Enhancing Public Health Services at Block Level: BPHU Overview
The Block Public Health Unit (BPHU) plays a crucial role in improving public health outcomes at the block level by augmenting healthcare services, strengthening referral systems, and focusing on social and environmental determinants of health. Key components, functions, and goals of BPHUs are outlined to enhance the existing healthcare infrastructure and respond effectively to public health emergencies.
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BLOCK PUBLIC HEALTH UNIT (BPHU) Prasanth K S/ NHSRC Regional workshop on 15FC/PM-ABHIM Lucknow / August 2022
Background Key Components of BPHU Factors to be considered in implementing BPHU CONTENT Financial details and Unit cost
BACKGROUND 15ThFC Support for Diagnostic Infrastructure at primary healthcare facilities Block Public Health Units Support for Diagnostic Infrastructure at Urban primary healthcare facilities Conversion of rural PHCs and SHCs to HWCs Building-less SHCs, PHCs and CHCs Urban Health and Wellness Centres PM ABHIM Building-less SHCs Urban Health and Wellness Centres Critical care blocks Integrated Public health labs Block Public health units Overlapped component 19-09-2024 3
INTRODUCTION Health facility at the Block level provides a limited range of clinical services mainly RMNCHA and selected infectious diseases. Most often fails in providing referral support to HWCs (SHC/PHC) within the block Capacity of these units to respond to / handle public health emergencies (outbreak detection/control/surveillance), was exposed by Covid. Block unit provides administrative control of health institutions within the block Need to augment the existing capacity of the Public healthcare system structure at the Block level to meet the requirements of a coordinated public health response (especially public health surveillance and response), referral support for HWCs at SHC & PHC level and increased attention to social & environmental determinants impacting health.
BLOCK PUBLIC HEALTH UNITS (BPHU) Every block in country is envisaged as having a CHC/ Block PHC/ SDH at the block headquarter which serves as a hub for referral from the SHCs and PHCs of the block COMPONENTS Block Public Health Lab Block Public Health facility Block HMIS Cell Block public health units are proposed in all blocks in 28 states under FC XV. BPHU 11 priority states are covered under PM-ABHIM
THE BLOCK PUBLIC HEALTH UNIT Responsible for developing a Block Level Plan, that sets block specific targets for national health programs, and brings improvement in population health outcomes, including focus on social and environmental determinants of health. Key Roles: Augment capacity of the Block facility to provide an expanded range of clinical services and serve as the referral point for the HWC in the block Support and supervise peripheral facilities (Health and Wellness Centers), Conducting school health programs, RBSK, community health awareness campaigns etc. Public Health Functions such as surveillance, and early detection of outbreaks, emergency preparedness and planning Enable health system preparedness and ensure early & timely response during outbreaks 6
THE BLOCK PUBLIC HEALTH LABORATORY BPHL would serve as a diagnostic hub for all the HWCs functional under its administrative control within the block. Key Roles: Conduct all Point of Care Tests (POCT) Provide comprehensive diagnostic facilities for infectious and non-infectious diseases to enable public health surveillance and support in generating evidence and confirmation of potential disease outbreaks (Improve disease surveillance (both human and animal) to support in generating evidence/forecasting potential outbreaks). Serve as hub for the diagnostic functions of the HWC in the block. Support the identification of initial cases associated with an outbreak, and actively coordinate / participate with the rapid response teams engaged in outbreak investigations. 7
