Job Description of Community Health Nurse Working at Various Levels

Rule 9 of Nepal Health Service Regulation, 2055 (1998)

Community Nursing Administrator

1. Position: Community Nursing Administrator
2. Service: Health
3. Group: PHN
4. Grade: Ninth/Tenth
5. Salary: Monthly, as prescribed by the Government of Nepal
6. Working hours: As prescribed by the Government of Nepal
7. Supervise: Subordinate or lower-level employees who work within the office department
8. Required qualifications: As specified in the relevant act and regulations.
9. Responsibilities: Reporting to the Head of the Office

Duties, responsibilities and tasks to be performed

Working following the Health Service Act and Regulations, while adhering to the Code of Ethics of the Nepal Nursing Council, and performing the following duties.

Work and responsibilities

1. Related to plans and programs

• Prepare technical specifications and detailed procurement plans for medicines, instruments, equipment, and other materials related to the program.
• Plan and implement various policies, strategies, standards, protocols, and programs to maintain the quality of nursing services in community, school, industrial, and other sectors.
• Prepare required resources and ensure the effective implementation of approved policies and plans related to nursing services.
• Develop plans to issue necessary laws, standards, and guidelines for the production and mobilization of quality and competent nursing and midwifery human resources.
• Develop plans for special programs, including required strategies, guidelines, standards, and protocols, to provide quality services to survivors and affected persons of gender-based violence.
• Prepare plans and programs to institutionalize gender equality and social inclusion in the health sector.
• Prepare and submit annual program plans within the approved budget framework by formulating budgets at the federal, provincial, and local levels, as per the job description of the concerned office.
• Develop plans for the preparation of necessary policies, strategies, guidelines, quality standards, and protocols at the national level as per the functions of the concerned division and submit them to the concerned authority.
• Prepare and submit action plans, including the involvement of subordinate staff, to systematically address potential problems in the health sector.
• Provide necessary advice, suggestions, and supervision in the process of developing other annual and long-term health strategic plans apart from the functions of the concerned division.
• Plan training and other capacity-building programs as required according to the functions of the concerned major division/department.
• Support by coordinating and facilitating the overall planning, implementation, and supervision of the division’s activities.

2. Administrative and managerial functions

• Carry out the daily functions of the branch, main branch, or center as per the job description assigned by the Ministry of Health and Population.
• Provide regular information to the head of the concerned office regarding the progress and difficulties of the programs assigned.
•  Play a role in implementing and ensuring the smooth, high-quality, effective, and timely implementation of programs conducted within the assigned section.
• Assist the concerned department chief in making proper arrangements for the procurement, development, and appropriate utilization of necessary human resources, physical infrastructure, information, and financial resources in health institutions and hospitals, based on integrated protocols/standards, for the implementation of various health service targets assigned to the department.
• Provide support and facilitation in activities carried out through the concerned authority for necessary suggestions and recommendations to ensure the timely adjustment and upgrading of programs implemented through concerned department.
• Perform managerial and administrative functions as the branch chief of the concerned section.
• Support work performance by mobilizing and motivating subordinate human resources.
• Develop policies, strategies, regulations, accreditation systems, and quality measurement standards for trainings conducted at national and provincial levels and at clinical training sites.
• Conduct and facilitate various health-related trainings and workshops.
• Ensure that, for the effective and quality implementation of programs under concerned section, subordinate staff as well as personnel at the central, provincial, district, and local levels have the required skills, knowledge, capacity, and the availability of necessary information/educational materials.

3. Coordination and facilitation

• Coordinate with all directorates, centers, sections, and other relevant government agencies for the implementation of public health related programs.
• Facilitate the implementation of programs to be conducted at the central, provincial, and local levels, as well as directives issued from time to time.
• Coordinate with organizations, donor agencies, and other relevant bodies working in the health sector to implement programs.
• Regularly disseminate information received from concerned offices; prepare and submit monthly, quarterly, and four-monthly progress reports to the concerned authorities; and provide feedback on reports received from concerned offices.

