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What is A and B , HWC, HA/HV

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IPHS Sub Health Centre Type A Type B delivery load PHC Type A Type B norms Ayushman Arogya Mandir

Based on the notes (IPHS/NRHM-NUHM classification of health facilities) and Park's Textbook of PSM:

HWC (Health and Wellness Centre)

HWC stands for Health and Wellness Centre, now renamed Ayushman Arogya Mandir. Under Ayushman Bharat (launched 14 April 2018, Bijapur, Chhattisgarh), existing Sub-Centres and PHCs are being upgraded into HWCs to deliver Comprehensive Primary Health Care (maternal-child health, NCD screening for hypertension/diabetes/3 common cancers, free drugs and diagnostics). The government's target is 1.5 lakh HWCs nationwide (Park's Textbook of Preventive and Social Medicine, p. ~845-846).

A and B categories (Type A vs Type B facilities)

Under IPHS, Sub-Centres and PHCs are graded into Type A and Type B based on delivery/caseload, which in turn determines staffing and bed strength:
Sub-Centre / HWC:
  • Type A: does not conduct deliveries (no delivery load) - 1-2 beds
  • Type B: does conduct deliveries (expected ~20 deliveries/month) - 2-3 beds
PHC:
  • Type A: <20 deliveries/month
  • Type B: >20 deliveries/month
  • Bed strength: Type A = 4-6 beds, Type B = 6-10 beds
Both categories otherwise share the same population norms (Sub-centre 1/3000 hilly-tribal, 1/5000 plains; PHC 1/20K hilly-tribal, 1/30K plains) - the A/B split is purely about whether/how much delivery care is provided, which drives the extra staff and bed requirement.

HA/HV

HA/HV = Health Assistant / Health Visitor, part of the PHC staffing pattern:
  • Health Assistant (Male) - supervises male Multi-Purpose Workers (MPWs)
  • Health Assistant (Female) / Lady Health Visitor (LHV) - supervises female MPWs (ANMs)
This matches the table in your notes at the PHC level ("MO-PHC; AYUSH-MO; Pharmacist; Lab tech; Nursing; HA/HV") - confirmed in Park's Textbook of Preventive and Social Medicine, Staffing Pattern table, p. ~849 - Health Assistant (Male): 1, Health Assistant (Female)/Lady Health Visitor: 1.
Quick summary table:
FacilityType AType B
Sub-Centre/HWCNo deliveries; 1-2 bedsConducts deliveries; 2-3 beds
PHC<20 deliveries/month; 4-6 beds>20 deliveries/month; 6-10 beds
Note: A recent PubMed check for meta-analyses/systematic reviews on this specific administrative topic returned no relevant results, which is expected since this is a health-system/policy classification rather than a clinical evidence question - the IPHS/Ayushman Bharat operational guidelines (verified via web) remain the authoritative current source.

Find latest IPHS/Ayushman Bharat guidelines and updates

In proportional mortality rate. The formula is... Death by a cause divided by total deaths into 100. Here... For example, if the d- ...proportional mortality rate of MI is being calculated, the death caused by MI divided by... ...total number of deaths due to any cause into 100. Am I correct?

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IPHS 2022 Ayushman Arogya Mandir latest guidelines update 2025 2026

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"IPHS 2022" Ayushman Arogya Mandir revised guidelines free medicines diagnostics package update 2025

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https://www.pib.gov.in/PressReleasePage.aspx?PRID=2222496

1. Latest IPHS / Ayushman Bharat Guidelines and Updates

Current status (as of 31 December 2025, per PIB press release dated 3 Feb 2026):
  • 1,82,944 Ayushman Arogya Mandirs (AAMs) operationalized nationwide by upgrading Sub Health Centres (SHCs) and Primary Health Centres (PHCs) - up from ~1,78,154 in July 2025 and ~22,559 at the initial 2019 rollout.
  • 30,817 AAMs operational in Tribal Districts and 24,327 in Aspirational Districts.
  • Expanded essential drug and diagnostic lists (this is the biggest recent update):
    • PHC-AAM: 172 drugs & 63 diagnostic tests (up from the earlier 107 drugs/19 tests under IPHS 2022)
    • SHC-AAM: 106 drugs & 14 diagnostic tests (up from the earlier 9 drugs/7 tests for Type A/B SHCs)
  • 12 packages of comprehensive primary health care are now delivered incrementally at AAMs: reproductive & child health, communicable diseases, NCDs, palliative/elderly care, mental health + neurological conditions (epilepsy, dementia) + substance use disorders, oral health, ENT care, and basic emergency care.
  • The IPHS 2022 standards remain the governing framework for staffing, bed strength, and infrastructure norms (Type A/B classification for SHC and PHC as discussed earlier). A web-based IPHS Dashboard (iphs.mohfw.gov.in) was launched in June 2024 for facilities, including AAMs, to self-assess compliance in real time.
  • Staffing model at SHC-AAM continues to be led by the Community Health Officer (CHO) - a BSc/GNM nurse or Ayurveda practitioner with a 6-month certificate in community health, supported by MPWs and ASHAs.
So the direction of change is: more AAMs operationalized, a much larger free-drug/diagnostics basket, and expansion of the service package beyond the original maternal-child-health/NCD focus to include mental health, neurology, substance use, and emergency care - while the core IPHS 2022 Type A/B facility classification and bed/staffing norms stay the same.

2. Proportional Mortality Rate - Yes, you are correct

Your formula is correct. Per Park's Textbook of Preventive and Social Medicine:
Proportional Mortality Rate (from a specific disease) = (Number of deaths from that specific disease in a year / Total deaths from all causes in that year) x 100
So for MI specifically:
PMR (MI) = (Deaths due to MI / Total deaths due to all causes) x 100
A few key points worth remembering alongside the formula:
  • It is expressed per 100 (or sometimes per 1000) total deaths - it is a proportion, not a true rate, since it has no time dimension and no population denominator.
  • It's used when population/census data isn't available (you only need death registration data).
  • Limitation: because it depends on two variables that can both change (deaths from the specific cause AND total deaths from all causes), it is not reliable for comparing different populations or different time periods directly - it's mainly useful for showing the relative importance of a cause of death within a given population group.
  • The same logic extends to other proportional rates you've noted, e.g., under-5 proportionate mortality rate = (deaths under 5 years / total deaths) x 100, and proportional mortality for age >=50 = (deaths aged >=50 / total deaths of all ages) x 100.
  • Park's Textbook of Preventive and Social Medicine, "Proportional mortality rate (Ratio)" section
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