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Children at Dhapo Colony Slum

Tuesday, February 21, 2023

Mahfooz (Formerly Quality Institutional Care and Alternative for Children (QIC & AC), UP

 

 

Mahfooz

(Formerly Quality Institutional Care and Alternative for Children (QIC & AC), UP)

-         A campaign for child rights since 2006

 

Growing up in an institution puts children at risk of physical, emotional and social harm. Every child has the right to grow up in a supportive family environment.  Children may be separated from their parents and placed in alternative care for various reasons like armed conflict, natural disaster and migration etc.  Still others may be separated as a result of government policies that fail to prioritize families or account for a child’s most basic need for nurturing care – a critical element of healthy growth and development.

It is with this issues and challenges in mind, the Quality Institutional Care and Alternative for Children (QIC-AC) came into existent in 2006. QIC-AC is an initiative by U.P based voluntary Organizations working in Allahabad, Varanasi, Badaun, Meerut, Lucknow, Sonbhadra, Bahraich, Mirzapur, Kaushambi and Ambadkarnagar for the rights, dignity and development of children living in the most difficult circumstances.  it is a network working for the rights, dignity and the development of children living in the most difficult circumstances. The network has been also working for the social emancipation of child labour and children in servitude in Uttar Pradesh.

The aim of QIC-AC is to promote and protect the rights of children through advocacy and networking, through strengthening the capacity of civil societies, CBOs and the government stakeholders.

 In the Annual Meeting of 2011, its members felt the need rename QIC-AC so that a common citizen in rural and urban UP understands it and connects with it easily. The group felt that the name is in English and too long to be understood by the common people. “Mahfooz” (meaning safe and secure) was the new name of QIC-AC adopted in 2011.

Mahfooz is an alliance of more than 50 organizations in Uttar Pradesh. It is the largest child protection network at the grassroot level currently active in the state of Uttar-Pradesh.

 After the formation of the network in 2006, QIC-AC conducted a primary research through collecting quantitative and qualitative data from all the  care & protection homes and remand homes  to understanding the issues of child protections across Uttar Pradesh.  through its working partner. It was found out that the conditions of the children in these homes are very pathetic and inhumane.  

QIC-AC/Mahfooz Focuses on:

·         Accelerate efforts to end the institutionalization of children, through targeted programming and advocacy.

·         Strengthen families to prevent family-child separation, and improve child protection and welfare.

·         Redirect resources and prioritize family-based alternative care within communities.

·         Improve data collection and reporting systems for children without parental care.

·         Advocacy: QIC-AC/ Mahfooz is doing regular advocacy for the implementation of the ICPS scheme, Juvenile justice act recommendations, and effective implementation of the child labor prohibition act and child marriage prohibition act. This includes drafting of first model rules for the child marriage act accepted by SCPCR.

·          Training: QIC-AC/ Mahfooz has trained para-legal volunteers, SJPUs, JJBs & CWCs members over the years for the strong implementation of child protection policies in the state.

·          Research: QIC-AC/ Mahfooz has done small and effective action research on the situation of children in CCIs, child marriage act implementation, challenges, etc

·          Monitoring state legislation: Together with other civil society actors Mahfooz has submitted suggestions on child protection policies and laws including recommendations on the trafficking bill, Juvenile justice state rules, POCSO implementation, child marriage prohibition act, and CLPRA

It is the largest network for child rights with the focus on child protection in Uttar Pradesh. It felt that the Juvenile justice is facing problems in UP.  The juvenile justice was facing many problems and trials were getting prolonged due to lack of proper police support. There was no home for the care of girls and mentally challenged children.

 

The journey is still on…

 

Voice of People (VOP), UP alliance partner of NAFRE

 

 

Voice of People (VOP)

                                        जिसका मुद्दा उसकी लड़ाई, 

                 जिसकी लड़ाई उसकी अगुवाई

Voice of People (VOP) was started in Uttar Pradesh as a campaign to propose a constitutional amendment to the government for free and compulsory education to all children in 2002. The National Alliance for the Fundamental Right to Education (NAFRE) was doing the same campaign at the national level. There was a clear difference between the NAFRE and VOP. The NAFRE was a national level alliance for ensuring every child get access to education as a fundamental right but VOP was a UP state level network working on child rights like education, health, nutrition and participation.  The alliance working under NAFRE disappeared after 2010 but the VOP is still working in Uttar Pradesh. 

