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DUTIES OF RURAL MEDICAL Assistant in PRIMARY HEALTH CENTRE The Rural Medical Assistant of Primary Health Centre (PHC) is responsible for implementing all activities grouped under Health and Family Welfare delivery system in PHC area. He/she is responsible in his individual capacity, as well as over all in charge. It is not possible to enumerate all his tasks. However, by virtue of his designation, it is implied that he will be solely responsible for the proper  functioning  of the PHC, and activities in relation to RCH, NRHM and other national programs. The detailed job functions of Rural Medical Assistant working in the PHC are as follows: I. Curative Work II. Preventive and Prom otive Work The Rural Medical Assistant will ensure that all the members of his/her Health Team are fully conversant with the various National Health & Family Welfare Programs including NRHM to be implemented in the area allotted to each Health functionary. He/she will further supervise their work periodically both in the clinics and in the community setting to give them the necessary guidance and direction. He/she will prepare operational plans and ensure effective implementation of the same to achieve the laid down targets under different National Health and Family Welfare Programmes. The MO will provide assistance in the formulation of village health and sanitation plan through the ANMs and coordinate with the PRIs in his/her PHC area. He/she will keep close liaison with Block Development Officer and his/her staff, community leaders and various social welfare agencies in his/her area and involve them to the best advantage in the promotion of health programmes in the area. Wherever possible, the MO will conduct field investigations to delineate local health problems for planning changes in the strategy of the effective delivery of Health and Family welfare services. He/she will coordinate and facilitate the functioning of AYUSH doctor in the PHC.
 * 1) 1.	The Rural Medical Assistant will organize the dispensary, outpatient department and will allot duties to the ancillary staff to ensure smooth running of the OPD.
 * 2) 2.	He/she will make suitable arrangements for the distribution of work in the treatment of emergency cases which come outside the normal OPD hours.
 * 3) 3.	He/she will organize laboratory services for cases where necessary and within the scope of his laboratory for proper diagnosis of doubtful cases.
 * 4) 4.	He/she will make arrangements for rendering services for the treatment of minor ailments at community level and at the PHC through the Health Assistants, Health Workers and others.
 * 5) 5.	He/she will attend to cases referred to him/her by Health Assistants, Health Workers, ASHA / Voluntary Health Workers where applicable, Dais or by the School Teachers.
 * 6) 6.	He/she will screen cases needing specialized medical attention including dental care and nursing care and refer them to referral institutions.
 * 7) 7.	He/she will provide guidance to the Health Assistants, Health Workers, Health Guides and School Teachers in the treatment of minor ailments.
 * 8) 8.	He/she will cooperate and or coordinate with other institutions providing medical care services in his/her area.
 * 9) 9.	He/she will visit each Sub-centre in his/her area at least once in a fortnight on a fixed day not only to check the work of the staff but also to provide curative services.
 * 10) 10.	Organize and participate in the “health day” at Anganwadi Centre once in a month.

1. Reproductive and Child Health Programme •        The MO will promote institutional delivery and ensure that the PHC has the facilities to act as 24x7 service delivery PHC. Family Planning •        He/she will provide leadership and guidance for special programmes such as in nutrition, prophylaxis against nutritional anemia amongst mothers and children (1-5 years) Prophylaxis against blindness and Vitamin A deficiency amongst children (1-5 years). •        He/she will provide basic MCH services. •        He/she will plan and implement UIP in line with the latest policy and ensure maximum possible coverage of the largest population in the PHC. •        He/she will ensure adequate supplies of vaccine and miscellaneous items required from time to time for the effective implementation of UIP. •        He/she will ensure proper storage of vaccine and maintenance and cold chain equipment. •        He/she will ensure through his/her health team early detection of diarrhoea and dehydration. •        He/she will arrange for correction of moderate and severe dehydration through appropriate treatment. •        He/she will ensure through his/her health team early detection of pneumonia cases and provide appropriate treatment. •        He/she will supervise the work of Health supervisors and Health workers in treatment of mild and moderate ARI. •        He/she will visit schools in the PHC area at regular intervals and arrange for medical check ups immunization and treatments with proper follow up of those students found to have defects. •        He/she will be responsible for proper and successful implementation of Family Planning Programme in PHC area, including education, motivation, and delivery of services and after care. •        she will be squarely responsible for giving immediate and sustained attention to any complications the acceptor develops due to acceptance of Family Planning methods. •        He/she will extend motivational advice to all eligible patients he /she sees in the OPD. •        He/she will get himself trained in tubectomy, wherever possible and organize tubectomy camps. •        He/she will organize and conduct vasectomy camps. •        He/she will seek help of other agencies such as District Bureau, Mobile Van and other association/voluntary organizations for tubectomy / IUD camps and MTP services. •        The following duties are common to all the activities coming under package of services for MCH: a.   He/she will provide leadership to his/her team in the implementation of Family Welfare Programme in the PHC catchments area. b.   