Assisting individuals andfamilies to promote and maintain their health
| Time | Assessment Focus |
|---|---|
| Immediately after birth (0–1 min) | APGAR score – to assess need for resuscitation |
| Within first hour | Vital signs, bonding, initiation of breastfeeding |
| Within 24 hours | Head-to-toe physical examination |
| Daily until discharge | Weight, temperature, feeding, cord care |
(At 1 minute and 5 minutes after birth)
| Parameter | Score 0 | Score 1 | Score 2 |
|---|---|---|---|
| A – Appearance (Color) | Blue/pale | Body pink, limbs blue | Completely pink |
| P – Pulse (Heart Rate) | Absent | <100 bpm | >100 bpm |
| G – Grimace (Reflex) | No response | Grimace | Cough/sneeze/cry |
| A – Activity (Muscle Tone) | Limp | Some flexion | Active motion |
| R – Respiration | Absent | Slow, irregular | Good, crying |
Score Interpretation:
| Parameter | Normal Range |
|---|---|
| Weight | 2.5 – 4 kg |
| Length | 45 – 55 cm |
| Head circumference | 33 – 35 cm |
| Chest circumference | 30 – 33 cm |
| Signs to Report Immediately |
|---|
| Poor cry or tone |
| Respiratory distress (grunting, retractions) |
| Jaundice within first 24 hours |
| Vomiting (projectile), abdominal distension |
| Seizures or abnormal movements |
| Not passing urine or stool within 24 hours |
| Hypothermia or fever |
| Bleeding from cord, nose, or mouth |
Assessment of the newborn is a crucial nursing responsibility that requires systematic observation, skill, and clinical judgment. A thorough evaluation helps to:
| Age | Assessment Schedule |
|---|---|
| Birth to 6 months | Monthly assessment |
| 6 to 12 months | Every 2–3 months or during illness/vaccination |
| As needed | During illness, follow-ups, or growth concerns |
| Parameter | Normal Range (Approximate) |
|---|---|
| Weight | 6 months: ~6.5 kg; 12 months: ~9–10 kg |
| Length | 6 months: ~65 cm; 12 months: ~75 cm |
| Head circumference | 6 months: ~42–44 cm; 12 months: ~45–47 cm |
| Chest circumference | Becomes equal to head circumference by 12 months |
| Mid-arm circumference | Used to assess nutritional status |
📌 Note: Plot all values on WHO growth charts to identify undernutrition or overweight.
| Parameter | Normal Range (Infants) |
|---|---|
| Temperature | 36.5°C – 37.5°C (axillary) |
| Respiratory Rate | 30–60 breaths per minute |
| Heart Rate | 100–160 bpm |
| Capillary Refill | Less than 2 seconds |
Use tools like Denver Developmental Screening Test (DDST) or Trivandrum Developmental Screening Chart (TDSC).
🗓️ Example Milestones:
Verify and document as per National Immunization Schedule (India):
| Age | Vaccines Given |
|---|---|
| At birth | BCG, OPV-0, Hep B-1 |
| 6 weeks | DPT-1, OPV-1, Hep B-2, Hib-1, IPV-1, Rotavirus-1 |
| 10 weeks | DPT-2, OPV-2, Hib-2, IPV-2, Rotavirus-2 |
| 14 weeks | DPT-3, OPV-3, Hib-3, IPV-3, Rotavirus-3, Hep B-3 |
| 9 months | Measles/MR, Vitamin A (1st dose) |
Check for missed or delayed doses and educate parents.
Use 24-hour dietary recall and M-UAC tape to assess nutritional status.
Assessment of an infant is a multi-dimensional process involving growth monitoring, developmental screening, physical examination, and parental interaction. Nurses and health professionals play a critical role in early identification of problems, counseling caregivers, and ensuring timely referrals.
A holistic approach combining child health, medical-surgical knowledge, and maternal care principles ensures better outcomes for both infants and families.
| Parameter | Normal Range (Approximate) |
|---|---|
| Weight | 10–14 kg (depends on age and growth curve) |
| Height/Length | 80–95 cm |
| Head circumference | 47–49 cm |
| Chest circumference | Nearly equal to or slightly more than head |
| Mid-arm circumference | >13.5 cm (used to assess malnutrition) |
📝 Note: Plot measurements on WHO growth charts to detect undernutrition or overweight.
| Vital Sign | Normal Range (Toddler) |
|---|---|
| Temperature | 36.5°C – 37.5°C (axillary) |
| Heart Rate | 90–130 beats/min |
| Respiratory Rate | 20–30 breaths/min |
| Blood Pressure | 90/60 to 100/64 mmHg (approximate) |
Assess based on the four domains:
| Age | Milestones |
|---|---|
| 12–18 months | Walks alone, drinks from cup, says 2–3 words |
| 18–24 months | Runs, climbs stairs, 10–20 words, points to body parts |
| 2–3 years | Jumps, feeds self, speaks 2–3 word sentences, toilet training begins |
Use tools like DDST (Denver Developmental Screening Test) for structured screening.
| Age | Vaccines Due |
|---|---|
| 16–24 months | DPT booster-1, OPV booster, MR-2, JE-1 (in endemic areas), Vitamin A 2nd dose |
| 2–3 years | Continue Vitamin A supplementation every 6 months until age 5 |
Check immunization card and counsel parents on any missed vaccines.
Assessment of a toddler is a holistic, multidisciplinary process that involves evaluating growth, development, nutrition, physical health, and the family environment. Integrating principles from child health, medical-surgical, and OBG nursing enables early identification of risk factors and developmental delays, and promotes preventive health care and parental education.
| Parameter | Normal Range (Approximate) |
|---|---|
| Weight | 14–18 kg (varies by age and sex) |
| Height | 95–110 cm |
| Head Circumference | 48–52 cm |
| BMI | Use BMI-for-age percentile chart |
📝 Plot all values on WHO growth charts or IAP standards to identify underweight, overweight, or stunting.
| Vital Sign | Normal Range (Preschool Child) |
|---|---|
| Temperature | 36.5°C – 37.5°C (axillary) |
| Heart Rate | 80–110 bpm |
| Respiratory Rate | 20–25 breaths per minute |
| Blood Pressure | ~95/65 mmHg (average) |
Assess the following domains using tools like DDST-II, ICDS checklists, or simple observation.
| Domain | Expected Milestones (3–6 years) |
|---|---|
| Gross Motor | Runs, climbs, jumps, hops on one foot, rides tricycle |
| Fine Motor | Draws shapes, uses scissors, builds tower, copies letters |
| Language | Speaks in sentences, asks questions, follows directions |
| Cognitive | Knows colors, numbers, can sort, simple problem-solving |
| Social | Plays with peers, understands rules, expresses emotions |
| Self-help | Brushes teeth, dresses with help, uses toilet independently |
| Age | Vaccines Recommended |
|---|---|
| 5–6 years | DPT booster-2, OPV booster, JE-2 (endemic areas) |
| Every 6 months till age 5 | Vitamin A supplementation |
Check immunization card and provide education on catch-up vaccination if needed.
Assessment of a preschool child is crucial to promote early development, detect problems, and prepare the child for school and social life. It combines knowledge from child development, medical observation, family health, and public health. A comprehensive approach ensures better outcomes for both the child and family through early intervention, guidance, and health promotion.
Obtain a detailed and confidential history from the adolescent and/or caregiver using the HEADSSS framework:
| Category | Focus Area |
|---|---|
| H – Home | Living conditions, parental relationship, family support |
| E – Education | School performance, attendance, bullying, goals |
| A – Activities | Hobbies, peer groups, screen time, physical activity |
| D – Drugs | Use of tobacco, alcohol, or other substances |
| S – Sexuality | Menstrual history, sexual activity, contraception |
| S – Safety | Risk-taking behaviors, injuries, abuse |
| S – Suicide/Depression | Mood, sleep, self-harm thoughts, anxiety |
| Parameter | Normal Range (Varies by Age & Sex) |
|---|---|
| Weight | Plot on WHO/IAP growth charts |
| Height | Rapid growth spurt during adolescence |
| BMI (kg/m²) | Use BMI-for-age percentile chart |
| Mid-arm circumference | Useful for nutritional screening |
Note: Assess growth patterns over time, not just a single measurement.
| Parameter | Normal Range (Approx.) |
|---|---|
| Temperature | 36.5°C – 37.5°C |
| Heart Rate | 60–100 bpm |
| Respiratory Rate | 12–20 breaths/min |
| Blood Pressure | Based on age, gender, height percentile charts |
| Stage | Features |
|---|---|
| Stage I | Prepubertal (no sexual development) |
| Stage II–IV | Progressive development of breasts/genitals, pubic hair |
| Stage V | Adult maturity |
Check for precocious puberty or delayed puberty.
Common Nutritional Issues:
🛠 Tools: PHQ-9 (depression screening), GAD-7 (anxiety), SDQ (Strengths and Difficulties Questionnaire)
Verify as per India’s Adolescent Immunization Schedule:
| Vaccine | Recommended Age |
|---|---|
| Tdap booster | 10–12 years |
| HPV vaccine (girls) | 9–14 years (2 doses) |
| JE vaccine (endemic areas) | As per local program |
| COVID-19 (as per MOHFW) | >12 years |
Refer immediately if you observe:
Assessment of adolescents is a holistic process that involves evaluating physical, emotional, sexual, behavioral, and social health. Nurses play a vital role in early detection, counseling, health education, and referral. This age group requires confidential, respectful, and non-judgmental care.
A thorough assessment can prevent long-term health issues and promote healthy transition into adulthood.
Gather the following information using a patient-centered, culturally sensitive approach:
| Parameter | Normal Range |
|---|---|
| Weight | Based on BMI |
| Height | Measured in cm or inches |
| BMI | 18.5–24.9 (Normal) |
| Waist Circumference | <90 cm (men), <80 cm (women) |
| MUAC | Assessed in nutritional screening |
Use BMI and waist-to-hip ratio to screen for metabolic syndrome or obesity.
| Vital Sign | Normal Range |
|---|---|
| Temperature | 36.5–37.5°C |
| Heart Rate | 60–100 bpm |
| Respiratory Rate | 12–20 breaths/min |
| Blood Pressure | <120/80 mmHg |
| SpO₂ | >95% (room air) |
| Pain Score | 0–10 (numeric pain rating scale) |
| Test | Purpose |
|---|---|
| CBC, ESR | Detect infection, anemia, inflammation |
| Blood Sugar, HbA1c | Screen for diabetes |
| Lipid Profile | Detect hyperlipidemia |
| Liver and Renal Function Tests | Assess organ function |
| Urinalysis | Detect UTI, proteinuria, diabetes |
| ECG | Cardiovascular screening |
| Pap smear / VIA | Cervical cancer screening in women |
| Pregnancy test / USG pelvis | For reproductive assessment in women |
| Chest X-ray | TB, pneumonia, lung conditions |
The assessment of an adult is a comprehensive, holistic process that evaluates physical health, psychosocial wellbeing, lifestyle, and reproductive status. Nurses play a key role in early identification, counseling, and health promotion. An integrated approach from child health, medical-surgical, and OBG nursing enhances the quality of care, disease prevention, and health education.
Ensure a respectful, empathetic, and slow-paced interaction, allowing for sensory or cognitive limitations.
| Parameter | Notes |
|---|---|
| Weight | Unintentional loss may indicate malnutrition |
| Height | Decreases with age due to bone changes |
| BMI | Ideal: 22–27 in elderly; <18.5 = undernutrition |
| Mid-arm circumference | Assesses muscle mass (sarcopenia risk) |
| Vital Sign | Notes |
|---|---|
| Temperature | May be lower than average; fever may be absent even in infection |
| Pulse | May be irregular due to arrhythmia |
| BP | Screen for hypertension and orthostatic hypotension |
| Respiratory Rate | Assess for dyspnea, COPD |
| Pain Score | Use numeric scale or facial expression scale for pain assessment |
Use standardized tools:
Look for:
| ADLs (Basic) | IADLs (Complex) |
|---|---|
| Bathing | Cooking |
| Dressing | Managing medications |
| Toileting | Handling finances |
| Feeding | Transportation and shopping |
| Transferring (mobility) | Using telephone or communication tools |
| Test | Purpose |
|---|---|
| CBC, ESR | Anemia, infection screening |
| RBS, HbA1c | Diabetes screening |
| Lipid profile | Cardiovascular risk |
| Renal function (Urea, Cr) | Kidney disease |
| LFT | Liver function, nutritional status |
| TSH | Hypo-/hyperthyroidism (common in elderly) |
| ECG | Arrhythmias, ischemia |
| Chest X-ray | TB, pneumonia, CHF |
| Pap smear / Mammogram (females) | Cancer screening |
| DEXA scan | Osteoporosis screening |
Assessment of the elderly requires a holistic, respectful, and multidisciplinary approach that addresses physical, cognitive, emotional, functional, and social health. Nurses play a key role in early identification of risks, chronic disease management, elder abuse prevention, and supporting independence and dignity in aging.
