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GOVERNMENT OF THE KHYBER PAKHTUNKHWA

HEALTH DEPARTMENT

NOTIFICATION

Peshawar, dated the 29TH January, 2015

No. SO (H&E)/2-65/2014.-In exercise of the powers conferred by section 10 of the Khyber Pakhtunkhwa Regulation of Lady Health Workers Program and Employees (Regularization and Standardization) Act, 2014 (Khyber Pakhtunkhwa Act No. XXVI of 2014), the Government of Khyber Pakhtunkhwa is pleased to make the following rules, namely:

THE KHYBER PAKHTUNKHWA REGULATION OF LADY HEALTH WORKERS PROGRAM EMPLOYEES SERVICE RULES, 2015

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1. Short title, application and commencement.---(1) These rules may be called the Khyber Pakhtunkhwa Regulation of Lady Health Workers Program Employees Service Rules, 2014.

(2) It shall apply to all the Program employees of the Program.

(3) They shall come into force at once.

2. Definitions.---In these rules, unless the context otherwise requires, the following expressions shall have the meanings hereby respectively assigned to them, that is to say,-

(a) “Act” means the Khyber Pakhtunkhwa Regulation of Lady Health Workers Program and Employees (Regularization and Standardization) Act, 2014 (Khyber Pakhtunkhwa Act No. XXVI of 2014);

(b) “Provincial Coordinator” means Head of the Program appointed by government from amongst member of service, Health Department.

(c) “Appointing Authority” means an authority specified in Rule.3.

(d) “Provincial Program Implementation Unit” means the

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Management Unit of the Program at Provincial level.

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RECRUITMENT AND OTHER TERMS AND CONDITIONS OF SERVICE OF EMPLOYEES

3. Method of appointment.---(1) There shall be Selection Committees for the purpose of making selection for initial appointment on contract basis to the posts of the Program, on the recommendations of which the appointing authority shall make appointment.

(2) The candidates applying for the various posts in the Program shall possess same qualification and age limit, as provided in the original Program.

4. Selection criteria for appointment of Lady Health Supervisor.---(1) There shall be a Selection Committee for the appointment of Lady Health Supervisors comprising of the following:

(a)

District Coordinator,

Lady Health Worker Program;

Chairman

(b)

a representative of District Health Officer;

Member

(c)

a representative of the Provincial Program Implementation Unit not below the rank of BPS-17; and

Member

(d)

Field Program Officer of

the concerned area.

Member-cum-Sectary

(2) The posts shall be advertised in two News papers or electronic media.

(3) Test and interview of the short listed candidates at District level shall be conducted.

(4) The Selection Committee shall place the list of recommended candidates, alongwith record of written test, before the District Health Officer.

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(5) The District Health Officer shall nominate an officer who shall not be a member of the selection committee to re-verify the documents, residential status of the candidates and to ensure that the recommendations have been made in accordance with the laid down criteria.

(6) On receipt of verification, the District Health Officer will accord final approval and will issue appointment orders of the selected/approved candidates and record of written test of the selected candidate be kept in her personal.

(7) Female, who shall apply for the post of Lady Health Supervisor should preferably married and must be permanent resident of the area for which she is to be appointed.

5. Selection criteria for appointment of Lady Health Workers.---(1) Female preferably married and must be permanent resident of the area for which she is to be appointed.

(2) There shall be a Selection Committee comprising of the following:

(a)

Medical Officer/Incharge,

First Level Care Facility;

Chairman

(b)

a female representative to be nominated by the District Health Officer from amongst Women Medical Officer or Lady Health Visitor or Female Medical Technician or Medical Technician or Dispenser posted at the same Facility;

Member

(c)

Lady Health Supervisor.

Member-cum-Sectary

(5) Married females/women with past experience in community development, having the required qualification, will be given preference.

(6) Candidate should be willing to carry out the services from her home which will be designated a “Health House” ensuring effective linkage between the community and the public health care delivery system.

