IPHS GUIDELINES for CHC to be called FRU
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IPHS guidelines Community Health Centre CHC criteria to be designated First Referral Unit FRU
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https://ruralindiaonline.org/en/library/resource/indian-publ…
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IPHS Criteria for a CHC to be Designated as First Referral Unit (FRU)
A Community Health Centre (CHC) is a 30-bedded facility at the block level meant to provide secondary-level referral care for cases coming from PHCs and Sub-Centres. Not every CHC automatically qualifies as an FRU - it must fulfill specific operational, infrastructural and manpower criteria laid down under the Indian Public Health Standards (IPHS).
Original IPHS (2012) - Core Criteria for FRU Designation
For a CHC (or any facility such as a sub-district/district hospital) to be operationalized as an FRU, three conditions must be met simultaneously and round-the-clock (24x7):
- Emergency Obstetric Care (EmOC), including surgical interventions like caesarean sections
- Newborn care
- Blood storage facility available on site (or a linked blood bank)
In addition, IPHS lays down the following functional requirements for an FRU-CHC:
- 24-hour delivery services, including normal and assisted deliveries
- Emergency care for obstetric complications (eclampsia, hemorrhage, obstructed labour, sepsis)
- Emergency care of sick children
- Full range of family planning services, including laparoscopic/minilap sterilization
- Safe abortion (MTP) services
- Treatment of STIs/RTIs
- Essential laboratory services (blood grouping, cross-matching, basic pathology)
- Referral/transport services (linked to 24x7 ambulance)
- Management of injury and trauma cases
- Adequate specialist manpower: Surgeon, Obstetrician/Gynaecologist, Physician, Paediatrician, plus an Anaesthetist (or trained Medical Officer), staff nurses (minimum 7 for a 30-bed CHC), OT technician and blood storage staff
- Functional operation theatre, labour room, and essential drugs/equipment as per the IPHS checklist
Updated IPHS 2022 - FRU vs Non-FRU CHC
The 2022 revision formally split CHCs into two categories:
| Feature | Non-FRU CHC | FRU-CHC |
|---|---|---|
| Care level | Essential care only (maternal-child health, infectious disease, NCDs, mental health, ophthalmic/ENT/dental) | Essential care plus specialist, operative, and blood transfusion services |
| Location | Rural areas only | Rural or urban (urban CHCs must all be FRU-type) |
| Operation theatre | Not mandatory 24x7 | One OT functioning round-the-clock plus one elective OT (urban 100-bed FRUs need an additional round-the-clock OT) |
| Oxygen-supported beds | 18 of 30 beds | 20 of 30 beds; 26 of 50 beds; 43 of 100 beds (urban) |
| Specialist staffing | Basic medical officers | Physician, Surgeon, Obstetrician-Gynaecologist, Paediatrician, Anaesthesiologist, Ophthalmologist, Orthopaedic specialist, Microbiologist/Pathologist, PMR specialist, plus General Duty MO, Dental MO, AYUSH MO |
| Infrastructure | Standard IPHS norms | Same norms with higher bed/water/toilet provisioning ( ~340-450 litres water/bed/day, 1 toilet per 6 beds) |
Practical Significance
Under the National Health Mission, only FRU-designated CHCs are counted toward emergency obstetric/newborn care (EmONC) referral networks and are eligible for the corresponding manpower, equipment, and infrastructure grants. A CHC that lacks 24x7 EmOC, newborn care, or blood storage capacity - even if it has 30 beds - is classified as non-FRU and cannot be counted in the FRU network for maternal mortality reduction programs.
Note: I could not locate this administrative/public-health-systems document in the clinical medical textbook library (it indexes clinical/basic science textbooks, not government health system guidelines), so this answer is based on the official IPHS documents and secondary sources via web search. If you need the exact page-referenced text from the original Ministry of Health & Family Welfare IPHS 2012 or 2022 PDF, let me know and I can pull the primary document.
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