal - Trolley (SS)
Linen Almirah________________
Stores Almirah_______________
Arm Board Adult _____________
Arm Board Child______________
SS Bucket with Lid____________
Bucket Plastic
_______ ~
Ambu bags
O, Cylinder with spanner ward type
Diet trolley - stainless steel______
Needle cutter and melter________
Thermometer clinical __________
Thermometer Rectal
______
Torch light___________________
_Cheatles_forcep^assorted_______
Stomach wash equipment_______

Infra Red lamp
______ __
Wax bath___________________
Emergency Resuscitation Kit-Adult
Enema Set_________ _________
CeilingFans$

* To be provided as per need.
A At least one screen per five beds except female wards.

$ One fan per four beds in the ward.

39

_______ 3_______
_______ 5_______
_______ 4_______
_______ 3_______
10
20
_______ 1_______
10
10
_______ 1_______
_______ 5_______
_______ 1_______
_______ 2_______
_______ 2_______
_______ 6_______
6
_______ 4_______
_______ 6_______
_______ 3_______
6
_______ 1_______
10
10
_______ 3_______
_______ 6_______

;_____ s_____
_______ 2_______
_______ 3_______
1 _______
2 _______
_______ 2_______
As per requirement

IPHS for 31 to 50 Bedded Hospitals

S.

_______________ XIV PM Equipments
Name of the Equipment

31-50 bedded
Sub District Hospital
2
3
1
2
10
10
4_________
1
1

No.
1
2
3
4
5
6
7
8
9

Mortuary table (Stainless steel)*
P.M. equipments (list)_______
Weighing machines (Organs)
Measuring glasses(liquids)
Aprons*_________________
PM gloves ( Pairs )*________
Rubber sheets*___________
Lens___________________
Spot lights

t

b *

I

* To be provided as per need.

S.
No.
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24

___________________ XV Linen
Name of the Equipment

Bedsheets_____________
Bedspreads______________
Blankets Red and blue_______
Patna towels_____________
Table cloth_______________
Draw sheet______________
Doctor's overcoat__________
Hospital worker OT coat______
Patients house coat (for female)
Patients Pyjama (for male) Shirt
Over shoes pairs___________
Pillows__________________
Pillows covers_____________
Mattress (foam) Adult_______
Paediatric Mattress_________
Abdominal sheets for OT_____
Pereneal sheets for OT______
Leggings________________
Curtain cloth windows and doors
Uniform / Apron____________
Mortuary sheet____________
Mats (Nylon)______________
Mackin tosh sheet (in meters)
Apron for cook
40

K
31-50 bedded
Sub District Hospital

200
_____ 300______
______ 20
100______
______ 30______
______ 30
______ 20______
______25
_____ 150
_____ 100
_____ 40
______60______
_____ 150______
_____ 50
_______6
_____ 30
_____ 30
_____ 40
As per requirement
As per requirement
10
______ 30_______
_______ 100_______ _
As per requirement

>
i

i

IPHS for 31 to 50 Bedded Hospitals

_____________ XVI Teaching Equipments

S.
No.

Name of the Equipment

1

Slide Projector

3
4

O.H.P
Screen_____
White / colour boards

___ 5_
___ 6
7
8

31-50 bedded
Sub District Hospital
1________
1_______
________ 1________
________ 1________
_______ 1_______
_______ 1_______
1

■■

Television colour
Tape Recorder (2 in 1 )

VCD Player
Radio

1

* To be provided as per need.

_____________
Q

XVII Administration
31-50 bedded
Sub District Hospital

Name of the Equipment

No.

1

Computer with Modem with UPS, Printer with

____________

2

_______________

1_

Intercom (15 lines)*

"

Fax Machine
Telephone
Public Address System*

__________

2
2
2

Internet Connection
Xerox Machine

1

* To be provided as per need.

XVIII Refrigeration & AC

J

S.
No.
1
2

Name of the Equipment

3

ILR_________
Deep Freezer_______
Coolers*________
Air conditioners

^5
6

31-50 bedded
Sub District Hospital
_______ 2_______

Refrigerator 165 litres

1________

Blood Bank Refrigerator

________ 1________
________ 1
As per requirement
3

* One cooler per 8 beds in the wards.

41

IPHS for 31 to 50 Bedded Hospitals

S.
No.

_______________ XIX Hospital Plants
Name of the Equipment

31-50 bedded
Sub District Hospital

1

Generator 40 / 50 KV

2

Portable 2.5 KV

S.
No.

_________ XX Hospital Fittings & Necessities ___________________
31-50 bedded
Name of the Equipment
Sub District Hospital

1

Ceiling Fans*

2

Exhaust Fan*

3

Pedestal Fan*

4

Wall Fan*__________

________ 1_

5

Hotwater geiser*

_______ 1_

6

Fire extinguishers*

1

7

Sewing Machine*

1

8

Lawn Mover*

_______ 1_

9

Aqua guard*

________ 4_

10

Emergency trauma set*

__ _____ 1_

11

Tube lights*_________

_______ 30

12

Drinking Water Fountain*

,

1
1

<

_______ 20
6

r-

iBi

_________

■

.ISO

/

• 1

* To be provided as per need.

S.
No.

_________________ XXI Transport
Name of the Equipment

31-50 bedded
Sub District Hospital

1

Ambulance

1

2

Pickup vehicles Maruti (Omni)

1

‘■fM '5.

«:

I

42

L
!
i

IW IPHS for 31 to 50 Bedded Hospitals

10.

Laboratory Services: Following services will be ensured, for advanced
diagnostic tests, a list of National Reference Laboratories has been provided
as annexure:

S. No.

Diagnostic Services / Tests

Speciality

CLINICAL PATHOLOGY

Haemoglobin estimation

a. Haematology

Total Leucocyte count
' -'v

Differential Leucocyte count

■' s

Absolute Eosinophil count__________

Reticulocyte count
Total RBC count

■

E.S.R._______________________ _

Bleeding time
Clotting time

Peripheral Blood Smear__________

Malaria/Filaria Parasite
Platelet count

Packed Cell volume
Blood grouping

Rh typing______________________

______________V
b. Urine Analysis

Blood Cross matching_____________
Urine for Albumin, Sugar, Deposits, bile
salts, bile pigments, acetone, specific
gravity, Reaction (pH)_____________

c. Stool Analysis

Stool for Ova cyst (Eh)
Hanging drop for V. Cholera_________

Occultblood
ii.

PATHOLOGY
Sputum cytology

a. Sputum

III.

