🧠 Must-know for NORCET, AIIMS, NHM-CHO, ESIC, RRB, GPSC Nursing Exams
A Sub-Centre (SC) is the most peripheral and first point of contact between the community and public health system. It is established based on population norms and staffed by frontline health workers.
📍 Norms (as per Indian Public Health Standards – IPHS):
| 🏘️ Area Type | 👥 Population Covered per SC |
|---|---|
| Plains | 5,000 people |
| Hilly/Tribal | 3,000 people |
| 👤 Post | 🔢 No. of Staff | 🎯 Role |
|---|---|---|
| Auxiliary Nurse Midwife (ANM – Female) | 1 (Mandatory) | Maternal & child health, immunization, FP |
| Multipurpose Health Worker (Male) | 1 | Vector control, sanitation, disease surveillance |
| ASHA (voluntary worker) | 1 per 1000 pop. | Community mobilization, health education |
| Second ANM (new norm) | 1 | Additional support for MCH services |
| Support staff / Attendant | 1 (optional) | Cleaning, basic support |
💡 Total functional team = Around 3–4 workers per SC.
✔️ Antenatal, postnatal care
✔️ Safe deliveries (institutional & home-based)
✔️ Referral for complications
✔️ Distribution of iron, folic acid, calcium
✔️ Newborn care, growth monitoring
✔️ Immunization as per National Immunization Schedule
✔️ Vitamin A, ORS, Zinc distribution
✔️ Pulse Polio campaigns
✔️ Counseling on spacing methods (OCPs, condoms, IUCDs)
✔️ Follow-up after sterilization
✔️ Motivation for family planning camps
✔️ Malaria, Dengue, TB, Leprosy surveillance
✔️ Mass drug administration (e.g., for Filariasis)
✔️ Reporting disease outbreaks
✔️ Record keeping and HMIS entry
✔️ Educating about hygiene, nutrition, breastfeeding
✔️ Conducting Village Health and Nutrition Days (VHNDs)
✔️ Collaborating with Anganwadi centres and schools
✔️ Birth & death registration
✔️ Adolescent health education
✔️ Screening of NCDs (BP, diabetes) at Health & Wellness SC
✔️ Assist in Ayushman Bharat Health & Wellness Centre (AB-HWC) services
✅ Q1. What is the population norm for 1 sub-centre in plains?
🅰️ 5,000 people
✅ Q2. Who is the primary care provider at a sub-centre?
🅰️ ANM (Auxiliary Nurse Midwife)
✅ Q3. What service is provided under VHND at SC level?
🅰️ ANC, immunization, family planning, nutrition
✅ Q4. Which program transformed SC into Health & Wellness Centre?
🅰️ Ayushman Bharat
✅ Q5. What is the role of MPHW (Male) at SC?
🅰️ Vector control, sanitation, disease surveillance
🧠 Essential for NORCET, AIIMS, NHM, RRB, ESIC, GPSC & State Nursing Exams
A Primary Health Centre (PHC) is the first contact point between the village community and a Medical Officer. It offers integrated preventive, promotive, and curative healthcare under the public health system.
📍 Population Norms (IPHS – Indian Public Health Standards):
| 🏘️ Area Type | 👥 Population Covered per PHC |
|---|---|
| Plains | 30,000 people |
| Hilly/Tribal | 20,000 people |
| 👤 Designation | 🔢 No. of Staff | 🎯 Key Responsibility |
|---|---|---|
| Medical Officer (MBBS) | 1 (or 2 in 24×7 PHC) | Leads clinical & administrative services |
| AYUSH Medical Officer | 1 | Provides alternate medicine care |
| Nursing Officer (Staff Nurse) | 3–5 | OPD, IPD, emergency & delivery care |
| Pharmacist | 1 | Dispensing and drug management |
| Lab Technician | 1 | Basic diagnostic tests (e.g., malaria, blood) |
| Health Worker (Male) | 1 | Vector control, sanitation, reporting |
| ANM / Health Worker (Female) | 1 | Maternal & child health, immunization |
| Block Health Educator | 1 | Health promotion and IEC activities |
| Clerk/Accountant | 1 | Record keeping and administrative support |
| Support staff / Attendant / Driver | 2–3 | Maintenance, cleanliness, ambulance driving |
💡 Some PHCs also have OT technician, X-ray technician, and midwives, depending on service expansion.