THE BLOCK HMIS CELL Mandated to collect, compile and analyze clinical, program and public health data to ensure effective monitoring, enable early detection of outbreaks. Key Roles: To undertake Data recording and compilation from peripheral facilities for decentralized reporting Analysis to support planning and monitoring of disease trends. Use data to identify pockets of higher morbidity/mortality and enable focused interventions. Enable strong local surveillance and enable early detection of outbreaks & EWS. Generate reports for information and timely and appropriate corrective action by service providers and public health managers. The cell would also link with the district HMIS unit and be integrated with the IHIP. The BPHU would also leverage Electronic Health Records (EHR) through the National Digital Health Mission (NDHM) 8
FACTORS TO BE CONSIDERED IN IMPLEMENTING BPHU Blocks located in the Aspirational district /tribal /backward / remote areas of the districts may be given preference. Preferably, blocks with good infrastructure set-up and complete / near-complete HR availability should be given preference in the first few years Avoid duplication of Funds i.e., FC-XV Health Grants, PM-ABHIM or with other sources The States /District may pool in additional funds from other sources like District Mineral Fund (DMF), CSR funds, etc. as supplementary financial resources required to cover the additional / newly formed blocks in the State 9
FACTORS TO BE CONSIDERED IN IMPLEMENTING BPHU The components of BPHU should preferably be located in the same premises. Suggestive area for the BPHU and BPHL will be 1000 Sq Ft each and 500 Sq Ft for HMIS cell. The existing HR of the facility and the BPMU, would be part of the BPHU. The HR at the designated health facility where BPHU will be established shall be as per Indian Public Health Standards (IPHS)
BLOCK PUBLIC HEALTH UNIT S No. 1 Infrastructure 1.1 Area (sq. ft.) 1.2 Cost (2000 per sq. ft.) (one time) 2 IT Equipment 2.1 Set up Cost (one time) Total non-recurring 2.2 Recurring cost 3 Monitoring and Supervision 4 Human resource (all HR will be as per existing IPHS & BPMU some add on HR is reflected here for one year) 4.1 Epidemiologist/Entomologist 42,500 per Epidemiologist (1 / Unit) Particulars Cost per Block Public Health Unit (in Rs.) Total (in Rs.) 1000 20,00,000 UNIT COST 20,00,000 2,00,000 2,00,000 22,00,000 48,000 24,000 4,000 per month 2,000 per month 42,500 4.2 4.3 Public Health Personnel Veterinary Doctors (Hiring/linkages with veterinary department) Lab Technician HR Cost per month HR Cost per Year Recurring cost per year (HR+ Others) 42,500 per specialist (1 / Unit) 42,500 0 - 4.4 24000 per technician (1 / Unit) 24,000 1,09,000 13,08,000 13,80,000
BLOCK PUBLIC HEALTH LABORATORY SL . 1 Infrastructure 1.1 Area (sq. ft.) 1.2 Cost (2000 per sq. ft.) (one time) 2 Equipment: additional equipment indicated below is required Particulars Cost per Block Public Health Unit (in Rs.) Total (in Rs.) 1000 20,00,000 20,00,000 UNIT COST 2.1 Hemoglobinometer electronic 2.2 Semiautomated Biochemistry analyser OR Fully automated Biochemistry analyser 2.3 Hematology analyser 2.4 Spirometer 2.5 Rotor/shaker 2.6 ESR analyser 2.7 TrueNat (Chip based Real time micro PCR) Total 2.8 Consumables (masks, PPE, etc. Bio medical waste) 3 Human resource (all HR will be as per IPHS, some add on HR is reflected here) 3.1 Lab Technician HR Cost per month HR Cost (per Year) Recurring Cost per year (HR+ Others) 6,500 (2 per Unit) 13,00,000 13,000 13,00,000 5,00,000 4,500 (4 per Unit) 15,000 1,50,000 7,00,000 5,00,000 18,000 15,000 1,50,000 7,00,000 46,96,000 58,500 24,000 per technician 24,000 24,000 2,88,000 3,46,500
BLOCK HMIS CELL Particulars SL Cost per Block HMIS Cell (in Rs.) Total (in Rs.) UNIT COST 1 1.1 2 2.1 2.2 3 Infrastructure Area (sq. ft.) Cost (2000 per sq. ft.) (one time) IT Equipment Set up Cost (one time) Total Recurring cost Human resource (supported by existing staff some add on HR is reflected here) Data Manager 500 10,00,000 10,00,000 2,00,000 2,00,000 12,00,000 48,000 4,000 per month 3.1 20,000 per manager (1 per Unit) 20,000 HR Cost per month HR Cost per Year Recurring cost per year (HR+ Others) 20,000 2,40,000 2,88,000 Composite Unit cost per BPHU: Total capital cost (in Rs) of the Block PH Unit with Labs 80,96,000 Total recurring cost (in Rs) of Block PH Unit with Labs 20,14,500
NEGATIVE LIST The funds under BPHU component cannot be utilized for the following: Repair and Renovation works of Block level facilities already undertaken under the NHM Funds, State Funds, any other grants for health e.g. MOTA, MOMA, CSR etc. Construction of boundary walls, entrance, pavements, footpaths etc. Purchase of Solar panels etc. Purchase of electronic items like TVs, cameras etc