MICROBIOLOGY
Smear for AFB, KLB (Diphtheria)
Grams Stain for Throat swab, sputum etc.
KOH study for fungus

I

I

43

IPHS for 31 to 50 Bedded Hospitals

S. No.
IV.

Speciality
SEROLOGY

Diagnostic Services / Tests
RPR Card test for syphillis______ _
Pregnancy test (Urine gravindex)
WIDAL test_________________ _
Rapid Test for HIV, HBs Ag, HCV

S. No.
V.

Speciality
BIOCHEMISTRY

Diagnostic Services / Tests
Blood Sugar____________
Blood urea_____________
Serum bilirubin__________
Liver function tests_______
Kidney function tests______
Blood Cholesterol________
Blood urictacid__________
Iodometry Titration

s. no
vi.
VII.

Speciality__________
CARDIAC INVESTIGATIONS
OPHTHALMOLOGY

VIII.

RADIOLOGY

Diagnostic Services / Tests
ECG
________________
Refraction by using Snellen’s chart
Retinoscopy_________________ _
Ophthalmoscopy_________________
Syringing____________________
Tension___________________ _
X-ray for Chest, Skull, Spine, Abdomen,
bones________
Dental X-ray
Ultrasonography*

* In consonance with PC and PNDT Act.

11.

Allocation of Bed Strength at Various Levels:
It should be done as per local needs.

REQUIREMENTS FOR OPERATION THEATRE
S. No

2
2

Item

Emergency OT/FW OT_______
Ophthalmology /General Surgery

44

Sub District Hospital
31-50 Bedded
1
1

JR1'

1
IPHS for 31 to 50 Bedded Hospitals

12.

List of Medicines / Instruments / Equipments /Lab Reagents / Other
Consumables and Disposables for District Hospitals.

S. No

Name of the item

A)

Analgesics/Antipyretics/Anti Inflamatory
1

Tab.Aspirin 300mg

2

Tab.Paracetamol 500mg

3

Inj.Diclofenac sodium

4

Tab.Diclofenac sod

5

Tab.Dolonex DT 20mg

6

Tab.lbuprofen

Chemotherapeutics

B)

1

J

7i

Inj.Crystalline penicillin 5 lac unit

8

Inj. Benzathene Penicliine

9

Inj,Fortified procaine pen 4 lac

10

Inj.Ampicillin 500mg

11

Inj.Gentamycin 40mg/2ml vial

12

Inj.crystalline penicillin 10 lac unit

13

Cap.Ampicillin 250mg

14

Cap.Tetracycline 250mg

15

Tab.Trimethoprim+Sulphamethazol ss

16

Tab.Ciprofloxacin 250mg

17

Tab.Ciprofloxacin 500mg

18

Inj.Ciprofloxacin 100ml

19

Tab.Erythromycin 250mg

20

Tab. Erythromycin 500mg

21

Syrup Cotrimoxazole 50ml

22

Syrup Ampicillin 125mg/5ml 60ml

23

Inj.Cefoperazone IGm

24

Inj.cefotaxime 500mg

45

r

BM

IPHS for 3110 50 Bedded Hospitals

T

25

Tab. Norfloxacin 200mg

26

Tab.Norfloxacin 400mg

27

Tab.Ofloxacin 200mg

28

lnj.Vionocef(Ceffixime)250mg

29

Inj.Amikacin sulphate 500mg

30

Inj.Amikacin sulphate lOOmg

31

Cap.Cefodroxyl 250mg

32

Inj.Amoxycillin 500mg

i-------

k

L

L2>
r----i

I

r"

Anti Diarrhoeal

33

Tab.Metronidazole 200mg

34

Tab. Metronidazole 400mg

35

Syrup. Metronidazole

36

Tab. Furazolidone 100mg

37

Tab. Diolaxanide Fuzate

38

Tab. Tinidazole 300mg

Dressing Material/Antiseptic lotion

D)

L

39

Povidone Iodine solution 500ml

40

Phenyl 5litr jar(Black Phenyl)

41

Benzalkonium chloride 500ml bottle

42

Rolled Bandage a)6cm
b)10cm
c)15cm

r

j

43

Bandage cloth(100cmx20mm) in Than

44

Surgical Guaze (50cmx18m) in Than

45

Adhesive plaster 7.5cm x 5mtr

46

Absorbent cotton I.P 500gm Net

47

P.O.P Bandage a) 10cm
b)15cm

f ■

V

I

r

IPHS for 31 to 50 Bedded Hospitals

48

Framycetin skin oint 100 G tube

49

Silver Sulphadiazene Oint 500gm jar

50

Antiseptic lotion containing:
a) Dichlorometxylenol 100ml bot

b) Haffkinol Slitre jar
51

Sterilium lotion

52

Bacillocid lotion
Infusion fluids

E)

r'

■

!

53

Inj. Dextrose 5% 500ml

54

Inj. Dextrose 10% 500ml bottle

55

Inj. Dextrose in Normal saline 500ml bt

56

Inj. Normal saline (Sod chloride) 500ml

57

Inj.Ringer lactate 500ml

58

Inj.Mannitol 20% 300ml

59

Inj.Water for 5ml amp

60

Inj.Water for 10ml amp

61

Inj.Dextrose 25%100ml bot

62

I.V.Metronidazole 100ml

63

Inj.Plasma Substitute 500ml bot

64

Inj.Lomodex.
Other Drugs & Material

F)

11

I

65

5ml
10ml

*I •

•
66

A

All Glass Syringes 2ml

'20ml

Hypodermic Needle (Pkt of 10 needle)

a) No.19

d■
I !•
Er'

A.

b) No.20
c) •No.21

a

F

IPHS for 31 to 50 Bedded Hospitals

d) No.22

r

e) No.23

f) No.24
g) No.25

h) No.26
67

Scalp vein sets no a) 19
b) 20

c) 21

d) 22
e) 23
f) 24
9) 25
h) 26

-

68

Geico all numbers

69

Tab.B.Complex NFI Therapeutic

70

Tab.Polyvitamin NFI Therapeutic

71

Inj.Dexamethasone 2mg/ml vial

72

Inj.Vitamin B Complex 10ml

73

Inj.BI2 Folic acid

74

Surgical Gloves

f

I

a) 6“

b) 6.1/2"
c) 7"
d) 7.5"

75

Catgut Chromic

a) 1 No.

b) 2 No.
c) 1-0 No
d) 2-0 NO

e) 8-0
76

Vicryl No.1

48

IPHS for 31 to 50 Bedded Hospitals

77

Sutupak 1,1/0,2,2/0

78

Prolene

79

X-Ray film 50 film packet (in Pkt) size

a) 6.1/2X8.1/2"

b) 8"x10"
c) 10"x12'.