VOP envisions a healthy, empowered, environmentally protected society, promoting social issues for behavioural change in Uttar Pradesh. Enhancing and influencing Knowledge, Attitude and Practice (KAP) in the intervention areas has been one of the core issues of the VOP. Education, health and nutrition has been the core area of the intervention of the network members.

Mission

•        Advocacy and networking with government to ensure access to education, health services and nutritious food.

•        Advocacy for opening of new schools, new ICDS centres and coverage of more communities under ASHA workers and ANMs.

•        Enabling/Training villagers on kitchen garden concept to ensure that their children and pregnant women get nutritious food.

•        Enable community mechanisms to manage common resources and needs to ensure happy and healthy childhood in their UP.

•        Enable community people especially women and children to access health care facilities

•        Inclusion of excluded and their entitlement in all Development activities/programmes.

•        These are some of the important

 

VOP champions innovative methods and technology that enable its member organization to play a critical role in the policy making process for the most marginalised section of Uttar Pradesh. VOP regularly conducts primary research to understand views of the people directly affecting its interventions.  VOP seeks to give the people from its intervention areas a greater voice in government by promoting the use of new methods and technologies like public hearing, consultation of civil society and government stakeholders and also sharing the ground reports with the concern state level departments and ministries.

Under the leadership of the VOP different groups were formed at the village level between 1999 and 2008. These CBOs played critical role in the child rights movement in UP.  Important among them were Mahila Haqdari Morcha, Kisan Sangathan, and Bal Manch. These groups were empowered to the extent that they could influence village-level politics. They ensured that all the village heads (Gram Pradhan) passed a resolution to open government schools in their respective villages.

 

VOP is network of civil societies. It is not a registered body. Most of the members of the VOP are working for the development of the most deprived section of our society.

The Criteria to be member of VOP:

·         Understanding of Child Rights Issues in Uttar Pradesh

o   Right to Survival

o   Right to Development

o   Right to Protection

o   Right to Participation

·         Members should be from UP

·         Should have been working in UP for more than 3 years on child rights issues

 

National Alliance for the Fundamental Right to Education (NAFRE)- An Initiative Before RTE Forum formation

 By Dr. Shaheen Ansari 

“Make Childcare and Education part of Fundamental Rights” was call given by a group of organizations and individuals working on child rights in 1998. According to The Times of India dated November 19, 2001 “…an alliance of 2,400 voluntary organisations working in the field of education which have come together to ensure that education becomes an effective fundamental right.” An alliance of these groups was formed on May 23, 1998 and came to be known as The National Alliance for the Fundamental Right to Education (NAFRE).

The Supreme Court’s landmark judgment in Unnikrishnan V/s State of Andhra Pradesh in 1993 expanded the scope of Article 21 of the Constitution of India to include the Right to Education.   NAFRE was a direct consequence of attempts to generate a campaign to support the SC judgement to make education a fundamental right.  A two days National Conference on Fundamental Right to Education was organised from May 24 to 25, 1998 in in New Delhi.

The NAFRE was not a registered body. It was envisaged as a platform of likeminded individual and organizations for making education a fundamental right. Many organizations had different views and understanding of different issues but were united on the minimum basis of a broad understanding that every child has a fundamental right to education and that it must be realized with a great deal of urgency.  In this regard. Article 45 of the Constitution of India and the Supreme Court Judgment in the case of Unnikrishnan vs the state of Andhra Pradesh will define the minimum basis of unity until further advancement of the Constitutional or legal status of the matter.

The advocacy and networking resulted in the 86th Constitutional Amendment (2002). It inserted Article 21A in the Indian Constitution which states: “The State shall provide free and compulsory education to all children of 6 to 14 years in such manner as the State, may by law determine.”

The NAFRE became a pan India movement and worked till 2010, one year after the passing of “the Right of Children to Free and Compulsory Education Act, 2009”. Though the RTE Act 2009 was not as per the demand of the members of NAFRE but it slowly and gradually withdrew the campaign and advocacy for making Childcare and Education part of Fundamental Rights. It has a long history but let us see the important points related to the NAFRE.

CRY participated in the ‘Voice Of India’ campaign, as a part of the National Alliance for the Fundamental Right to Education (NAFRE), to propose a constitutional amendment to the government for free and compulsory education to all children. As a result of the ‘Voice of India’ campaign, NAFRE contributed towards bringing in the Right of Children to Free and Compulsory Education Act, 2009.

 

NAFRE’s Objectives/Goals on Education:

•        Education is a fundamental right of every child. All children must be in school, not-at work:

•        The right to education of every Indian child should be realized by year 2005. This is possible.

