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medical social worker role healthcare team functions

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Here is a note on the Medical Social Worker, drawn from Park's Textbook of Preventive and Social Medicine (p. 790):

Medical Social Worker

A medical social worker is a paramedical worker trained in social case work and in the art of interviewing people.

Settings Where Employed

Medical social workers are found across a wide range of health settings, including:
  • Hospitals
  • Tuberculosis clinics
  • Family planning clinics
  • Cancer control centres
  • Mental health services
  • Maternal and child welfare services
  • School and university health services

Role as a Link

The medical social worker forms a link between the institution (hospital/clinic) and the community. This bridging role is central to the concept of social medicine.

Principal Functions

  1. Family visits - Probes into the personal, economic, and social causes of illness.
  2. Social history collection - Gathers social history of the patient to supplement the medical history taken by the physician.
  3. Community resources - Tries to secure help for the patient through available community resources.
  4. Rehabilitation - In chronic disabling illnesses such as tuberculosis, leprosy, and poliomyelitis, the medical social worker plays a key role in patient rehabilitation.

Importance in the Healthcare Team

The medical social worker is now recognized as an essential professional colleague of the doctor in:
  • Analysing and correcting social and emotional factors affecting health
  • Supplying information of fundamental importance in formulating a complete diagnosis
  • Directing the treatment of many patients
"A medical social worker bears the same relationship to the effectiveness of social medicine, as does the nurse to clinical medicine."
  • Park's Textbook of Preventive and Social Medicine, p. 790

In Summary

The medical social worker addresses the psychosocial dimensions of illness - the aspects a purely clinical approach cannot cover. By assessing social determinants, connecting patients to community support, and aiding rehabilitation, they are indispensable to holistic patient care.

Write about... Job responsibilities of oMulti-purpos Health assistant female

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Multipurpose Health Worker (Female) - ANM

Overview

Under the Multipurpose Worker Scheme, one Health Worker Female (ANM - Auxiliary Nurse Midwife) and one Health Worker Male are posted at each sub-centre. She is expected to cover:
  • 5,000 population (3,000 in tribal and hilly areas)
  • She limits her activities to 350-500 families within this area
(Park's Textbook of Preventive and Social Medicine, p. 1010)

Job Responsibilities

1. Maternal and Child Health (MCH)

  1. Register and provide care to pregnant women throughout pregnancy.
  2. Ensure every pregnant woman makes at least 4 antenatal visits as per schedule.
  3. Test urine of pregnant women for albumin and sugar; estimate haemoglobin level.
  4. Refer all pregnant women to PHC for RPR test for syphilis.
  5. Refer cases of abnormal pregnancy and gynaecological problems to Health Assistant Female (LHV) or PHC.
  6. Conduct deliveries in her area when called upon.
  7. Supervise deliveries conducted by Dais and assist them when needed.
  8. Refer cases of difficult labour and newborns with abnormalities for institutional care and provide follow-up.
  9. Identify beneficiaries and complete formalities for Janani Suraksha Yojana (JSY); submit monthly accounts by 7th of each month.
  10. Track all pregnancies by name for scheduled ANC/PNC services.
  11. Make post-natal home visits on 0, 3, 7, and 42nd day for home/sub-centre deliveries; on 3, 7, and 42nd day for institutional deliveries.
  12. For low birth weight babies - six post-natal visits on 0, 3, 7, 14, 21, and 28th day; screen for congenital abnormalities and danger signs per IMNCI guidelines.
  13. Initiate early breastfeeding within 1 hour of birth; exclusive breastfeeding for 6 months; timely weaning at 6 months.
  14. Assess growth and development of infants and under-5 children; make timely referrals.
  15. Treat cases of diarrhoea, ARI (pneumonia), and minor ailments; refer severe cases per IMNCI guidelines.
  16. Educate mothers on maternal and child health, family planning, nutrition, immunization, and hygiene.
  17. Assist Medical Officer and Health Assistant (Female) in antenatal and postnatal clinics.

2. Family Planning

  1. Maintain eligible couple registers and update at all times.
  2. Distribute conventional contraceptives and oral contraceptives to couples.
  3. Provide follow-up to female family planning acceptors; identify and manage side effects; refer cases needing physician attention to PHC.
  4. Establish female depot holders and ensure continuous supply of conventional contraceptives.
  5. Build rapport with acceptors, village leaders, ASHA, Dais, and others for motivation.

3. Medical Termination of Pregnancy (MTP)

  1. Identify women requiring help for MTP and refer them to the nearest approved institution.
  2. Educate the community about consequences of septic abortion and availability of MTP services.

4. Nutrition

  1. Identify cases of malnutrition among infants and under-5 children; give necessary treatment/advice; refer serious cases to PHC.
  2. Distribute Iron and Folic Acid (IFA) tablets to pregnant women, nursing mothers, and children up to 5 years.
  3. Administer Vitamin A solution to children as per guidelines.

5. Universal Immunization Programme (UIP)

  1. Immunize pregnant women with Tetanus Toxoid (TT).
  2. Administer pentavalent, DPT, OPV, IPV, measles, hepatitis B, and BCG vaccines to infants and children per schedule.
  3. Ensure injection safety, safe disposal, and record/report/manage Adverse Events Following Immunization (AEFI); submit monthly UIP reports and weekly surveillance reports (AFP, measles under IDSP); serious AEFI and outbreaks to be reported immediately.
  4. Responsible for cold chain maintenance for vaccines during fixed and outreach sessions.
  5. Manage waste generated during immunization per GOI/CPCB guidelines.
  6. Prepare work plans, estimate beneficiaries and logistics, prepare due list in coordination with Anganwadi Worker and ASHA.
  7. Maintain tracking bag/tickler box at sub-centre for follow-up.
  8. Track dropouts and left-outs; maintain MCH register and immunization card counterfoils.

3A. Health Assistant Female (LHV) - Supervisory Role

The Health Assistant Female (Lady Health Visitor / LHV) operates at a higher level under the multipurpose workers scheme:
  • Covers a population of 30,000 (20,000 in tribal/hilly areas)
  • Supervises 6 sub-centres, each with one Health Worker Female

Key Functions of the Health Assistant (Female):

AreaResponsibilities
Supervision & GuidanceSupervise and guide ANMs; visit each sub-centre at least once a week; assess and submit ANM performance reports to MO-PHC
TeamworkCoordinate with Health Assistant Male; attend block-level meetings; assist MOs in organizing health services; participate in mass camps
Supplies & EquipmentCheck sub-centre stores; ensure proper drug storage and equipment maintenance; ensure ANM's general and midwifery kits are maintained; keep sub-centre clean
Records & ReportsScrutinize ANM records; consolidate and submit periodical reports to MO-PHC
Kala-azar (endemic areas)Check minimum 10% of houses; guide suspected cases to PHC/CHC
Source: Park's Textbook of Preventive and Social Medicine, pp. 1010-1011
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