4. Monitoring, supervision, and evaluation

• Develop and establish indicators for monitoring and evaluation of the implementation status and work progress of related program.
• Develop and support the development of necessary records, forms, registers, and reporting formats related to the program.
• Conduct and facilitate effective and continuous monitoring and supervision, based on indicators, to ensure service delivery and quality standards.
• Conduct and facilitate regular monitoring and supervision of the implementation status of programs operated by the concerned section, as per the organization’s annual monitoring and evaluation plan.
• Review the programs of the concerned section based on findings identified through monitoring, and to prepare improvement and corrective action plans.
• Seek support from concerned agencies to resolve issues identified during supervision and matters raised in the feedback process, and to provide necessary coordination, facilitation, and guidance for problem-solving.
• Bases on the section’s assigned responsibilities, conduct monitoring, evaluation, and supervision of programs implemented at the provincial and local levels, and provide or facilitate necessary technical support.

5. Health Education, Information, and Communication

• Develop plans for the preparation of program-related information materials and ensure their effective implementation
• Prepare or facilitate the preparation of necessary strategies, guidelines, standards, protocols, and educational materials for the delivery of geriatric-friendly health services.
• Develop and implement health education, information, and communication activities for encouraging every citizen to take responsibility for their own health.

6. Studies and Research

• Formulate policies and regulations based on facts related to the work area, and to conduct studies and research.
• Conduct necessary studies and research for the timely development of nursing services.
• Assist the Chief Nursing Administrator in conducting studies and research-related activities associated to the field of nursing.
• Conduct and assist in studies and research related to the policies, plans, and programs of the Ministry of Health and Population or its branches.

7. Training related

• Support the Ministry of Health and Population in developing policies, strategies, and protocols for training-related development.
• Organize meetings to conduct programs according to the job responsibilities of to their own branch.
• Ensure the provision of necessary vaccines, medicines, instruments, and other supplies for health programs from the concerned authorities, and to arrange for their proper storage, distribution, and use.
• Monitor and supervise the activities of staff under concerned branch
• Perform duties as the acting office chief on a regular basis in the absence of the office chief, based on seniority and work performance

8. Records and Reports

• Maintain records of program-related activities according to the prescribed format and prepare or facilitate the preparation of reports.
• Maintain records of bi-annual and annual reviews of related programs and prepare or facilitate the preparation of reports.
• Prioritize health problems related to programs based on the analysis of received information and prepare plans for implementing measures for problem-solving.
• Regularly review program-related information received through the Integrated Health Information Management System and provide feedback.
• Prepare monthly, quarterly, and annual reports based that records and submit them to the concerned authority on time.

9. Other functions

• Participate in research related to disaster management and risk reduction and to develop future plans based on the findings obtained.
• Develop and implement plans for carrying out programs and activities managed by concerned department during outbreak and epidemic situations.
• Perform duties as assigned and carry out other tasks as required.
• Work regularly, by leading the Section under the Directorate, to achieve the targets set by the Directorate, and to provide necessary support on a regular basis in fulfilling the leadership role of the Directorate Chief.
• Validate and analyze the data received from related programs and prepare necessary plans to strengthen services.
• Ensure the regular flow of information from the department; to send periodic (monthly, quarterly, four-monthly, bi-annual, and annual) progress reports to the concerned authorities; and to provide support in tasks such as giving feedback on reports received.
• Conduct fair and impartial evaluations by adopting a performance-based appraisal process for subordinate staff.
• Prepare and submit the necessary monitoring and supervision tools/materials for studying and supervising the effectiveness of nursing services.
• Support the Chief Nursing Administration in monitoring whether existing nursing services are being delivered effectively.
• Conduct supervision and monitoring, prepare and submit reports with necessary recommendations to the Chief Nursing Administrator, and provide formal and informal suggestions as required.