✔️ Treatment of minor ailments and chronic diseases
✔️ 6–10 bed inpatient facility
✔️ Emergency care for accidents, burns, bites
✔️ Antenatal, postnatal, and newborn care
✔️ Normal deliveries (24×7)
✔️ Referral of high-risk pregnancies
✔️ All vaccines as per National Immunization Schedule
✔️ IUCD insertion, OCPs, condoms
✔️ Sterilization referrals & camps
✔️ Implementation of:
✔️ Hemoglobin, malaria, urine, blood sugar, pregnancy test
✔️ Basic pathological investigations
✔️ Health awareness camps
✔️ Counseling on nutrition, hygiene, breastfeeding
✔️ Organizing school health checkups
✔️ Maintain registers: ANC, deliveries, family planning, immunization
✔️ Submit reports to Block/District level via HMIS portal
✔️ Conduct OPD & IPD care
✔️ Monitor labor room, assist deliveries
✔️ Support immunization & outreach
✔️ Administer emergency drugs
✔️ Supervise ANMs, ASHAs
✔️ Maintain case sheets & nursing records
✅ Q1. What is the population coverage norm for one PHC in plains?
🅰️ 30,000
✅ Q2. How many beds are usually available at a PHC?
🅰️ 6–10 beds
✅ Q3. Who is the administrative and clinical head of PHC?
🅰️ Medical Officer
✅ Q4. What major programs are implemented through PHCs?
🅰️ TB (NTEP), Leprosy, Malaria, UIP, NCDs
✅ Q5. What role does a staff nurse play at a PHC?
🅰️ Conducts OPD, deliveries, immunization, emergency care
🧠 Essential for NORCET, AIIMS, NHM, RRB, GPSC, ESIC & State Nursing Exams
A Community Health Centre (CHC) is a 30-bed secondary-level referral unit that provides specialist care, bridging between Primary Health Centres (PHCs) and District Hospitals.
📍 It serves as a referral centre for 4 PHCs.
| 🏘️ Area Type | 👥 Population Covered per CHC |
|---|---|
| Plains | 1.2 lakh |
| Hilly/Tribal | 80,000 |
| 👤 Designation | 🔢 No. of Staff | 🎯 Responsibility |
|---|---|---|
| Medical Specialists (Surgeon, Physician, OBG, Pediatrician) | 4 | Provide specialist outpatient/inpatient care |
| General Duty Medical Officer (MO) | 6 | OPD, emergencies, minor OT |
| Nursing Officer (Staff Nurse) | 7–10 | Ward care, emergency, maternity, OT support |
| Public Health Nurse (PHN) | 1 | MCH supervision, training, immunization |
| ANM | 1–2 | MCH, FP, immunization |
| Pharmacist | 1–2 | Dispensing, inventory management |
| Lab Technician | 1–2 | Diagnostic services |
| Radiographer / X-ray Tech | 1 | Imaging |
| OT Technician / Attendant | 1–2 | OT assistance |
| Clerk / Record Keeper | 1 | Admin & reporting |
| Ward Boys / Sweepers / Drivers | 4–5 | Support services & ambulance |
💡 CHCs may also include Dental Surgeon, AYUSH MO, and Physiotherapist based on service expansion.