(7) In specific/difficult/uncovered areas the District Health Officer in consultation with District Program Implementation unit, may substitute the members of the Selection Committees to meet the desired objective.

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6. Selection Criteria for Driver for the vehicle of Lady Health Supervisor.---The candidate must be permanent resident of the area for which he is to be appointed. He shall have written consent of the Lady Health Supervisor with whom he has to perform duty.

7. Selection criteria for the post of provincial program implementation unit in bps-1 to bps-16.---(1) There shall be a Selection Committee comprising of the following:

(a)

Deputy Provincial Coordinator;

Chairman

(b)

Training Coordinator;

Member

(c)

A representative nominated by the Director General Health Services not below the rank of BPS-17;

Member

(2) The Provincial Coordinator shall be the appointing authority for the post of Provincial Program Implementation Unit.

(3) The posts shall be advertised in two News papers/electronic media by the Provincial Coordinator.

(4) Test and interview of the short listed candidates at provincial level shall be conducted.

(8) The Selection Committee shall place the list of recommended candidates alongwith record of written test, before the Provincial Coordinator.

(9) The Provincial Coordinator shall nominate an officer, who shall not be a member of the selection committee to re-verify the documents, residential status of the candidates and to ensure that the recommendations have been made in accordance with the laid down criteria.

(10) On receipt of verification, the Provincial Coordinator shall accord final approval and will issue appointment orders of the selected candidates and record of written test of the selected candidates be kept in her/their personal files.

8. Selection criteria for the post of BPS-17 in the Provincial Program Implementation Unit.---(1) There shall be a Selection Committee comprising of the following:

(a)

Director Public Health;

Chairman

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(b)

Provincial Coordinator; and

Member

(c)

Section Officer Health Department.

Member

(2) The Secretary Health shall be the appointing authority for the post of Provincial Program Implementation Unit in Basic Pay Scale 17.

(3) The posts shall be advertised in two News papers/electronic media by the Health Department.

(4) Test and interview of the short listed candidates at provincial level shall be conducted.

(5) The Selection Committee shall place the list of recommended candidates alongwith record of written test, before the Secretary Health.

(6) The Secretary Health shall nominate an officer, who shall not be a member of the selection committee to re-verify the documents, residential status of the candidates and to ensure that the recommendations have been made in accordance with the laid down criteria.

(7) On receipt of verification, the Secretary Health shall accord final approval and will issue appointment orders of the selected candidates and record of written test of the selected candidates be kept in her/their personal files.

9. Recommendation of the Selection Committee.--- When an appointing authority does not accept the recommendation of Selection Committee, it shall record its reasons and obtain order of the next higher authority.

10. Functions of the Lady Health Supervisor.---(1) To carryout extensive supervision and monitoring of the field activities of Lady Health Workers. Lady Health Supervisor shall visit the Health House of every Lady Health Worker under her supervision at-least twice a month.

(2) Lady Health Supervisor shall provide supportive supervision, on job training, verbal and written feedback to her Lady Health Workers.

(3) Lady Health Supervisor may act as trainer in the refresher training as and when required by the District Program Implementation Unit.

(4) Lady Health Supervisor shall attend the Continued Education Sessions in all the relevant health facilities.

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(5) Lady Health Supervisor shall carryout verbal autopsy of infant deaths reported by her Lady Health Worker.

(6) Lady Health Supervisor shall assist the District Program Implementation Unit in the preliminary scanning/verification of candidates for the positions of Lady Health Workers.

(7) Lady Health Supervisor shall liaise between District and First Level Care Facility (FLCF) for the effective coordination of activities of the program.

(8) Lady Health Supervisor shall attend the District Program Monthly Review (DPMR).

(9) Lady Health Supervisor shall ensure regular maintenance of vehicle and its movement registers, if allotted.

11. Functions of the Lady Health Workers---(1) The Lady Health Worker shall provide Primary Health Care services to the community at their doorstep in her catchment area.

(2) The Lady Health Worker shall register all family members in the catchment area especially the eligible couples (married women age 15-49 years) in her respective area and maintain upto date information about her catchment area’s population.