Community Nursing Officer           

1. Position: Community Nursing Officer
2. Service: Health
3. Group: Community Nursing / Public Health Nursing
4.  Grade: Seventh/Eighth
5. Salary: Monthly, as prescribed by the Government of Nepal
6. Working hours: As prescribed by the Government of Nepal
7. To supervise: Subordinate or lower-level employees who work within the unit
8. Required qualifications: As specified in the relevant act and regulations.
9. Responsibilities: Reporting to the Head of the Office and the Head of the Branch.

Duties, Responsibilities and tasks to be performed

Perform duties according to the Nepal Health Service Act and Regulations, while following the Code of Ethics of the Nepal Nursing Council.

Work and Responsibilities

1. Related to plans and programs

• Planning of various policies, strategies, standards, protocols, and programs to maintain the quality of nursing services (for community, school, industry, and other sectors).
• Assist the Chief Nursing Administrator in implementing various policies and plans related to nursing education, which are necessary to effectively deliver existing services in the country.
• Prepare and present the necessary materials to effectively implement the existing policies and plans related to nursing services.
• Prepare plans for formulating necessary laws, standards, and guidelines for the production and mobilization of qualified and skilled nursing and midwifery personnel.
• Prepare plans forpolicies, guidelines, standards, protocols, and special programsrequiredto providequality services to victims and affected individuals of sexual violence.
• Prepare the necessary strategies, guidelines, standards, protocols, and educational materials for the delivery of geriatric-friendly health services.
• Prepare guidelines and standards related to the operation of social services and integrated services.
• Develop policies and programs to promote gender equality and social inclusion in the health sector.
• Develop gender-sensitive and socially inclusive budgets and programs in the health sector at federal, provincial, and local levels.
• Prepare and submit annual work plans by aligning provincial- and local-level budgets with the work description, assigned responsibilities, and mandate of the position, within the framework of the approved budget.
• Implement planned programs for HIV and Sexually Transmitted Infection (STI) control.
• Participate in preparing technical specifications, procurement plans, and distribution plans for medicines, instruments, equipment, and other materials related to programs.
• Prepare and submit plans for programs for comprehensive, preventive, promotive, and rehabilitative health service delivery.
• Assist in making arrangements for the availability, proper storage, inventory, and appropriate use of vaccines, medicines, equipment, and other essential supplies required for health programs by obtaining them from the concerned authorities.
• Prepare plans for epidemiology, malaria control, kala-azar control, and natural disaster management programs.
• Prepare plans for maternal and neonatal health, reproductive health, family planning, adolescent health, integrated child health, immunization, and nutrition programs.
• Prepare plans for capacity-building programs for nursing personnel according to related subjects and areas of work.

2. Administrative and managerial functions:

• Carry out daily activities of the branch, department, and center according to the job description prescribed by the Ministry of Health and Population.
• Inform regularly to the concerned office chief about the progress and challenges of the programs assigned.
• Assist the concerned Head of in making proper arrangements for the procurement, development, and utilization of necessary human resources, physical infrastructure, information, and financial resources in health institutions and hospitals, based on approved protocols and regulations, for the implementation of various health service targets received by concerned authority.
• Assist the concerned Head of department, as per approved protocols and regulations, in making proper arrangements for the procurement, development, and utilization of required human resources, physical infrastructure, information, and financial resources in health institutions and hospitals for the implementation of various health service targets assigned to the concerned body.
• Provide support and facilitation for necessary suggestions and recommendations from the related authority for the timely adjustment and upgrading of programs implemented through the concerned body.
• Prepare and submit a necessary work plan for creating a gender-friendly work environment in the organization and submit it to the concerned authority.

3. Coordination and Facilitation

• Coordinate with all divisions, centers, sections, and other related stakeholders for the implementation of public health-related programs.
• Provide facilitation in the implementation of programs to be conducted at the central, provincial, and local levels, as well as in following instructions issued from time to time.
• Implement programs by coordinating with organizations, donor agencies, and other bodies working in the health sector.
• Assist in tasks such as the regular flow of information from the workplace sending monthly/quarterly progress reports to the concerned authorities, and providing support or feedback on reports received from subordinate units.
• Coordinate public health programs implemented by the hospital.