A___

d) 12"x15"

■i

80

Fixer

81

Developer

82

CT Scan film

83

Ultrasound scan film

84

Dental film

85

Oral Rehydration powder 27.5g

86

Ether Anaesthetic 500ml

87

Halothane
Eye Drops

G)

88

Sulphacetamide eye drops 10% 5ml

89

Framycetin with steroid eye drops 5ml

90

Framycetin eye drops 5ml

91

Ciprofloxacin eye drops

92

Gentamycin eye drops,
Other Material

H)

93

Rubber Mackintosch Sheet in mtr

94

Sterile Infusion sets(Plastic)

95

Antisera

I
I

I) A

5ml

II) B

5ml

III) D

5ml

IV) AB 5ml

96

Inj.MethylErgometrine 0.2mg/amp

49

IPHS for 31 to 50 Bedded Hospitals

97

Inj.Streptokinase 7.5lac vial

98

Inj.Streptokinase 15lac vial

99

Inj.PAM

100

Tab. Antacid

101

ARS

102

Syp.Antacid

103

Inj.Rabipur

104

Inj.Ranitidine 2ML

105

Tab.Ranitidine

106

Tab.Omeprazole

107

Cough syrup Slitre Jar

108

Cough syrup with Noscapine 100ml

109

Coir Mattress

110

Inj.Lignocaine 1%

111

Inj.lignocaine 2%

112

Inj.Lignocaine 5%

113

Inj.Marcaine

114

Inj. Diazepam

115

Inj. Salbactum+Cefoperazone2Gm

116

Inj. Amoxycillin with clavutanite acid 600mg

117

Cap.Amoxycillin250+cloxacillin 250

118

Inj. Cefuroxime 250/750

119

Tab. Pefloxacin 400mg

120

Tab. Gattifloxacin 400mg

121

Tab. Valdecoxib 20mg

122

Tab. Atrovastatin Wmg

123

Sy. Himalt-X

124

Sy. Protein (Provita)

I

I

50

• f

IPHS for 31 to 50 Bedded Hospitals

Antibiotics and Chemo'therapeutics

I)
1

Tab.Chloroquine phosphate 250mg

2

Inj.Chloroquine phosphate

3

Inj.Quinine

4

Tab.Erythromycine Esteararte 250mg

5

■Syp.Erythromycine

6

Tab. Phenoxymethyl PeniciIlin 125mg

7

Cap.Rifampicin

8
' 9

Cap.Neomycin

11

Inj.Benzathine penicillin 12lac
Antihistaminics/anti-allergic

12

Inj.Pheniramine maleate

13

Tab.Diphenhydramine (eqv.Benadryl)

14

Tab.Cetrizine

15

Tab.Chlorpheniramine maleate 4mg

16

Tab.Diethylcarbamazin
Drugs acting ori Digestive system

K)

I

Tab.Ethambutol 400mg

10

J)

J

Tab.lsoniazid 100mg

17

Tab.Cyclopam

18

Inj.Cyclopam

19

Tab.Bisacodyl

20

Tab.Perinorm

21

Inj.Perinorm

22

syrup.Furazolidone

23

Inj.Prochlorperazine(Stemetil)

24

Tab.Piperazine citrate

25

Tab.Mebendazole 100mg

26

Syp.Mebendazole

51 Mi
1

? C

\l.V

V

■

^1]

IPHS for 31 to 50 Bedded Hospitals

27

Sy. Piperazine Citrate

28

Sy. Pyrantel Pamoate

29

Tab.Belladona

Drugs related to Hoemopoetic system

L)
30

Tab.Ferrous sulphate200mg

31

Inj.lron Dextran/lron sorbitol

M)

Eye ointment

32

Chloramphenicol eye ointment & applicaps

33

Chloramphenicol + Dexamethsone ointment

34

Gentamycin eye/ear drops

35

Dexamethasone eye drops

36

Drosyn eye drops

37

Atropine eye ointment

N)

in®

Drugs acting on Cardiac vascular system
38

Inj.adrenaline

39

Inj.atropine sulphate

40

Inj.Digoxine

41

Tab.Digoxine

42

Inj.Mephentine

43

Tab.Atenolol

44

Tab.lsoxuprine

45

Inj.Duvadilan

46

Tab.Methyldopa

47

Tab.Isosorbide Dinitrate(Sorbitrate)

48

Tab. Propranolol

49

Tab.Verapamil(lsoptin)

50

tab.Enalepril2.5/5mg

52

I

IPHS for 31 to 50 Bedded Hospitals

Drugs acting on Central/peripheral Nervous system

0)
51

Inj.Pentazocine (Fortwin)

52

Inj.Pavlon 2ml amp

53

Inj.Chlorpromazine 25mg(like Largactil)

54

Inj.Promethazine Hcl Phenergan

55

inj.Pethidine

56

Inj.Diazepam 5mg

57

Tab.Haloperidol

58

Inj.Haloperidol

59

Tab.Diazepam 5mg

60

Tab. Phenobarbitone 30mg

61

Tab. Phenobarbitone 60mg

62

Tab.Largactil 25mg

63

Tab.Pacitane

64

Tab.Surmontil

65

Syrup.Phenergan

66

Syrup Paracetamol

67

Ethyl chloride spray

68

Lignocaine oint

69

Gentamycin eye/ear drops

70

Betnesol-N/Efcorlin Nasal drops
Drugs acting on Respiratory system

P)
I

*

71

Inj.Aminophylline

72

Tab.Aminophylline

73

Inj.Deriphylline

74

Tab.Deriphylline

75

Tab.Salbutamol 2mg

76

Syrup Tedral

77

Syrup.Salbutamol

53

1

I

1;
IPHS for 31 to 50 Bedded Hospitals

Q)

Antiseptic Ointment

78

Furacin skin oint

79

Framycetin skin oint

Drugs acting on UroGenital system

R)

80

Tab.Frusemide 40mg

81

Inj.KCL

82

Liquid KCL

83

Tab.Pyridicil

84

Inj.Frusemide
Drugs acting on Uterus and Female Genital Tracts

S)
85

Inj.Pitocin

86

Inj.Prostodin

87

Tab. Mesoprostol

88

Tab.Duvadilan

89

Inj. Duvadilan

90

Tab.Methyl Ergometrine

91

Tab.Primolut-N

92

Haymycin vaginal tab

93

Inj. Magnessium Sulphate

94

Inj.Ethacredin lact(Emcredyl)
Hormonal Preparation

T)
95

Inj.Insulin Rapid

96

Insulin lente Besal

97

Inj. Cry Insulin

98

Inj. Mixtard

99

Inj. Testesterone plain 25mg

100

Testesterone Depot 50mg

101

Tab. Biguanide

102

Tab. Chlorpropamide 100mg

54

II

■

■1 IPHS for 31 to 50 Bedded Hospitals

103

Tab. Prednisolone 5mg

104

Tab. Tolbutamide 500mg

105

Tab. Glibenclamide

106

Tab. Betamethasone

Vitamins

U)
107

Inj.ViVA”

108

Inj.CholcalciferoH 6lac

109

Inj.Ascorbic acid

110

Inj.Pyridoxin 50mg

■

■■.-<

■

111

Inj.Vit K

112

Tab,.Vit'“A” & “D”

113

Tab.Ascorbic acid 100mg
Other drugs

V)
114

Inj.Antirabies vaccine

115

Inj.Antisnake venom

116

Inj.AntiDiphtheria Serum

117

Inj.Cyclophosphamide

118

Inj.Sodabicarb
■

;•

■

*1
;■

.......................