An integrated perspective from medical-surgical, child health (family dynamics), and OBG nursing (gender-sensitive care) ensures quality elder care.
| Visit | Recommended Time |
|---|---|
| 1st | Before 12 weeks |
| 2nd | Between 14–26 weeks |
| 3rd | Between 28–34 weeks |
| 4th | After 36 weeks |
📝 High-risk pregnancies may require more frequent visits.
📝 Use obstetric score format, e.g., G3P1L1A1
| Feature | Observation |
|---|---|
| General appearance | Anxious, pale, fatigued, alert |
| Height & Weight | Assess BMI, weight gain trend |
| Vital signs | Temp: 36.5–37.5°C, HR: 80–100 bpm, RR: 18–22, BP: <140/90 mmHg |
| Pallor | Check conjunctiva, tongue |
| Edema | Hands, legs, face (sudden = preeclampsia risk) |
| Jaundice/Cyanosis | Indicative of liver/cardiac issues |
| Breast examination | Enlargement, Montgomery tubercles, colostrum |
| Varicose veins | Legs and vulvar area |
| Spine and posture | Lordosis, back pain |
| Oral hygiene | Bleeding gums, dental issues |
Performed after 20 weeks of gestation
Ensure bladder is empty, and the mother lies supine with slight head elevation
| Maneuver | Purpose |
|---|---|
| Fundal grip | Identify the fetal part in the fundus |
| Lateral grip | Locate fetal back and limbs |
| Pelvic grip | Determine presenting part |
| Pawlik’s grip | Check for engagement of fetal head |
| Test | Purpose |
|---|---|
| Hemoglobin (Hb) | Screen for anemia |
| Blood group & Rh typing | Rh incompatibility risk |
| Blood sugar (FBS/PPBS) | Detect gestational diabetes |
| Urine routine (albumin, sugar) | Detect UTI or preeclampsia |
| VDRL, HIV, HBsAg | Screen for STIs |
| Thyroid Profile (TSH) | Assess thyroid disorders |
| Ultrasound (USG) | Dating, fetal growth, anomalies |
Provide counseling on iron, calcium, folic acid, protein-rich and green leafy foods.
| Supplement | Dose |
|---|---|
| Folic acid | 400 mcg/day (before and during early pregnancy) |
| Iron + Folic acid | 60 mg elemental iron + 500 mcg folic acid/day |
| Calcium | 500 mg twice daily (after 14 weeks) |
| TT Injections | 2 doses during pregnancy (TT or Td) |
⚠️ Such clients require closer follow-up and specialist referral.
Antenatal assessment is a vital part of maternal healthcare aimed at ensuring the health of both mother and fetus. It involves a detailed history, systemic examination, obstetric evaluation, lab investigations, and counseling. Integrated knowledge from child health (maternal bonding), medical-surgical (coexisting diseases), and OBG nursing (reproductive focus) enables nurses to provide comprehensive, preventive, and promotive care throughout pregnancy.
The postnatal period is considered from delivery to 6 weeks (42 days) after childbirth and includes:
| Parameter | Normal Findings / Concerns |
|---|---|
| Appearance | Alert, oriented, not excessively fatigued |
| Vital signs | T: 36.5–37.5°C, HR: 60–100 bpm, RR: 18–22, BP: <140/90 |
| Pallor | May indicate anemia or blood loss |
| Edema | Could suggest preeclampsia, DVT, or infection |
| Hydration & nutrition | Skin turgor, mucous membranes |
| Pain assessment | Abdomen, perineum, breast, surgical site if C-section |
| Criteria | Observation |
|---|---|
| Shape & size | Symmetrical, soft (engorgement = hard, painful) |
| Nipples | Inverted, cracked, sore (risk of feeding issues) |
| Areola | Look for redness, fissures |
| Milk secretion | Colostrum initially, followed by mature milk |
| Signs of mastitis | Redness, heat, tenderness, fever |
📝 Educate on correct latching, exclusive breastfeeding, and nipple care.
| Parameter | Normal Finding |
|---|---|
| Fundal height | Firm, midline; descends ~1 finger/day |
| Fundal position | Just below umbilicus (immediate postpartum) |
| Consistency | Firm; soft = uterine atony → risk of PPH |
| Involution | Uterus returns to pelvic cavity by 10 days |
🛠️ Use proper technique: Support lower uterus, palpate fundus gently.
| Type | Duration | Color / Nature |
|---|---|---|
| Lochia rubra | 1–3 days | Red, bloody |
| Lochia serosa | 4–10 days | Pinkish-brown, watery |
| Lochia alba | 10–21 days or more | White or yellowish |
⚠️ Foul smell, excessive flow, or clots → signs of infection or hemorrhage.
| Test | Purpose |
|---|---|
| Hemoglobin | Assess for postpartum anemia |
| Blood pressure monitoring | Rule out postpartum preeclampsia |
| Blood glucose (if GDM) | Postpartum glucose control |
| Urine test | Infection or proteinuria check |
| Wound site culture | If signs of infection (C-section, episiotomy) |
| Medication / Care | Notes |
|---|---|
| Iron and folic acid | Continue for 3 months postpartum |
| Calcium supplements | Especially if breastfeeding |
| Analgesics / antibiotics | As prescribed (especially after cesarean) |
| Family planning counseling | Lactational amenorrhea, condoms, IUCD etc. |
| Immunizations | TT booster, Rubella (if not given earlier) |
A postnatal assessment is a critical nursing responsibility that ensures the physical recovery, emotional wellbeing, and parenting readiness of the mother. It also ensures safe newborn care. An integrated approach using principles from OBG nursing (reproductive health), medical-surgical (systemic monitoring), and child health (mother-infant interaction) helps in delivering comprehensive, family-centered, and preventive postpartum care.
A widely accepted tool for adolescent assessment:
| Domain | Key Questions (confidential and respectful) |
|---|---|
| H – Home | Who lives at home? Relationship with family? |
| E – Education | School performance, interests, goals |
| A – Activities | Hobbies, social media use, physical activity |
| D – Drugs | Any use of tobacco, alcohol, or substances? |
| S – Sexuality | Menstrual history, sexual activity, contraception |
| S – Safety | Any abuse, bullying, unsafe travel |
| S – Suicide | Sadness, stress, sleep, body image issues |
Note: Create a safe, confidential, and non-judgmental space for the girl.
| Parameter | Normal Range/Notes |
|---|---|
| Weight | Compare with WHO/IAP growth charts |
| Height | Rapid growth occurs during puberty |
| BMI | Screen for obesity or undernutrition |
| Mid-arm circumference | For nutritional status |
📝 Plot values on adolescent growth charts and assess trends.
| Vital Sign | Normal Range |
|---|---|
| Temperature | 36.5–37.5°C |
| Heart Rate | 60–100 bpm |
| Respiratory Rate | 12–20/min |
| Blood Pressure | Based on age, height, and sex |
| SpO₂ | ≥ 95% |
🩸 Educate on menstrual hygiene practices, use of pads/cups, and infection prevention.
Refer to Adolescent Friendly Health Services (AFHS) if needed.
| Nutrient Deficiency | Signs & Symptoms |
|---|---|
| Iron (Anemia) | Pallor, fatigue, shortness of breath, headache |
| Calcium/Vitamin D | Bone pain, poor posture, delayed growth |
| Protein-energy malnutrition | Wasting, weakness, stunting |
Use:
Promote:
Assess for:
Encourage:
Provide age-appropriate information on:
🩺 Refer to RKSK (Rashtriya Kishor Swasthya Karyakram) guidelines
| Vaccine | Age/Group |
|---|---|
| Td/Tdap | 10 and 16 years |
| HPV (optional) | Girls 9–14 years (2 doses) |
| Rubella | As per national guidelines |
| COVID-19 | ≥12 years (as per current program) |
Assessment of an adolescent girl must be holistic, respectful, and empowering. It goes beyond physical health to include reproductive, emotional, nutritional, and social aspects. Integrating knowledge from child health (family and emotional support), medical-surgical (anemia, growth issues), and OBG nursing (menstrual and reproductive health) allows nurses and healthcare providers to deliver safe, adolescent-friendly, and gender-sensitive care.
Growth refers to quantitative changes—like increase in height, weight, and head circumference.
| Parameter | Tools Used | Notes |
|---|---|---|
| Weight | Infant/baby weighing scale | Plot on WHO/IAP growth charts |
| Height/Length | Infantometer / stadiometer | <2 yrs: length, >2 yrs: height |
| Head circumference | Non-stretchable measuring tape | Important up to 2 years |
| Mid-Upper Arm Circumference (MUAC) | MUAC tape | 6 months to 5 years—malnutrition indicator |
📊 Always plot values on growth charts for trend analysis and early detection of faltering.
Development refers to qualitative progress in a child’s skills and functions across four main domains:
| Domain | Examples |
|---|---|
| Gross motor | Sitting, standing, walking |
| Fine motor | Holding objects, drawing, pincer grasp |
| Language | Babbling, speaking, following commands |
| Social/personal | Smiling, interaction, self-care |
| Age | Gross Motor | Fine Motor | Language | Social/Personal |
|---|---|---|---|---|
| 1 month | Head lag | Grasps reflexively | Cries | Regards face |
| 3 months | Partial head control | Holds rattle briefly | Coos, turns to sound | Social smile |
| 6 months | Sits with support | Transfers objects | Babbles, laughs | Recognizes mother |
| 9 months | Crawls, stands with support | Pincer grasp begins | Mama, dada | Stranger anxiety |
| 12 months | Walks with support | Neat pincer grasp | Says 1–2 words | Waves bye-bye, claps hands |
| Age | Gross Motor | Fine Motor | Language | Social/Personal |
|---|---|---|---|---|
| 15 months | Walks alone | Builds 2-block tower | Says a few words | Imitates actions |
| 18 months | Climbs stairs with help | Scribbles | 10–20 words | Uses spoon, shows emotions |
| 2 years | Runs, jumps | Builds 4–6 block tower | 2–3 word sentences | Begins toilet training |
| 3 years | Rides tricycle | Copies circle | Asks questions | Plays with peers |
| Age | Gross Motor | Fine Motor | Language | Social/Personal |
|---|---|---|---|---|
| 4 years | Hops on one foot | Draws a person | Tells stories, full sentences | Dresses self, cooperative play |
| 5 years | Skips, balances | Prints letters | Understands rules | Shows independence |
Monitoring a child’s growth and development is essential to ensure they are on the right path to healthy physical and mental maturity. Early identification of growth faltering or developmental delay leads to timely intervention and better long-term outcomes. Nurses play a crucial role in tracking progress, educating families, and ensuring holistic child development.
Growth refers to quantitative changes—like increase in height, weight, and head circumference.
| Parameter | Tools Used | Notes |
|---|---|---|
| Weight | Infant/baby weighing scale | Plot on WHO/IAP growth charts |
| Height/Length | Infantometer / stadiometer | <2 yrs: length, >2 yrs: height |
| Head circumference | Non-stretchable measuring tape | Important up to 2 years |
| Mid-Upper Arm Circumference (MUAC) | MUAC tape | 6 months to 5 years—malnutrition indicator |
📊 Always plot values on growth charts for trend analysis and early detection of faltering.
Development refers to qualitative progress in a child’s skills and functions across four main domains:
| Domain | Examples |
|---|---|
| Gross motor | Sitting, standing, walking |
| Fine motor | Holding objects, drawing, pincer grasp |
| Language | Babbling, speaking, following commands |
| Social/personal | Smiling, interaction, self-care |
| Age | Gross Motor | Fine Motor | Language | Social/Personal |
|---|---|---|---|---|
| 1 month | Head lag | Grasps reflexively | Cries | Regards face |
| 3 months | Partial head control | Holds rattle briefly | Coos, turns to sound | Social smile |
| 6 months | Sits with support | Transfers objects | Babbles, laughs | Recognizes mother |
| 9 months | Crawls, stands with support | Pincer grasp begins | Mama, dada | Stranger anxiety |
| 12 months | Walks with support | Neat pincer grasp | Says 1–2 words | Waves bye-bye, claps hands |
| Age | Gross Motor | Fine Motor | Language | Social/Personal |
|---|---|---|---|---|
| 15 months | Walks alone | Builds 2-block tower | Says a few words | Imitates actions |
| 18 months | Climbs stairs with help | Scribbles | 10–20 words | Uses spoon, shows emotions |
| 2 years | Runs, jumps | Builds 4–6 block tower | 2–3 word sentences | Begins toilet training |
| 3 years | Rides tricycle | Copies circle | Asks questions | Plays with peers |
| Age | Gross Motor | Fine Motor | Language | Social/Personal |
|---|---|---|---|---|
| 4 years | Hops on one foot | Draws a person | Tells stories, full sentences | Dresses self, cooperative play |
| 5 years | Skips, balances | Prints letters | Understands rules | Shows independence |
Monitoring a child’s growth and development is essential to ensure they are on the right path to healthy physical and mental maturity. Early identification of growth faltering or developmental delay leads to timely intervention and better long-term outcomes. Nurses play a crucial role in tracking progress, educating families, and ensuring holistic child development.
