Health Post Standards

Comprehensive and Basic Health Post

(CES 300-1,2)

October, 2022
Outline
1. Scope

2. Definition

3. General requirements

4. Specific requirements

A. Practice

B. Premises

C. Professional

D. Product
A. Comprehensive Specialized
Health Post
1. Scope

This Ethiopian standard provides minimum requirements for the

establishment and maintenance of comprehensive health
post(CHP) with respect to practices, premises, professionals and
products put into use for the CHP
2. Definition

• CHP is service delivery outlet where comprehensive health

extension services are provided.

• A package of services comprising promotive, preventive, curative

and community based rehabilitative health extension services.
3. General requirements

• The CHP

Provide health services through household services, community level services,

school health services, facility level health services, mobile health services and
work place health services.

0pen for 24 hours a day and seven days a week.

Collect, organize, analyse, use and report routine local health data.

Have functional referral and linkage system.

Promote privacy of patients and clients.

Standard domains: 4 Ps

Practice Professionals

Premises Products
4. Specific requirements

4.1 Practice; Five broad areas

• Preventive and promotion services = 18 interv
• Outpatient services = 23 interv
• Delivery services = 3 interv
• Pharmaceutical service
• Laboratory Service
Specific requirements cont…
4.1.1 Preventive and promotion service practice
Coordinate malaria
prevention, control and
elimination
Screening and link of
common communicable
and non-communicable Identification and
diseases, and mental Prevention referral of TB
neurological and suspected cases.
substance use Disorder
(MNSD).
Integrated community
management of new-born
and childhood illness
(ICMNCI)
Specific requirements cont…
Postpartum FP, FP,
EPI, initiation of
early breastfeeding
Self-breast
Proper solid and
examination
liquid waste
management
Danger signs, maternal
waiting services, skilled Sanitation marketing
delivery, postpartum for improved latrine
Promotion and healthy housing
care
conditions.

ANC, PMTCT, LLIN use,

maternal nutrition, birth
preparedness and Community-based
complication readiness promotion of hygiene and
environmental health
Specific requirements cont…
4.1.2 Outpatient services

The CHP shall provide the following services:

 Integrated management of new-born and childhood illness (IMNCI),
 Pre-referral management of labour complications,
 Manage maternal sepsis, mastitis, PPH and pre-referral PPH,
 Screen children and maternal malnutrition,
 SAM and MAM management for malnourished children,
 Immunizations service,
 All family planning methods except permanent methods,
 Comprehensive abortion care,
 Manage neglected tropical diseases (NTDs) based on national protocols,
 Treat menstrual problems and irregularities,
 Adolescent friendly sexual and reproductive health services,
Specific requirements cont…
 Major communicable and non-communicable diseases interventions,

 Syndromic case management for STIs,

 Post-exposure prophylaxis (PEP) for occupational exposure and sexual assault victims,

 Diagnose (RDT) and treat uncomplicated malaria cases and provide pre-referral treatment for severe
and complicated malaria cases,

 Basic palliative and rehabilitative care,

 Follow up for chronic illnesses,

 Basic emergency service,

 Disaster management service,

 Basic wound management,

 Minor surgeries including male circumcision,

 First-line treatment for common childhood illnesses such as pharyngitis, tonsillitis, sinusitis, otitis
media, eye infections, UTIs and scabies,
Specific requirements cont…

4.1.3 Delivery service

Focused ante natal care (FANC)
Normal delivery and active management of the third stage of
labour.
Provide post natal care.
Specific requirements cont…

4.1.4 Pharmaceutical Services

• Standard operating procedure (SOP) for dispensing and medication use
counseling to ensure patients' safety and correct use of medications.

• Prescribing and dispensing practices shall be according to the standard (see

the CHP requirements for the details )

• Written procedures shall be available for the return of expired, damaged,

leftover and empty packs from outlets to medical store to prevent potential
misuse.
Specific requirements cont…

• The storage condition shall provide adequate protection to the

medicines from all environmental factors until the medicine is delivered to
the patient.
• Expired or obsolete medicines shall be stocked in a separate place until
disposition.
• Medicines requiring special environmental conditions shall be stored
accordingly. I.e cold chain system, inflammable substances
• Daily medicine consumption at different outlets of the CHP shall be
recorded, compiled and analyzed for the appropriate supply and use of
medicines.
Specific requirements cont…
4.1.5 Laboratory service
• Provide both microscopic and non-microscopic test services.
• Have written procedure manuals, SOPs or guidelines for all tests and equipment
and quality assurance and control processes.
• Establish a system for management of reagents, including availability, storage,
and testing for accuracy; Procedures for collecting, identifying, processing, and
disposing of specimen
• Have protocols and procedures for the availability of laboratory services
including the emergency services for 24 hours a day and seven days a week;
availability of laboratory information management system.
Specific requirements cont…

4.2 Premises
• Well marked and easily accessible

• Room arrangements of outpatient services shall consider proximity

between related services with easy access to dispensary and other
admin services.

• Uninterrupted water and power sources

• Have adequate light, ventilation and sanitation facilities.

Specific requirements cont…
• Information, communication equipment and data processing
devices with internet connection.

• Means of emergency communication and transportation.

• Waste disposal system such as incinerator, placenta pit .

 Specific requirements cont…
Premises required Number of rooms Space (Sq. meter)
Outpatien Waiting area 2 15 each
t service MCH service (ANC,FP, EPI) 1 12
units
Labour room with bathroom 1 25
Delivery room (with two coaches) 1 28
PNC room with baby corner 1 35
Procedure room 1 12
Adult and child examination room including emergency 2 12 each
Clean utility room 1 7
Latrine for male, female and disables 5 35
Staff office Staff office 1 9
and HIS Card room 1 9
Guard’s room 1 7
Janitor`s room 1 4
 Specific requirements cont…

Pharmacy Dispensing room 1 12

service Medical store intended for medicines, vaccines, lab 1 15
reagents and medical equipment storage
Laboratory Recording and reporting area 1 with 20
service Specimen collection area different
partition
Microscopic analysis and rapid- test analysis area
Storage corner
Residential Professionals` living rooms 8 15 each
rooms Common kitchen 1 20
Common shower and toilet(separated with partition) 4 30
 Specific requirements cont…
4.3 Professional
Professionals required Level of education Number required

Family health professional BSc 1

Health officer BSc 1
Midwife Level 4 1
Nurse Level 4 1
Environmental health Level 4 1
Health extension worker Level 4 2
Pharmacy technician Level 4 1
Medical laboratory technician/technologist Level 4 /Bsc 1
Cleaner (shared with other services) 1
Specific requirements cont…
4.4 Product

• The CHP shall have medicines and medical supplies based on the
national list.
• The CHP shall have the following equipment's and supplies: see
the standard(OPD, Laboratory, delivery and pharmacy)
 Remaining issues
• Further Guidelines, Protocols, SOPs,
etc. required
• Mapping and customizing the existing
ones
• Regular and continuous SSVs and
regulatory visits to ensure the proper
application of the standards
B. Basic Health Post
Scope
This Ethiopian standard specifies minimum
requirements for the establishment and
maintenance of basic health post (BHP)
with respect to practices, premises,
professionals and products or materials
that are required to provide Basic health
services at primary level of care.
Basic Health Post (BHP) Requirements

There has been a difference between BHP and CHP in

terms of practices, premises, professionals and products
or materials
Discussion Points
• How is the application of HP requirements in your region?

• What are the enabling and hindering factors to apply the standards?
How can you make use of those enabling factors and eliminate the
hindering factors for the better implementation of the standards

• What are the differences between BHP and CHP in terms of the new
standards?