........................ .-ty-.—■

119

Inj.Calcium Gluconate

120

Tab.Calcium lactate

121

Tr.lodine

122

Tr.Benzoin

123

Glcial acetic caid

124

Benedict solution

125

Caster oil

126

Liquid paraffin

127 •

Glycerine

128

Glycerine Suppositories

W

Turpentine oil
55

HHMi

F

IPHS for 31 to 50 Bedded Hospitals HHBBBHMM

130

Potassium Permangnate

131

Formaldehyde

132

Dextrose Powder

133

Methylated spirit

134

Cotrimazole lotion

135

Cotrimazole cream

136

Tab.Theophylline

137

ECG Roll

138

Burnion Oint

139

Flemigel APC Ointment

140

Syp.Himobin

141

APDYL Cough & Noscopin

142

Tab. Septilin

143

Tab. Cystone

144

Tab. Gasex

145

Syp. Mentat

146

Oint. Pilex

147

Rumalaya Gel

148

Pinku Pedratic Cough Syp.

r
T

(W)

Others
1

Tab.Liv52

2

Syrup Liv52

3

Cap. Doxycycline 100mg

4

Inj. Heparin sod.WOOlU

5

Tab. Dipyridamol (Like Persentine)

6

Inj. Dopamine

7

Tab. Glyceryl Trinitrate

8

Tab.Amitryptilline

9

Tab.trifluoperazine(1 mg)

i

56

IPHS for 31 to 50 Bedded Hospitals

_____
'/.X

.

10

Tab.Nitrofurantine

11

Inj.Valethemide Bromide(Epidosyn)

12

Inj.lsolyte-M

13

Inj.lsolyte-P

14

Inj.lsolyte-G

15

Cap.Cephalexin 250mg

16

Tab.Taxim

17

Inj.Metaclopramide

18

Tab.Folic acid

19

Inj.Lignocaine Hcl 2%

20

Inj.Nor adrenaline

21

Betadine lotion

22

Tab.stilboesteral

23

Inj.Pyridoxine

24

Hydrogen peroxide

25

Inj.magnesium sulphate

26

Benzyl Benzoate

27

GammaBenzene Hexachloride

28

Inj.Tetglobe

29

Inj. Paracetamol

30

Pilocarpine eye drops 1%

31

Sy.Orciprenaline

32

Suturing needles (RB,Cutting)

33

Inj.Calcium pantothernate

34

Inj.Xylocaine 4% 30 ml

35

Halothane

36

Mixture Alkaline

37

Inj. Phenabarbitone 200mg

38

Inj. B12 (Cynacobalamine)

's

57

IPHS for 31 to 50 Bedded Hospitals

39

Neosporin, Nebasuef, Soframycin Pow

40

Magnasium Sulphate Powder

41

Furacin Cream

42

Xylocaine jelly

43

Formaldehyde Lotion

44

Cetrimide 100ml bott 3.5%, 1.5% 1

45

Bacitrium powder 10mg botts

46

Bleaching Powder 5 Kg Pkts(ISI Mark)

47

Ether Solvent

48

Sodium Hypochloride Sod. 5 ltrs/1 ltrs

49

Inj. Diphthoria antition ADS)10000I.U

50

Inj. Gas gangrene Antitoxin(AGGS)10000

51

Inj. Hydroxy Progesterone5O0mg/2ml

52

Inj. Methyl Prednisolon 500mg vial

53

Inj. Multivitamin I.V

54

Inj. Potassium chloride

55

Inj. Quinine Dihydrochloride

56

Tetanus Antitoxin 10000 I.U

57

Inj. Tetanus Toxoid 5ml vial

58

Inj. Theophylline Etophylline

59

Inj. Vitamin A

60

Tab. Ferrous sulphate200mg+Folic acid

61

Tab. Ferrous sulphate 300mg

62

Tab. Griseofulvin125mg

63

Tab. Phenobarbitone 30mg

64

Tab. Phenobarbitone 60mg

65

Tab. Pyridoxin 10mg

66

Tab. Thyroxine sod 0.1 mg

67

Warfarin sod 5mg

I

58

IPHS for 31 to 50 Bedded Hospitals

68

Tab. Alprazolam 0.25mg

69

Tab. Amlodipine 5mg

70

Tab. Amlodipine 10mg

71

Tab. Nefidipine 20mg

72

Tab. Nefidipine 30mg

73

Tab. Riboflavin 10mg
Syp. Ferrous Gluconate 100ml bottle

__

75

Cream Fluconozole 15gm tube

76

Sus. Furazolidone

77

Oint. Hydrocortisone acetate

78

Syp. Isoniazid 100mg/5ml 100ml bot

79

Liquid paraffin

79A

Linctus codein 500ml bot

80

Cream Miconozole 2% 15gm tube

81

Syp.Nalidixic acid

82

syp. Norfloxacin

83

Phenylepinephrine eye drops

84

Pilocarpine eye drops 2%

85

Syp.Pottassium chloride 400ml bot

86

Syp.Primaquine

87

Suspension Pyrantel pamoate

88

Sus Rifampicin

89

Syp.Salbutamol 100ml bot

90

Syp.Theophylline 100ml

91

Syp.Vitamin B.Complex

92

Vit D-3 Granules

93

Opthalmic & ear drops

94.