Social development is the process through which a child learns to interact with others, build relationships, understand social norms, and express emotions appropriately in a given environment.
It includes the development of empathy, cooperation, communication, and self-regulation, and lays the foundation for personality and behavior throughout life.
| Age Group | Social Developmental Milestones |
|---|---|
| 0–6 months | Smiles responsively, recognizes mother’s voice, calms when comforted |
| 6–12 months | Stranger anxiety, enjoys peek-a-boo, imitates facial expressions |
| 1–2 years | Shows separation anxiety, imitates adults, begins parallel play |
| 2–3 years | Plays alongside peers (parallel play), shows defiance, copies actions |
| 3–4 years | Begins cooperative play, shares toys, shows empathy, understands rules |
| 4–5 years | Seeks friendships, takes turns, follows simple group instructions |
| 6+ years | Forms close friendships, understands fairness, teamwork, peer influence |
| Factor | Influence on Social Development |
|---|---|
| Family environment | First source of bonding, love, and emotional support |
| Parenting style | Authoritative parenting promotes positive social skills |
| Peers and siblings | Learning sharing, competition, friendship |
| Schooling | Structured group interaction, discipline, cooperation |
| Culture and media | Shapes beliefs, gender roles, behavior norms |
| Nutrition & health | Malnutrition or chronic illness can delay development |
| Emotional safety | Exposure to abuse, neglect, or trauma affects interaction |
| Type of Play | Social Impact |
|---|---|
| Solitary Play (Infants) | Explores environment, basic learning |
| Parallel Play (Toddlers) | Observes and mimics others, basic interaction |
| Associative Play (Preschoolers) | Shares materials, some cooperation |
| Cooperative Play (4+ years) | Team games, role play, develops leadership and empathy |
🛑 Refer early to child psychologist, developmental pediatrician, or special educator.
Social development is a core aspect of a child’s holistic growth, shaping their ability to connect, empathize, and adapt in society. Nurses, educators, and parents play a key role in nurturing healthy relationships, emotional maturity, and social skills from infancy through adolescence.
Body temperature is the measure of the body’s ability to generate and get rid of heat, reflecting metabolic activity and homeostasis.
| Site | Normal Range | Notes |
|---|---|---|
| Oral | 36.5°C – 37.5°C | Common, convenient |
| Axillary | 36.0°C – 37.0°C | Lower than oral; used for infants |
| Rectal | 37.0°C – 38.0°C | 0.5°C higher than oral; accurate |
| Tympanic | 36.5°C – 37.5°C | Ear temperature |
| Temporal | 36.5°C – 37.5°C | Forehead scanner |
| Method | Instrument Used |
|---|---|
| Digital Thermometer | Oral, axillary, rectal readings |
| Mercury Thermometer | Phased out in many settings |
| Infrared Thermometer | Forehead/ear – contactless |
| Temperature (°C) | Interpretation |
|---|---|
| <35.0°C | Hypothermia |
| 36.5°C–37.5°C | Normal |
| 37.6°C–38.3°C | Low-grade fever |
| 38.4°C–39.9°C | Moderate fever |
| ≥40°C | High fever (Hyperpyrexia) |
Blood pressure is the force exerted by circulating blood on the walls of arteries. It reflects cardiac output, vascular resistance, and overall circulatory health.
| BP Category | Systolic (mmHg) | Diastolic (mmHg) |
|---|---|---|
| Normal | <120 | <80 |
| Elevated | 120–129 | <80 |
| Stage 1 Hypertension | 130–139 | 80–89 |
| Stage 2 Hypertension | ≥140 | ≥90 |
| Hypotension | <90 | <60 |
| Instrument Type | Description |
|---|---|
| Mercury Sphygmomanometer | Traditional, accurate, being phased out |
| Aneroid Sphygmomanometer | Manual, with dial gauge |
| Digital BP Monitor | Electronic, automatic, easy to use |
Temperature and blood pressure monitoring are vital signs that help detect illness early, guide clinical decisions, and ensure safe nursing care. Nurses must use proper techniques, interpret values accurately, and respond promptly to abnormal findings.
The menstrual cycle is a monthly sequence of hormonal and physiological changes in a woman’s body that prepares the uterus for a potential pregnancy. If pregnancy doesn’t occur, the uterus sheds its lining, resulting in menstrual bleeding.
Average cycle length: 28 days (can range from 21 to 35 days in adults)
Menstruation duration: 3–7 days
The menstrual cycle has 4 key phases, regulated mainly by estrogen, progesterone, FSH, and LH.
| Hormone | Function |
|---|---|
| FSH | Stimulates follicle growth in ovary |
| LH | Triggers ovulation |
| Estrogen | Builds up endometrial lining, regulates FSH and LH |
| Progesterone | Maintains uterine lining for pregnancy |
| Feature | Normal | Abnormal (Needs Evaluation) |
|---|---|---|
| Cycle length | 21–35 days | <21 or >35 days |
| Duration of bleeding | 3–7 days | >7 days or <2 days |
| Blood loss | ~30–80 ml | Very heavy flow or passage of clots |
| Pain | Mild to moderate cramps | Severe pain affecting daily activity |
| Regularity | Fairly regular | Irregular or skipped periods |
🩺 May indicate PCOS, thyroid disorders, stress, or reproductive conditions. Needs medical evaluation if persistent.
The menstrual cycle is a natural and vital part of female reproductive health. Nurses play a key role in assessing, educating, and supporting girls and women in understanding and managing their menstrual health.
| Menstruating Women | 5–7 days after period starts (monthly) | | Postmenopausal Women | Same date each month (e.g., 1st or 15th) | | Pregnant/Lactating Women| Monthly, with technique adjusted for changes |
BSE and TSE are simple, cost-free, and life-saving self-screening techniques that promote early detection of cancer and body awareness. Nurses have a key role in empowering individuals through education, building confidence, and reducing cancer-related stigma and delay in diagnosis.
| Warning Signs |
|---|
| Persistent cough (>2 weeks) |
| Shortness of breath / wheezing |
| Chest pain, especially on breathing |
| High fever with chills |
| Coughing up blood (hemoptysis) |
| Cyanosis (bluish lips or nails) |
| Noisy or rapid breathing in children |
| Warning Signs |
|---|
| Chest pain (tightness, pressure, radiating to arm/jaw) |
| Shortness of breath (especially on exertion or lying) |
| Irregular heartbeat or palpitations |
| Sudden dizziness or fainting |
| Swelling in legs, ankles, or abdomen |
| Persistent fatigue or weakness |
| High or fluctuating blood pressure |
| Warning Signs |
|---|
| Sudden weakness or numbness on one side of the body |
| Slurred speech or inability to speak |
| Sudden confusion or altered consciousness |
| Severe or persistent headache |
| Seizures or convulsions |
| Loss of coordination or balance |
| High fever with neck stiffness (meningitis sign) |
| Warning Signs |
|---|
| Persistent abdominal pain or bloating |
| Nausea, vomiting (especially if blood is present) |
| Jaundice (yellowing of eyes or skin) |
| Loss of appetite and significant weight loss |
| Bloody or black stools |
| Pain in lower right abdomen (appendicitis) |
| Warning Signs |
|---|
| Excessive thirst and urination (polyuria, polydipsia) |
| Increased hunger with weight loss |
| Fatigue and irritability |
| Delayed wound healing |
| Frequent infections (UTIs, skin) |
| Blurred vision |
| Tingling or numbness in feet |
Use the CAUTION acronym:
| Letter | Stands for |
|---|---|
| C | Change in bowel or bladder habits |
| A | A sore that doesn’t heal |
| U | Unusual bleeding or discharge |
| T | Thickening or lump in breast/testicles/elsewhere |
| I | Indigestion or difficulty swallowing |
| O | Obvious change in wart or mole |
| N | Nagging cough or hoarseness |
| General Danger Signs in Children (WHO/IMNCI) |
|---|
| Not feeding well |
| Lethargic or unconscious |
| Convulsions |
| Fast or difficult breathing |
| High-grade fever |
| Severe dehydration (sunken eyes, no tears, dry mouth) |
| Vomiting everything |
| Warning Signs |
|---|
| Persistent sadness or withdrawal |
| Mood swings, irritability |
| Sleep disturbance (too much or too little) |
| Loss of interest in activities |
| Thoughts of self-harm or suicide |
| Difficulty concentrating |
| Delusions or hallucinations (in psychosis) |
| Menstrual irregularities, heavy bleeding | | Pelvic pain, abnormal vaginal discharge | | Breast lumps, nipple discharge | | Pain during intercourse or urination |
| Testicular lumps or swelling | | Erectile dysfunction or painful ejaculation | | Blood in semen or urine |
| Warning Signs of Tuberculosis |
|---|
| Persistent cough >2 weeks |
| Weight loss, fever, night sweats |
| Coughing up blood |
| Warning Signs of HIV/AIDS | | Unexplained weight loss | | Recurrent infections | | Oral thrush, chronic diarrhea, night sweats |
| Warning Signs of COVID-19 | | Fever, cough, sore throat, breathlessness | | Loss of smell/taste | | Sudden drop in oxygen saturation |
Recognizing warning signs of various diseases enables early detection, prompt intervention, and better outcomes. Nurses, students, and community health workers play a vital role in screening, education, and referral—especially in primary and preventive care.
| Test Type | Normal Range |
|---|---|
| Fasting (FBS) | 70 – 100 mg/dL |
| Postprandial (PPBS) | <140 mg/dL after 2 hours of meals |
| Random Blood Sugar (RBS) | <200 mg/dL |
| HbA1c (3-month avg.) | <5.7% (normal), ≥6.5% (diabetes) |
| Group | Normal Hb Range |
|---|---|
| Men | 13 – 17 g/dL |
| Women | 12 – 15 g/dL |
| Pregnant Women | ≥11 g/dL |
| Children | 11 – 14 g/dL |
These simple, cost-effective screening tests are crucial for early detection, prevention, and management of common conditions like diabetes, kidney disease, pregnancy complications, and anemia. Nurses play a vital role in test administration, patient education, and prompt referrals.
| S.No | Procedure Step | Yes | No | Remarks |
|---|---|---|---|---|
| A. GENERAL PREPARATION | ||||
| 1 | Verified doctor’s order / screening schedule | |||
| 2 | Explained procedure to the patient (verbal consent) | |||
| 3 | Performed hand hygiene | |||
| 4 | Assembled required articles |
| Steps | Yes | No | Remarks |
|---|---|---|---|
| 5 | Provided labeled, clean, dry container to patient | ||
| 6 | Instructed on collecting midstream urine sample | ||
| 7 | Used dipstick or Benedict’s/heat test method | ||
| 8 | Compared results with color chart / observation | ||
| 9 | Disposed urine sample safely (as per protocol) | ||
| 10 | Documented result and informed supervisor/doctor |
| Steps | Yes | No | Remarks |
|---|---|---|---|
| 11 | Assembled glucometer, lancet, and test strips | ||
| 12 | Ensured patient was fasting (for FBS) or post-meal (PPBS) | ||
| 13 | Cleaned finger with spirit swab and let dry | ||
| 14 | Performed finger prick with sterile lancet | ||
| 15 | Collected first drop on test strip, inserted into glucometer | ||
| 16 | Recorded reading and observed patient for any symptoms | ||
| 17 | Applied cotton to prick site and ensured patient comfort | ||
| 18 | Documented reading (FBS/PPBS/RBS) |
| Steps | Yes | No | Remarks |
|---|---|---|---|
| 19 | Assembled equipment: Sahli’s apparatus / Hb scale | ||
| 20 | Cleaned finger (capillary) or prepared for venipuncture | ||
| 21 | Collected blood sample properly (as per method used) | ||
| 22 | Mixed with N/10 HCl (if Sahli’s method) and waited | ||
| 23 | Matched color with standard or read machine value | ||
| 24 | Disposed used materials safely | ||
| 25 | Documented Hb value and reported low levels if any |
| Steps | Yes | No | Remarks |
|---|---|---|---|
| 26 | Cleaned and disinfected equipment | ||
| 27 | Removed gloves and performed hand hygiene | ||
| 28 | Reassured and educated the patient on findings | ||
| 29 | Recorded date, time, and findings in the nursing record |
A routine health check-up is a regular, scheduled examination of individuals (children, adolescents, adults, elderly, or pregnant women) to maintain health, detect diseases early, and promote healthy living under primary health care settings.