•        Quality and equitability of education must improve all across India.

•        Government cannot successfully implement the right to education on its own. People's participation is essential. Mechanisms have to be developed at the school and in administration through models, statutes, and mutual cooperation to encourage effective participation of people.

•        In spite of differing views on various specific issues, anyone participating in the Alliance must actively work to make sure that aLL children are in school and learning.

•        Factors impeding universalisation of elementary education are more social political, and cultural in nature.

·         Improvement of pedagogical techniques and their wide, effective dissemination is essential to make school learning effective. This is also a way to involve more teachers, parents and to overcome the impediments.

•        Replicable large-scale work is important.

•        All sections of the civil society have to work together. Empowerment of teachers and parents arc key issues.

·         In order to ensure that aLL children are in school, it is essential to counter gender bias at all stages and levels.

·         The Alliance will not work in a manner that may undermine, nationally or internationally, the gains of the last fifty years and the long history of social reform and struggle for self-reliance.

 

What will the NAFRE do?

The Alliance will work in a multi-pronged manner. It will:

•        act as a platform to voice various opinions about specific issues so that more and more people who are normally away from such debates learn about them and participate in creating a broader consensus

•        work with all levels of government, the Parliament, the people, the media and industry/business to make fundamental right to education and related matters a national priority.

•        monitor the status of education while also encouraging, creating, and catalyzing large-scale replicable models of realization of the fundamental right.

•        work to gather and disseminate factual information about education, not only to opinion-makers and policymakers but also to the parents of children whose future is at stake.

 

Who can participate in the Alliance?

At this time, any organization or individual who can contribute to the work of the Alliance will become a part of the Alliance at the recommendation of one of the founding partners.

The Alliance is no exclusive club. Nor is it a closed-door organization.  A group of a few organizations meeting occasionally cannot hope to make an impact on the status of education nationally. We must make an impact. Large numbers of organizations working in some harmony across the country for the realization of the fundamental right to education are essential for the formation of a true National Alliance The few major organizations who have joined together to form the Alliance will work to make it grow.

 

Who will decide policies and action plans? How?

The Alliance is not a static entity. As it evolves and grows, the methods of running the organization will also evolve Decision-making processes have to suit the form of organization and the goals/ activity of the organization. The small number of founding partners have met in Delhi twice and have taken a few decisions by mutual consultation. As our state and district-level activities grow, State Chapters and a National Coordinating Group will be formed. The decision-making process will go on changing. If it does not, there will be no Alliance! Hence, we will have to make a beginning and allow the best-suited decision-making process to evolve for each state and at the national level.

One clear restriction will be that no one will make policy statements on behalf of the Alliance unless a due process is followed. Also, no action anywhere can be called an Alliance action unless it is approved through due process. The meaning of "'due process' will change continuously until the Alliance has reached a sizable strength in terms of numbers, geographic coverage, and commitment of partners.

Any decision-making process, which leads to narrowing the scope for participation by large numbers of people, or which causes inaction, or causes undue delays in action, cannot be justified in the context of the National Alliance.

 

What action is planned at this time? Can it be changed? Modified?

•        Campaign to meet every MP across the country in her/his constituency in order to inform them and to gauge their response. In order to make this campaign a success, we will have to contact and induct at least one group in every Lok Sabha constituency to join the Alliance action. The campaign is not only an advocacy action, but also an exercise in building an organization through this action.

•        Work in about 1000 villages and a few cities to create models of realizing the children's right to education through activation of people. This exercise will help us to exchange experiences in different parts of the country. It will also help us to evolve, learn, and document replicable solutions to universal and specific problems.

 

In the first action, a common discipline and time-schedule will have to be followed so that we come across as an Alliance. In the latter plan, each individual or organization will have the opportunity to try different models and philosophies to ensure realization of the right to education of every child in the given group of villages. There is sufficient scope to try out different models and ideas in the 1000 village plan

 

What about financing activities of the Alliance?

The founding partners have decided that, at least for the time being, there will be no central pool of funds. As and when activities are decided upon, the Funding agencies in the Alliance will have bilateral or multilateral understanding with the grassroots organizations concerned about meeting financial needs.

In the final analysis...

Ultimately, the survival and success of the National Alliance will depend upon how much we can trust one other, whether we can make a better impact together than we can individually, whether we activate people in large numbers or we get entangled in debates.