Glycerine Mag sulphate ear drops

95

Pilocarpine eye drops 4%

59

IPHS for 31 to 50 Bedded Hospitals

96

Oint Acyclovir 3% 5gm tube

97

Benzyl Benzoate emulsion 50ml bot

98

Oint.Betamethasone

99

Cream Clotrimazole skin 1% 15gm

100

Oint Dexamethasone 1%+ Framycetin

101

oint contain clotrimazole+Genta+Flucon

102

Oint Flucanazole 10 mg

103

Cream Framyctin 1% 20gm tube/IOOgm

104

Lot.Gamabenzene hexachloride1% bt

105

Glycerine Suppository USP 3gm bott/10

106

Cream Nitrofurazone 0.2% jar of 500g

107

Oint Silversulpadiazene 1 % 25g

108

AIDS Protective kit

109

EAR DROP

110

Wax Solvent Eardrops

111

Antifungal 2 Anti biotic Ear Drops (Clohoaimazole PMB)

112

Stewed & AB Ear Drops

K,

■

■ 60

I

IPHS for 31 to 50 Bedded Hospitals

13.

Capacity Building

Service / performance evaluation by
independent agencies

At the time of entry into service, induction
training of at least six months duration must be made
mandatory for all categories of health care workers.
This must be a comprehensive training and must
have components of requisite skill enhancement,
management and knowledge about the drugs/
equipments and services offered at all levels of
health care.

District Monitoring Committees formed
under NRHM shall monitor the upgradation of
Hospitals to IPHS. Annual Jansamvad may also be
held as a mechanism of monitoring.

Monitoring of laboratory
Internal Quality Assessment Scheme

Secondly, at a duration of every two years,
on the job training must be provided to all categories
of health care personnel to upgrade their knowledge
and skills in technical and management fields.

' 14.

External Quality Assessment Scheme
Record Maintenance

Computers have to be used for accurate
record maintenance and with connectivity to
the District Health Systems, State and
National Level.

Quality Assurance in Service
Delivery

Quality of service should be maintained at
all levels. Standard treatment protocols for locally
common diseases and diseases covered under all
national programmes should be made available at
all sub district hospitals. All the efforts that are being
made to improve hardware i.e. infrastructure and
software i.e. human resources are necessary but
not sufficient. These need to be guided by standard
treatment protocols and Quality Assurance in
Service Delivery.

15.

Rogi Kalyan Samities (RKS) /
Hospital Management Committee
(HMC)

Each sub district hospital should have a Rogi
Kalyan Samiti / Hospital Management Committee
with involvement of PRIs and other stakeholders
as per the guidelines issued by the Government of
India. These RKS should be registered bodies with
an account for Itself in the local bank. The RKS /
HMC will have authority to raise their own resources
by charging user fees and by any other means and
utilized the same for the improvement of service
rendered by the Sub District Hospital.

Quality Control
Internal Monitoring
Social audit through Rogi Kalyan Samities /
Panchayati Raj Institutions

16.

Medical Audit, Technical Audit, Financial
Audit, Disaster Preparedness Audit, Monitoring of
Accessibility and equity issues, information
exchange.

Citizen’s Charter

Each Sub District hospital should display a
citizen’s charter for the sub district hospital indicating
the services available, user fees charged, if any,
and a grievance redressal system. A modal citizen’s
charter is given as under.

External Monitoring

Monitoring by PRI / Rogi Kalyan Samities
61

IPHS for 31 to 50 Bedded Hospitals

General Information

OUR MOTTO - SERVICE WITH SMILE

CITIZENS CHARTER

Enquiry, Reception and Registration Services:

This charter seeks to provide a framework which
enables our users to know:

This counter is functioning round the clock.
Location guide maps have been put up at various
places in this hospital.

What services are available in this hospital;

The quality of services they are entitled to;

Colour coded guidelines and directional signboards
are fixed at strategic points for guidance.

The means through which complaints
regarding denial or poor quality of services
will be redressed.

Telephone enquiries can be made over telephone
numbers:
, &

Standards of Service:
This is a District, Sub-district/divisional
hospital;

, Fax:

Casualty & Emergency Services:

It provides medical care to all patients who
come to the hospital;

All Casualty Services are available round the clock.
Duty Doctor is available round the clock.

Standards are influenced by patients load
and availability of resources;

Specialist doctors are available on call from
resident doctors.

Yet we insist that all our users receive
courteous and prompt attention.

Emergency services are available for all
specialities as listed in the ORD Services.

Locations:

Emergency Operations are done in-

It is located on

road in front of

OT located on

This hospital has-

Doctors:

building.

Maternity OT
Orthopaedic Emergency OT ,
Burns and plastic OT
Main OT for Neurosurgery cases

(including residents
)■

Nurses:
staff).

floor of

(including supervisory

Emergency Operation Theatre is functioned round
the clock.

Beds:

In serious cases, treatment/management gets
priority over paper work like registration and medico
legal requirements. The decision rests with the
treating doctor.

Doctors wear white aprons and nurses are in
uniform.
All Staff member wear identity cards.

62

IPHS for 31 to 50 Bedded Hospitals

OPD Services:

Various outpatient services available in the hospital are detailed below (as available):
OPD

_____________________

Place

Time of Registration
..

...

■

..

General Medicine

I

■

<

■■

■■

■

■

■

Paediatrics
...

1_______________ ■

;.1_______________________

Generar Surgery
Obstetric & Gynec.

Eye I
ENT

Skin
Urology
Cardiology

Psychiatry

I

Radiotherapy

2_

Neurology
Orthopaedics

Burns & plastics
......_____ . ____
Dental OPD

ISM Services:

i Homeopathic
-

Ayurvedic

Any other
63

Time of OPD

IPHS for 31 to 50 Bedded Hospitals

There is a Central Collection Centre for receiving
and collecting various specimens for testing. The
timings' for receiving specimens are 9:00 AM to
11:30 AM.
, •

In OPDs specialists are available for consultation.
OPD services are available on all working days
excluding Sundays and Gazetted Holidays.

On Saturdays, the hospital functions from
................. AM to....................PM.
Medical Facilities Not Available:

Emergency: Emergency Laboratory Services are
available 24 hours for limited tests relating to clinical
pathology and bio-chemistry.

Organ Transplantation

Radio Diagnostic Services:
Routine: These services include:
X-Rays

Ultrasound and
Some specialities do not have indoor patients
services:

CAT Scan

Psychiatry

Routine X-Rays are done from 9:00 AM to 1:00 PM.
Registration is done from 9:00 AM to 11:30 AM.

D-addiction

Ultrasound examination is done from 9:00 AM to
4:00 PM.

Dental
Nuclear Medicine

Emergency: Emergency X-Ray services are also
available round the clock. CAT Scan services are
also available round the clock.

Genetic Counselling

■

Endochronology

I

Indoor Patient Services:
Geriatrics

There are total of
indoor patient care.

Laboratory Services:

Routine: Laboratory Services are provided in the
field of (as available):

Wards providing free

Emergency ward A admits emergency cases for
medical problems.