Routine check-ups are preventive, not problem-based.
| Component | Details |
|---|---|
| History Taking | Present complaints, family history, past illnesses |
| General Physical Exam | Weight, height, pulse, BP, temperature, respiration, pallor, edema |
| Anthropometry | BMI, MUAC, head/chest circumference (in children) |
| Vital Signs Monitoring | Blood pressure, temperature, pulse, SpO₂ |
| Systemic Examination | Cardiovascular, respiratory, GI, neurological, etc. |
| Nutritional Assessment | Dietary habits, anemia signs, under/overweight |
| Developmental Screening | Especially in infants and children (milestones, growth) |
| Vision and Hearing Check | For school children, elderly, and general public |
| Mental Health Screening | Mood, behavior, anxiety, depression (especially in adolescents and elderly) |
| Reproductive Health Assessment | Menstrual issues, STIs, contraception, pregnancy status |
| Test | Purpose |
|---|---|
| Urine sugar and albumin | Screen for diabetes, kidney issues |
| Blood sugar (RBS/FBS) | Detect prediabetes or diabetes |
| Hemoglobin (Hb) | Detect anemia |
| Rapid malaria/dengue test | If symptomatic or endemic area |
| Pregnancy test | For women of reproductive age |
| Group | Recommended Frequency |
|---|---|
| Children | Monthly (0–1 year), every 3–6 months after |
| Adolescents | Annually or during school health days |
| Pregnant Women | 4 minimum antenatal check-ups |
| Adults (18–45) | Once every 1–2 years |
| Elderly (45+) | Annually or bi-annually |
Routine check-ups under primary health care are essential to ensure early detection, health maintenance, and preventive care. Nurses play a central role in conducting these check-ups, educating the community, and reducing the burden of preventable diseases.
Immunization is a preventive health measure that involves administering vaccines to individuals to protect against vaccine-preventable diseases (VPDs). It is a cornerstone of Primary Health Care (PHC), aiming to reduce morbidity and mortality, particularly among infants, children, and pregnant women.
Launched in 1985, the Universal Immunization Programme (UIP) is one of the largest public health initiatives globally, providing free vaccines against several life-threatening diseases. The UIP has undergone continuous updates to include new vaccines and improve coverage.
The National Immunization Schedule (NIS) outlines the recommended timing and dosage of vaccines for different age groups. Below is the updated schedule as of March 2025:
| Age | Vaccines |
|---|---|
| At Birth | – BCG (Bacillus Calmette-Guerin) |
| – Hepatitis B-1 | |
| – OPV-0 (Oral Polio Vaccine) | |
| 6 Weeks | – Pentavalent-1 (DPT-Hep B-Hib) |
| – OPV-1 | |
| – fIPV-1 (Fractional Inactivated Polio Vaccine) | |
| – Rotavirus-1 | |
| – PCV-1 (Pneumococcal Conjugate Vaccine) | |
| 10 Weeks | – Pentavalent-2 |
| – OPV-2 | |
| – Rotavirus-2 | |
| – PCV-2 | |
| 14 Weeks | – Pentavalent-3 |
| – OPV-3 | |
| – fIPV-2 | |
| – Rotavirus-3 | |
| – PCV-Booster | |
| 9-12 Months | – MR-1 (Measles-Rubella) |
| – JE-1 (Japanese Encephalitis, in endemic areas) | |
| – Vitamin A-1 | |
| 16-24 Months | – MR-2 |
| – DPT Booster-1 | |
| – OPV Booster | |
| – JE-2 (in endemic areas) | |
| – Vitamin A-2 | |
| 5-6 Years | – DPT Booster-2 |
| 10 Years | – Tdap/Td (Tetanus and adult diphtheria) |
| 16 Years | – Tdap/Td |
| Timing | Vaccine |
|---|---|
| Early Pregnancy | – Td-1 (Tetanus and adult diphtheria) |
| 4 Weeks Later | – Td-2 |
| If previously vaccinated within 3 years | – Td Booster |
Note: The schedule may vary based on regional health policies and the introduction of new vaccines.
Maintaining the potency of vaccines is crucial. The cold chain ensures that vaccines are stored and transported within the recommended temperature range (2°C to 8°C). Equipment used includes:
Nurses are integral to the success of immunization programs. Their responsibilities include:
Immunization services under India’s Primary Health Care system have evolved to include a comprehensive range of vaccines aimed at preventing life-threatening diseases. Continuous updates and the introduction of new vaccines reflect the commitment to public health and disease prevention. Nurses and healthcare workers play a pivotal role in
Primary Health Care (PHC) is not limited to treating illness—it emphasizes holistic, person-centered care, including early diagnosis and supportive counseling. These components enable early intervention, better compliance, and health promotion.
Counseling is a confidential, supportive, and interactive process that helps individuals understand their health conditions, make informed decisions, and adopt healthy behaviors.
| Health Area | Counseling Focus |
|---|---|
| Maternal Health | Antenatal/postnatal care, nutrition, birth planning, breastfeeding |
| Child Health | Immunization, nutrition, hygiene, growth monitoring |
| Adolescent Health | Menstrual hygiene, substance abuse, sexual & mental health |
| Family Planning | Contraceptive choices, spacing, permanent methods |
| Chronic Diseases | Diabetes, hypertension, compliance with treatment |
| Mental Health | Stress, anxiety, depression, suicide prevention |
| HIV/TB Services | Pre-test & post-test counseling, adherence, stigma reduction |
| Substance Use | Harm reduction, motivation, rehabilitation referrals |
Diagnosis is the process of identifying a disease or condition based on signs, symptoms, history, and diagnostic tests.
| Type | Description |
|---|---|
| Clinical Diagnosis | Based on symptoms, history, and physical exam |
| Provisional/Working Diagnosis | Temporary diagnosis made before confirmatory tests |
| Laboratory Diagnosis | Based on test results (e.g., urine, blood, sputum, stool) |
| Screening Diagnosis | Identifying risk groups in apparently healthy individuals |
| Test/Service | Used to Detect |
|---|---|
| Hemoglobin Estimation | Anemia |
| Urine Test (sugar, albumin) | Diabetes, kidney disorders |
| Blood Sugar (FBS, RBS) | Diabetes mellitus |
| BP Monitoring | Hypertension |
| Pregnancy Test | Early pregnancy detection (UPT) |
| Malaria/Dengue Test | Acute febrile illnesses |
| Sputum Test | Tuberculosis diagnosis (CBNAAT or smear) |
| Rapid Diagnostic Kits (RDKs) | For HIV, Hep B, COVID-19, etc. |
| Anthropometry | Nutritional status in children |
Advanced diagnostic support may be referred to CHC/District Hospital if not available at PHC.
Counseling and diagnosis go hand in hand.
Example:
Counseling and diagnosis are integral to the provision of quality primary health care, enabling early detection, timely management, and empowered decision-making. Nurses and frontline health workers play a crucial role in bridging medical care with emotional and behavioral support, ensuring holistic health for individuals and families.
| Disease | Home Management |
|---|---|
| Fever | – Tepid sponging, paracetamol, rest, fluids – Watch for warning signs (rash, high fever, drowsiness) |
| Diarrhea | – Give ORS after every loose stool – Continue breastfeeding/feeding – Maintain hygiene |
| Cough & Cold | – Steam inhalation – Warm fluids, honey (if child >1 yr) – Avoid self-medication |
| Minor Wounds | – Clean with clean water & antiseptic – Cover with sterile dressing – Watch for signs of infection |
| Worm Infestation | – Deworming with albendazole every 6 months – Personal hygiene, wash vegetables well |
| Minor Burns | – Cool the burn with water – Do not apply oil/paste – Use clean dressing |
| Anemia | – Iron-rich diet (green leafy vegetables, jaggery, dates) – Oral iron & folic acid tablets |
| Skin Infections/Scabies | – Keep area clean – Use prescribed ointments or permethrin – Treat all family members |
| Constipation in children | – High-fiber diet, fluids – Encourage active play – Avoid unnecessary enemas |
| Disease/Condition | Health Centre-Level Management |
|---|---|
| Malaria | – Test with Rapid Diagnostic Kit (RDK) – Treat with ACT as per guidelines |
| Tuberculosis (TB) | – Collect sputum sample – Refer for GeneXpert test – Initiate DOTS therapy |
| Diabetes | – Check random blood sugar – Lifestyle counseling – Start oral hypoglycemics as per protocol |
| Hypertension | – BP measurement – Salt restriction counseling – Initiate medication and follow-up |
| Pregnancy-Related Illnesses | – Check Hb, BP, urine protein – Manage anemia, pre-eclampsia – Refer high-risk cases |
| Pneumonia in Children | – Identify fast breathing (IMNCI) – Start oral antibiotics (amoxicillin) – Refer severe cases |
| Dysentery/Bloody Diarrhea | – Give ORS + zinc – Start antibiotics if needed – Refer if dehydrated |
| UTI | – Check urine albumin/sugar – Start antibiotics if confirmed – Encourage fluids |
| Scabies or Fungal Infections | – Prescribe topical antifungals/antiparasitics – Educate on hygiene, clothing wash |
| Conjunctivitis | – Eye drops (antibiotic) – Hygiene instruction – Avoid eye rubbing & sharing towels |
Used in PHCs and home visits for children under 5 years.
Refer if:
| At Home Visit / SC / PHC |
|---|
| Assess symptoms and identify severity |
| Provide basic treatment and medications as per protocol |
| Educate on nutrition, hygiene, hydration, medication adherence |
| Maintain patient record, report notifiable diseases |
| Counsel for preventive practices and follow-up |
| Ensure timely referral and transportation if needed |
Management of common diseases at home and PHC level helps in early treatment, reduces complications, and prevents unnecessary hospital admissions. Nurses and health workers play a vital role in first-contact care, health education, and timely referrals, thus strengthening the foundation of primary health care.
Standing Orders are pre-approved clinical protocols that authorize non-physician healthcare providers (such as nurses, ANMs, CHOs) to:
These protocols are issued by the MoHFW under the National Health Mission (NHM) to ensure timely, uniform, and evidence-based care at Sub-centres, Health and Wellness Centres (HWCs), and PHCs.
| Condition | Permitted Actions by ANM/CHO |
|---|---|
| Fever (malaria/dengue) | Perform RDK test, give antipyretics, refer if severe |
| Diarrhea | Start ORS + Zinc, educate caregiver |
| Acute Respiratory Infections | Start amoxicillin (in children if signs of pneumonia), refer if severe |
| Anemia | Check Hb, provide IFA tablets, counsel on iron-rich diet |
| Hypertension | Check BP, initiate amlodipine (5 mg), monitor and refer if >160/100 |
| Diabetes | Check RBS, give metformin 500 mg (if >140 mg/dL), refer uncontrolled |
| Worm Infestation | Deworming with albendazole as per age group |
| Scabies/Fungal infections | Prescribe permethrin cream or clotrimazole lotion |
| Minor wounds | Clean, dress, give tetanus toxoid if needed |
| UTI | Treat with cotrimoxazole, refer complicated cases |
| Antenatal Care | Check BP, weight, urine albumin, administer IFA, calcium, Td |
| Postnatal Care | Monitor bleeding, fever, signs of infection, counsel for breastfeeding |
| Family Planning | Provide OCPs, condoms, injectable contraception (as trained) |
| Mental Health | Screen with PHQ-9 or GAD-7, refer if suicidal or severe symptoms |
Every standing order includes:
✅ Provides legal and professional safety to health workers
✅ Reduces delay in initial treatment and referral
✅ Standardizes care in remote and underserved areas
✅ Empowers nurses/ANMs to act independently
✅ Improves community trust and access to care
Standing Orders approved by the MoHFW form a critical bridge between diagnosis and immediate treatment in primary health care settings. They enable trained nurses and health workers to deliver safe, effective, and timely interventions, especially where doctors may not be immediately available. By adhering to these protocols, frontline workers strengthen health systems and save lives.
To ensure safe, rational, and effective delivery of medications and injections to patients at Sub-centres, PHCs, and Health & Wellness Centres, based on standard treatment guidelines and standing orders issued by MoHFW.