तुम्हारे पाँव के नीचे कोई ज़मीन नहीं / दुष्यंत कुमार

 



तुम्हारे पाँव के नीचे कोई ज़मीन नहीं
कमाल ये है कि फिर भी तुम्हें यक़ीन नहीं

मैं बेपनाह अँधेरों को सुब्ह कैसे कहूँ
मैं इन नज़ारों का अँधा तमाशबीन नहीं

तेरी ज़ुबान है झूठी ज्म्हूरियत की तरह
तू एक ज़लील-सी गाली से बेहतरीन नहीं

तुम्हीं से प्यार जतायें तुम्हीं को खा जाएँ
अदीब यों तो सियासी हैं पर कमीन नहीं

तुझे क़सम है ख़ुदी को बहुत हलाक न कर
तु इस मशीन का पुर्ज़ा है तू मशीन नहीं

बहुत मशहूर है आएँ ज़रूर आप यहाँ
ये मुल्क देखने लायक़ तो है हसीन नहीं

ज़रा-सा तौर-तरीक़ों में हेर-फेर करो
तुम्हारे हाथ में कालर हो, आस्तीन नहीं

Friday, January 27, 2023

इस ज़मीं पर तो प्यार बिखरा है

इस ज़मीं पर तो प्यार बिखरा है 

धर्म के नाम पर सियासत में 
इतनी नफ़रत कहाँ से लाते हो
इस ज़मीं पर तो प्यार बिखरा है 
जिसको क़ुदरत1 ने ख़ुद सँवारा है 

ढलते सूरज पे इक नज़र डालो 
उसके दामन में अब्र2 का टुकड़ा 
महव-ए-हैरत3 हूँ, लाखों रंगों से 
खेलता है कि जैसे सारे रंग
अब बिखेरेगा, तब बिखेरेगा 
और हंगाम-ए-रंग-ओ-बू4 के तुफ़ैल5 
इन हवाओं में, इन फ़िज़ाओं में 
अम्न के सुर बिखरते देखोगे 
उसको देखो ज़रा नज़र भर कर

इक ज़रा ठहरो चाँद निकलेगा 
अपने दाग़ों को दूध से धो कर 
आसमाँ की बिसात पर देखो 
सारे तारों के नरम मोहरों को 
एक एक करके फिर सजाएगा 
और तुमसे करेगा सरगोशी6 
दिल ये ग़मगीन है अगर तो क्या 
रात संगीन7 है अगर तो क्या 
सुबह आएगी, नूर बिखरेगा 
खेलते खेलते सफ़र अपना 
मंज़िलों का पता बताएगा 

सुबहदम8 चल के घास पर देखो 
प्यार की धुन पे लाखों बूँदों को 
अम्न के गीत गाते पाओगे
और सबा9 पास से जो गुज़रेगी 
तुमको एहसास बस यही होगा 
‘जैसे कह दी किसी ने प्यार की बात’

बिखरे फूलों ने लाखों रंगों से 
सारे गुलशन को यूँ सजाया है 
जैसे कहते हों इक ज़रा सोचो 
इश्क़ की कोई हद नहीं होती 

बहते दरिया की नर्म मौजें हों 
या कि सहरा10 में रेत के ज़र्रे 
परबतों की हसीन वादी या 
बिखरी बिखरी से बर्फ़ की परतें 
झूमते गाते सारे झरने भी 
हमको पैग़ाम-ए-अम्न देते हैं 

और चाहो तो आँख बंद कर लो 
दिल की आवाज़ को सुनो, पैहम 
धड़कनें तुमको ये बताएँगी 
इस ज़मीं पर तो प्यार बिखरा है 

नफ़रतें बस सियासतों में हैं 
हर सियासत के ऐसे पहलू को 
दिल से अपने निकालना होगा 
अम्न के, आशिक़ी के पैकर11 में 
हर सियासत को ढालना होगा 

दिल्ली 
05.01.2023

1. क़ुदरत = प्रकृति, 2. अब्र = बादल, 3. महव-ए-हैरत = हैरत में, 4. हंगाम-ए-रंग-ओ-बू = रंग और बू का हंगामा, 5. तुफ़ैल = वजह से, 6. सरगोशी = धीमी आवाज़ में बात करना, 7. संगीन = सख़्त, पत्थर जैसी, 8. सुबहदम = सुबह के वक़्त, 9. सबा = अच्छी बहती हवा, 10. सहरा = रेगिस्तान, 11. पैकर = आकार

Wednesday, December 21, 2022

Note on IPHS 2022

 

Note on IPHS 2022

Introduction/ Background:

Milestones

·         1952- Establishment of PHCs in India

·         1978- Alma Ata Declaration – “Health for All” through the Primary Health Care Approach

·         India signed it and committed to achieve health for all by 2000

·         2005- National Rural Health Mission (NRHM)

·         2007- Indian Public Health Standards (IPHS)

·         2012- First Revision  of IPHS

·         2013- National Urban Health Mission (NUHM)

·         2017- National Health Policy

·         2018- Ayushman Bharat Health and Wellness Centres (AB-HWCs)

·         2022- Second Revision of IPHS

·         India has committed to achieve Universal Health Coverage (UHC) by 2030- The concept covers three key elements — access, quality, and financial protection.

