Indicative Service Norms by levels of Service Delivery*

Services** / Levels of service delivery
Community (Outreach) / First point of service delivery (U-PHC) / Referral Centre - U- CHC (Specialist services)
A. Essential Health Services
A1. Maternal health / Registration, ANC, identification of danger signs, referral for institutional delivery, follow-up
Counseling and behavior promotion / ANC, PNC, initial management of complicated delivery cases and referral, management of regular maternal health conditions, referral of complicated cases / Delivery (normal and complicated), management
of complicated Gynae/ maternal health condition, hospitalization and surgicalinterventions, including blood transfusion.
A2. Family
welfare / Counseling, distribution of OCP/CC, referral for sterilization, follow-up of contraceptive related complications / Distribution of OCP/ CC, IUD insertion, referral for sterilization, management of contraceptive related complications / Sterilization operations, fertility treatment
A3. Child health and nutrition / Immunization, identification of danger signs, referral, follow-up, distribution of ORS, paediatric cotrimoxazole post- natal visits/counseling for newborn care / Diagnosis and treatment of childhood illnesses, referral of acute cases/ chronic illness
Identification and referral of neonatal sickness / Management
of complicated paediatric/neo-natal cases, hospitalization, surgical interventions, blood transfusion
A4. RTI/STI
(including HIV/ AIDS) / referral, community level follow-up for ensuring adherence to treatment regime of cases undergoing treatment / Symptomatic Diagnosis and primary treatment and referral of complicated cases / Management of complicated cases, hospitalization (if needed)
A5. Nutrition deficiency disorders / Height/weight measurement, Hb testing, distribution of therapeutic doses of IFA, promotion of iodized salt, nutrition supplements to identified children and pregnant/ lactating women
Promotion of breast feeding, complementary feeding for prevention of under-nutrition / Diagnosis and treatment of seriously deficient patients, referral of acute deficiency cases / Management of acute deficiency cases, hospitalization
Treatment and rehabilitation of severe under-nutrition
A6. Vector- borne diseases / Slide collection, testing using RDKs, DDT
Counseling for practices for vector control and protection / Diagnosis and treatment, referral of terminally ill cases / Management of terminally ill cases, hospitalization
A7. Mental
Health / Initial screening and referral / Psychiatric and neurological services, including hospitalization, if needed
Services** / Levels of service delivery
Community (Outreach) / First point of service delivery (U-PHC) / Referral Centre - U- CHC (Specialist services)
A7.1 Oral
Health / Diagnosis and referral / Management of complicated cases, hospitalization (if needed)
A7.2 Hearing Impairment/ Deafness / Management of complicated cases, hospitalization (if needed)
A8. Chest infections (TB/ Asthma) / Symptomatic search and referral, ensuring adherence to DOTs, other treatment / Diagnosis and treatment, referral of complicated cases / Management of complicated cases
A9. Cardio- vascular diseases / BP measurement, symptomatic search and referral, follow-up of under- treatment patients / Diagnosis and treatment and referral during specialist visits, / Management of emergency cases, hospitalization and surgical interventions (if needed)
A10. Diabetes / Blood/urine sugar test (using disposable kit), symptomatic search and referral, / Diagnosis and treatment, referral of complicated cases / Management of complicated cases, hospitalization (if needed)
A11. Cancer / Symptomatic search and referral, follow-up of under-treatment patients / Identification and referral, follow-up of under-treatment patients / Diagnosis, treatment, hospitalization (if and when needed)
A12. Trauma care (burns & injuries) / First aid and referral / First aid , emergency resuscitation, documentation for MLC (if applicable) and referral / Case management and hospitalization, physiotherapy and rehabilitation
A13. Other surgical interventions / --- not applicable --- / Identification and referral / Hospitalization and
surgical interventions
B. Other support services
B1. IEC/BCC / IPC, Health Camps/fairs, performing arts, wall/poster writing, events (in schools, women’s groups) / Distribution of health
education material / Distribution of health
education material
B2. Counseling / Individual and group/family
counseling – / Patient/attendant
counseling / Patient/attendant
counseling
B3. Personal & Social Hygiene / IEC on hygiene, community mobilization for cleanliness drives, disinfection of water sources, etc. / --- not applicable --- / --- not applicable ---

*Norms adapted from NCMH Report

** Services based on situational analysis