✔️ OPD and inpatient treatment
✔️ Surgical, gynecological, pediatric, and medicine services
✔️ Minor surgeries and first aid for trauma
✔️ ANC, PNC, labor room delivery (normal/assisted)
✔️ Emergency obstetric care
✔️ Newborn care and stabilization unit (NBSU)
✔️ Counseling and provision of contraceptives
✔️ IUCD insertion
✔️ Tubectomy/vasectomy surgeries
✔️ Referral for permanent sterilization
✔️ Laboratory testing (blood, urine, sputum)
✔️ X-ray and imaging
✔️ Pregnancy testing and minor procedures
✔️ Malaria, TB, Leprosy, Diarrheal, NCD screening
✔️ Outbreak response
✔️ Vector-borne disease surveillance
✔️ Awareness about sanitation, nutrition, lifestyle diseases
✔️ Counseling on breastfeeding, hygiene, FP
✔️ School and community-based health programs
✔️ Upward referrals to District Hospitals
✔️ Downward supervision of PHCs
✔️ 24×7 emergency transport (ambulance)
✔️ Manage OPD, IPD, MCH services
✔️ Assist in deliveries & OT procedures
✔️ Provide immunization & maintain cold chain
✔️ Support national health programs (e.g., JSY, UIP, NTEP)
✔️ Maintain nursing records and coordinate referrals
✔️ Supervise ANMs and PHC nurses under their jurisdiction
✅ Q1. What is the population norm for a CHC in plains?
🅰️ 1.2 lakh
✅ Q2. How many specialist doctors are posted at CHC as per IPHS?
🅰️ 4 (Surgeon, Physician, Pediatrician, OBG)
✅ Q3. What is the total bed capacity of a CHC?
🅰️ 30 beds
✅ Q4. Which services are provided 24×7 at CHC?
🅰️ Emergency, deliveries, minor surgeries, referrals
✅ Q5. What is the full form of CHC?
🅰️ Community Health Centre
🧠 High-yield for NORCET, AIIMS, NHM, RRB, ESIC & State PSC Nursing Exams
A Sub-District Hospital is a secondary-level referral center, located in Taluka/Tehsil areas, serving as an upgrade from CHCs.
📌 Population Coverage (as per IPHS):
| 👤 Post | 🔢 No. | 🎯 Role |
|---|---|---|
| Specialist Doctors (OBG, Surgery, Medicine, Pediatrics, etc.) | 6–8 | Secondary-level treatment |
| General Duty Medical Officers (GDMOs) | 4–6 | Routine OPD, IPD, emergencies |
| Staff Nurses | 15–20 | IPD, OPD, ICU, Labour room |
| Pharmacist | 2 | Dispensing and inventory |
| Lab Technician, Radiographer, OT Tech | 2–3 each | Diagnostics & support |
| Public Health Nurse (PHN) | 1 | Health program coordination |
| Administrative Staff, Ward Boys, Sweepers | As required | Maintenance and support |
✔️ Outpatient and inpatient care
✔️ Emergency and first aid services
✔️ 24×7 maternity care & labor room
✔️ Minor surgeries
✔️ Diagnostic lab, imaging, pharmacy
✔️ Referral services to District Hospital
✔️ Implement National Health Programs
✔️ Record maintenance and HMIS reporting
A District Hospital is a tertiary care center and main hospital for the entire district, providing comprehensive specialty care.
📌 Population Norms:
| 👤 Post | 🔢 No. | 🎯 Role |
|---|---|---|
| Specialist Doctors (Surgery, Medicine, Ortho, ENT, Eye, Psychiatry, etc.) | 8–12 | Specialty clinical care |
| General Duty Medical Officers | 10–12 | General OPD, IPD, emergencies |
| Nursing Officers (Staff Nurses) | 30–50 | ICU, OT, MCH, Emergency, IPD |
| ANMs / Midwives | 5–8 | MCH, labor room, immunization |
| Pharmacists | 3–4 | Drug dispensing |
| Lab Techs, Radiographers | 3–5 | Imaging, diagnostics |
| OT Technician, ECG Tech | 2–3 | Surgical support |
| Public Health Nurse / PHN | 1–2 | Community program management |
| Admin Staff, Record Clerks | 10+ | Support functions |
| Drivers, Attendants, Sweepers | As required | Maintenance, ambulance, cleaning |
✔️ Comprehensive inpatient and outpatient care
✔️ Emergency and trauma care
✔️ ICU, SNCU (neonatal), OT, blood bank
✔️ Specialist clinics – ENT, Eye, Skin, Psych
✔️ Surgical, orthopaedic, gynecological procedures
✔️ Referral for super-specialty or teaching hospitals
✔️ Conduct medico-legal cases
✔️ Training for nurses, ANMs, paramedics
✔️ Implementation of NHM and state health schemes
✔️ Public health surveillance, disaster response
A Specialty Hospital focuses on care in one or more specific disciplines, such as cardiology, oncology, nephrology, psychiatry, etc.
