Which of the following are the team members of Health and Wellness Centre (HWC) at Sub Centre (SC) level? 1. Community health officers (Mid-Level Health Provider) 2. ANM 3. ASHA 4. Anganwadi worker

1. A

   1, 2, 3 and 4

2. B

   2 and 3 only

3. C

   1 and 4 only

4. D

   1, 2 and 3 only

Appeared in: ESIC Nursing Officer-7July 2024

Explanation

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• The Health and Wellness Centre (HWC) at the Sub-Centre level is led by a Community Health Officer (CHO), also known as a Mid-Level Health Provider (MLHP).
• The team includes the existing cadre of Multipurpose Workers, primarily the Auxiliary Nurse Midwife (ANM), who handles maternal and child health services.
• Accredited Social Health Activists (ASHAs) are also integral to the team, serving as the crucial link for community mobilization and health education.
• This three-tiered team (CHO, ANM, ASHA) is mandated under the Ayushman Bharat program to deliver comprehensive primary healthcare.

Why Other Options Were Wrong

• Option A: This option incorrectly includes the Anganwadi worker as a formal member of the HWC team.
• Option B: This option is incomplete as it omits the Community Health Officer (CHO), who is the designated team leader of the HWC at the Sub-Centre level.
• Option C: This option incorrectly includes the Anganwadi worker and omits two core members of the team: the ANM and the ASHA.

Related Visual

• Visual 1: Organizational Chart - A chart showing the structure of the primary healthcare team at the Sub-Centre HWC, with the CHO at the lead, supported by the ANM(s) and a team of ASHAs.

Clinical Relevance

• Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Composition of the Health and Wellness Centre (HWC) team at the Sub-Centre level under Ayushman Bharat as background academic context rather than a clinical decision trigger.
• Understanding the HWC team structure is essential for community health nurses to ensure effective coordination, proper delegation of tasks, and seamless patient referrals.
• Knowing the distinct roles helps in leveraging each member's strengths; for instance, using ASHAs for community mobilization and the CHO for clinical management and leadership.
• What if? If an Anganwadi worker identifies a child with Severe Acute Malnutrition (SAM), she does not manage it herself but refers the child to the ANM or CHO at the HWC for clinical assessment and further referral to a Nutrition Rehabilitation Centre (NRC), demonstrating inter-departmental collaboration.

How to Approach the Question

• First, identify the core subject of the question: the team composition of a specific health facility.
• Note the precise level mentioned: 'Health and Wellness Centre (HWC) at Sub Centre (SC) level'. This is a specific entity under the Ayushman Bharat scheme.
• Recall the staffing pattern for this upgraded facility. The key change was the introduction of the Community Health Officer (CHO) to lead the team.
• Consider the existing grassroots workers. The ANM and ASHA are foundational roles in rural health and were integrated into the new HWC structure.
• Differentiate between health department staff and staff from other departments. The Anganwadi worker is part of the ICDS scheme (Ministry of Women & Child Development), making them a collaborator, not a direct team member of the HWC (Ministry of Health & Family Welfare).
• Select the option that includes the CHO, ANM, and ASHA, and excludes the Anganwadi worker.

Concept Tested & Keywords

• Concept Tested: Composition of the Health and Wellness Centre (HWC) team at the Sub-Centre level under Ayushman Bharat.
• Stem keywords: Health and Wellness Centre, HWC, Sub Centre, team members
• Lead-in keywords: Which of the following
• Clinical cues: The care setting changes urgency, monitoring level, and the expected nursing action.
• Negative lead-in flag: false

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QwgNmDJIs7NuubruC4Q_YX

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