(3) The Lady Health Worker shall organize community by developing women groups in health committees in her area.

(4) The Lady Health Worker will arrange meetings of these groups in order to effectively involve them in primary health care, family planning and related community activities.

(5) The Lady Health Worker shall keep close liaison with influential women of her area including lady teachers, community midwives, traditional birth attendants and clients.

(6) The Lady Health Worker shall pay visit 6 to 8 household every day to ensure that all registered households are visited once every month.

(7) The Lady Health Worker shall discuss with the community, issues related to better health, hygiene, nutrition, sanitation and family planning emphasizing their benefits towards quality of life.

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(8) The Lady Health Worker shall coordinate with local community midwives or other skilled birth attendants and local health facilities for appropriate antenatal, natal and postnatal services. She will also conduct antenatal, natal and postnatal care as described in her training.

(9) The Lady Health Worker shall act as liaison between formal health system and her community as well as ensure coordinated support from Non Governmental Organizations (NGOs) and other departments.

(10) As part of their tasks, the Lady Health Worker shall undertake nutritional interventions such as anemia control, growth monitoring, assessing common risk factors causing malnutrition and nutritional counseling. They shall be able to treat iron deficiency anemia among all women specially pregnant and lactating mothers as well as anemic young children.

(11) The Lady Health Worker shall promote nutritional education with emphasis on early initiation and exclusive breast feeding for six months and weaning practices, maternal nutrition and macronutrient malnutrition.

(12) The Lady Health Worker shall coordinate with Expanded Program on Immunization (EPI) of mothers against Tetanus and children against communicable diseases. The Lady Health Workers trained in routine EPI, will ensure timely vaccinations (in her catchment area only) with support from the local health facility/EPI staff. The Lady Health Workers (LHWs) will also participate in various campaigns for immunization against EPI target diseases e.g Polio, MNT, Measles etc in her catchment area only. The Lady Health Workers will be involved in the surveillance activities in her catchment area only.

(13) The Lady Health Worker shall motivate and counsel clients for adoption and continuation of family planning methods. She will provide condoms, oral pills and administer injectable contraceptives, as per define protocols to eligible couples in the community inform them about proper use and possible side effects.

(14) The Lady Health Worker shall carry out prevention and treatment of common ailments e.g. diarrheal diseases, acute respiratory infections, tuberculosis, intestinal parasites, malaria, primary eye care, scabies, first aid for injuries and other minor diseases using basic essential drugs. She will refer cases to nearest centers as per given guidelines. For this purpose a kit of certain inexpensive basic drugs will be provided to Lady Health Worker/Senior Lady Health Worker. The Lady Health Worker/Senior Lady Health Worker will also be involved in T.B, AIDs, Hepatitis and Malaria prevention/control.

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(15) The Lady Health Worker shall disseminate health education messages on individual and community hygiene and sanitation as well as information regarding preventive measures against spread of AIDs, Hepatitis etc.

(16) The Lady Health Worker shall attend monthly continuing education sessions at her base facility to share progress regarding all activities carried out by her including the home visits, number of family planning acceptors by methods and stock position of contraceptives with Incharge of Facility. She will also attend education sessions, submit her monthly report and collect one month supplies from Health Facility.

(17) The Lady Health Workers will not be involved in any other activity without the prior permission/guidelines from the Provincial Program Implementation Unit.

12. Training of the Lady Health Supervisor.--Total duration of training for the Lady Health Supervisor will be one year. The Lady Health Supervisor will start field activities after the initial three months training. The training will be carried out in two phases.

(a) Three months (Initial training)

(b) Nine months (Field/on job training)

13. Training of Lady Health Workers.---(1) The training of Lady Health Workers will be conducted in two main phases for a total of twelve months (03 months basic training at classroom and 09 months task based training in the field) using program training manuals and curriculum. This will be followed by continued training at the health facility alongwith refresher trainings.

(2) In health facilities where 10 or more Lady Health Workers or under basic training, there shall be three trainers.

