Subcenters, Level 1 Primary health care center, not operational 24x7, Level 1 | 5,000 people or 3,000 in remote areas 30,000 or more people (20,000 in remote areas) | 1–2 inpatient/observation beds 6 inpatient/observation beds |
| • Identification and referral for danger signs • Pregnancy testing and counseling• Antenatal care• Intranatal care• Normal deliveries by skilled birth attendant (Partograph, active management of the third stage of labor, etc.)• Pre-referral management for obstetric emergencies (Eclampsia, postpartum hemorrhage, shock)• Postnatal care– 24–48 hours stay post-delivery• Immediate newborn care – drying, warming, skin-to-skin contact• Initiation of breastfeeding• Postpartum contraceptive counseling | Newborn Care Corner • Essential newborn care including resuscitation • Zero day immunization (OPV, BCG, Hepatitis B; as per Government of India schedule), Inj. Vit. K Care of normal newborn • Breastfeeding/ feeding support, thermo-regulation, and asepsis Care of sick newborn • Identification, stabilization, and initial management of complications (sepsis, low birth weight/premature babies, etc.) before referral and prompt referral of “sick” newborn • Referral services | Counseling and provision of spacing methods including interval intrauterine device |
Primary health care center operational 24x7, Level 2Non-first referral unit - community health care center, Level 2 | 30,000 or more people (20,000 in remote areas) 120,000 people in urban areas or 80,000 people in remote areas | 6 inpatient/observation beds 30 bedded | 1–2 Medical officers (on-call after outpatient department hours) Minimum 4 staff nurses/auxiliary nurse-midwives each for labor room and maternity ward 2 Lab technicians (for round-the-clock service delivery) Sweeper–3 for labor room (preferably female) and maternity ward HR for NBSU
| All services listed in facilities above in Level 1, plus the following:
Assisted vaginal deliveries Management of complications other than those requiring referral to L3 including blood transfusion or surgery Episiotomy and suturing Stabilization of obstetric emergencies and referral to L3 wherever required Antenatal steroids for preterm labor HIV screening 48 hours stay postdelivery Comprehensive abortion care Case management of sexually transmitted infection Antibiotics for preterm or premature rupture of membranes for prevention of sepsis of newborns
| NBSU (Newborn Stabilization Unit) All newborn care services those in Level 1, plus the following: Care of sick newborn • Identification and Management of LBW infants >/= 1800 gm with no other complications • Phototherapy for newborns with hyperbilirubinemia • Management of newborn sepsis • Stabilization and referral of sick newborns and those with very low birth weight | All Services provided in Level 1, plus the following: Female sterilization including post-partum sterilization, male sterilization (conventional and no-scalpel vasectomy) |
First referral unit community health center, Level 3 Subdistrict hospital / referral hospital, Level 3District hospital, Level 3 | 120,000 people in urban areas or 80,000 people in remote areas 100,000 - 500,00 population All population in the district (35,000 to 3,000,000) | 30 bedded 31–50 bedded for small population (100,000) – 51–100 beds for large population (500,000) 300 beds for 1,000,000 people population; As the population increase the recommended beds increase to a maximum of 500 beds | Specialists including gynecologist/ emergency obstetric care, anesthetist/LSAS, pediatrician Medical officers Staff nurse, cleaning staff, counselor, lab technician 1 certified sonologist (on call after routine hours) HR for SNCU | All services listed in facilities above in Level 1 and 2, plus the following:
Comprehensive management of all obstetric emergencies, e.g., PIH/eclampsia, sepsis, PPH, retained placenta, shock, obstructed labor, severe anemia Cesarean delivery and other surgical interventions Blood bank/storage center Blood grouping and cross-matching Link ART/ART at district hospital
| Sick newborn care unit All newborn care services those in Level 1 and 2, plus the following: Care of sick newborn
Identification and management of LBW infants >/= 1800 gm Management of all sick newborns (except those requiring mechanical ventilation and major surgical interventions) Follow-up of all babies discharged from the unit and including of high-risk newborns
| All services provided in Level 1 and 2, plus the following:
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