Staffing pattern.docx(Community Health Nursing)

Staffing Pattern of SC, PHC, UHC, CHC, and DH

The staffing pattern in healthcare facilities is a crucial determinant of their efficiency and quality of services. In India, the government has established specific staffing norms for different levels of healthcare institutions, ensuring that resources are allocated according to the population’s needs and the services provided. This document outlines the staffing patterns for Sub-Centers (SC), Primary Health Centers (PHC), Urban Health Centers (UHC), Community Health Centers (CHC), and District Hospitals (DH).

1. Sub-Centers (SC)

Sub-Centers are the first point of contact in the rural healthcare system, serving a population of 3,000 to 5,000 in plain and hilly areas, respectively. The staffing pattern includes:

Auxiliary Nurse Midwife (ANM): 1-2 per SC

Male Health Worker: 1 per SC

ASHA (Accredited Social Health Activist): Linked to the SC for community outreach

2. Primary Health Centers (PHC)

PHCs provide primary-level curative and preventive services, covering a population of 20,000 to 30,000. The staff includes:

Medical Officer (MO): 1-2 (MBBS)

Nursing Staff: 3-4

Pharmacist: 1

Lab Technician: 1

Health Worker (Male/Female): 2-4

Support Staff: Ward boys, cleaners, etc.

3. Urban Health Centers (UHC)

UHCs cater to urban populations, focusing on primary care and public health services. The staffing pattern includes:

Medical Officer (MO): 1 (MBBS)

Staff Nurses: 2-3

Pharmacist: 1

Lab Technician: 1

ANM: 2

Support Staff: 1-2

4. Community Health Centers (CHC)

CHCs serve as the first referral units (FRUs) for primary care facilities, catering to approximately 80,000 to 1,20,000 people. The staff includes:

Specialists: 4 (General Physician, Surgeon, Obstetrician/Gynecologist, Pediatrician)

Medical Officers: 1-2

Nursing Staff: 7-10

Pharmacist: 1

Lab Technician: 1-2

Radiographer: 1

Support Staff: 5-10 (Ward boys, cleaners, etc.)

5. District Hospitals (DH)

District Hospitals provide secondary and tertiary care to the district population. The staffing pattern depends on the bed strength, typically ranging from 100 to 500 beds. Example for a 100-bed hospital:

Specialists: 10-15 (Including Physicians, Surgeons, Pediatricians, Gynecologists, Orthopedic Surgeons, etc.)

Medical Officers: 5-10

Nursing Staff: 20-40

Pharmacist: 2-4

Lab Technicians: 4-6

Radiographers: 2

Support Staff: 20-30

Challenges in Staffing

Shortages: Inadequate number of healthcare workers, especially in rural and remote areas.

Skill Gaps: Need for continuous training and capacity building.

Workload: Overburdened staff due to high patient-to-provider ratios.

Distribution Inequities: Urban areas often have better staffing compared to rural areas.

Recommendations for Improvement

Recruitment Drives: Hire more healthcare workers to fill vacancies.

Training Programs: Conduct regular training sessions to upgrade skills.

Incentives for Rural Postings: Provide financial and non-financial benefits to encourage

1. STAFFING PATTERN OF SUB CENTER
The staffing pattern of a Sub-Centre (SC) in India is designed to
provide basic health services at the village level, catering to a
population of 5,000 in plain areas and 3,000 in hilly or tribal
areas. Sub-Centers are the first point of contact between the
community and the healthcare system.
Staffing Pattern of a Sub-Centre
1. Health Workers:
1.Auxiliary Nurse Midwife (ANM):
•1 ANM (Female): Responsible for maternal and child
health (MCH), immunization, and family planning services.
•In upgraded Sub-Centers under National Health
Mission (NHM), 2 ANMs are deployed.
2.Multipurpose Health Worker (Male):
•1 Male Health Worker: Provides services related to
communicable diseases, sanitation, and disease
surveillance.
2. Support Staff:
•ASHA (Accredited Social Health Activist):

2. •Works in the community to support ANM in outreach
activities and mobilizing the community for health services.
•Volunteers (Optional):
•Local volunteers may assist in outreach programs
under specific schemes.
3. Additional Staff in Upgraded Sub-Centers:
•Data Entry Operator: (optional, depending on the state and
programs).
•Pharmacist: (optional, in upgraded Sub-Centers).
Key Points:
1.Sub-Centers are primarily managed by ANMs with support
from ASHAs and Male Health Workers.
2.They serve as outreach centers to deliver preventive,
promotive, and basic curative care.
3.Upgraded Sub-Centers under NHM may have additional
staff and improved infrastructure, including basic laboratory
facilities.
4.Each Sub-Centre receives financial support for operational
costs like drug procurement, maintenance, and outreach
activities.