4. Monitoring, Supervision, and Evaluation

• Develop indicators for monitoring and evaluating the implementation status and progress of the related programs.
• Develop necessary record forms, registers, and reporting formats related to the programs.
• Verify and analyze the data received from relevant programs and develop necessary plans for service improvement.
• Ensure service delivery and quality based on indicators.
• Monitor and supervise programs at assigned level and provide guidance for improvement based on the feedback received.
• Monitor service delivery, its quality, and the programs implemented by subordinate staff..
• Prepare and submit necessary materials for supervision and monitoring, including tools for evaluating the effectiveness of nursing services.
• Assist the Chief Nursing Administrator in monitoring whether the existing nursing services are being carried out effectively.
• Supervise and monitor, prepare reports with necessary recommendations, and submit them to the Chief Nursing Administrator, as well as provide formal and informal suggestions as required.
• Provide technical support and conduct monitoring of public health programs implemented through hospitals.
• Assist in the regular flow of information; send periodic progress reports (monthly, quarterly/trimester, bi-annual, and annual) to the concerned authorities; and support activities such as providing feedback on reports received.

5. Health education, Information, and Communication

• Prepare plans for the development and formulation of information materials related to programs, distribute them, and ensure their effective implementation.
• Develop and implement health education, information, and communication activities that encourage every citizen to take responsibility for their own health.

6. Study and Research

• Formulate evidence-based policies and regulations related to programs, and conduct studies and research.
• Conduct necessary studies and research to develop nursing services in a humane and client-friendly manner.
• Play a supportive role to the Chief Nursing Administration in planning studies and research related to nursing subjects.

7. Training related

• Assist the Ministry of Health and Population in preparing policies, strategies, and protocols related to training and development.
• Formulating policies, strategies, quality standards, and evaluation criteria for regulating and accrediting training conducted at central and provincial levels as well as at clinical training sites.
• Conduct and facilitate various health-related trainings and workshops.

8. Records and Reports

• Maintain records of program-related activities according to the format and prepare reports.
• Maintain records of the half- yearly and annual reviews of the related programs and prepare reports.
• Based on the analysis of the information received, determine the priority of health problems related to the program and develop plans to implement measures for solving the problems.
• Regularly review and maintain program-related information obtained through the Integrated Health Information Management System.

9. Other tasks

• Participate in activities such as disaster management and risk reduction, and based on the results obtained, formulate future plans.
• During outbreaks or epidemics, plan and implement the programs and activities managed by the organization.
• Carry out other tasks as assigned and according to the prescribed rules.
• Perform other necessary tasks as per the training received and standard operating procedures (SOPs).

Public Health Nurse              

1. Position: Public Health Nurse
2. Service: Health
3. Group: Public Health Nursing
4.  Grade: Fifth/Sixth
5. Salary: Monthly, as prescribed by the Government of Nepal
6. Working hours: As prescribed by the Government of Nepal
7. To supervise: Subordinate or lower-level employees who work within the unit
8. Required qualifications: As specified in the relevant act and regulations.
9. Responsibilities: Reporting to the Head of the Office and the Head of the Branch

Duties, Responsibilities and tasks to be performed

Working under the Nepal Health Service Act and Regulations, and adhering to the Code of Ethics of the Nepal Nursing Council, to take full responsibility, as per rules, for the implementation of the following public health programs: safe motherhood, newborn health, immunization, adolescent sexual and reproductive health, reproductive health of elderly women, gender-based violence, infertility, safe abortion, and other related public health programs, and to carry out the following tasks accordingly.

1. Planning and programs related

• As per the directives of the Provincial Health Office or the Chief of the Health Office, to coordinate and consult with the Section Chief and, as the focal person for the assigned programs, prepare annual, quarterly, and monthly work plans, obtain approval, and implement and ensure the effective implementation of the approved plans.
• To assist the concerned Section Chiefs in concerned province and district in arranging the necessary resources, including the budget, for the regular implementation of Safe Motherhood programs, Reproductive Health programs, Family Planning programs, immunization programs, Female Community Health Volunteer (FCHV) Programme and other related health programs.
• To assist the Section Chief in planning the supply of medicines, equipment, instruments, and other materials related to the programs, including procurement details and stock management.