Bio-chemistry

Emergency ward B admits emergency cases for
surgical problems.

Microbiology
Haematology

.1.

There is a----------------- bedded Intensive Care Unit
for care of seriously ill patients.

Cytology

/\-------------------- bedded intensive Coronary Care
Unit takes care of heart patients requiring intensive
treatment.

Histopathology including FNAC

Clinical Pathology

64

I

i

I
K

'T

IPHS for 31 to 50 Bedded Hospitals

In the Burns Department, there are------------bedded Intensive Care Unit to treat seriously injured
burns patients.

------------- Ambulances are available to pick up
patients from their places (on payment of nominal
charges) and also for discharged patients.

There are----- ----- - ------- labour rooms for
conducting deliveries round the clock.

Mortuary Van is available on payment between 9:00
AM to 4:00 PM.

------------------------ nurseries provide necessary
care to the newborns - normal as well those born
with disease.

Public Telephone Booths are provided at various
locations.

Stand-by Electricity Generators have been provided.
Chemist Shops are available outside the hospital.
Canteen for patients and their attendants is
available.

All indoor patients receive treatment under the
guidance and supervision during office hours i.e.
9:00 AM to 4:00 PM.

Outside office hours, treatment is given by doctor
on duty and specialists are available on call.

Lifts are available for access to higher floors.

Adequate toilet Facilities for use of patients and their
attendants are available.

Free diet is provided to all patients in the General
Wards.

Complaints & Grievances:

Every patient is given one attendant pass.

There will be occasions when our services will not
be upto your expectations.

Visitors are allowed only between 5:00 PM to 7:00
PM,

Please do not hesitate to register your complaints.
It will only help us serve you better.

Investigations like CAT Scan, Ultra Sound, Bariummeal, ECHO, TMT etc. are charged for as per
Government approved rates.

Every grievance will be duly acknowledged.

We aim to settle your genuine complaints within 10
working days of its receipt.

For poor patients, these charges can be waived
partially or fully on the recommendation of the
H.O.D. by the Additional Medical Superintendent.
In case of emergency CMO (on duty) may waive off
these charges.

Suggestions/Complaint boxes are also provided at
various locations in the hospital.

If we cannot, we will explain the reasons and the
time we will take to resolve.

A Staff Nurse is on duty round the clock in the ward.
Admitted patients should contact the Staff Nurse for
any medical assistance they need.

Name, designation and telephone number of the
nodal officer concerned is duly displayed at the
Reception.

Other Facilities:

Dr
Designation....
Tele (O)
(M) .
Meeting Hours

' Other facilities available include:
Cold Drinking Water

Wheel chairs and trolleys are available in the OPD
and casualty.
65

(R)

to

1
IPHS for 31 to 50 Bedded Hospitals

Responsibilities of the Users:

Beware of Touts.

The success of this charter depends on the support
we receive from our uses.

The Hospital is a “No Smoking Zone” and smoking
is a Punishable Offence.

Please try to appreciate the various constraints
under which the hospital is functioning.

Please refrain from demanding undue favours from
the staff and officials as it encourages corruption.

On an average more than---------- lacs patients
attend the OPD annually and more than-------------- lacs patients are attended annually in the
casualty and emergency wards.

Please provide useful feedback & constructed
suggestions. These may be addressed to the
Medical Superintendent of the Hospital.
“No Smoking Please”

Please do not inconvenience other patients.

Don’t split here & there

Please help us in keeping the hospital and its
surroundings neat and clean.

Use Dustbin

Please use the facilities of this hospital with care.

Give regards to Ladies and Senior Citizens

Keep Hospital Clean

■66

■

I

I

IPHS for 31 to 50 Bedded Hospitals

Annexure -1
Guidelines for the Project providing financial support to the selected Government
Hospitals for Hospital Waste Management.

providing financial assistance to identified hospitals/
institutions under Central/State Governments for:

The Ministry of Environment & Forests
notified the “Bio-Medical Waste (Management &
Handling) Rules, 1998” in July, 1998.

1.

In accordance with the rules (Rule 4), it is
the duty of every “Occupier”, i.e. a person who has
the control over the institution and/or its premises,
to take all steps to ensure that the waste generated
is handled without any adverse effect to human
health and environment. The Rules further state that
every Occupier, where required, shall set up
requisite bio-medical waste treatment facilities like
incinerator, autoclave, micrbwave system for the
treatment of waste, or ensure requisite treatment of
waste at a common treatment facility or any other
treatment facility. No untreated bio-medical waste
shall be kept stored beyond a period of 48 hours
(Rules 5 & 6).
The hospitals, nursing homes, clinic,
dispensary, animal house, pathological lab, etc. are,
therefore, required to set in place the biological
waste treatment facilities. It is, however, not
incumbent that every institution has to have its own
waste treatment facilities. The rules also envisage
that common facility or any other facilities can be
used for waste treatment. However, it is incumbent
on the occupier to ensure that the waste is treated
within a period of 48 hours. Schedule VI of the rules
also provides the time limits by which the waste
treatment facilities are required to be in place.

I

Purchase of equipments such as:

a)

Incinerator

b)

Microwave

c)

Autoclave

d)

Shredder

2.

Other equipments including colour coded
bags and puncture proof containers,
protective gears, etc.

3.

Civil and electrical works to house and
operate the waste treatment facilities.

4.

Training

5.

I EC activities.

Hospital Waste Management System must
be established in accordance with the Bio-Medical
Waste (Management & Handling) Rules, 1998
(Annexure).

Segregation must be done at the source of
generation of waste. As 80-85% of waste generated
in hospitals is non-hazardous or general waste,
segregation will reduce the quantum of waste that
needs special treatment to only 15-20% of the total
waste. The categories for segregation of waste and
colour coding and type of container should be as in
Schedule 1 and 2 of the Bio-Medical Waste
(Management & Handling) Rules, 1998.

In connection with the implementation of the
Rules, it has been decided to take up pilot projects
in selected Government hospitals - Central and

The various options for treatment of waste

can be selected according to feasibility and type of
waste as given in the Schedule - I. The correct
colour bag should be used for the particular
treatment option.

State.

AIM: The aim of the scheme is to implement
pilot projects to have a demonstration effect by

67

IPHS for 31 to 50 Bedded Hospitals

The various options are:

1.

2.

3.