He/she will ensure adequate supplies of equipment, drugs, educational material and contraceptives required for the services programmes. •        He/she will provide MCH services such as ante-natal, intra-natal and postnatal care of mothers and infants and child care through clinics at the PHC and Sub centres. •        He/she will actively involve his health team in the effective implementation of the Nutrition Programmes and administration of Vitamin ‘A’ an Iron & Folic Acid Tablets and will coordinate with ICDS. •        Adequate stocks of ORS to ensure availability of ORS packets throughout the year. •        Monitor all cases of diarrhea especially for children between 0-5 years. •        Recording and reporting of all details due to diarrhea especially for children between 0 -5 years. •        Organize wells to be chlorinated and coordination with sewage agency for sanitation. •        Training of all health personnel like ASHAs, Anganwadi Workers, Dais and others who are involved in health care regarding ORT programme. 2. Universal Immunization Programme (UIP) 	He/she will plan and implement UIP in line with the latest policy and ensure cent percent coverage of the target population in the PHC (i.e. pregnant mothers and new born infants). 	He/she will ensure adequate supplies of vaccines miscellaneous items required from time to time for the effective implementation of UIP. 	He/she will ensure proper storage of vaccine and maintenance of cold chain equipment, planning and monitoring of performance and training of staff. 3. National Vector Borne Disease Control Programme (NVBDCP) Malaria 	He/she will be responsible for all NVBDCP operations in his/her PHC area and will be responsible for all administrative and technical matters. 	He/she should be completely acquainted with all problems and difficulties regarding surveillance and spray operations in his/her PHC area and be responsible for immediate among whenever the necessity arises. 	The Rural Medical Assistantwill guide the Health Workers and Health Assistants on all treatment schedules, especially radical treatment with primaquine. As far as possible he/she should investigate all malaria cases in the area less than API 2 regarding their nature and origin, and institute necessary measures in this connection. He/she should ensure that prompt remedial measures are carried out by the Health Assistance, about positive cases detected in areas with API less than two. He/she should give specific instructions to them in this respect, while sending the result of blood slides found positive. 	He/she will check the microscopic work of the Laboratory Technician and dispatch prescribed per-centage of such slides to the Zonal Organization/Regional Office for Health and Family Welfare (Government of India) and State headquarters for cross checking as laid down from time to time. 	He/she should, during his/her monthly meetings, ensure proper accounts of slides and anti malaria drugs issued to the Health Workers and Health Assistant Male. 	The publicity material and mass media equipment received from time to time will be properly distributed or affixed as per the instructions from the district organization. 	He/she should consult the booklet on Management and treatment of Cerebral malaria and treat cerebral malaria cases as and when required. 	He/she should ensure that all categories of staff in the periphery administering radical treatment to the positive cases should observe the instructions laid down under NVBDCP on the subject and in case toxic effects are observed in a patient who is receiving primaquine the drug is stopped by the peripheral worker and such cases are brought to his/her notice for follow up action/advice if any. Where Japanese Encephalitis are endemic the following additional duties are expected from him: Japanese Encephalitis (JE): 	He/she will be responsible for all anti Japanese Enphalitis operations in his /her area and will be responsible for all administrative and technical matters. 	He/she should be completely acquainted with all problems and difficulties regarding surveillance, diagnosis, treatment and spray operations in his/her PHC areas and be responsible for immediate action whenever the necessity arises. 	He/she will guide the Health Workers and Health Assistants on all treatment schedules, criteria for suspecting a case to be of J.E. and the approaches for motivation of the people for accepting J.E. control activities and to approach for immediate medical care to prevent death. 	He/she will arrange to collect and transport sera sample to the identified virology lab orders. 	He/she will be responsible for all health education activities in his/her area. 	He/she will be overall responsible for all J.E. control activities in his/her areas including spray operations for the purpose, he/she may identify one Rural Medical Assistantwho can be made solely responsible for J.E. control. 	He/she will be responsible for regular reporting to the District Malaria Officer, Civil Surgeon, Monitoring, Record Maintenance of adequate provisions for drugs etc. Filariasis 	He/she should be completely acquainted with all problems and difficulties regarding microfilaria survey (night blood survey), line-listing of Lymphodema & Hydrocele cases in all the villages, diagnosis and home based morbidity management, Mass Drug Administration and serious adverse experiences of DEC. 	He/she will be responsible for ensuring all behaviour change communication activities for increasing the compliance during MDA. 	He or she will be responsible for assessment of coverage in his area and moping up operation. 	He/she will ensure that rapid response team is well prepared to meet the exigencies during MDA. 	He/she will be responsible for regular and prompt reporting of data pertaining to ELF. Control of Communicable Diseases: 	He/she will ensure that all the steps are being taken for the control of communicable diseases and for the proper maintenance of sanitation in the villages. 	He/she will take the necessary action in case of any outbreak of epidemic in his/her area. 	Perform duties under the IDSP.