Dispensing refers to the accurate preparation, packaging, labeling, and distribution of medicines to patients, along with instructions for proper use.
| Principle | Explanation |
|---|---|
| Right Drug | As per prescription or standing order |
| Right Dose | Correct strength/amount |
| Right Route | Oral, topical, injectable, etc. |
| Right Time | Frequency and duration of therapy |
| Right Patient | Check patient name, ID |
| Right Instruction | Clear usage directions (before/after meals, storage, etc.) |
| Category | Common Medicines |
|---|---|
| Analgesics | Paracetamol, Ibuprofen |
| Antibiotics | Amoxicillin, Cotrimoxazole, Azithromycin |
| Antacids | Ranitidine, Pantoprazole |
| Antihypertensives | Amlodipine, Enalapril |
| Antidiabetics | Metformin |
| Antihelminthics | Albendazole |
| ORS & Zinc | For diarrhea management |
| Antifungals | Clotrimazole cream |
| Antiseptics | Betadine, spirit, chlorhexidine |
| Iron, Folic Acid, Calcium | For anemia and pregnancy care |
| Type | Examples |
|---|---|
| Vaccines (Immunization) | BCG, OPV, DPT, MR, Td |
| Therapeutic injections | Tetanus toxoid, vitamin B12, injectable contraceptives |
| Emergency injections | Adrenaline, Atropine, Diclofenac, Oxytocin |
| Antibiotic injections | Ceftriaxone, Gentamicin (as per protocol) |
| Route | Common Sites | Used For |
|---|---|---|
| Intramuscular (IM) | Deltoid, gluteal, vastus lateralis | Vaccines, antibiotics, TT |
| Subcutaneous (SC) | Upper arm (triceps), abdomen | Insulin, some vaccines |
| Intradermal (ID) | Forearm | BCG, Mantoux test |
| Intravenous (IV) | Forearm veins | Emergency drugs (at PHC/CHC only) |
| Symptoms to Monitor For | Action to Take |
|---|---|
| Fever, pain, redness | Paracetamol, local care |
| Swelling, abscess | Antibiotics, refer if needed |
| Anaphylaxis (rash, difficulty breathing, collapse) | Give adrenaline IM and refer immediately |
| Syncope (fainting) | Keep patient flat, observe closely |
🛑 Always report AEFI as per national guidelines.
Safe drug dispensing and injection administration at health centres are vital services that ensure timely treatment, disease prevention, and patient satisfaction. Nurses and health workers play a central role by following protocols, educating patients, and ensuring infection prevention and accurate documentation.
Continuing medical care refers to the ongoing treatment, monitoring, education, and support provided to individuals with chronic diseases or long-term disabilities within the community setting.
It helps patients manage their conditions at home, maintain independence, prevent complications, and reduce hospital readmissions.
| Chronic Diseases | Disabilities |
|---|---|
| Diabetes mellitus | Physical disability (amputation, paralysis) |
| Hypertension | Cerebral palsy, polio |
| Tuberculosis (TB) | Intellectual disability |
| HIV/AIDS | Speech or hearing impairment |
| Cancer (palliative phase) | Visual impairment |
| Asthma/COPD | Developmental delay (children) |
| Mental health disorders | Autism, ADHD |
| Stroke/paralysis | Age-related mobility issues |
| Responsibilities |
|---|
| Visit the patient regularly for health assessment |
| Ensure medication adherence and refill reminders |
| Monitor vital signs, blood sugar, wound healing, etc. |
| Educate family on disease management, hygiene, nutrition |
| Identify warning signs/complications |
| Encourage lifestyle modification |
| Provide emotional and psychological support |
| Facilitate access to rehabilitation and support groups |
| Ensure referral for specialized care when needed |
| Maintain home visit records and follow-up registers |
| Tool/Record | Purpose |
|---|---|
| Home Visit Register | Record of follow-ups and findings |
| NCD Screening Cards | Track BP, sugar levels, lifestyle advice |
| Disability Register | Community mapping of persons with disabilities |
| Immunization / ANC Cards | For maternal-child continuity |
| Referral Forms | For higher-level facility care |
| Scheme | Benefits |
|---|---|
| RBSK (Rashtriya Bal Swasthya Karyakram) | Screening and referral for child disabilities |
| NPPCD (for deafness) | Early detection and hearing aid support |
| NPHCE (for elderly) | Community-based geriatric care |
| ADIP Scheme | Aids for disabled persons |
| Ayushman Bharat – HWCs | Free follow-up care for NCDs and mental health |
Continuing medical care and follow-up in the community is vital for people with chronic illnesses, disabilities, or long-term needs. It enhances quality of life, ensures treatment compliance, and strengthens primary health care. Nurses and frontline health workers are at the heart of this system, providing compassionate, consistent, and comprehensive care at the doorstep.
Therapeutic procedures are clinical or nursing interventions carried out to treat, manage, or relieve a client’s medical condition, as prescribed by a doctor or guided by nursing protocols.
These procedures support physical recovery, psychological comfort, and family involvement in care.
| Phase | Key Responsibilities |
|---|---|
| Before | – Verify physician’s order – Explain procedure to patient – Collect supplies – Ensure privacy & hygiene |
| During | – Maintain aseptic technique – Monitor patient’s response – Perform steps as per protocol |
| After | – Clean area – Dispose waste safely – Document findings – Educate client/family if needed |
| Why It Matters | Nurse’s Role |
|---|---|
| Encourages compliance and cooperation | Explain procedures in simple language |
| Builds trust and transparency | Allow family presence if appropriate |
| Promotes home-based care after discharge | Demonstrate simple tasks (e.g., dressing, feeding) |
| Supports emotional well-being | Offer reassurance and psychological support |
Carrying out therapeutic procedures safely and compassionately is a core nursing responsibility. It requires clinical skill, communication, and family involvement. By following protocols, nurses help ensure timely recovery, patient dignity, and trust in the healthcare system—both at the facility and in the community.
Maintaining these ensures continuity of care, accountability, legal protection, and public health planning.
| Type | Purpose |
|---|---|
| Family folder | Complete record of each family in a community |
| Individual health card | For tracking antenatal, postnatal, child care |
| Eligible couple register | Records contraceptive use and family planning |
| Child immunization card | Tracks routine immunization |
| Register | Used For |
|---|---|
| Antenatal & Postnatal Register | Pregnancy tracking and maternal care |
| Birth and death register | Vital events registration |
| Immunization register | Vaccination coverage |
| OPD register | Records all outpatient visits |
| NCD register | Hypertension, diabetes, and cancer follow-up |
| TB and leprosy register | DOTS and MDT patient records |
| HBNC/HBYC register | Home visits for newborn and young child care |
| School health register | Check-ups and interventions for students |
| Report | Frequency | Submitted To |
|---|---|---|
| Monthly work report | Monthly | Medical Officer/PHC in-charge |
| Disease surveillance report | Weekly / Immediately (in outbreak) | Block Health Officer |
| Immunization summary | Monthly | District Health Office |
| Maternal & Child Health (MCH) report | Monthly | Health and Family Welfare Dept. |
| NCD screening report | Monthly | NPCDCS nodal officer |
| Digital Tools Used | Benefits |
|---|---|
| ABHA ID (Ayushman Bharat Health Account) | Unique ID for lifelong records |
| e-RaktKosh, e-Sanjeevani, Nikshay, ANMOL | Real-time data, teleconsultation |
| HMIS (Health Management Info System) | Centralized health reporting platform |
✅ Nurses must be oriented to mobile/tablet-based data entry for improved efficiency and real-time reporting.
Health records and reports are the backbone of effective public health practice. They ensure continuity of care, monitor service quality, and help government bodies plan and evaluate health programs. Nurses play a critical role in accurate documentation, timely reporting, and data-driven care.
Client records are personalized, confidential, and chronological documents that contain the medical history, health services provided, treatment details, and nursing care plans of an individual patient or client.
Proper record-keeping helps in continuity of care, legal protection, communication among health team members, and program monitoring.
| Type of Record | Used In |
|---|---|
| Individual Health Record | Clinics, hospitals, home-based care |
| Antenatal/PNC/MCH Card | Pregnancy and newborn tracking |
| Immunization Card | For child and adult immunizations |
| Chronic Illness Register | For diabetes, hypertension, TB, HIV/AIDS |
| Nursing Care Plan/Progress Notes | Inpatient care and home visits |
| Family Folder (in community) | Entire family’s health record at sub-centre level |
| Section | Includes |
|---|---|
| Identification Data | Name, age, sex, ID number, address, contact |
| Medical History | Past illnesses, allergies, surgeries, family history |
| Present Complaint | Symptoms, duration, diagnosis |
| Assessment Findings | Vitals, examination results, lab tests |
| Treatment Given | Medications, injections, procedures |
| Nursing Care Plan | Interventions, outcomes, patient response |
| Follow-Up & Referral | Next visit date, referred services |
| Signature & Date | Of nurse or health worker providing care |
Many PHCs and HWCs are moving toward electronic health records (EHRs).
| Tool/Platform Used | Purpose |
|---|---|
| ABHA ID (Ayushman Bharat Health Account) | Unique health record for individuals |
| e-Sanjeevani | Digital OPD and follow-up tracking |
| HMIS (Health Mgmt Info System) | Aggregate reporting and data storage |
✅ Nurses and CHOs should be trained in tablet/mobile-based entry and confidentiality protocols.
Maintaining accurate and updated client records is a fundamental duty of all nurses and health workers. It ensures safe, accountable, and patient-centered care. Whether in the clinic, community, or home, organized record-keeping strengthens the health system and improves outcomes.
Facility-level health records are organized documents that capture the details of health services provided, patient care, and public health programs within a health facility.
These include:
| Category | Examples of Records |
|---|---|
| Patient Records | OPD, IPD, ANC, PNC, child care cards |
| Registers | Antenatal, immunization, delivery, family planning, TB, NCD |
| Laboratory Records | Test results, sample registers |
| Pharmacy/Drug Records | Drug stock register, issue register, indent register |
| Equipment and Supply Records | Cold chain logbook, equipment maintenance register |
| Human Resource Records | Attendance register, duty rosters |
| Reporting Records | Monthly, quarterly reports to health department |
| Referral Records | Inward and outward referral registers |
| Register Name | Purpose |
|---|---|
| OPD Register | Daily outpatient attendance and diagnosis |
| Antenatal Register | ANC visits, tests, supplements, high-risk ID |
| Delivery Register (PHC/CHC) | All deliveries conducted – mother and baby status |
| Immunization Register | Record of routine immunization and vaccines |
| Family Planning Register | Method adopted, counselling, follow-up |
| NCD Register | BP, blood sugar records, medications given |
| Laboratory Register | Sample collection, test results, reporting |
| Drug Stock and Issue Register | Daily medicine availability, dispensing record |
Modern facilities also use digital platforms provided by the MoHFW:
| Platform | Purpose |
|---|---|
| HMIS | Health Management Information System – facility reporting |
| ANMOL App | Real-time data entry by ANMs for MCH care |
| ABHA ID (NDHM) | Patient health record linkage for Ayushman Bharat |
| Nikshay Portal | TB patient tracking and follow-up |
| e-RaktKosh, e-Sanjeevani | Blood, telemedicine and referral management |
✅ Nurses must be trained in tablet/laptop data entry, data privacy, and e-reporting protocols.
| Storage Guidelines | Purpose |
|---|---|
| Keep physical records in locked cabinets | Prevent unauthorized access |
| Arrange registers chronologically | Easy retrieval and verification |
| Store digital data with backup & passwords | Avoid data loss and breaches |
| Retain records as per MoHFW retention policy | (e.g., OPD/IPD records: 3–5 years) |
Maintaining health records at the facility level is essential for organized, safe, and effective health service delivery. Nurses and health workers play a key role in ensuring accurate documentation, secure storage, timely reporting, and meaningful use of data—ultimately improving public health outcomes.
| Context | Examples of Documented Activities |
|---|---|
| Home Visits | Antenatal/postnatal care, newborn check-up, chronic illness care, health education |
| Clinics/Health Centers | OPD attendance, immunization, NCD screening, family planning |
| Field Visits | School health checkups, outreach camps, community meetings, awareness programs |
| Heading | Details to Include |
|---|---|
| Date & Time | Exact date of activity or visit |
| Place of Activity | Village name, ward, school, sub-center, home location |
| Beneficiary Details | Name, age, gender, ID/family folder number |
| Type of Service Given | Check-up, immunization, counseling, medication, referral |
| Health Findings | BP, weight, symptoms, test results (if applicable) |
| Action Taken | Health education, drugs dispensed, injections given |
| Follow-up Advice | Next visit date, referral, caregiver instructions |
| Signature | Of reporting nurse/health worker |
| Tool/Register | Purpose |
|---|---|
| Home Visit Register | Daily field-level services tracking |
| Mother and Child Protection Card | Tracking ANC, PNC, and immunization |
| Eligible Couple Register | Family planning services |
| Referral Slip/Booklet | Referrals to PHC/CHC or specialists |
| Daily/Weekly Report Format | Summary of activities for supervisor submission |
| Service Registers (clinic) | OPD, NCD, FP, Immunization |
✅ Reports may be handwritten or digital, depending on facility capacity.
| App/Platform | Used For |
|---|---|
| ANMOL App | Real-time ANC/PNC and child tracking |
| e-RaktKosh, Nikshay, ABHA | Blood services, TB follow-up, health records |
| HMIS (Health Management Info System) | Facility and outreach reporting |
yamlCopyEdit🗓️ Date: 30 March 2025
📍 Place: Dhana Village, Anganwadi #4
👩👧 Beneficiaries: 6 Pregnant Women, 4 Children <5 yrs
🩺 Activities:
- ANC check-up (4 women) – BP, weight, Hb screening done
- 2 women given IFA + calcium tablets
- 2 children given Pentavalent-3 vaccine
- 1 suspected TB case referred to PHC
📣 Health Education: Clean water use, handwashing
📝 Remarks: One high-risk pregnancy – follow-up planned
👩 Nurse Signature: [Your Name]
Report writing and documentation are essential for evidence-based community nursing. A well-kept report reflects a nurse’s professionalism, ensures better health outcomes, and strengthens public health systems. Nurses and health workers must treat documentation as a vital part of care—not just paperwork.
