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Structure and Functioning of a Basic Health Unit (BHU)

First Level Care Facilities (Flcf)
These are health institutions where first contact between the patient and the professional health care providers takes place. They include Rural Health Centers (RHC), Dispensaries, MCH centers and out patient departments (OPD) of hospitals.

Basic Health Unit (BHU)
Each union council has BHU, charged with following rules:
1. Provision of first level referral capability for patients referred by LHW, FHWs and primary level organized curative care using approved essential drugs list. BHU in turn and should refer patients to RHC as and when necessary.
2. Center for provision of static and out reach services:
· MHC, FP, EPI and advice on food and nutrition.
· Sanitation, health education
· CDD, CDC, ARI and other special programmes
3. A focal point, where community and the public sector health functionaries come together to resolve issues concerning health.
4. Responsible for support and logistics, and management to LHW, TBAs dispensaries, MCH centers, sub health centers etc 
falling in the assigned geographical limits of BHU, in turn receives such support from RHC.

Structure of BHU
Each BHU is a small colony which consists of main BHU building and number of residences for the staff.
It is mandatory for medical offices and the LHVs to reside in their respective residencies so as to ensure their presence round the clock.

Standard Equipment and Furniture of BHU
Each BHU is provided with a standard set of equipment and furniture…

Essential Drugs for BHU
The “pill culture” that has consistently been promoted over the years by commercial drug companies, doctors and pharmacists has fed most people in both rich developed countries and in poor developing countries to have an exaggerated faith in ability of drugs to prevent or cure diseases, improve strength and vitality and provide physiological pleasure. This is one of the cause of 
increasing demand of medicines all over the world and increase in number of pharmaceutical products.

A standard list essential drugs at each BHU is given as Annexure-4 . when prescribing drugs the health personnel must stick to this list.

Patient/Client Record Cards and Service Delivery Facility Cards
The health personnel’s are required to understand thoroughly these instruments with the help of health management information system for FLCF instruction manual.

Patient Management
While managing the patients attending a health facility the following must be followed:
· Utmost courtesy should be shown to the patient.
· Health facility timings must be strictly observed.
· All relevant information should be properly recorded.
· The patient should be provided with medicines in accordance with the essential drug list.
· Prescribing fancy drugs must be avoided.
· Should not become unnecessary influenced by the medical representatives etc
· National policies regarding treatment/management of diarrhea, ARI, malaria, , TB etc should be followed.
· Appropriate health messages must be conveyed and preventive health services offered to appropriate clients.

Staff At BHU
1. Stationed staff:
· MO
· Medical Assistant/ FHT/MHT
· LHV
· Dispenser
· Dai/ Midwife
· Other support staff

2. Out Reach Staff
· Sanitary inspector
· Communicable disease control supervisor.
· EPI vaccinator
· LHW of prime minister programme.

Supervision and Monitoring
Monitoring means “keeping track of day to day programme activities” and supervision means process of helping and individual of group in performing their assigned activities”.

Imperest Account
Each MO at BHU is provided with an imperest money of Rs 100/- . this can be utilized to make urgent necessary purchases of small items e.g. bulbs, locks etc. proper recipients must be obtained and represented to DDHO for reimbursement of the 
amount.

Pay Bills
Each health personnel has to prepare his own pay bill every month and will submit it to the DDHO/DHO as soon as possible.

Maintenance and Repair Equipment
Every possible care should be taken that the equipment remains in absolute working condition. However if need of repair arises the DDHO should be informed in writing for necessary action. 

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Thanks to,
Sadia Saeed
Member e-team 4th year,
emed