Life would have been easier if my job was just to conduct the OPD and be done with it, but as the Medical Officer in charge of the hospital, there is a long list of extra responsibilities entrusted upon me. This mostly includes Administrative duties and social responsibilities.
In order to understand the process of administration in a hospital, one should be familiar with the staff pattern of the hospital. So let’s start from there.
The three main categories of employees in a government hospital are the Clinical staff, the Office staff and the Health workers.
The Clinical staff consists of doctors, the staff nurses, the pharmacists, the nursing assistants, hospital attenders, drivers (optional) and the part-time staff. The number of employees under each of these categories varies depending upon the type of the Hospital. For example, in a PHC like mine, there are only 2 doctors (including me), one staff nurse, one pharmacist, one lab technician, one nursing assistant etc. In a higher level of primary health care system, like in a Community Health Centre (CHC), there can be up to 4 specialist doctors, 7 staff nurses and so on.
The Office staff just consists of clerks and office assistants.In a PHC, there will only be one Clerk and one office assistant. Their number also increases as one goes up the ladder of hospitals. The office staff are mainly concerned with duties like managing the cash-books, creating and disbursing the monthly salary, all the treasury visitings, and to properly manage the office files associated with the hospital.
The Multi Purpose Health Workers (MPHW) aka JPHNs (Junior Public Health Nurse or MPHW-Female) and JHIs (Junior Health Inspector or MPW-Male). The JPHNs are headed by a PHN (Public Health Nurse) and the JHIs are headed by the HI (Health Inspector).
The MPHW are trained to provide primary health care including preventive, promotional and basic curative services operating from the grass-root level of primary health care which is called the ‘Sub-Centre’. They have many Institutional and field level duties which cannot be summarised in one single blog post. It requires the real commitment and hard work of these field staff for the proper implementation of all the National health programmes like the Pulse Polio Programme, the Mass Drug Administration programme, the Universal Immunisation Programme etc.. They have become the most important link between the community and various levels of primary health care institutions. Depending upon the level of the institution, the number of MPHW varies. In my PHC, there are 4 JHIs and 7 JPHNs, one HI and one PHN.
This topic cannot be completed without special mention to the ASHAs (Accredited Social Health Activist). One of the greatest contribution from NRHM (National Rural Health Mission) apart from funding many Health programmes was definitely building up a group of trained female community health activists in every village of India. These ladies who are selected from their own village and trained to become the crucial link between the community and the public health system are called ASHAs. If you want to learn more about an ASHA, click here.
I hope that you have now become familiar with the staff pattern in a public hospital. But, the thing to point out here is that none of the Private Hospitals or Private medical colleges have these MPHWs or similar categories of employees for giving primary health care services. They conduct medical camps and mostly offer just curative services which I do appreciate 🙂