2. Administrative and managerial function

• Carry out the daily tasks of the office where one is posted, within the assigned work responsibilities.
• Provide the concerned Section Chief with regular updates on the progress and challenges of the assigned programs.
• To initiate arrangements with the Office Chief, through the Section Chief, for managing the necessary resources and means (human resources, materials, tools, equipment, etc.) required to implement the programs assigned responsibility.
• As the focal person, to ensure the regular and smooth delivery of services for the programs managed, and to carry out activities according to the assigned responsibilities:

2.1. Safe Motherhood and Family Planning services

• Arrange for the provision of counseling services to targeted individuals/couples regarding the use of regular family planning services and emergency family planning services.
• Assist the concerned chief in arranging for services provided by the civil or health institutions to reach the community effectively.
• Ensure whether Safe Motherhood and Family Planning clinics are being operated or not in provincial hospitals, primary health centers, health posts, birthing centers, and other related institutions.
• Make arrangements for the operation of Maternal and Newborn clinic.
• Ensure whether the quality of the services being provided is maintained or not.
• Make arrangements for the regular operation of Safe Motherhood clinics and support their effective functioning.
• Make arrangements for the provision of necessary warm delivery bag/kits, medicines, and equipment to provide newborn care counseling and services through various institutions.

2.2. Prevention and treatment of pregnancy-related complications.

• Make arrangements, in coordination with health institutions, to ensure the continuous availability of safe abortion services.
• Provide support for the operation and management of Safe Abortion clinics

2.3. Sexually Transmitted Diseases and AIDS Control Program

• Identify target groups and conduct orientation/education on VCT and PMTCT to prevent HIV/AIDS.
• Operate and facilitate the Condom Promotion Program.
• Strengthen the STI and HIV/AIDS Coordination Committee and, through the committee, coordinate with all governmental and non-governmental organizations to implement programs.

2.4. Adolescent Health

• Establish and facilitate need-based counseling clinics for adolescents.
• Accredit adolescent-friendly service–providing institutions and provide the necessary support for effective service delivery.
• Establish Adolescent-Friendly Information Centers in schools and arrange the required counseling services to ensure their maximum utilization.

2.5. Prevention and treatment of infertility

• Arrange and provide clinic consultations as needed for the prevention and treatment of infertility
• Provide counseling on reproductive health issues for aging women at the community or at local level, along with arranging for referral services.

2.6 Immunization

• Regularly coordinate and collaborate with the concerned personnel at the district and local levels, as well as through clinics and outreach, to ensure the continuity of vaccination services.
• Ensure that all target groups receive vaccination services and supervise to confirm this, as well as provide any necessary guidance.
• Ensure that the standards are maintained and arrange for the necessary measures according to the guidelines, confirming whether they have been met or not.
• Monitor and supervise the implementation of the vaccination program carried out by all governmental and non-governmental organizations, and provide necessary guidance whenever needed.

2.7. Nutrition

• Organize maternal and child nutrition programs at the local level, and to arrange the necessary resources, such as weighing scales, nutrition cards, and other necessary supplies.
• Regularly conduct child growth monitoring through nutrition clinics and government well-baby clinics.
• Implement and facilitate large scale of Vitamin A capsule distribution program in the assigned district and local areas according to guidelines, and coordinate with and support concerned personnel.
• Assist in promoting the use of iodized salt.
• Assist and facilitate the implementation of the iron-folic acid supplementation program for adolescent girls at the school level.
• Manage children with severe malnutrition and to support and facilitate the implementation of the referral system.

2.8 Female Community Health Volunteers (FCHVs) program

• Coordinate the preparation of the work plan for the Female Community Health Volunteer program and to arrange the necessary training sessions and related activities.
• Arrange the necessary monitoring registers, forms, guidelines, identity documents, and related materials for the Female Community Health Volunteers.
• Arrange observation visits for FCHVs and make provisions for awards/incentives.
• Keep records/information on whether the biannual review workshop of FCHVs has been conducted or not.
• Make necessary arrangements for conducting basic and refresher training for FCHVs.