📌 Examples:
| 👤 Post | 🔢 No. | 🎯 Role |
|---|---|---|
| Super Specialists (DM/MCh) | Varies | High-end procedures in focused specialties |
| Specialist Doctors (MD/MS) | Varies | Clinical management |
| General Duty MOs | Support | Pre/post-operative care, admissions |
| Highly trained Nursing Officers | 50+ | ICU, OT, dialysis, chemo, cardiac care |
| OT, ICU, Cath Lab Technicians | Specialized | Complex monitoring and support |
| Pharmacists, Diagnostic Techs | Adequate | Medication & test services |
| Psychologists, Counselors | Mental health centers | |
| Admin and Support Staff | Essential | Records, bio-medical waste, HR |
✔️ Advanced diagnosis & treatment in focused area
✔️ Surgeries, procedures, rehab, counseling
✔️ Critical care (e.g., cardiac ICU, dialysis units)
✔️ Chemotherapy, radiation, cardiac cath lab
✔️ Organ transplant support (in tertiary centers)
✔️ Follow-up & palliative care
✔️ Research & clinical trials
✔️ Specialized nursing training centers
✅ Patient care in IPD, OPD, ICU, and emergency
✅ Delivery assistance, surgical prep and post-op care
✅ Administering drugs, fluids, and injections
✅ Maintaining aseptic technique in wards and OTs
✅ Patient education and discharge counseling
✅ Record-keeping and handover documentation
✅ Supervision of junior staff and training interns
✅ Q1. What is the bed capacity of a standard district hospital?
🅰️ 100–500 beds (IPHS recommends minimum 100)
✅ Q2. Who supervises nursing in district hospitals?
🅰️ Chief Nursing Officer / Nursing Superintendent
✅ Q3. Which hospital level manages medico-legal cases?
🅰️ District Hospital
✅ Q4. Which unit is available in specialty maternity hospitals?
🅰️ Labour Room, SNCU, Operation Theatre
✅ Q5. What does SDH primarily serve as?
🅰️ Secondary care & referral from CHCs/PHCs
🧠 Must-know for NORCET, NHM, AIIMS, RRB, ESIC, GPSC & CHO Exams
🧠 Definition:
A Public-Private Partnership (PPP) is a collaborative agreement between the government (public sector) and private sector entities to provide healthcare services, infrastructure, or programs effectively and efficiently.
✅ Aim: Utilize public resources + private expertise
✅ Focus: Better healthcare delivery, innovation, and service reach
| 🔹 Feature | ✅ Explanation |
|---|---|
| 📑 Contract-based | Works under signed MoUs or agreements |
| 🏗️ Infrastructure support | Private helps build/maintain hospitals, labs |
| 🧪 Service delivery | Diagnostic, surgical, ambulance services |
| 👥 Human resource sharing | Private sector staff involved in public hospitals |
| 💸 Cost-sharing model | Shared investment, risk, and revenue |
| 🔹 Model | 🧠 Example |
|---|---|
| Build-Operate-Transfer (BOT) | Private builds hospital → runs → transfers to govt |
| Joint Venture | Government + private co-own diagnostic centres |
| Contracting-in | Private doctors in govt hospitals (specialist gaps) |
| Franchise Model | Govt licenses health services to private clinics |
| Voucher Scheme | Poor patients use govt-funded private services |
| Referral-based model | Govt refers cases to empaneled private hospitals (e.g., Ayushman Bharat) |
| 🏥 Service Area | 🚑 Example |
|---|---|
| 🚑 Ambulance Services | 108 Emergency Ambulance (GVK-EMRI) – Public funding, private operation |
| 🏥 Diagnostics | PPP-run CT scan/MRI labs inside govt hospitals |
| 👩⚕️ Maternal Health | Chiranjeevi Yojana (Gujarat) – Private OBGs conduct free deliveries |
| 🧪 Pathology Labs | PPP labs in DH/SDH for free TB, HIV, malaria tests |
| 🎓 Medical Education | PPP medical and nursing colleges in underserved areas |
| 💉 Immunization Support | Cold chain maintenance by private logistics firms |
✅ Coordinate with private staff for patient care
✅ Provide government-supplied medicines and monitor usage