 

India is a signatory to the Alma Ata Declaration of 1978 and had committed to attaining “Health for All” by 2000 through the Primary Health Care approach. It was the first international declaration underlining the importance of primary health care.  Primary Health Care seeks to extend the first level of the health system from sick care to the development of health. It seeks to protect and promote the health of defined population health problems at an early stage. The National Rural Health Mission (NRHM) was launched by the Prime Minister of India in 2005 with a goal to improve the availability and accessibility of quality health care to the people, especially for those residing in rural areas, the poor, and women.

There is a three tier system of healthcare in rural areas which starts with the Sub Centre, then the Primary Health Centre (PHCs) and the last one is the Community Health Centre.  The establishment of PHCs in India started as early as in 1952, and there have been several changes to meet the increasing demand for health care services. Quality services like preventive, promotive, curative, supervisory, and outreach services are to be provided by the PHCs, and the National Rural Health Mission 2005 (NRHM 2005) aimed at strengthening the PHCs for this.

The Indian Public Health Standards (IPHS) was first published in 2007 under the NRHM 2005. IPHS have been used as reference points for public health care infrastructure planning and upgradation. The IPHS was first revised in 2012 and then in 2022.

Since the  last  revision  of  the  IPHS  in  2012,  a  number  of  new  initiatives,  interventions,  programmes  and  projects  have  been  introduced  in  the  public  health  system.  The  introduction  of  comprehensive  primary  health  care  through  strengthened  sub-centres  and  PHCs  (now  known  as  Health  and  Wellness  Centres  or  HWC), and similarly, in urban areas, Urban Health and Wellness Centres, speciality UPHCs (Polyclinics), are some of the new additions. Since then, key policy shifts have been proposed under the National Health Policy 2017 (NHP 2017) for public health care delivery system in the following areas:

·         Clinical care: From standalone curative to a preventive, promotive and rehabilitative approach for achieving comprehensive wellness in health.

·         Primary care: From selective care to assured comprehensive care with linkages to referral hospitals.

·         Drugs,  diagnostics,  and  emergency  services:  From  user  fees and  cost  recovery  to  assured  free  drugs, diagnostic and emergency services to all in public hospitals.

·         Infrastructure  and  human  resource  for  health  development:  From  a  normative  approach  to  a  targeted approach to reach underserved areas with “time to care approach”.

·         Urban health: From token interventions to on-scale assured interventions to organise PHC delivery and referral support for urban poor. Also, to advocate for collaboration with other sectors to address wider determinants of urban health.

·         National Health Programmes: Integration with health systems for programme effectiveness and in turn contributing to strengthening health systems for efficiency.

The above mentioned are the important developments in the domain of “Health for All”. The NHP 2017 and Ayushman Bharat 2018 necessitated the revision of IPHS 2012. It is essential to incorporate them in existing IPHS.

 

The Indian Public Health Standard 2022 (IPHS 2022):

India has commitment to achieve Universal Health Coverage (UHC) by 2030. The concept covers three key elements — access, quality, and financial protection. According to NITI Aayog “UHC entails ensuring all people have access to quality health services – including prevention, promotion, treatment, rehabilitation, and palliation – without incurring financial hardship. The concept covers three key elements — access, quality, and financial protection. India is committed to achieving Universal Health care for all by 2030, which is fundamental to achieving the other Sustainable Development Goals.”. These are the guiding principles while developing the IPHS 2022 document.

The IPHS 2022 guidelines have been framed for:

·         District Hospitals (DH) & Sub-District Hospitals (SDH).

·         Community Health Centres (CHC) – rural and urban.

·         Primary Health Centres (PHC) and Health and Wellness Centre for rural and urban, including Multispecialty UPHC (Polyclinics) in urban areas.

·         Sub-health Centre- Health and Wellness Centre (SHC-HWC) for rural and urban areas.