Social issues are problems that arise due to cultural, economic, gender, environmental, or behavioral factors that negatively impact the health, growth, and well-being of individuals and families.
These are non-medical in nature but have a direct effect on physical, mental, reproductive, and child health.
| Social Issue | Impact on Health & Development |
|---|---|
| Poverty and unemployment | Malnutrition, lack of access to healthcare, poor hygiene |
| Early marriage and adolescent pregnancy | High-risk pregnancy, school dropout, anemia |
| Domestic violence | Physical injury, mental trauma, reproductive issues |
| Gender inequality | Poor maternal health, female child neglect |
| Substance abuse (alcohol/drugs) | Violence, neglect of children, infections (e.g., HIV, TB) |
| Poor sanitation and housing | Spread of communicable diseases, poor child growth |
| Illiteracy and lack of awareness | Delays in seeking care, non-compliance with treatment |
| Child labor | Physical injuries, mental stress, missed immunization and education |
| Social stigma (HIV, TB, disability) | Isolation, poor treatment-seeking behavior, discrimination |
| Migration | Interrupted schooling, poor health access, malnutrition |
| Tool / Strategy | Use in Community |
|---|---|
| Home visit interviews | Identify economic, emotional, and abuse-related challenges |
| Social history format | Document family structure, livelihood, education, stressors |
| Role plays and skits | Engage community in recognizing and reflecting on social issues |
| Counseling and motivation | Help clients find their own solutions with support |
| Community resource mapping | Identify local NGOs, support groups, welfare schemes |
| Scheme Name | Purpose |
|---|---|
| Janani Suraksha Yojana | Incentives for institutional deliveries |
| Integrated Child Development Scheme (ICDS) | Nutrition & pre-school support via Anganwadi |
| PM Matru Vandana Yojana | Maternity benefit for first pregnancy |
| One-Stop Centers / Sakhi | Support for women in violence/abuse situations |
| Rashtriya Kishor Swasthya Karyakram (RKSK) | Adolescent health education & support |
| Disability Welfare Schemes | Pensions, aids, rehabilitation |
Addressing social issues in family health is as important as treating diseases. Nurses and community health workers are in a unique position to be educators, counselors, advocates, and agents of social change. By sensitizing the community and building strong referral linkages, we can promote safe, empowered, and healthy families.
Women Empowerment is the process of enabling women to:
It means giving women the freedom, respect, knowledge, and power to live with dignity and independence.
| Area | Empowerment Focus |
|---|---|
| Health | Reproductive rights, access to healthcare, safe childbirth, menstrual hygiene |
| Education | Adult literacy, skill training, vocational education |
| Economy | Self-employment, SHGs, financial literacy, bank access |
| Social Rights | Legal awareness, prevention of child marriage/dowry |
| Leadership | Involvement in Panchayat, Mahila Mandals, SHGs |
| Safety & Dignity | Protection from domestic violence, workplace harassment |
| Nursing Action | Impact |
|---|---|
| Educate women on health, hygiene, nutrition | Builds confidence and well-being |
| Promote institutional deliveries & ANC/PNC | Reduces maternal mortality |
| Provide contraceptive counseling | Supports reproductive choices |
| Conduct awareness sessions on rights/laws | Protects against exploitation |
| Encourage income-generating skills | Promotes financial freedom |
| Identify and report domestic violence | Ensures safety and referral |
| Scheme Name | Benefit/Objective |
|---|---|
| Beti Bachao Beti Padhao | Promotes girl child education and survival |
| PM Matru Vandana Yojana | Maternity benefit for first pregnancy |
| Janani Suraksha Yojana (JSY) | Incentive for institutional delivery |
| Mahila Shakti Kendra | Community-based support and capacity building |
| One Stop Centers (OSC) | Violence and abuse support (legal, medical, shelter) |
| STEP (Support to Training & Employment Program) | Skill-building for poor and rural women |
| Empowered Women Can: |
|---|
| Make decisions about their own health and family |
| Access healthcare and demand quality services |
| Participate in Gram Sabha or community meetings |
| Report domestic violence or injustice |
| Support and educate other women/girls |
| Earn and manage income independently |
Women empowerment is not only a right, but a key to a healthier, stronger, and more equal society. Nurses and health workers have a powerful role in empowering women by educating, supporting, advocating, and connecting them with opportunities and resources. Empowered women create empowered families and communities.
Abuse is any intentional act of violence, neglect, or exploitation that causes harm to a woman or a child. It may be physical, emotional, sexual, or economic, and often occurs in homes, schools, workplaces, or public spaces.
Abuse is a violation of human rights and leads to severe physical, emotional, and psychological consequences.
| Type of Abuse | Examples |
|---|---|
| Physical Abuse | Hitting, slapping, kicking, burning, acid attacks |
| Sexual Abuse | Rape, molestation, forced sex in marriage, sexual harassment |
| Emotional/Psychological | Verbal threats, humiliation, isolation, controlling behavior |
| Economic Abuse | Denial of money, restricting employment or access to resources |
| Domestic Violence | Any form of abuse within the household, often by a partner/spouse |
| Type of Abuse | Examples |
|---|---|
| Physical Abuse | Beating, burning, shaking, slapping |
| Sexual Abuse | Incest, molestation, exploitation, pornography involvement |
| Emotional Abuse | Rejection, threats, neglect, excessive criticism |
| Child Neglect | Not providing food, shelter, education, or healthcare |
| Child Labor | Forcing children to work in unsafe or exploitative conditions |
| Law/Act | Purpose |
|---|---|
| Protection of Women from Domestic Violence Act (2005) | Protection from all forms of domestic violence |
| POCSO Act (2012) – Protection of Children from Sexual Offences | Strict punishment for sexual crimes against children |
| Child Labour (Prohibition) Act | Prevents employment of children in hazardous work |
| Juvenile Justice Act (2015) | Protection and rehabilitation of abused children |
| Dowry Prohibition Act (1961) | Prevents dowry-related violence and exploitation |
| Action | Details |
|---|---|
| Identify signs | Injuries, fearful behavior, inconsistent stories |
| Listen actively | Be empathetic, don’t blame the victim |
| Document findings | Use clear, factual language; note physical & emotional signs |
| Ensure safety | Offer safe space, do not send back if danger is present |
| Report as mandated | Use legal channels (Childline 1098, police 100, One Stop Center) |
| Refer | To counselor, legal support, protection services |
| Educate | Conduct awareness sessions in schools, SHGs, VHNDs |
Women and child abuse is a serious public health and human rights issue. Nurses and health workers play a critical role in identifying, supporting, and protecting vulnerable individuals. Through education, early detection, documentation, and referral, we can help break the cycle of abuse and build safe, healthy communities.
Elder abuse is any intentional or unintentional act that causes harm or distress to an elderly person (60 years or above). This harm can be physical, emotional, financial, sexual, or due to neglect, usually inflicted by family members, caregivers, or institutions.
Elder abuse is a silent and growing issue, especially in homes and care settings, often hidden due to shame, fear, or dependence.
| Type of Abuse | Examples |
|---|---|
| Physical Abuse | Hitting, slapping, burning, restraining unnecessarily |
| Emotional/Psychological | Verbal insults, threats, ignoring, humiliation |
| Financial Abuse | Misuse of pensions, stealing property, forcing asset transfers |
| Sexual Abuse | Unwanted sexual contact or exploitation |
| Neglect | Ignoring basic needs – food, hygiene, medication, companionship |
| Abandonment | Leaving elders unattended or in hospitals without support |
| Law/Act | Protection Offered |
|---|---|
| Maintenance and Welfare of Parents and Senior Citizens Act (2007) | Legal right to claim maintenance from children |
| Domestic Violence Act (2005) | Protects elders (especially women) from abuse at home |
| Indian Penal Code (IPC) Sections | For physical harm, financial fraud, etc. |
| Old Age Pension Schemes (State-wise) | Financial support for vulnerable elderly persons |
| Responsibility | Action Steps |
|---|---|
| Identification | Observe injuries, emotional signs, malnourishment |
| Communication | Speak gently, privately; build trust |
| Documentation | Note exact words, symptoms, physical evidence |
| Reporting | Inform supervisor/PHC doctor, report to local authority if needed |
| Referral | Link with social worker, old age shelter, NGO, legal aid |
| Education | Counsel family on elder care, rights, and emotional needs |
| Helpline | Number |
|---|---|
| Elder Helpline (NISD – Govt. of India) | 📞 14567 (toll-free) |
| Police | 📞 100 |
| Senior Citizen Cell (Local Police/NGO) | Available at district level |
| NGOs like HelpAge India | www.helpageindia.org |
Elder abuse is a serious but often hidden problem. Nurses and community health workers must be vigilant, compassionate, and proactive in identifying, preventing, and reporting elder abuse. With proper education, support systems, and legal action, we can ensure that our elders live with dignity, respect, and safety.
Female foeticide is the deliberate abortion of a female fetus after determining the sex of the unborn baby. It is often performed due to a strong preference for sons, and it is illegal, unethical, and inhumane.
Female foeticide reflects deep-rooted gender bias and is a serious social crime that harms the health, balance, and future of society.
| Cause | Explanation |
|---|---|
| Son preference | Seen as future breadwinner, family name bearer |
| Dowry system | Daughters viewed as financial burden |
| Gender discrimination | Belief that boys have more social, economic value |
| Lack of awareness | Ignorance about legal rights, value of girls |
| Illegal sex determination | Use of ultrasound for gender detection before birth |
| Family/social pressure | In-laws or husbands pressuring women for male children |
| Area | Consequences |
|---|---|
| Society | Decline in sex ratio, increased crimes against women |
| Family | Psychological trauma, pressure on women, guilt, broken relationships |
| Women’s Health | Unsafe abortions, maternal mortality, reproductive damage |
| Nation | Gender imbalance, increased trafficking, violence, unrest |
India’s sex ratio (as per NFHS-5):
📉 Still low in several states like Haryana, Punjab, Rajasthan, Gujarat.
| Responsibility | How to Act |
|---|---|
| Awareness creation | Educate women, families, and youth about the value of girls |
| Antenatal counseling | Promote acceptance of both genders during ANC visits |
| Monitoring & reporting | Report any suspected illegal sex determination or abortion |
| Community mobilization | Conduct VHND talks, SHG meetings, and school sessions |
| Support services | Link mothers to government schemes for girl children |
| Advocacy | Work with Panchayat leaders, teachers, NGOs, and local media |
| Act/Scheme | Purpose |
|---|---|
| PCPNDT Act, 1994 | Bans prenatal sex determination and regulates ultrasound use |
| Beti Bachao, Beti Padhao Yojana | Promotes girl child survival, education, and empowerment |
| Girl Child Schemes (e.g., Sukanya Samriddhi Yojana) | Financial support for girl child development |
| Conditional Cash Transfers (e.g., Ladli Scheme) | Incentivizes birth and education of girls |
Female foeticide is not only a crime, but also a social tragedy. Nurses, community health workers, educators, and families must work together to change mindsets, promote gender equality, and protect every girl child’s right to live and thrive. Saving daughters today means saving the future of our society.