✅ Record and report service data to authorities
✅ Refer patients from public to empaneled private hospitals
✅ Assist during mobile health camps and PPP OPDs
✅ Supervise quality and infection control in PPP units
✅ Faster infrastructure development
✅ Bridging gap in specialist care
✅ Innovation in diagnostics and emergency care
✅ Improved outreach in tribal, remote areas
✅ Better management of hospital operations
❌ Inequity if not properly monitored
❌ Quality variations between private partners
❌ Conflicts over cost, roles, and revenue
❌ Lack of clear accountability
❌ Limited data sharing and integration
✅ Q1. 108 ambulance service is an example of —
🅰️ Public-Private Partnership
✅ Q2. Chiranjeevi Scheme of Gujarat is associated with —
🅰️ Safe delivery through PPP model
✅ Q3. What is the main benefit of PPP in healthcare?
🅰️ Improved efficiency and reach of services
✅ Q4. Who operates diagnostic services in PPP diagnostic centers?
🅰️ Private partner under government regulation
✅ Q5. Voucher scheme in PPP helps —
🅰️ Poor patients access private services at no cost
🧠 Important for NORCET, NHM, AIIMS, GPSC, RRB, and ESIC Exams
🧠 Definition:
The Indigenous Systems of Medicine (ISM) are the traditional healthcare practices that originated and evolved within India over thousands of years, based on natural remedies, herbs, lifestyle, and holistic health principles.
| 🌿 System | 📘 Description |
|---|---|
| Ayurveda | Science of life, uses herbal drugs, diet, panchakarma, yoga; based on Tridosha theory (Vata, Pitta, Kapha) |
| Yoga & Naturopathy | Mind-body harmony through postures, breathing (Pranayama), diet, and detox; Naturopathy promotes self-healing through natural means |
| Unani | Greco-Arabic origin; balance of 4 humors (blood, phlegm, yellow and black bile); herbal formulations used |
| Siddha | Ancient Tamil system; emphasizes on 96 thathuvams (elements); uses metals, minerals, and herbs |
| Homeopathy | “Like cures like” principle; uses micro-doses of plant/mineral extracts to stimulate healing |
| Sowa-Rigpa | Tibetan medicine system; based on Buddhist philosophy and natural healing |
✅ All these are regulated under Ministry of AYUSH (Ayurveda, Yoga & Naturopathy, Unani, Siddha, Homeopathy)
| 🏛️ Body | 🎯 Role |
|---|---|
| Ministry of AYUSH | Apex ministry for policy & program implementation |
| CCIM / NCISM (for Ayurveda, Unani, Siddha) | Regulatory body for education & practice |
| CCH / NCH (for Homeopathy) | Curriculum & practitioner regulation |
| AYUSH Colleges & Dispensaries | Nationwide institutions for ISM education and practice |
| 💊 System | 🧰 Medicinal Forms & Therapies |
|---|---|
| Ayurveda | Kashayam (decoctions), Churna (powders), Basti (enema), Panchakarma |
| Unani | Joshanda (herbal tea), Ilaaj-bit-Tadbeer (regimental therapy) |
| Siddha | Thailam (oil), Parpam (powder), Tablet using herbs/metals |
| Homeopathy | Globules (sugar pills), liquid dilutions |
| Yoga & Naturopathy | Hydrotherapy, fasting, mud therapy, asanas, herbal diet |
✅ Holistic and preventive in approach
✅ Low-cost, accessible in rural areas
✅ Minimal side effects
✅ Strong community trust
✅ Complements modern medicine under Integrative Health Care
❌ Lack of scientific validation in some areas
❌ Standardization and dosage issues
❌ Inadequate integration with mainstream healthcare
❌ Limited global acceptance compared to allopathy
🔹 AYUSH Health & Wellness Centres (HWCs) under Ayushman Bharat
🔹 International Day of Yoga – celebrated every 21st June
🔹 Integration in Medical Tourism & Wellness Industry
🔹 AYUSH products included in Jan Aushadhi stores
🔹 AYUSH e-prescription portal for standard digital access
✅ Q1. AYUSH stands for —
🅰️ Ayurveda, Yoga, Unani, Siddha, Homeopathy
✅ Q2. Tridosha theory is the basis of which system?