Incineration: The incinerator installed
must meet the specification and emission
standards as given in the Bio-Medical
Waste (Management & Handling) Rules,
1998 and must meet the guidelines
developed by Central Pollution Control
Board for design and construction of bio
medical waste incinerator (circulated to all
States/UTs vide letter no. Z.28015/50/
2003-H, dated 18.11.2003) - a certificate
may be taken from the State Pollution
Control Board. Waste category, 1,2,3, 5,
& 6 as stated in the Schedule - I of the
bio-Medical Waste (Management &
Handling) Rules, 1998. Wherever common
facilities for treatment and disposal of bio
medical waste are available, installation
of incinerators by individual hospitals may
not be encouraged and such waste should
be transported to the common facility for
proper treatment.

4.

Needle and Syringe Destroyer; These
units can be used for needles and syringes
at the point of use. These will destroy the
used needles reducing it to ashes and cut
the syringe effectively preventing the re-use.

5.

Transportation of Waste: Within the
hospital in dedicated wheeled containers,
trolleys or carts should be used to transport
the bins or plastic bags to the site of storage/
treatment. The wheeled container should be
designed so that waste can be easily loaded,
remain secure during transportation, does
not have sharp edges and is easy to clean
and disinfect.

The assistance will be given direct to the
hospital/institute for purchase of equipments for
waste treatment facilities/installation of equipment
and civil/electrical works to house the waste
treatment facilities, training, IEC activities including
preparation and publication of literature, posters,
pamphlets, etc. The financial assistance will be
limited to Rs.85 lakhs per hospital or Rs.1.50 crore
per State/UT. The estimated costs are as under

Autoclaving/Microwaving: Standards for
autoclaving and microwaving are provided
in the Bio-Medical Waste (Management &
Handling) Rules, 1998. The equipment for
autoclaving or microwaving waste should
conform to these standards. These options
can be selected for waste categories 3, 4,
6, 7 of Schedule - I of the Bio-Medical
Waste (Management & Handling) Rules,
1998.
Shredder: Shredding will cause a
reduction in the volume of waste and will
also effectively prevent its re-use. It is
required for waste category 4 and 7 of the
Schedule - I of the Bio-Medical Waste
(Management & Handling) Rules, 1998. it
should be ensured that waste is
disinfected by chemicals/microwaving/
autoclaving before shredding.

68

1.

Incinerator or Microwave = Rs.35.00 lakhs

2.

Shredder (Approx. 100 kg to 360 kgJhour)
= Rs.10.00 lakhs

3.

Autoclave (Approx. Cap. Vol. 1015 litre)
= Rs.30.00 lakhs

4.

Waste transportation: Onsite-wheel barrow/
wheeled container or similar carriage
= Upto max. of Rs.50,000.00

5.

Civil and Electrical works =

Rs.2.50 lakhs

6.

Literature/IEC/Training of Staff
= Rs.2.00 lakhs

7.

Procurement of equipments like needle
shredder puncture proof containers for
sharps, colour coded bags, trolleys,
protective gears for staff etc. for Disposal
of hospital wastes
= Rs.5.00 lakhs

IPHS for 31 to 50 Bedded Hospitals

I

of equipment/maintenance of the
equipments/transportation of thw waste/
expenditure incurred on civil/electrical works
will be audited by the Accountant General
of the State Government / UT Administration
and its utilization certificate will be forwarded
to the Ministry of Health & Family Welfare
within a period of six months after the expiry
of the financial year during which the grants
is sanctioned.

The following eligibility conditions have to
be fulfilled for availing of financial assistance:
The application for financial assistance
should be forwarded to this Ministry through
the State Government/UT Administration
concerned.

The State Government/UT Administration
should ensure that the existing facilities are
inspected by a responsible officer and
deficiencies pointed out. The proposal for
additionalities, if any, in the form of
equipment should be, as far as possible, by
way of complementary equipments
supported by estimates of concerned
authorities.
iii.

The cost of equipments to be purchased
should be indicated. The equipments will be
purchased as per prescribed procedure.
These will be entered into an Assets
Register to be maintained by the hospital.

iv.

The grant will be subject to the condition that
the State Government / UT Administration
will give an undertaking that adequate
arrangements for running the. equipments
and their maintenance for disposal of
hospital waste shall be made.

v.

The grant will be subject to the condition that
the State Government/UT Administration/
Hospital will give an undertaking that they
will provide the required trained manpower
for running of the equipments and their
maintenance for proper treatment and
disposal for the bio-medical waste.

vi.

The funds sanctioned will be utilized for the
purpose for which it is sanctioned.

vii.

The accounts of the hospital about purchase

The financial assistance will be limited to
Rs.85 lakhs per hospital or Rs.1.5 crore per State/
UT. The State/UTs will have the option to choose
any equipment (s) from the list above to cover as
many hospitals as possible. However, the financial
assistance per State will be provided upto a
maximum amount of Rs.1.5 crore.
Scrutiny of Applications:

The applications received from the State
Government/UT Administrations for setting up of
facilities for disposal of hospital waste in the
-hospitals under their administrative control will be
considered in the Ministry in a Committee headed
by Additional Secretary and proposals cleared for
giving financial assistance. The proposals then will
be processed for sanction of financial assistance to
the Government Hospitals/institutes. In the case of
Central Government Hospitals/lnstitutions, the Head
of the Institutions may send their proposal through
Dte.GHS.
The Joint Secretary (Hospital), DDG level
officer in the Dte.GHS concerned with hospitals
matters will be the Nodal Officer for implementation
of the scheme. The proposals will be examined
through a Committee consisting of Additional
Secretary, Chairman, the Joint Secretary dealing
with hospital matters, Joint Secretary (FA) or his
representative, DDG level officer dealing with
hospitals in Dte.GHS and one representative of

69

IPHS for 31 to 50 Bedded Hospitals

will be sanctioned to the State Government/UT
Administration/Occupier and it will be implemented
by the concerned Government and to the concerned
Head of the Hospital in case’of Central Government
Hospitals/lnstitutions.

