Series: Understanding MSDS for Basic Health Units | Post 1 of 46
“That Is for the Private Clinics”
Dr. Saima Nawaz had been the Women Medical Officer and in-charge of a Basic Health Unit near Renala Khurd, in Okara district, for four years. Her OPD saw close to a hundred patients on a busy morning. The LHV ran the antenatal clinic, the vaccinator covered the villages on a fixed tour programme, and the Lady Health Workers of the catchment brought their monthly reports every month without fail.
When a colleague at the district meeting mentioned the Minimum Service Delivery Standards, Dr. Saima shrugged. “The Healthcare Commission is for private hospitals and clinics. We are a government facility. The district health office inspects us.”
Her colleague opened a booklet on her phone. It was titled “MSDS and Indicators for Basic Health Units (Cat-III HCEs)”, Edition 1, published by the Punjab Healthcare Commission. It had been written for facilities exactly like hers.
Why a Government BHU Is Covered
The introduction of the manual is clear on this point. The Government of the Punjab promulgated the Punjab Healthcare Commission (PHC) Act 2010. Under it, the Commission is legally mandated to regulate all Healthcare Establishments (HCEs) in the public and private sectors through registration, to prescribe minimum service delivery standards for all categories of HCEs, and to license them on the basis of implementation of the respective set of MSDS. A footnote in the manual adds that under Section 13 of the PHC Act 2010, all HCEs are required to get registered with the PHC.
The manual also explains why BHUs needed their own set. As per government policy, one BHU is provided at every rural union council to give the rural population access to affordable and equitable primary healthcare. A BHU provides all eight components of primary healthcare, so its standards had to be consistent with the Essential Package of Health Services (EPHS) prescribed by the government. They could not simply copy the standards written for a general practitioner’s clinic or a single specialty clinic. The enhanced scope of BHUs working on a 24/7 basis for maternal and neonatal care was also considered.
What the Manual Contains
The MSDS for BHUs comprise 24 standards and 75 indicators, organized in 10 functional areas:
- 2.1 Responsibilities of Management (ROM): Standards 1 to 4, Indicators 1 to 13
- 2.2 Facility Management and Safety (FMS): Standards 5 to 7, Indicators 14 to 19
- 2.3 Human Resource Management (HRM): Standards 8 to 10, Indicators 20 to 25
- 2.4 Information Management Systems (IMS): Standard 11, Indicators 26 to 32
- 2.5 Quality Assurance (QA) / Quality Improvement (QI): Standards 12 and 13, Indicators 33 to 35
- 2.6 Access, Assessment and Continuity of Care (AAC): Standards 14 and 15, Indicators 36 to 40
- 2.7 Care of Patients (COP): Standards 16 and 17, Indicators 41 to 51
- 2.8 Management of Medications (MOM) / Dispensing: Standards 18 to 20, Indicators 52 to 65
- 2.9 Patient Rights and Education (PRE): Standards 21 to 23, Indicators 66 to 74
- 2.10 Infection Control (IC): Standard 24, Indicator 75
A survey process and scoring method is given after each indicator. The reference manual then provides Standard Operating Procedures for implementing the MSDS, where section 2.N explains Indicator N. It also carries the job descriptions of BHU staff and a Self-Assessment Scoring Matrix for use by the BHU staff themselves.
Compliance with the applicable standards, on the basis of the declared scope of services of a particular BHU, is required to qualify for the regular license from the PHC. Standards or indicators that are not applicable to a particular BHU are excluded during assessment.
What Dr. Saima Did Next
She obtained her own copy of the manual and read it over two evenings. Much of it described work her staff already did: immunization, antenatal care, DHIS reporting. The difference was that the manual asked for proof. A register, a displayed chart, a signed record, a staff member who could explain the procedure when asked.
She called a short staff meeting, read out the ten functional areas and assigned each to one person to study against the SOPs. The dispenser took medicines, the LHV took obstetric care, and Dr. Saima kept management and records for herself. Within a month they had their first honest self-assessment on the scoring matrix, with a list of gaps to close.
A Quick Self-Check
- Do you have a copy of the MSDS and Indicators for Basic Health Units at your BHU?
- Is your BHU registered with the PHC, as the PHC Act 2010 requires of all HCEs?
- Can you name the 10 functional areas the standards are grouped into?
- Has your staff read the SOPs for the indicators that relate to their own work?
- Have you scored your BHU on the Self-Assessment Scoring Matrix?
Rate this article
How useful was it for you?
UPMED reads every review; some are shown on this page.
Log in to write a few lines too.