Commercial Sex Workers (CSWs) are individuals—women, men, or transgender persons—who provide sexual services in exchange for money or goods.
Sex work may be done by choice, due to poverty, trafficking, social pressure, or lack of alternatives. CSWs are part of a marginalized group with high health and social vulnerabilities.
| Health Concern | Examples/Impact |
|---|---|
| Sexually Transmitted Infections (STIs) | Gonorrhea, syphilis, HPV, HIV |
| Reproductive Health Problems | Unwanted pregnancies, unsafe abortions, menstrual issues |
| Mental Health Issues | Anxiety, depression, trauma, substance abuse |
| Physical Violence | Domestic or client-related violence, forced sex |
| Lack of Maternity Care | Late ANC registration, unsafe delivery |
| Area | Nurse’s Responsibility |
|---|---|
| Health Education | Safe sex, condom use, STI prevention, menstrual hygiene |
| STI/HIV Screening | Organize regular testing, facilitate ART/PrEP referrals |
| Counseling | Reproductive rights, contraception, gender-based violence |
| Outreach Services | Mobile clinics, health camps, free checkups |
| Non-judgmental Care | Treat with empathy, privacy, and without discrimination |
| Linkage to Schemes | Welfare schemes, ID creation, insurance, rehabilitation |
| Partnering with NGOs | For outreach, education, and rehabilitation support |
| Program/Scheme | Objective |
|---|---|
| National AIDS Control Program (NACP) | Provides free STI/HIV testing, ART, condoms, IEC |
| Targeted Interventions (TIs) | Specific outreach for CSWs and high-risk groups |
| Swadhar Greh Scheme | Shelter and rehabilitation for destitute or trafficked women |
| ASHAs and CHOs (in urban settings) | Engage in linking CSWs to PHC services |
Commercial sex workers are part of our communities and deserve respect, healthcare, protection, and dignity. Nurses and health workers play a key role in delivering non-judgmental, confidential, and accessible services that promote health, rights, and empowerment of this vulnerable group.
Substance abuse refers to the harmful or hazardous use of psychoactive substances like alcohol, tobacco, illicit drugs, or prescription medicines for non-medical purposes.
It involves the overuse, misuse, or dependency on substances that alter mood, thinking, or behavior—often leading to physical, mental, social, and legal problems.
| Category | Examples | Effect on Body |
|---|---|---|
| Tobacco/Nicotine | Cigarettes, beedis, chewing tobacco | Addiction, cancer, heart disease |
| Alcohol | Country liquor, spirits, beer | Liver damage, mental illness, accidents |
| Illicit Drugs | Heroin, cocaine, cannabis, LSD | Brain damage, HIV risk, death |
| Inhalants | Glue, petrol, paint thinners | Brain and organ damage |
| Prescription Drugs (misuse) | Sleeping pills, painkillers, sedatives | Dependency, overdose risk |
| Risk Factor | Explanation |
|---|---|
| Peer Pressure | Common in adolescents and youth |
| Mental Health Issues | Stress, anxiety, depression |
| Family History | Addiction in family or poor parenting |
| Easy Availability | Access to alcohol, tobacco, drugs |
| Lack of Awareness | About harmful effects and legal consequences |
| Unemployment/Poverty | Escape from reality or coping mechanism |
| Law | Purpose |
|---|---|
| Narcotic Drugs and Psychotropic Substances (NDPS) Act, 1985 | Prohibits production, trafficking, and misuse of narcotic drugs |
| COTPA Act (2003) | Prohibits smoking in public, advertising of tobacco |
| Juvenile Justice Act (2015) | Protection of children from drug-related offenses |
✅ Selling or consuming illicit substances is punishable.
| Action Area | Responsibilities |
|---|---|
| Identification | Screen individuals showing signs of dependence or withdrawal |
| Counseling | Educate on harmful effects, motivate to quit |
| Referral | Link to De-addiction centers, mental health professionals |
| Community Awareness | Conduct sessions in schools, colleges, VHNDs, SHGs |
| Support & Follow-up | Provide ongoing encouragement and family counseling |
| Prevent Relapse | Encourage healthy lifestyle, coping strategies |
Substance abuse is a disease, not a moral failure. It affects health, families, and society. Nurses and health workers have a crucial role in prevention, education, early identification, and compassionate care. By promoting awareness, counseling, and treatment, we can build a healthier and drug-free community.
Trauma services refer to medical, psychological, social, and rehabilitative support systems available to individuals or families who have experienced a sudden or severe physical, emotional, or psychological injury.
Trauma may be due to accidents, violence, natural disasters, sexual assault, suicide attempts, or mental breakdowns.
| Type of Trauma | Examples |
|---|---|
| Physical Trauma | Road traffic accidents, falls, burns, blunt injuries |
| Sexual & Domestic Violence | Rape, assault, child abuse, intimate partner violence |
| Emotional/Psychological Trauma | Death of loved one, PTSD, abuse history |
| Disaster-Related Trauma | Floods, earthquakes, fire, mass casualties |
| Conflict or Migration | Refugees, displaced families, riot survivors |
| Action | Role Description |
|---|---|
| Initial Care & Stabilization | Provide first aid, emotional support, ensure safety |
| Assessment | Identify physical/psychological trauma signs during home/clinic visits |
| Referral and Transport | Refer to nearest trauma or mental health center; coordinate ambulance |
| Emotional First Aid | Comfort, reassure, and validate victims’ feelings |
| Resource Navigation | Help clients access schemes, shelters, legal support, free meds |
| Documentation & Reporting | Maintain incident details; report to MO, police (if abuse/crime) |
| Community Mapping | Know your area’s available NGOs, hospitals, mental health providers |
| Advocacy and Follow-up | Encourage survivors and families to seek ongoing support |
| Program/Service | Purpose |
|---|---|
| One Stop Centre (Sakhi) | Medical + legal + psychological support under one roof for women |
| District Mental Health Programme (DMHP) | Mental health care in PHC/CHC settings |
| Nirbhaya Fund | Government-supported services for gender-based violence victims |
| PM Jan Arogya Yojana (Ayushman Bharat) | Free care for trauma and emergency cases in empanelled hospitals |
| Disaster Relief Teams (SDRF/NDRF) | Trauma care and rehab during natural disasters |
| HelpAge India | Trauma counseling and care for elderly abuse or accidents |
| Helpline | Purpose |
|---|---|
| 108 | Emergency ambulance |
| 100 | Police help |
| 1091 / 181 | Women’s helpline |
| 1098 | Childline for abused/traumatized children |
| KIRAN (Mental Health) | 1800-599-0019 (24×7 national helpline) |
Utilizing community trauma resources is essential to help clients and families recover from crises, injuries, violence, and emotional distress. Nurses and health workers are crucial in identifying trauma, providing initial care, and ensuring timely linkage to supportive services. With proper knowledge and compassionate care, we can restore health, safety, and dignity for trauma survivors.
Old Age Homes (also known as Senior Citizen Homes or Vruddha Ashrams) are residential facilities that provide housing, food, healthcare, emotional support, and companionship to elderly people who:
They aim to offer safety, dignity, medical care, and social engagement to older adults.
| Type | Features |
|---|---|
| Government-Run Homes | Free or subsidized; basic facilities; under Social Welfare Dept. |
| NGO-Run Homes | Often supported by donations; may offer holistic care |
| Private Paid Homes | Better infrastructure and care services; fees apply |
| Day-Care Centers for Elderly | Open during daytime; provide food, games, medical check-ups |
| Service | Description |
|---|---|
| Accommodation & Food | Safe rooms, nutritious meals, cleanliness |
| Medical Care | Regular check-ups, medicine, physiotherapy, health monitoring |
| Nursing Care | Help with bathing, dressing, wound care, chronic illness care |
| Mental Health Support | Counseling for depression, anxiety, memory loss |
| Recreational Activities | Games, reading, yoga, prayers, cultural celebrations |
| Spiritual and Social Support | Religious events, community bonding |
| Responsibility | Role Description |
|---|---|
| Health Assessment | Monitor vitals, chronic conditions, nutritional status |
| Medication Management | Timely administration and storage of medicines |
| Wound and Mobility Care | Dressing, fall prevention, pressure sore care |
| Mental Health Support | Identify signs of dementia, depression, anxiety |
| Counseling and Emotional Support | Provide a listening ear and emotional validation |
| Health Education | Teach hygiene, exercise, diet, and chronic disease care |
| Referral Coordination | Link with specialists, hospitals, diagnostic services |
| Scheme/Policy | Benefit |
|---|---|
| Maintenance and Welfare of Parents and Senior Citizens Act (2007) | Legal right to claim maintenance from children |
| Integrated Programme for Senior Citizens (IPSrC) | Funding for NGOs to run old age homes |
| Indira Gandhi National Old Age Pension Scheme (IGNOAPS) | ₹200–₹500/month for elderly BPL persons |
| Ayushman Bharat / PMJAY | Free secondary and tertiary care for elderly (if eligible) |
| National Policy on Older Persons | Focuses on healthcare, income security, shelter, safety |
| Service | Helpline Number |
|---|---|
| Senior Citizens Helpline | 📞 14567 (24×7 toll-free) |
| Police Emergency | 📞 100 |
| HelpAge India | www.helpageindia.org |
Old age homes are not just shelters—they are homes that restore dignity, health, and happiness in the later years of life. With proper healthcare, emotional support, and community involvement, we can make aging a graceful, respected, and cared-for experience. Nurses and health workers are vital in ensuring this vision becomes a reality.
An orphanage (also called a child care institution) is a residential facility that provides shelter, food, education, and care to children who:
These institutions aim to ensure that orphaned or vulnerable children receive basic needs, protection, and emotional support in a safe environment.
| Category | Examples |
|---|---|
| Orphans | Children with no living parents |
| Abandoned Children | Left in public places or hospitals |
| Children of Single Parents | Who cannot care for them due to poverty or illness |
| Rescued Children | From trafficking, child labor, abuse, or natural disasters |
| Children in Conflict with Law | Under protection until rehabilitation or reintegration |
| Responsibility | Description |
|---|---|
| Health Screening | On admission: check for anemia, infections, malnutrition |
| Vaccination | Ensure age-appropriate immunization is up to date |
| Growth Monitoring | Record weight, height, BMI regularly |
| Health Education | Hygiene, nutrition, puberty education, dental care |
| First Aid and Minor Illness Care | Treat minor injuries or infections |
| Mental Health Support | Identify anxiety, trauma, depression, refer for counseling |
| Referrals | For eye, hearing, disability assessments, chronic illness |
| Health Record Maintenance | Individual child health cards, regular documentation |
| Service Area | Examples |
|---|---|
| Basic Needs | Food, shelter, clothing, personal care |
| Education | Schooling, tuition, vocational training |
| Medical Care | Routine check-ups, immunization, emergency care |
| Psycho-Social Support | Counseling, trauma recovery, social skill development |
| Legal Support | Identity documents, protection from abuse, adoption follow-up |
| Rehabilitation | Preparation for reintegration into society or foster care |
| Law/Scheme | Purpose |
|---|---|
| Juvenile Justice (Care & Protection) Act, 2015 | Regulation of orphanages, rights of children in need of care |
| Integrated Child Protection Scheme (ICPS) | Financial and technical support for child care institutions |
| Adoption Regulations (via CARA) | Legal adoption and foster care processes |
| Bal Asha/Bal Griha | Registered children’s homes under state child welfare departments |
| Right to Education (RTE) | Ensures schooling for orphaned children |
Orphanages play a vital role in protecting and nurturing vulnerable children. However, every child deserves a family-like environment, love, and care. Nurses, health workers, and community members together can ensure these children grow up healthy, safe, and empowered, ready to thrive in society.
Homes for physically challenged individuals are residential facilities that provide shelter, personal care, medical support, rehabilitation, and skill training to people who have mobility, sensory, or neuromuscular disabilities, and are unable to live independently or lack family support.
