AUXILIARY NURSING AND MIDWIFERY ( MULTIPURPOSE MULTIPURPOSE HEALTH ASSISTANT (F) TRAINING TRAINING )
INTRODUCTION Today the Indian nursing council is a statutory body that regulates nursing education in the country through prescription, inspection, examination, certification and maintaining its stand for a uniform syllabus at each level of nursing. The training grew out of the earlier auxiliary nursing and midwifery course. The ANM course was for 2 years and mainly covered maternal and childcare and family welfare. The INC revised the ANMs syllabus in 1977 and reduced the duration to 18months. There are nearly 500 schools offering this course in India at present. PHILOSOPHY Indian Nursing Council (INC) prescribed the minimum syllabus for the training of health workers and the minimum requirements for the recognition of any institution offering such a course. The requirements prescribed are minimum both in regard to what should be included in the curriculum and to the teaching, clinical and physical resources resources necessary for for its implementation. In the initial stages alternative methods might be utilized to implement the general education component of the health workers. The INC is committed to the position that the health workers training programme must fit into the higher secondary education system. At this stage INC envisages component according to:
The resources available.
The commitments of the state registration nursing councils to bring nursing education for health worker into the mainstream of general education.
The philosophy of the institution or training centre conducting the health workers training programme.
Cooperation of the board of secondary education.
These are: a. The integrated approach: Where general education subjects would be offered concurrently with vocational subjects and vocation related science. Subjects the term 'integrated' is 'integrated' is used here with reference to placement of subjects and not as a method of organizing or teaching subject matter. b. The elective approach: Where general education subjects would be offered as electives on an optional basis on successful completion of the vocational training programme. AUXILIARY NURSING AND MIDWIFERY
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c. The non-formal approach: Where students would take the responsibility to study the general education subject and take the required examination as private candidate after successfully completing the vocational training programme, extent of such support would vary in regard to provision of leave, library, facilities, laboratory facilities, and arrangement etc. VENUE The training programme for health workers should preferably be conducted in a primary health centre, district or Taluk hospital, or hospital or health institution with facilities for providing greater part of the training in the rural areas. OBJECTIVES General: At the end of the training programme, the student health worker should demonstrate ability to plan and carry out job responsibilities assigned to him/her under the multipurpose worker scheme. Specific: The student worker should demonstrate ability to: o
Explain the principles of healthful living related to all age groups in the community.
o
Perform basic health care activities in community and institutional settings.
o
o
o
o
Plan and carry out nutrition and health education activities in the home, clinic and community. Provide basic material and child health care including immunization service, family health care and family planning services. Perform basic midwifery procedures and basic nursing techniques with special emphasis on domiciliary and home nursing procedures (health worker female). Participate in prevention and control of communicable diseases, assist in execution of national health programmes, promote village and environmental sanitation, perform basic nursing techniques (health worker male).
o
Provide first aid and emergency nursing care elementary medical care.
o
Participate as a responsible member of health team.
o
Identify community resources, which could be utilized for health promotion, health maintenance and prevention of disease.
o
Assist in the training of community/village level health worker.
o
Promote community development activities. ADMINISTRATION OF SCHOOL
Administrative Head A Principal Nursing Officer should be appointed as an administrative head of the school training centre or training section. She should be M.Sc. Nursing with 3 years of teaching experience or B.Sc (N) with 5 years of teaching experience. AUXILIARY NURSING AND MIDWIFERY
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Budget Regular budgetary allocation should be made for teaching equipment and supplies and office equipment.
Transport.
Contingencies.
Library books and journals.
External lectures (for general education subjects).
Staff For 30 students or less the following full time staff is required. Teaching classroom and field. Principal /Nursing officer
1
Public health nurse
2
Nursing tutor
2
Senior sanitarian
1.
Non-teaching Chowkidar/peon Cleaner Cook Housekeeper Clerk Teaching Facilities The following facilities would be required for recognizing the training programme.
Two classrooms to accommodate at least 30 students at a time with standard classroom equipments such as blackboard, bulletin board.
One demonstration cum laboratory room.
One reading room cum library.
Two office rooms, storage space for records, equipments.
Equipments for teaching nursing and midwifery procedures.
Books and journals.
Audio-visual aids, charts, models, kits,
It is recommended that there should be at least one lecture room with a capacity for seating all the candidates on the rolls.
