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Infrastructure for Clinical Services

Subsequent to general principles for infrastructure, following considerations should be kept in mind while planning for infrastructure of clinical services.

Screening and Holding Area

Before entering for registration, the facility should have enough space (either open or closed) to hold and undertake preliminary screening, if need be, for any symptom of infections which can quickly be transmitted specially during epidemics and pandemics.


Each facility should provide for computerized registration of cases coming to OPD. This can be done

during OPD consultation by CHO or any other designated staff in SHC in rural areas and by ANM/Other

support staff in UHWCs.

Waiting area

Adequate seating arrangement preferably, which are less space occupying and easy to maintain should be

placed. Messages conveying people to provide seats to elderly, pregnant women, disabled persons, children,

adolescents, and patients should be properly displayed.

Adequate space should be allocated for persons using mobility devices, for example wheelchairs, crutches

and walkers, white cane, etc., as well as those walking with the assistance of others. Waiting area for OPD

should have a patient friendly ambience and can have colorful wall paintings.

Patient amenities in waiting areas should include:

Essential amenities

  • Fans
  • Clean drinking water
  • Clean and gender sensitive toilets

Desirable amenities

  • Air-conditioning
  • Television/LCD in waiting area displaying facility related information, health related IEC

Consultation room

The consultation room should have enough space to accommodate table and at least two chairs, where interaction with patients can be undertaken with confidentiality and dignity. It should be well lit and ventilated.

An examination table, curtains (wheeled, wall mounted, single piece), hand washing facilities should be provided, as needed.

Clinical Laboratory

The laboratory should have equipment and reagents for conducting all tests enumerated to be provided at the level of AAPLA DAWAKHANA. List of tests to be undertaken at the facility should be clearly be displayed.

Laboratory should not be a thoroughfare and various testing areas should be clearly marked. It should have facility for running water, testing and cleaning area and kept well maintained at all times. The diagnostics can also be conducted in a PPP model with results being secured from a NABL certified lab.

Record keeping

Every facility / AAPLA DAWAKHANA should plan to ensure safe upkeep of the necessary records preferably utilizing IT systems. The records should be made available as per the request for audit by the government empaneled entity.


The HWC should have adequate and spacious stores located away from patient traffic with facility for storing

drugs, consumables, records, linen, furniture, equipment, and sundry articles.

Guidelines for safe disposal of expired drugs and vaccines should be adhered to. The store should have small space for keeping a month’s stock of drugs and linen and there should be system of indenting medicines depending upon frequency as required through a digitized stock keeping system.

Teleconsultation (if applicable within facility)

Adequate space and equipment as per guidelines should be made available. Allotted space along with internet/telephone connection will facilitate the effective delivery of telemedicine services. To optimize the use of space, the health and wellness section can be equipped with teleconsultation facilities. IT requirements should be set up to meet the needs of capturing, transmitting images, prescriptions, and diagnostic reports for teleconsultations. Video calling feature should be enabled in the existing IT system to connect with hubs identified for teleconsultation services.

Minimum requirement for teleconsultation infrastructure includes Telemedicine diagnostic kit, Desktop with headphone, microphone and HD web camera, Printer, and last mile connectivity (minimum 2 MBPS).

The teleconsultation can further be provided in a hub & spoke model by respective doctors in an agile mode as well from the respective community (within facilities) or beyond as per the emerging needs keeping the consideration around pandemics or any situation that may arise or as per the request of the government.

Support Services

  • Washrooms – Gender sensitive, clean and functional toilets with regular supply of running water.
  • Decontamination and washing facilities – The facility should be available for both linen and equipment. Linkages with mechanized laundry at DH/CHC level can be established if required.