3. Coordination and Facilitation

• Ensure regular health service delivery and carry out necessary coordination and facilitation with peripheral health facilities, hospitals, local levels, primary health care centers, and birthing centers.
• Coordinate with related community-based, private, and non-governmental organizations operating at the provincial and local levels, and to implement health programs accordingly.
• Maintain coordination with all section heads of the health office/local level, as well as with all health institution staff under the concerned health institutions.
• Coordinate with governmental and non-governmental organizations and perform the role of coordinator for meetings of the Reproductive Health Coordination Committee.
• Discuss the targets, progress, and problems related to reproductive health activities, and to provide feedback to higher authorities or concerned bodies based on service coverage and major needs.
• Make programs effective through coordination with subordinates and other concerned individuals or organizations.
• Support the arrangement of equipment, supplies, and medicines for safe motherhood services in various health institutions as per need.

4. Monitoring, Supervision, and Evaluation

• Supervise Reproductive Health activities and provide guidance, support, and advice.
• Supervise activities related to Safe Motherhood, safe abortion, adolescent Reproductive Health, uterine prolapse, and other health services in district-level health institutions; to prepare reports and present them to the chief, provide feedback to concerned institutions, and take necessary actions to address identified problems.
• Supervise FCHV and school health education activities, provide necessary guidance, and give feedback to the concerned institutions.
• Prepare and present charts and graphs related to the targets, progress, service coverage, and major issues of reproductive health activities.
• Discuss the feedback received from higher authorities with the staff of the relevant health institutions and health offices, and to inform concerned individuals or organizations as per the instructions.
• Participate in group planning, identify the status of programs based on the health institution’s profile and monitoring, review program progress, and assist in preparing plans.
• Identify the status of programs and, if progress is unsatisfactory, assist in reviewing and planning corrective measures to achieve desired progress.
• Participate in the review of program progress based on the institution’s profile and monitoring data.
• Regularly monitor the availability and utilization of post-abortion care and family planning services.
• Prepare a supervision schedule as determined by the integrated supervision system and submit it for approval to the higher authorities.
• Conduct necessary supervision using the checklist as per the approved schedule, prepare supervision reports, and provide feedback to the concerned authorities.
• Analyze the strengths and weaknesses observed during supervision and provide recommendations for appropriate action.
• Periodically evaluate programs and their progress and submit reports to higher authorities.
• Ensure that safe motherhood-related activities are being implemented according to the plan at hospitals, primary health care centers, health posts, and village clinics.
• Supervise reproductive health activities and provide guidance, support, and advice.
• Supervise safe motherhood and family planning activities, prepare reports, present them to the chief, and provide feedback to the concerned institutions.
• Supervise FCHV and school health education activities, provide necessary guidance, and give feedback to the concerned institutions.

5. Health Education, Information, and Communication

• To coordinate and organize health education programs as needed in various organizations.
• To make arrangements for the regular conduct of school health education programs and ensure their proper implementation.
• Conduct community information, education, and communication programs to raise awareness among the public and mobilize community support.
• Encourage each citizen to take responsibility for their own health, assist branch heads in the development of public health education, information, and communication, and ensure their implementation.

6. Study and research

• Participate in studies and research conducted by the concerned office/agency and provide assistance in those studies/research.

7. Training related

• Arrange appropriate training to ensure the provision of quality services by the employees working at various levels under your supervision.
• Arrange training related to safe motherhood and family planning.
• Arrange appropriate training to ensure the provision of quality services by employees at various levels within the district/local level related to the work performed.
• Assist the office head in the selection of appropriate service providers for training related to safe motherhood, safe abortion, adolescent reproductive health, and other health services.
• After training, ensure that the service providers deliver services regularly in the institution and provide technical support as needed.