The National Health Policy 2017 envisages the attainment of the highest possible level of health and well-being for all. It aspires to achieve increased and more equitable access to healthcare by improving quality and investment in public health. An important steps towards improving quality of healthcare delivery is through the IPHS; a set of uniform standards to provide norms and benchmarks for quality of infrastructure, human resources services to be delivered from public health facilities at all level. 

With the launch of NUHM 2013, NHP 2017, and AB in 2018, the focus has shifted from selective health services to comprehensive and quality Primary and Secondary health care services to all population irrespective of their geographical location or financial status from Health & Wellness Centre (HWC) level to District Hospital level.   

HWCs have been designated to provide 12 packages of comprehensive Primary Health Care while Community Health Centres (CHCs) have been designated to provide basic secondary care services near to the community with special focus to the underserved and remote areas of the community. District Hospitals supported by Sub-District Hospitals are the epicentre in a district for providing assured secondary care referral care services for those referred from HWCs and CHCs.

Revision of IPHS guidelines for DHs, SDHs, CHCs and PHCs was required to include the widened scope of comprehensive Primary Health Care services and strengthen the secondary healthcare service delivery.

 

 

 

 

 

2012

Health care delivery in India has been envisaged at three levels namely primary, secondary and tertiary. The secondary level of health care essentially includes Community Health Centres (CHCs), constituting the  First Referral Units (FRUs) and the Sub-district and District Hospitals. The CHCs were designed to provide

referral health care for cases from the Primary Health Centres level and for cases in need of specialist care approaching the centre directly.

2022

4 PHCs are included under each CHC thus catering to approximately 80,000 populations in tribal/hilly/desert areas and 1,20,000 population for plain areas

Community Health Centre in rural areas (CHC) is to be established for a population norm of 80,000 (in hilly and tribal areas) and 1,20,000 (in plains) and/or time to care approach.

CHC is a 30-bedded hospital providing specialist care in Medicine, Obstetrics and Gynecology, Surgery, Paediatrics, Dental and AYUSH.

 

There are 4535 CHCs functioning in the country as on March 2010 as per Rural Health Statistics Bulletin 2010.

 

Objectives of Indian Public Health

Standards (IPHS) for CHCs:

·         To provide optimal expert care to the community.

·         To achieve and maintain an acceptable standard of quality of care.

·         To ensure that services at CHC are commensurate with universal best practices and are responsive and sensitive to the client needs/expectations.

The broad objectives of the IPHS for public health facilities includes the following: To define uniform benchmark ensuring high quality services that are accountable, responsive, and sensitive to the needs of the community.

1. To specify the minimum assured (Essential) and achievable (Desirable) services that are expected to be provided at different levels of public health facilities.

2. To provide guidance on health systems strengthening components which includes architectural design of facilities, human resources for health, drugs, diagnostics, equipment, administrative and logistical support services to improve the overall health related outcomes.

3. To achieve and maintain an acceptable standard of the quality of care at public facilities. 4. To facilitate monitoring and supervision of the facilities. 5. To provide guidance and tools for governance, leadership and evaluation

Physical Infrastructure

Disaster Prevention Measures: (For all new upcoming facilities in seismic zone 5 or other disaster prone areas). Building structure and the internal structure should be made disaster proof especially earthquake proof, flood proof and equipped with fire protection measures.

Disaster And Emergency Preparedness:

All health care facilities should be resilient to climatic and environmental changes. They should also be capable of handling sudden health care needs during disasters and unforeseen emergencies/epidemics/ pandemics.

Emergency Room/Casualty:

At the moment, the emergency cases are being attended in OPD during OPD hours and in inpatient units afterwards. It is recommended to

have a separate earmarked emergency area to be located near the entrance of hospital preferably having 4 rooms (one for doctor,

one for minor OT, one for plaster/dressing)

and one for patient observation (At least 4

beds).

Emergency Care:

Every district should have at least one district hospital which should be comprehensively functional for providing secondary care services as defined in the guidelines. While all secondary care services are important, certain critical services like emergency, High Dependency Unit (HDU)/Intensive Care Unit (ICU), Operation Theatre (OT), Labour Delivery & Recovery complex, Special Newborn Care Unit (SNCU), lab and imaging services, etc. need to be prioritised.

 

While operationalising any FRU, the population norms of five lakhs and/or time to care approach should be taken into consideration. The principle for the ‘time to care’ approach should ensure the availability of emergency care services and stabilisation of the patient within the ‘Golden

Hour’ from the onset of the emergency within the population being catered to.