3. STAFFING PATTERN OF PHC
1.Medical Staff:
•Medical Officer (MO):
•1 (preferably an MBBS doctor)
•In upgraded PHCs, 2 Medical Officers (one male and
one female).
•AYUSH Medical Officer: 1 (optional, depending on
the state policy).
2.Nursing Staff:
•Staff Nurse: 3
•ANM (Auxiliary Nurse Midwife): 2 (one ANM for
outreach activities).
3.Pharmacist:
•1 (responsible for drug dispensing and maintaining
stock).
4.Lab Technician:
•1 (for conducting diagnostic tests).
5.Health Workers:
•Male Health Worker (MPW): 1 (for communicable
disease control and sanitation).

4. •Health Assistant (Female) or Lady Health Visitor
(LHV): 1 (to supervise ANMs and support maternal-child
health services).
6.Support Staff:
•Clerk/Accountant: 1 (to handle administrative and
financial work).
•Driver: 1 (if the PHC has a vehicle for patient transport
or outreach services).
•Group D Worker (Peon/Attendant): 1-2 (for cleaning,
assisting, and support tasks).
7.Sanitation Staff:
•Sweeper/Janitor: 1 (to maintain cleanliness of the
facility).
Key Points:
•Some PHCs, especially those upgraded under National
Health Mission (NHM), may include additional staff like a
dentist, counsellor, or data entry operator.

STAFFING PATTERN OF CHC
The staffing pattern of a Community Health Centre (CHC) in
India is defined by the Indian Public Health Standards (IPHS)

5. guidelines. A CHC is a 30-bedded referral unit and caters to a
population of approximately 80,000–1,20,000 in plain areas and
40,000–80,000 in hilly/tribal areas. It serves as a referral center
for four Primary Health Centers (PHCs).
Staffing Pattern of a CHC
1. Medical Staff:
•General Surgeon: 1
•Physician/General Medicine Specialist: 1
•Obstetrician & Gynecologist (OBG): 1
•Pediatrician: 1
•Medical Officer (MBBS): 3 (to manage OPD, IPD, and
emergencies).
•Dental Surgeon: 1 (for dental health services).
•AYUSH Medical Officer: 1 (optional, depending on state
policy).
2. Nursing Staff:
•Staff Nurses: 7 (to provide nursing care in wards, labor
rooms, and OT).
•Auxiliary Nurse Midwife (ANM): 2 (for outreach and
MCH services).

6. 3. Paramedical Staff:
•Pharmacist: 1 (to dispense medicines and maintain stock).
•Lab Technician: 1 (for diagnostic services).
•Radiographer: 1 (for X-rays and imaging).
•Ophthalmic Assistant: 1 (for vision and eye care services).
•ECG Technician: 1 (optional, depending on equipment
availability).
4. Administrative Staff:
•Health Assistant (Male and Female): 2 (for supervision of
outreach activities).
•Clerk/Accountant: 1 (for administrative and financial
work).
5. Support Staff:
•Ward Boys/Ayah: 2-3 (for assisting nurses and patient
care).
•Sweeper/Janitor: 1-2 (for maintaining cleanliness).
•Driver: 1 (for ambulance services, if available).
•Watchman/Chowkidar: 1 (for security).
6. Specialists (Optional in Upgraded CHCs):

7. •Anesthetist, Orthopedician, ENT Specialist, or Public
Health Specialist (depending on the state and specific health
needs).
Key Points:
1.CHCs act as First Referral Units (FRUs), providing
emergency obstetric care and other specialty services.
2.Staffing patterns may vary based on the state government’s
guidelines or whether the CHC is upgraded under the
National Health Mission (NHM).
3.Additional posts like a counselor, data entry operator, or
social worker may be present in NHM-supported CHCs.

8. STAFFING PATTERN OF UHC
The staffing pattern of an Urban Health Centre (UHC), also
known as an Urban Primary Health Centre (UPHC) , is
designed to provide primary healthcare services to urban
populations. Each UHC typically caters to a population of
50,000–75,000 and focuses on preventive, promotive, and
curative healthcare.
Staffing Pattern of an Urban Health Centre (UHC)
1. Medical Staff:
•Medical Officer (MO): 1-2
•Preferably MBBS doctors, with at least one female
Medical Officer.
•AYUSH Medical Officer: 1 (optional, depending on state
policy).