8. Record and report

• Maintain accurate records and reports received in the institution, prepare graphs/charts for presentation, and assist in explaining them.
• Assist in preparing monthly, quarterly, and annual reports and ensure their timely submission to the concerned authority.
• Maintain records and report according to the forms and registers prescribed by the National Integrated Health Information Management System.

9. Other functions

• In addition to the duties mentioned above, recommend training and development opportunities for subordinate staff based on their growth, development, and training needs.
• Provide support in organizing orientation programs related to various health programs and in celebrating national health days.
• Conduct or facilitate research and evaluation activities as required for the proper development of services.
• During outbreaks or epidemic situations, collaborate with the branch head in preparing plans and implementing programs and activities managed by the office.
• Carry out duties as assigned and perform other tasks as required.
• Perform other duties according to the the training and skills acquired.

Auxiliary Nurse Midwife (ANM)

1. Position: ANM
2. Group: Axillary Nursing
3. Grade: Forth /Fifth/Sixth
4. Salary: Monthly, as prescribed by the Government of Nepal
5. Working hours: As prescribed by the Government of Nepal
6. Supervise: supporting staff, FCHVs.
7. Required qualifications: As specified in the relevant act and regulations.
8. Responsibilities: Head of the Office, Head of Nursing and Nursing Incharge

Tasks, duties, and responsibilities to be performed

Auxiliary Nurse Midwives (ANMs) working in health center under the Nepal Health Service Act and Regulations perform the following tasks according to the Code of Ethics prepared by the Nepal Nursing Council and the scope of practice for registered ANMs.

Main responsibility

 Play a supportive role in providing nursing and midwifery services delivered by the health facilities according to the Minimum Service Standards, and to provide nursing and/or midwifery health services from the assigned section/unit.

Related to service delivery

1. Internal services

• Handover and takeover of information regarding admitted patients.
• Provide basic nursing and health care services as required to patients admitted to the ward.
• Assist doctors and other nursing and supporting staff in providing care to patients.
• Ensure patient care as well as ward cleanliness and to prevent infection.
• Administer medicines and injections to patients in a timely manner as required.
• Establishes therapeutic relationship with patients using interpersonal relationships and provides necessary health-related advice to patients and their relatives.
• Assists in patient admission and discharge processes.
• Supports staff nurses in checking emergency medicines and equipment.
• Immediately reports to higher authorities in case of a medico-legal case.

Safe Motherhood

• Conduct examination of pregnant women
• Provide comprehensive health services for pregnant women through holistic care by effectively informing them.
• Collect information on the physical health of a pregnant women, provide counseling and testing related to HIV, and conduct other necessary examinations, guidance, and recommendations as required.
• Advise pregnant women in developing a birth plan from antenatal preparation to delivery, including how to reach a safe delivery site, who will conduct the delivery, and ensure timely and organized referral when necessary.
• Detect the onset of labor pain.
•  Fill out the partograph for pregnant women in labor and immediately report any abnormal conditions.
• Assess the health status of the mother and the fetus during labor and provide necessary care.
• Provide routine normal delivery services.
• Take appropriate measures to manage prolonged labor and, if necessary, refer to a health institution.
• Actively manage the third stage of labor (Active 3^rd stage management).
•  Conduct immediate assessment of the newborn at birth and provide essential immediate newborn care services.
• Identify critical complications in newborn, provide essential life-saving procedure, and provide life-saving services. If trained, perform resuscitation for newborn born with asphyxia; if not trained, promptly refer the newborn to a facility where such services are available
• Identify conditions such as hemorrhage and high blood pressure during labor, and provide emergency obstetric services using first-line life-saving procedures to prevent risk to life, and refer the patient as necessary to a facility where surgical services are effectively available.
•  Immediately after delivery, assist the newborn with breastfeeding and encourage the mother to practice early and exclusive breastfeeding and educate the family about its importance
•  Provide counseling on family planning methods that can be adopted during the postpartum period, offer guidance, and refer as needed.
• Advise pregnant women and their families on the importance of nutrition, hygiene, immunization, and birth preparedness.
• Ensure all women receive respectful maternity care.
• Immediately report any abnormal condition in the mother or newborn and assist in necessary management.
•  Provide postpartum and newborn care as required, including perineal care, breast care, and support for breastfeeding.
• Provide family planning counseling services and provide family planning methods.

