Indian Public Health Standards

1. What is IPHS?

Indian Public Health Standards are a set of standards envisaged to improve the quality of health care delivery in the country under the National Rural Health Mission.

2. What is the need for IPHS?

The health care system in India has expanded considerably over the last few decades. However, the quality of services is not uniform due to various reasons like non-availability of manpower, problem of access, acceptability, lack of community involvement, etc. Hence, standards are being introduced in order to improve the quality of public health level.

3. Who will be recommending these standards?

A Task Group under the Director General of Health Services was constituted to recommend the Standards. The IPHS is based on its recommendation.

4. Who will it be applicable to?

The NRHM aims at strengthening hospital care, for rural areas. At present these standards are being applied only to the Community Health Centres (CHCs). As a first steps requirements for a Minimum Functional Grade of a CHC are being prescribed. Further upgradation will be proposed after these minimum requirements have been met. Subsequently, standards for PHC and SC shall also be developed.

5. Why another set of standards?

Although it is true that there are existing standards as prescribed by the Bureau of Indian Standards for 30-bedded hospital, these are at present not achievable as they are very resource-intensive. Hence a less resource intensive standard suited to the requirements of the system has been developed.

6. What are the various recommendations under IPHS?

  • Improvement in the availability of specialist services in the CHCs by ensuring availability of all the sanctioned specialists. Additional sanction of the post of Anaesthetist and Public Health Manager is also envisaged.
  • Strengthening support staff, by recommending a Public Health Nurse and an ANM in all these Centres, in addition to the existing staff.
  • Norms for infrastructure, equipment, laboratory, blood storage facilities, and drugs have been formulated.
  • Guidelines for management of routine and emergency cases under National Health Programmes are being provided to all CHCs, to maintain uniformity and optimum standardised treatment.

7. How will compliance to these standards be ensured?

  • Monitoring and evaluation would be both internal as well as external.
  • Training of medical as well as para medical staff.
  • Charter of Patients 'Rights would be' prominently displayed in all these centres.
  • Rogi Kalyan Sarnitis would be formed to improve accountability.
  • The District Health Mission would monitor the progress for maintenance of standards at facility level.

8. How will the Mission address the issues of absentee doctors in rural areas?

Availability of doctors and paramedics in rural areas is important to the success of the Mission. The States will examine the possibility and modalities for having district level cadres for doctors and black level cadres for ANMs as resolved in the 7th Conference of the Central Council of Health & Family Welfare Ministers, in August 2003. The District Health Missions will have greater flexibility for engaging the services of private doctors on contractual basis to provide services in public health institutions. Most importantly, the States shall indicate their commitment to devolve the funds and programmes for health and family welfare to Panchayati Raj Institutions under the NRHM, to ensure effective accountability of the public health providers at corresponding levels. The Mission also proposes to involve Professional Medical Associations viz. Indian Medical Association (IMA), Federation of Obstetricians and Gynecologists of India (FOGSI), etc. to build peer and professional support for the programme.