 *  MCH Services
 *  Prophylaxis Schemes
 *  Immunization Programme
 *  Oral Rehydration Therapy in Diarrhoeal Diseases

Leprosy: 	He/she will provide facilities for early detection of cases of Leprosy and confirmation of their diagnosis and treatment. 	He/she will ensure that all cases of Leprosy take regular and complete treatment. Tuberculosis: 	He/she will provide facilities for early detection of cases of Tuberculosis, confirmation of their diagnosis and treatment. 	He/she will ensure that all cases of Tuberculosis take regular and complete treatment. 	Ensure functioning of Microscopic Centre (if the PHC is designated so) and provision of DOTS. Sexually Transmitted Diseases (STD) : 	He/she will ensure that all cases of STD are diagnosed and properly treated and their contacts are traced for early detection. 	He/she will provide facilities for RPR test, for all pregnant women at the PHC. School Health: 	He/she will visit schools in the PHC area at regular intervals and arrange for Medical Checkups, immunization and treatment with proper follow up of those students found to have defects. National Programme for Prevention of Visual Impairment and Control of Blindness: 	He/she will make arrangements for rendering: 	Treatment for minor ailments 	Testing of vision 	He/she will refer cases to the appropriate institutes for specialized treatment. 	He/she will extend support to mobile eye care units. Training 	He/she will organize training programmes including continuing education for the staff of PHC and VHN under the guidance of the district health authorities and Health & Family Welfare Training centres. 	He/she will also make arrangements/provide guidance to the health assistant female and health worker female in organizing training programmes for indigenous dais practicing in the area and ASHAs where applicable. Administrative Work 	He/she will supervise the work of staff working under him/her. 	He/her will ensure general cleanliness inside and outside the premises of the PHC and also proper maintenance of equipment under his/her charge. 	He/she will ensure to keep up to date inventory and stock register of all the stores and equipment supplied to him/her and will be responsible for its correct accounting. 	He/she will get indents prepared timely for drugs, instruments, vaccines, ORS and contraceptive etc. sufficiently in advance and will submit them to the appropriate health authorities. 	He/she will check the proper maintenance of the transport given in his/her charge. 	He/she will scrutinize the programmes of his/her staff and suggest changes if necessary to suit the priority of work. 	He/she will get prepared and display charts in his/her own room to explain clearly the geographical areas, location of peripheral health units, morbidity and mortality, health statistics and other important information about his/her area. 	He/she will hold monthly staff meetings with his/her own staff with a view to evaluating the progress of work and suggesting steps to be taken for further improvements. 	He/she will ensure the regular supply of medicines and disbursements of honorarium to health guides. 	He/she will ensure the maintenance of the prescribed records at PHC level. 	He/she will receive reports from the periphery, get them compiled and submit them regularly to the district health authorities. 	He/she will keep notes of his/her visits to the area and submit every month his/her tour report to the CMO. 	He/she will discharge all the financial duties entrusted to him/her. 	 RURAL MEDICAL ASSISTANTWORKS IN THE PHC

Attendance Register 	Attendance Register should be closed by the In-charge Medical Officer. If he is absent, second MO should close the attendance register daily. 	Late attendance register should be maintained. 	Movement register should be checked by the MO. Out Patient Disposal 	Avoid the overcrowding by giving prior instructions to the staff and to regulate the crowd by token & queue system. 	Avoid arguments with beneficiaries, incase of any interruption arising from them. 	Adopt drug token system. 	He should enter the abstract of the cases in the online tally sheet (daily). 	In between the OP disposal, surprise visit to the injection OP for the method of injections, sterilization and disposal of needle and others (Needle destroyer and hub cutter) should be undertaken. 	Inspect the Pharmacy, verify the drug tokens and the last entry made in the registers on previous day. 	Cross Check the prescription and drugs. 	Adopt drug tray system. 	Inspect the Lab to verify the entry of last sample collection, method of tests done and also the general cleanliness. 	Inspect the dressing room for the method of dressing, cleanliness and waste disposal system. 	During the hospital rounds, inspect the roof corners for cleanliness, RO system, Television, Lights, toilet and facilities. 	Continue the OP disposal. 	After OP disposal, tally sheet should be sorted out and handed over to the responsible person for online reporting. After OP Disposal 	He should see the daily letters/communications from the higher officials and give proper instructions to the concerned person for necessary action. 	MO should ensure the entry of online reports and verify it daily. 	Inspect the postnatal ward and check the case sheets. 	Inspect the OT, delivery room, Lab, Pharmacy, siddha wing, ICTC center. 	Make surprise inspection to office room at least twice a week for quick disposal of files. 	Check personal register and other records maintained by the Ministerial Staff at least once in a Month. 	Check the inspection register, Suggestion register and others. 	Check the account maintenance system for inflow and outflow. 	Check the water source, gardening and other building in the campus. 	Please avoid dumping of materials and equipments without disposal to the periphery. 	At the time of inspection surprise verification of log books and vehicle maintenance can be made. 	Check the EDD list and intimate the delivery report to the DDHS. 	Give direction to all the VHNs about EDD mothers. 	Conduct the evening OP. 	Verify the closure of registers at all level. 	Callover all staff of the PHC to discuss about the next day duties, special programmes and personal grievances. 	Keep the name and phone number of call duty doctor at a visible place 	He should inspect the surrounding area for sanitation and encroachment. 	He should maintain the asset registers 	Any time MO should alert to face any message from higher officials or information notified from field.