Central Pollution Control Board/Ministry of
Environment & Forests as members. The Member
Secretary of the Committee will be Director/Deputy
Secretary dealing with hospital matters. The funds
for setting up facilities for disposal of hospital waste

70

IPHS for 31 to 50 Bedded Hospitals

Annexure - II

Referral Laboratory Networks
Referral Laboratory Network for Advanced diagnostic facilities

IDSP Level ■ 4 Labs
South
Central
Zone
Zone

IDSP
North
Zone

East
Zone

South
Zone

Level - 5
Labs

CMC
Vellore

PGIMER
Chandigarh

RMRC
Dibrugarh,

KEM
Mumbai,

NICED &
NICD

Trivandrum
Medical
College

AllMS Delhi Cuttack
Medical
CRI Kasauli College

AFMC
Pune
BJ MC

CMC
Vellore

AFMC,
Pune

VP Chest
Institute,
Delhi

Surat
Medical
College

CMC Vellore
& PGIMER
Chandigarh

Advance Diagnostic Facilities
Bacterial diagnosis
Enteric bacteria:
Vibrio cholerae,
Shigella, ;
Salmonella'
Streptococcus
pyogenes and
S pneumoniae

Indore
Medical
College

St. John
Medical
College,
Bangalore

VP. Chest
University
of Delhi

-C.diphtheriae

BHU

CMC,
Vellore

NICD,
Delhi

Neisseria
meningitidis and
N. gonorrheae

SN Medical
College,
Agra

State PH
Lab
Trivandrum

PGIMER
Chandigarh

Staphylococcus

BHU

'mgr

Maulana
Azad
Medical
College,
Delhi

STM,
Kolkata

AFMC,
Pune

NICD, Delhi

AllMS
VRI

RMRC,
Bubaneswar
&

BJMC

RMRC
Port Blair

Medical
University

■

Leptospirosis

»

DRDE

Virology
Institute,
Allepey

STM,
Kolkata

Dibrugarh

Tamil Nadu
University,
Chennai

VCRC,
Pondicherry

71

IPHS for 31 to 50 Bedded Hospitals

Viral Diagnosis

Enteric viruses

DRDE

CMC,
Vellore

AllMS &
Villupuram
Chest
Institute

NICED
Kolkata

EVRC,
Mumbai,
NIV & NICD

Arboviruses

DRDE

CMC,
Vellore

AllMS &
NICD Delhi
Chest
Institute

NICED
Kolkata

NIV

Myxoviruses

DRDE

CMC,
Vellore

AllMS &
NICD Delhi
Chest
Institute

NICED
Kolkata

NIV, HSADL
Bhopal

Hepatitis viruses

DRDE

CMC,
Vellore

AllMS
ICGEB,
Delhi

NICED
Kolkata

NIV

Neurotropic viruses

DRDE

CMC,
Vellore

AllMS &
NICD Delhi*

NIV
NIMHANS

HIV

DRDE

CMC,
Vellore

AllMS

NARI, NICD
& NACO
ICGEB, Delhi

Parasitic Diagnosis
Malaria

All State Public Health Laboratories

MRC,Delhi
ICGEB, Delhi

Filaria

All State Public Health Laboratories

NVBDCP, Delhi VCRC
Pondicherry

Zoonoses
Dengue

DRDE

VCRC,
AllMS
Pondicherry
Institute of
Virology,
Aleppey

NICED

NIV

NIV
ICGEB,
Delhi

JE

DRDE

CRME,

NICED

NIV

NIV /NICD

AllMS

Madurai &
NIMHANS

VCRC,
Pondicherry

72

■

IPHS for 31 to 50 Bedded Hospitals

Plague

DRDE

NICD
Bangalore

Rickettsial diseases

DRDE

CMC,
Vellore

€

NICD,
Delhi

Haffikins
Institute

NICD,
Delhi

AFMC

NICD
IVRI

BJMC

NICD
IVRI

KEM
Mumbai,

NICED &
NICD

Others of Public Health Importance
Anthrax

DRDE

CMC,
Vellore

IGIB

Microbial water
quality monitoring

NEERI,
Nagpur

CMC
Vellore,

PGIMER
Chandigarh

Trivandrum
Medical
College

NICED,
Calcutta

RMRC,
Dibrugarh,
Cuttack
AllMS, Delhi Medical
College
CRI Kasauli

HAFFKIN’s,
Mumbai

AFMC Pune
Other laboratories to perform support functions

NIV, NICD, HSADL

Outbreak investigation
support

Medical Colleges and state public health
laboratories as L3/ L4

NICD, NIV, NICED,
VCRC

I

Laboratory data
management

Medical Colleges, state public health laboratories
and all the L4 & L5 laboratories (in their area of
expertise)

NIV, NICD

I
I

Capacity building

All the L4 & L5 laboratories (in their area of
expertise)

NIV, NICD

Quality assurance

All the L4 & L5 laboratories (in their area of
expertise)'

CMC, TRC, NTI, AFMC,
NARI, RMRC, Port Blair
NIV, NICD

Quality control of
reagents & kits
evaluation

All the L4 & L5 laboratories (in their area of
expertise)

CMC, TRC, NARI,
RMRC,Port Blair NIV,
NICD, BJMC, NICED

‘ Unknown pathogens

I

DRDE, NIV, IVRI, NICED,
NICD, MRC, Delhi

Production & supply of
reagents/ kits/ biological/
standard reference
materials

Biosafety & bio
containment

AFMC, Pune
NARI
TRC, Chennai
RMRC, Port Blair

Other laboratories to perform support function

73

HSADL, NIV/MCC,
DRDE, NICD

1
IPHS for 31 to 50 Bedded Hospitals

List of Abbreviations
BJMC

BJ Medical College

CHC

Community Health Centre

CME

Continuing Medical Education

CSSD

Central Sterile and Supply Department

CRI

Central Research Institute

CRME

Centre for Research in Medical Entomology

DRDE

Defense Research and Development Establishment

ICGEB

International Centre for Genetic Engineering and Bio-technology

EVRC

Enterovirus Research Centre

FRU

First Referral Unit

HSADL

High Security Animal Diseases Laboratory

IGIB

Institute of Genomics and Integrative Biology

IPHS

Indian Public Health Standards

IVRI

Indian Veterinary Research Institute

KEM

King Edmund Memorial Hospital

MRC

Malaria Research Centre

NARI

National AIDS Research Institute

NEERI

National Environmental Engineering Institute

NICED

National Institute of Cholera and Endemic Diseases

NIV

National Institute of Virology

NRHM

National Rural Health Mission

PRI

Panchayati Raj Institution

RKS/HMC

Rogi Kalyan Samiti / Hospital Management Committee

RMRC

Regional Medical Research Centre

STM

School of Tropical Medicines

VCRC

Vector Control Research Centre

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IPHS for 31 to 50 Bedded Hospitals

References
*

1.

Indian Standard Basic Requirement for Hospital Planning; Part 2 Upto 100 Bedded Hospital, Bureau
of Indian Standards, New Delhi, January, 2001

2.

Rationalisation of Service Norms for Secondary Care Hospitals, Health & Family Welfare
Department, Govt, of Tamil Nadu. (Unpublished)

3.

District Health Facilities, Guidelines for Development and Operations; WHO; 1998.

4.

Indian Public Health Standards (IPHS) for Community Health Centres; Directorate General of Health
Services, Ministry of Health & Family Welfare, Govt, of India.

5.

Population Census of India, 2001; Office of the Registrar General, India.

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