Role of District Public Health Nurses (DPHNs) in the districts have reduced over the years resulting in their under utilisation, affecting the quality of Maternal and Child Health (MCH) services, a study said.

The study conducted by IIM-Ahmedabad was aimed at understanding the role of DPHN in the public health care system in Gujarat.

The DPHNs, originally part of the Maternal and Child Health division of Department of health, are primarily

responsible for monitoring maternal and child health services at the district level.

The study found that the role of DPHNs has reduced over the years because they have not been assigned new roles with change in programmes and policies.

“The DPHNs are under utilised which affects the quality of maternal and child health services in the district,” the study said.

It further stated DPHN spend majority of their time in the office (49 per cent) where they have a limited role and as a result their supervisory role for nurses and midwives has lost its importance.

DPHNs spend about one third of their time in field supervision, mostly visiting centres accessible by public

transport, as they do not have an allotted government vehicle.

Also as they do not submit any field report, there is no follow-up action from their visit, the study said.

As per the study, DPHNs seem to have an important role in solving problems of field workers as they are mediators between the district and peripheral facilities, but most of the DPHNs have training only for clinical work in hospitals.

“Their 10-month training to qualify for public health nurses is inadequate to develop knowledge and skills in public health. There is a gap between their training and posting due to delays in government procedures of promotion,” it said.

Based on observations, the study concluded that though the activities of DPHNs include some administration, supervision and education as recommended in their job description, they are not given the administrative power, facilities and recognition due to which their role is marginalised in the district health system.

For the study purpose, 25 districts of Gujarat were grouped into six regions - Ahmedabad, Gandhinagar, Rajkot, Bhavnagar, Vadodara and Surat.

Two districts from each of the six regions were selected depending on the availability of DPHNs. The data for the study were collected through observation, interviews of DPHNs and their supervisors.

Keywords: IIM-ADPHNnursesMCH