The Role of the District Public Health Nurses: A Study from Gujarat
Abstract
The role of District Public Health Nurses (DPHN) and District Public Health Nurse
Officers (DPHNOs) as supervisors of the Public Health nursing and midwifery staff in a
district was investigated. Thirteen DPHNs and DPHNOs from six districts selected from
six geographic zones of Gujarat were observed for one week using the time motion
method. Their activities and time spent were noted and the DPHNs/DPHNOs and their
supervisors were interviewed.
The role of the DPHNs has reduced over the years because they have not been assigned
new roles with change in programmes and policies. Most of the DPHNs have training for
clinical work in hospitals. Their 10 month training to qualify for PHN is inadequate to
develop knowledge and skills in public health. There is a gap between their training and
posting due to delays in government procedures of promotion. The DPHN/DPHNOs
spend majority of their time in the office (49%) where they have a limited role. Their
supervisory role for nurses and midwives has lost its importance. They spend about 1/3rd
of their time in field supervision mostly visiting centres accessible by public transport as
they do not have an allotted government vehicle. As they do not submit any field report,
there is no follow-up action from their visit. Nevertheless they seem to have an important
role in solving problems of field workers as they are mediators between the district and
peripheral facilities. To conclude the DPHNs are under utilized which affects the quality
of maternal and child health services in the district.
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