AUXILIARY NURSING AND MIDWIFERY

( MULTIPURPOSE HEALTH ASSISTANT (F) 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 necessary 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 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.

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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 Plan and carry out nutrition and health education activities in the home, clinic and
community.
o Provide basic material and child health care including immunization service, family
health care and family planning services.
o Perform basic midwifery procedures and basic nursing techniques with special
emphasis on domiciliary and home nursing procedures (health worker female).
o 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.
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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.

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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 76 weeks

Vacation 4 weeks
Gazatted holidays 3 weeks
Examinations including preparatory 3 weeks
Available weeks 66 weeks
Teaching hours per week 44 hours
Total available hours 2904 hours

Instructional Hours
First year (one year)

Sl. No. Course title Theory Practical

1. Community health nursing 180 130
Health promotion
 Nutrition,
2.  human body and hygiene, 195 220
 Environmental sanitation,
 Mental health
Primary health care nursing
 Infection & Immunization
 Communicable disease
3. 320 440
 Community health problems
 Primary medical care
 First aid and referral
4. Child health nursing 180 200
Total hours 875 990

Second year (six month)

Sl. No. Course title Theory Practical

1. Midwifery 360 560

2. Health center management 75 60

Total hours 435 620

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Scheme of Examination

Theory and practical examinations at the end of first year

Internal Board
Paper Course title Duration
assessment exams
Theory
paper I
Community health nursing 25 75 3 hours
Theory Health promotion
paper II
25 75 3 hours
Theory Primary health care nursing
25 75
paper III 3 hours
Practical Community health nursing and
100 100
paper I health promotion
Practical
paper II
Child health nursing 100 100

Total 275 425

Grand total of first year marks 700

Theory and practical examinations at the end of the course

Internal Board
Paper Course title Duration
assessment exams
Theory
paper IV
Child health nursing 25 75 3 hours
Theory Midwifery
paper V
25 75 3 hours
Theory Health care management
25 75
paper VI 3 hours
Practical Midwifery 100 100
paper I
Practical Primary health care center and
100 100 3 hours
paper II health care management
Total 275 425

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 assign-
ments, 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 years
 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 75% aggregate (internal and external).
 First class 70% to 74.9% .
 Second class 60% to 69%.
 Third class 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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