🅰️ Ayurveda
✅ Q3. Who governs homeopathy education in India?
🅰️ National Commission for Homeopathy (NCH)
✅ Q4. Sowa-Rigpa is a traditional medicine system of —
🅰️ Tibetan origin
✅ Q5. The Ministry responsible for ISM in India is —
🅰️ Ministry of AYUSH
🧠 Important for NORCET, NHM, RRB, AIIMS, ESIC, GPSC & CHO Exams
🧠 Definition:
National Volunteer Health Agencies are non-governmental, non-profit organizations working in collaboration with the government and communities to improve public health, particularly in underserved and rural areas.
✅ These agencies support health services, conduct awareness campaigns, and provide volunteer-based healthcare delivery.
| 🩺 Function | ✅ Description |
|---|---|
| 📢 Health Education & Awareness | Conduct IEC/BCC campaigns on hygiene, nutrition, TB, HIV, sanitation |
| 💊 Health Service Delivery | Mobile clinics, camps, first aid, immunization support |
| 🤝 Support to Government Programs | Aid in implementation of RNTCP, NACP, Pulse Polio, JSY, etc. |
| 👨👩👧 Community Mobilization | Promote participation in health programs like VHNDs, NHM |
| 🎓 Training & Capacity Building | Train ASHAs, ANMs, youth, and local leaders in health skills |
| 💵 Resource Mobilization | Collect donations, organize fundraising, supply logistics |
| 🧾 Monitoring & Evaluation | Participate in local surveys, research, and feedback collection |
| 🏢 Agency Name | 🎯 Key Focus Areas |
|---|---|
| Indian Red Cross Society (IRCS) | Blood donation, disaster response, first aid training |
| Family Planning Association of India (FPAI) | Contraception, reproductive health, adolescent education |
| Voluntary Health Association of India (VHAI) | Public health advocacy, policy research, TB, NCDs |
| Tata Memorial Centre (NGO arm) | Cancer screening and awareness |
| SEWA Rural, Gujarat | Rural maternal and child health |
| Ramkrishna Mission Health Wing | Charitable hospitals, mobile units |
| Deepalaya / CRY / Smile Foundation | Child health, immunization, and malnutrition |
| The Leprosy Mission | Leprosy elimination and rehabilitation |
🔹 Support for NHM & RMNCH+A
🔹 Pulse Polio Immunization drives
🔹 TB case finding (RNTCP/NTEP)
🔹 Maternal-child health awareness campaigns
🔹 HIV/AIDS counseling (NACO program)
🔹 COVID-19 response & vaccination awareness
✅ Coordinate for outreach camps
✅ Collaborate during school health programs
✅ Refer patients to NGO-run specialty units
✅ Conduct health talks with NGO trainers
✅ Support data collection and reporting with agencies
✅ Q1. Which volunteer agency supports blood donation drives in India?
🅰️ Indian Red Cross Society
✅ Q2. FPAI focuses mainly on —
🅰️ Reproductive and adolescent health
✅ Q3. VHAI works in the area of —
🅰️ Public health education and policy advocacy
✅ Q4. Which NGO supports leprosy rehabilitation in India?
🅰️ The Leprosy Mission
✅ Q5. What is the main role of volunteer health agencies?
🅰️ Supplement government efforts in health education and service delivery