Field/Teaching Laboratory/Clinical Facilities Field practice and experience should be provided through arrangements with a variety of health agencies, community facilities and hospital. AUXILIARY NURSING AND MIDWIFERY
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Affiliations with the schools and other institutions should be considered when training centre/ school lacks adequate facilities for providing appropriate learning experience. The sanction of facilities should be consistent with educational needs of students and instructional objectives. Residential Facilities Each training centre should leave permission for accommodating atleast 60 students at a time in the hostel with:
Furnished single and double rooms for students.
Kitchen, dining hall, pantry, store room.
Bathing and toilet facilities.
Study room.
Common room/recreation room.
Visitor's room.
The hostel must be adequately furnished with electricity and running water facilities. There should be provision for both outdoor and indoor recreation.
Each training centre should have 5 quarters for providing accommodation to teaching staff.
Transport The following facilities for transport of staff and students will be required for implementation of the training programme. Mini bus — 1 Mopeds 6-8 Jeep/station wagon — 1.
ENTRANCE REQUIREMENTS 1. Age: The minimum age for admission will be 16 years and upper age limit is 35 years. 2. Education: The minimum educational requirements for admission shall be successful completion of 10th class of the central board of secondary or a recognized equivalent examination. Pass certificate will be required to support application subjects of study must be equivalent to these prescribed by the central board of secondary education for the 10th class. 3. Health: Admission is subjected to satisfactory of medical examination report.
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CURRICULUM PLAN Duration of course One year and 6 months Total weeks for 1 ½ year Vacation Gazatted holidays Examinations including preparatory Available weeks Teaching hours per week Total available hours
76 weeks 4 weeks 3 weeks 3 weeks 66 weeks 44 hours 2904 hours
Instructional Hours First year (one year)
Sl. No. 1.
2.
3.
4.
Course title
Theory
Practical
Community health nursing Health promotion Nutrition, human body and hygiene, Environmental sanitation, Mental health Primary health care nursing Infection & Immunization Communicable disease Community health problems Primary medical care First aid and referral
180
130
195
220
320
440
Child health nursing
180
200
Total hours
875
990
Course title
Theory
Practical
360
560
75
60
435
620
Second year (six month)
Sl. No. 1.
Midwifery
2.
Health center management Total hours
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Scheme of Examination
Theory and practical examinations at the end of first year Paper Theory paper I
Course title
Community health nursing
Internal assessment
Board exams
Duration
25
75
3 hours
25
75
3 hours
25
75
Theory paper II
Health promotion
Theory paper III
Primary health care nursing
Practical paper I
Community health nursing and health promotion
100
100
Practical paper II
Child health nursing
100
100
275
425
Total
3 hours
Grand total of first year marks 700
Theory and practical examinations at the end of the course Paper Theory paper IV
Course title
Child health nursing
Internal assessment
Board exams
Duration
25
75
3 hours
25
75
3 hours
25
75
Theory paper V
Midwifery
Theory paper VI
Health care management
Practical paper I
Midwifery
100
100
Practical paper II
Primary health care center and health care management
100
100
275
425
Total
3 hours
3 hours
Grand total of first year marks 700
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Eligibility for Admission to Final Examinations To be eligible for admission to the examination, the head of the school has to certify that the candidate: Has attended not less than three fourth (75%) of the total classes for each paper (lectures, practical and field work). Has completed the practical training requirements. Has a record of her/his practical experience, duly completed and signed by the head of the school. Internal assessment will he made on the basis of classroom tests, written assignments, performance in the community and clinical area along with records and reports maintained by the students. Pass mark for each nursing subject on aggregate will be = 50%
A candidate has lo pass in theory and practical exam separately in each of the paper.
Maximum number of attempts permitted for each paper is 3 Including first attempt
Maximum duration of completion of the course = 4 y ears
A candidate failing in more than one subject will not be promoted to the next year.
No candidate shall be admitted to the second year examination unless the candidate has passed the first year examination.
(Internal and external evaluation marks to be considered Independently)
Award of Class Distinction First class Second class Third class
75% aggregate (internal and external). 70% to 74.9% . 60% to 69%. 50% to 59%.
Conclusion Health is a fundamental human right. Maintenance of maximum level of health entails individual as social responsibility. However health cannot be adequately protected by health services without active involvement of community. The Indian Nursing Council (INC) believes that ANM/FHW plays vital role in the rural health care delivery system. She should b sensitive and accountable to meet the health needs of the community. She should be able to provide accessible, equitable, affordable and quality health care.
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