Safe abortion

• If an incomplete abortion is confirmed, provide post-abortion care services according to the training received, including post-abortion care.
• If services for managing incomplete abortion are not available, refer the patient to an appropriate health facility.
•  Provide family planning counseling to prevent unexpected pregnancies.

 Newborn care

• Provide newborn care according to the training received, and apply appropriate health management procedures if any problems arise.
• Perform resuscitation if necessary, keep the newborn warm, and practice kangaroo mother care by placing the baby on the mother’s warm chest. Encourage early breastfeeding.
• Provide health education to promote exclusive breastfeeding for the newborn up to six months.

Adolescent Health

• Provide counseling services regarding various health problems during adolescence and provide services as needed.
• Provide necessary health education to adolescents about the physical changes that occur during adolescence.

Immunization

• Conduct immunization clinics in the health institution.
•  Supervise to ensure that the target group receives vaccination services.
• Conduct immunization programs according to the guidelines of the Integrated Immunization Program to maintain the quality of vaccines.

Nutrition

• Implement maternal and child nutrition programs in health institutions and arrange necessary materials such as weighing scales, nutrition cards, etc.
• Conduct programs related to maternal and child nutrition.
•  Monitor child growth.
• Implement Vitamin A capsule and deworming medicine distribution programs.
• Promote iodized salt consumption.
•  Assist in referring severely malnourished children.
• Provide iron tablets along with deworming medicine to pregnant women according to clinical protocols to prevent anemia.

Family Planning services

• Provide family planning counselling to postpartum women and, make family planning methods available according to the woman’s choice.
• Provide counseling and services regarding emergency contraception.
• Provide the selected method (IUCD or Norplant) to women who wish to use it, according to the training received
• Regularly follow up with family planning users, manage any adverse effects, and refer them to appropriate services if needed

Outpatient service

• Assist in the conducting Maternal, Child, and Family Planning service clinic.
• Provide counseling services related to family planning.
• Provide appropriate counseling and healthcare services to pregnant women.
• Ensure services are delivered according to national policies on reproductive health, communicable diseases, and child health
• Provide routine immunization services and ensure the availability of necessary health services to postnatal mothers and newborns as required.
• Assist in preparing reports and submitting them to the concerned section.

Management-related supervision

1. Supervision and monitoring

• Supervise and provide proper guidance to ANMs, students, and supporting staff.
• Conduct supervision and monitoring of health services provided by skilled personnel such as; Female Community Health Volunteers (FCHVs).

2. Record and Report

• Maintain accurate records of nursing services, treatments, and medications provided to patients, and prepare reports or assist in report preparation.
• Assist in bringing materials for which one is responsible and in preparing reports on damaged or broken items in the inventory.

3. Information, Education, Communication, and Counseling (IECC)

• Provide health education and counseling related to treatment to clients/patients, and their relatives as required.
• Inform the concerned person or authority in case of any emergency, critical, or significant incidents.
• Provide patients and their relatives with accurate information and counseling about hospital and ward/unit policies, rules, and available facilities.
• Ensure whether postnatal mothers are breastfeeding or not, and provide education on the importance of exclusive breastfeeding.
• Provide education to patients and their relatives on personal hygiene.

4. Monitoring and evaluation

• Assess the condition of clients/patients and evaluate whether the nursing and maternity services provided meet quality standards, and take corrective actions as needed.
• Inform the ward in-charge about the ward’s cleanliness and assist in its management.

5. Other functions

• Perform duties under the guidance of the Hospital Health In-Charge and Nursing In-Charge as a member of the hospital health team.
• Ensure arrangements for 24-hour maternity and emergency services.
•  Implement community health programs.

For more details: Click below for Nepali version