These homes promote independent living, dignity, inclusion, and care for individuals with physical impairments, including cerebral palsy, spinal injuries, amputations, muscular dystrophy, or multiple disabilities.
| Beneficiaries | Conditions Covered |
|---|---|
| Physically disabled individuals (adults/children) | Amputations, spinal cord injuries, cerebral palsy |
| Orthopedically impaired persons | Polio, post-trauma disability, arthritis-related disability |
| Persons with multiple disabilities | Visual + physical, hearing + motor |
| Abandoned or homeless disabled individuals | Those without family care or financial support |
| Service Area | Examples |
|---|---|
| Basic Facilities | Clean living space, hygiene care, nutritious meals |
| Medical and Nursing Care | Daily health monitoring, medication, first aid, nursing procedures |
| Rehabilitation Services | Physiotherapy, occupational therapy, speech therapy |
| Mobility Aids Support | Wheelchairs, crutches, artificial limbs, calipers |
| Skill Development | Tailoring, computer skills, crafts, vocational training |
| Counseling & Emotional Support | Address depression, stigma, social anxiety |
| Legal and Welfare Linkages | Disability certificate, pension schemes, assistive devices |
| Responsibility | Role Description |
|---|---|
| Health Assessment | Monitor vital signs, nutritional status, pressure sores |
| Medication Administration | Ensure timely medicines and chronic illness management |
| Physiotherapy Assistance | Support daily exercise and physical movement routines |
| ADL Support | Help with bathing, dressing, toilet care as needed |
| Emotional Counseling | Provide mental support, build self-esteem |
| Health Education | Teach about personal hygiene, exercises, self-care |
| Referral Coordination | Arrange hospital referrals, specialist care, or surgeries |
| Documentation | Maintain health records, rehabilitation progress |
| Scheme/Program | Benefit Offered |
|---|---|
| Deendayal Disabled Rehabilitation Scheme (DDRS) | Financial aid to NGOs running residential and rehab homes |
| ADIP Scheme (MoSJE) | Free mobility aids and appliances (wheelchairs, hearing aids) |
| UDID Card Scheme | Unified Disability ID for availing all disability benefits |
| Divyangjan Pension Schemes (State-specific) | Monthly pension for persons with 40%+ disability |
| Skill Training under NSDC or NHFDC | Free skill-building and entrepreneurship programs |
| Organization/Body | Support Provided |
|---|---|
| National Institutes under MoSJE | Specialized rehab for each disability type |
| District Disability Rehabilitation Centres (DDRCs) | Assistive devices, therapy, medical camps |
| NGOs (e.g., Amar Seva Sangam, Samarth) | Community-based and residential care homes |
| Local District Social Welfare Office | Registration, pensions, scheme access |
Homes for physically challenged individuals offer more than just shelter—they provide empowerment, care, and a chance at independent living. Nurses and health workers play a central role in medical care, rehabilitation, and emotional support, helping every resident live with dignity, strength, and self-worth.
Destitute individuals are people who are:
These are individuals who live in extreme poverty, isolation, or abandonment, often with no food, shelter, or medical care.
Homes for the destitute are residential facilities—run by governments, NGOs, or religious institutions—that provide:
These homes are also referred to as:
| Service Area | Nursing Responsibilities |
|---|---|
| Health Screening | Assess for malnutrition, infections, wounds, dehydration |
| Medical and Nursing Care | Treat minor ailments, refer for major illnesses, chronic care |
| Mental Health Support | Identify depression, psychosis, trauma—refer or counsel |
| Daily Living Assistance | Help with bathing, feeding, dressing for those unable to manage |
| Health Education | Teach hygiene, healthy habits, medicine adherence |
| Vaccination & Referrals | Ensure immunizations, screen for TB, HIV, NCDs |
| Record Maintenance | Maintain individual care plans and treatment charts |
| Service Provided | Description |
|---|---|
| Shelter & Food | Safe sleeping area, regular nutritious meals |
| Clothing & Hygiene | Basic clothing, bathing, laundry support |
| Medical & Nursing Care | First aid, chronic illness care, disability support |
| Psychosocial Counseling | Trauma recovery, emotional support |
| Rehabilitation Services | Vocational training, addiction recovery, disability rehab |
| Legal & Social Support | Help with ID proof, pensions, reconnecting with families |
| Law/Scheme/Program | Purpose |
|---|---|
| Destitute and Beggars Relief Acts (State-wise) | Legal care and rehabilitation of beggars and homeless |
| Shelters under DAY-NULM (Urban Livelihood Mission) | Urban shelters with meals, care, and support for the homeless |
| Integrated Programme for Older Persons (IPOP) | Support for destitute elderly in homes |
| Pradhan Mantri Awas Yojana (PMAY) | Housing for the urban poor and destitute |
| NGOs like Mother Teresa Homes, Snehalaya, Hope Foundation | Care for abandoned children, women, and elderly |
| Support Type | Contact/Service |
|---|---|
| Police Rescue Help | 📞 100 or nearest police station |
| Women & Child Helpline | 📞 181 / 1098 (for abused or abandoned individuals) |
| Health Emergency Ambulance | 📞 108 |
| Social Welfare Department | Local office for placement into shelter homes |
| NGOs and Charities | Red Cross, HelpAge India, Missionaries of Charity, etc. |
Homes for destitute individuals are a lifeline for those who have no one else to turn to. Nurses and health workers play a vital role in restoring health, hope, and dignity through compassionate care, rehabilitation, and reintegration support. These homes are not just shelters—they are spaces of healing and humanity.
Palliative care is specialized medical and nursing care for people living with serious, chronic, or life-threatening illnesses, focusing on relief from pain, symptoms, emotional stress, and spiritual distress—not cure.
It aims to improve the quality of life for both the patient and their family, especially during advanced stages of illness or end-of-life care.
Palliative care centres are dedicated healthcare facilities (standalone or part of hospitals/hospices) where patients with advanced illness receive comprehensive, holistic care that includes:
| Illnesses Often Requiring Palliative Care |
|---|
| Advanced cancers (e.g., breast, lung, colon) |
| HIV/AIDS |
| End-stage organ failure (kidney, liver, heart) |
| Chronic respiratory diseases (e.g., COPD) |
| Neurodegenerative diseases (e.g., Parkinson’s, ALS) |
| Stroke, dementia, Alzheimer’s |
| Multiple sclerosis or progressive disabilities |
| Service Area | Examples |
|---|---|
| Pain & Symptom Management | Medications (e.g., morphine), wound care, oxygen therapy |
| Nursing Support | Pressure sore prevention, personal hygiene, feeding support |
| Psychological Counseling | Coping with fear, anxiety, depression |
| Spiritual Support | Prayers, last rites, spiritual healing (as per patient’s faith) |
| Family Care | Education on home care, respite care, bereavement counseling |
| Home-Based Palliative Care | Nurse-led or CHO visits for bedridden patients at home |
| Nursing Responsibility | Details |
|---|---|
| Pain Assessment & Relief | Use tools like Wong-Baker or Numeric Pain Scale |
| Medication Administration | Including controlled drugs like morphine (as per protocol) |
| ADL Support | Help with bathing, feeding, toileting |
| Psychological Support | Listen empathetically, provide reassurance |
| Family Teaching | Guide in caregiving, lifting, oral care, repositioning |
| Comfort Measures | Positioning, music, touch, aromatherapy, silence |
| End-of-Life Care | Provide peaceful environment, manage death with dignity |
| Documentation | Maintain care plans, consent forms, pain charts |
| Organization/Program | Support Offered |
|---|---|
| National Program for Palliative Care (NPPC) | Guidelines and support for palliative care units |
| Kerala Palliative Care Model | Community-based home care (internationally recognized) |
| Pain and Palliative Care Society (PPCS) | Free hospice and home-based care (especially in Kerala) |
| CanSupport, Pallium India, Karunashraya | NGOs offering free palliative services and counseling |
| Ayushman Bharat – HWC Model | Promotes palliative care at primary level (trained CHOs, ANMs) |
| Myth | Reality |
|---|---|
| Palliative care is only for cancer. | It is for any life-limiting illness. |
| It means “giving up.” | It means comfort and dignity, not abandoning treatment. |
| Pain in illness is unavoidable. | Proper pain management can relieve most suffering. |
Palliative care centres offer a gentle, holistic, and humane approach to managing life-limiting illness. Nurses are at the heart of palliative care, offering hands-on compassion, comfort, and continuity. By promoting early referral, home-based care, and emotional healing, we can help patients live well—even in their final moments.
Hospice care is a specialized form of palliative care focused on providing comfort, dignity, and holistic support to individuals in the final stages of a terminal illness, when curative treatment is no longer effective or desired.
Hospice care centers aim to help patients live their remaining life peacefully, free from pain and distress, while offering emotional and spiritual support to both patients and their families.
Hospice care centres are residential healthcare facilities that provide:
Hospices may operate as:
Hospice care is typically offered to patients with less than 6 months of expected life, such as those with:
| Nursing Role | Responsibilities |
|---|---|
| Pain and Symptom Relief | Administer analgesics (e.g., morphine), monitor comfort levels |
| Psychosocial Support | Counsel patients and families, reduce fear of death |
| ADL Support | Assist in bathing, feeding, oral hygiene, mobility |
| Family Education | Teach about caregiving, signs of approaching death |
| Spiritual Presence | Provide quiet companionship or refer to spiritual counselors |
| End-of-Life Care | Maintain calm, comfort, and respect during the final hours |
| Grief Support | Offer bereavement counseling to loved ones |
| Documentation | Maintain pain charts, care plans, DNR orders |
| Feature | Purpose |
|---|---|
| Pain Management Protocols | Standardized approaches for pain relief |
| Family-Centered Care | Families are involved in care decisions |
| Multidisciplinary Team | Includes doctor, nurse, counselor, social worker, volunteer |
| Calm Environment | Peaceful setting with privacy and comfort |
| Spiritual and Cultural Sensitivity | Rituals, prayers, last rites as per beliefs |
| Bereavement Programs | Counseling for families post-death |
| Aspect | Palliative Care | Hospice Care |
|---|---|---|
| Timing | At any stage of illness | Final stages of terminal illness |
| Goal | Improve quality of life while managing disease | Focus only on comfort and dignity |
| Treatment | Along with curative treatment | Curative treatment is stopped |
| Duration | Long-term | Usually for last 6 months or less |
| Hospice Provider | Location/Reach |
|---|---|
| CanSupport | Delhi NCR – home-based hospice and day-care |
| Shanti Avedna Sadan | Mumbai, Goa, Delhi – residential hospice |
| Karunashraya Hospice | Bengaluru – inpatient palliative and hospice care |
| Pallium India | Kerala – community and institutional hospice models |
| Sneha Sadan, Hope Foundation, etc. | Local NGO-run hospices in various states |
Hospice care centres provide compassionate, patient-centered, and family-inclusive support during the most vulnerable phase of life. Nurses play an essential role by offering gentle, respectful care, creating meaningful moments, and ensuring that death is approached with peace, dignity, and love.
An Assisted Living Facility is a residential community that offers housing, personal care, and limited medical support to people who are:
It is designed for individuals who do not need 24-hour nursing care, but cannot live completely on their own.
| Ideal Residents |
|---|
| Seniors needing help with bathing, dressing, eating |
| Individuals with mobility issues or mild disabilities |
| Elderly persons with memory loss or mild dementia |
| Adults recovering from surgery or illness (not bedbound) |
| People preferring a safe, community-based environment |
| Service Area | Examples |
|---|---|
| Personal Care Support | Bathing, grooming, dressing, toileting |
| Housekeeping & Laundry | Daily cleaning, linen change, personal laundry |
| Medication Management | Reminders, administration under supervision |
| Health Monitoring | Vital signs, chronic condition checks (BP, sugar, etc.) |
| Emergency Response | Staff on call, panic buttons, basic first aid |
| Meals & Nutrition | Balanced, age-appropriate meals and snacks |
| Recreational Activities | Games, music, yoga, group events, spiritual sessions |
| Transportation Assistance | For hospital visits, shopping, or outings |
| Nursing Role | Responsibilities |
|---|---|
| Assessment | Monitor residents’ physical and mental health |
| Care Planning | Develop personalized care plans |
| Medication Assistance | Supervise doses, check reactions or side effects |
| Wound/Chronic Illness Care | Basic nursing support for diabetes, HTN, skin care, etc. |
| Emergency Management | First response to falls, breathlessness, fever, etc. |
| Coordination | Liaise with doctors, hospitals, family members |
| Resident Education | Promote self-care, mobility exercises, mental stimulation |
| Record Keeping | Maintain resident care logs, vitals, incident reports |
Though still growing in India, some well-known providers include:
| Provider | Locations |
|---|---|
| Athulya Assisted Living | Chennai, Coimbatore |
| Antara Senior Living | Delhi NCR, Dehradun |
| Emoha Elder Care | Delhi NCR (also home-based assisted care) |
| CovaiCare, Asha Nivas | Bengaluru, Coimbatore, Pune |
✔️ Mostly private and self-paid models
✔️ Limited government-run assisted living homes
Assisted Living Facilities offer a balanced approach to aging with support and independence. Nurses and health staff in these settings play a crucial role in maintaining health, dignity, and happiness for elderly and dependent adults. As India’s aging population rises, assisted living will become an essential care model for dignified elder care.