9. 2. Nursing Staff:
•Staff Nurses: 3-5
•Provide nursing care, manage immunization, family
planning, and maternal and child health services.
3. Paramedical Staff:
•Pharmacist: 1
•Dispenses medicines and maintains drug inventory.
•Lab Technician: 1
•Conducts basic diagnostic tests like blood, urine, and
sputum tests.
4. Community and Outreach Staff:
•ANM (Auxiliary Nurse Midwife): 2
•Responsible for maternal and child health,
immunization, and family planning outreach activities.
•Urban ASHAs:
•1 ASHA for every 2,000-2,500 population to assist in
mobilizing the community for healthcare services.
•Public Health Nurse/Health Visitor: 1 (optional, for
supervision of outreach activities).
5. Administrative Staff:
•Clerk/Accountant: 1

10. •Handles administrative and financial records.
•Data Entry Operator: 1
•Manages health records and digital data entry.
6. Support Staff:
•Group D Staff/Attendant: 1-2
•Assists in facility maintenance and patient care.
•Sweeper/Janitor: 1-2
•Maintains cleanliness of the facility.
Key Features:
1.UHCs provide outpatient care, immunization, maternal
and child health services, disease prevention, and health
education.
2.The staffing may vary depending on the size of the
population served and the state government’s guidelines.
3.In some upgraded UHCs, additional staff like counselors,
specialists, or physiotherapists may be appointed.
STAFFING PATTERN OF DH

11. The staffing pattern of a District Hospital (DH) in India is
outlined by the Indian Public Health Standards (IPHS). District
Hospitals are secondary-level referral centers that cater to a
population of 10–12 lakh (1–1.2 million). The staffing structure
depends on the bed strength of the hospital, typically ranging
from 100 to 500 beds.
Staffing Pattern of a District Hospital
1. Medical Staff
•Medical Superintendent: 1 (Head of the hospital).
•Specialists (varies by hospital size):
•General Surgeon: 1-2
•Physician: 1-2
•Obstetrician & Gynecologist: 1-2
•Pediatrician: 1-2
•Orthopedic Surgeon: 1-2
•Anesthetist: 1-2
•Radiologist: 1-2
•Pathologist: 1-2
•ENT Specialist: 1
•Ophthalmologist: 1
•Dentist: 1
•Psychiatrist: 1

12. •Casualty Medical Officer (CMO): 2-3 (for 24x7 emergency
services).
•Medical Officers (General Duty): 5-10 (depending on bed
strength).
2. Nursing Staff
•Staff Nurses:
•1 Nurse per 6 beds in general wards.
•1 Nurse per 2 beds in ICU/CCU.
•1 Nurse for every delivery table (in the labor room).
•Nursing Superintendent: 1
•Deputy Nursing Superintendent: 1-2 (for larger hospitals).
•Assistant Nursing Superintendent: 2-3
3. Paramedical Staff
•Pharmacist: 2-4
•Lab Technicians: 2-5 (depending on diagnostic load).
•Radiographer/X-Ray Technician: 1-2
•Blood Bank Technician: 2 (in hospitals with blood banks).
•OT Technician: 2-4 (for operation theater services).
•Physiotherapist: 1-2
•Dietician: 1 (to plan patient diets).
•ECG Technician: 1
•Dental Technician: 1

13. 4. Administrative Staff
•Hospital Administrator: 1 (optional in larger hospitals).
•Clerk/Accountant: 2-4
•Data Entry Operators: 3-5
•Receptionist: 1-2
5. Support Staff
•Ward Boys/Ayahs: 1 per 12 beds.
•Sweepers/Janitors: 1 per 8,000 sq. ft. area.
•Security Guards: 3-6 (for 24x7 security).
•Drivers: 2-4 (for ambulances and other vehicles).
6. Specialists (Optional in Larger District Hospitals)
•Cardiology, Neurology, Oncology, Nephrology, Urology
specialists, depending on hospital size and services provided.
Key Points
1.The staffing pattern depends on the bed strength and
service load of the hospital.
2.District Hospitals serve as referral centers for Community
Health Centers (CHCs) and provide specialized healthcare.
3.The NHM or state-specific guidelines may add additional
roles like counselors, biomedical engineers, or IT staff.