Indian Public Health Standards, 2022: Volume IV (Health and Wellness Centre-Sub Health Centre)

As per the IPHS 2022, Sub Health Centres and Primary Health Centres are being transformed into Health and Wellness Centres (HWCs). The HWCs are to ensure that the ‘time to care’ should not be more than “30 minutes from the farthest village”. There are to be 150,000 such HWCs in the country by December 2022, the report states.

The standards classify Health and Wellness Centres-Sub Health Centres (HWC-SHC) into two types: rural and urban. A rural HWC-SHC situated in the plains will provide services to a population of 5,000 people and one in hilly, tribal or desert areas will provide services to a population of 3,000. An urban HWC or UHWC will cater to 15,000-20,000 people, which should predominantly be “poor and vulnerable populations, residing in slums or other such pockets”.

HWCs are also expected to provide ‘teleconsultations’; such centres should have adequate internet or telephone connection in order to facilitate the effective delivery of telemedicine services, the report states. In addition to medical services provided on location at the HWC, the centres are also expected to perform community outreach programmes for the screening and detection of diseases such as tuberculosis, leprosy, fever, hypertension, diabetes, asthma and glaucoma.

The infrastructure of HWC-SHCs and UHWCs should be planned considering easy access for elderly people and people with disabilities. The centres should comply with the Rights of Persons with Disabilities Act, 2016, and the Guidelines and Space Standards for Barrier Free Environment for Disabled and Elderly Persons.

HWC-SHCs and UHWCs are required to have two day-care beds. Further, such facilities with which have two beds are expected to have three oxygen cylinders with a capacity of 1,500 litres each.

The centres need to have round-the-clock supply of piped soft water through a water tank large enough to store three days’ worth of required water. The HWCs should also have storage space for 5-7 days’ worth of linen and drugs. Additionally, a system should be in place to order medicines from linked HWCs and UHWCs.

The centre should have a community health officer, an auxiliary nurse midwife and a male multi-purpose worker (MPW), the IPHS 2022 state. The staff for UHWC should include a medical officer, a staff nurse or a pharmacist, and a male multi-purpose worker.

In rural HWCs, the report outlines the requirement of one accredited social health activist (ASHA) per 1,000 people or one ASHA per habitation in tribal, hilly and desert areas. For UHWCs, the requirement is of one ASHA per 2,000 people and one auxiliary nurse midwife per 10,000 people.

The IPHS provide a list of essential medicines for HWCs to be made available to patients free of cost under Government of India’s Free Drugs Service Initiative. These include medicines like anaesthetic agents, analgesics, anti-convulsants, antidotes for poisons. HWCs are also expected to carry anti-bacterial medicines, cardiovascular medicines, contraceptives, and vaccines.

The report states that the Jan Arogya Samiti (JAS) – a community platform for monitoring healthcare services and amenities – must help in overseeing the HWCs. The members of JASs are required to ascertain gaps pertaining to physical infrastructure, services (essential and desirable), human resources for health, drugs, and diagnostics at HWCs.

The standards require HWCs to coordinate and organise meetings at the zilla/block/gram panchayat level in order to plan and organise health programmes. These meetings will also help in planning strategies for education and communication related to healthcare, the report states.

Focus and Factoids by Siddhita Sonavane.

PARI Library's health archive project is part of an initiative supported by the Azim Premji University to develop a free-access repository of health-related reports relevant to rural India.