(3) In health facilities where less than ten Lady Health Workers are under basic training, there should be two trainers.

(4) One of the trainers shall be a female to facilitate training in areas such as family planning, maternal health.

(5) The number of trainees per session may not be less than five and more than fifteen.

(6) In case where less than five candidates for training are selected in one First Level Care Facility and they cannot be attached with other facility, approval for training of less than five trainees shall be sought from Provincial Program Implementation Unit.

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14. Catchment area for Lady Health Worker.---(1) One Lady Health Worker will be selected to serve on average a catchment area with a population of 1,000 to 1,500 residents depending on the density of and accessibility to the population. In urban/densely populated areas the minimum catchment population will be 1200/LHW and in areas where population per Lady Health Worker is less, in case of dropouts/termination, the catchment population will be readjusted to ensure the above mentioned population coverage instead of new recruitments.

(2) In hard hilly terrain where the population tends to be scattered, the population in the catchment area of the Lady Health Worker can be low up to 1,000. The catchment area of Lady Health Workers will be such that it takes approximately an hour to walk to the farthest house in the catchment area. There should be only one Lady Health Worker in a cluster of 150 to 200 households.

15. Seniority.---The appointing authority shall cause a inter-se-seniority list of the following cadres on yearly basis.

(a) Community Embedded Employees;

(b) Logistics Officer of the Provincial Program Implementation Unit;

(c) Field Program Officers of the Provincial Program Implementation Unit;

(d) Management Information System Coordinator, of the Provincial Program Implementation Unit; and

(e) Ministerial Staff of the Provincial Program Implementation Unit.

16. Posting/ Transfer.---Every Program employee, other than Community Embedded Employee, shall be liable to serve anywhere in the Province against the cadre post in the Program.

17. Pension, General Provident Fund, Benevolent Fund and Group Insurance.---(1) Rules made by Government, regulating Pension, General Provident Fund, Benevolent Fund and Group Insurance shall apply for regulating the matters of Pension, General Provident Fund, Benevolent Fund and Group Insurance for those employees of Program whose services have been regularized under this Act.

18. Shuhada package.---Shuhada package as admissible to civil servants of the Government shall be applicable mutatis mutandis to the program employees other than the clause of appointment of the package.

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19. Retirement from Service.--- (1) A program employee working on regular basis, shall retire from service-

(a) On such date after he/she has completed twenty years of service qualifying for pension or other retirement benefits as the competent authority may in public interest, direct; or

(b) Where no direction is given under sub rule (a), on the completion of sixtieth year of his age.

(2) No direction under sub-rule (1)(a) shall be made until the program employee has been informed in writing of the grounds on which it is proposed to make the direction, and has been given a reasonable opportunity of showing cause against the said direction.

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MISCELLANEOUS

20. Performance Evaluation Report.---The Performance Evaluation Reports of the Community Embedded Employees will be initiated by in the following manner;

S.No.

Designation.

Reporting Officer.

Countersigning Officer.

1.

Lady Health Supervisor

District Coordinator, LHW Program.

District Health Officer.

2.

Lady Health Worker.

Lady Health Supervisor, as the case may be.

District Coordinator, LHW Program.

21. Conduct.---The Khyber Pakhtunkhwa Government Servant (Conduct) Rules, 1987 and auxiliary instructions issued from time to times shall be applicable mutatis mutandis to the program employees.

22. General provisions.---In all other matters not expressly provided for in these rules, the rules, if any, made by Government, so far as may be practicable, shall be applied for disposal of such matters.

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SECRETARY TO GOVT. OF KHYBER PAKHTUKHWA

HEALTH DEPARTMENT

Endst: No & date even.

Copy of above is forwarded to:

1. The Registrar, Supreme Court of Pakistan. Islamabad.

2. All Administrative Secretaries, to Govt. of Khyber Pakhtunkhwa.

3. The Accountant General Khyber Pakhtunkhwa.

4. The Principal Secretary to Governor, Khyber Pakhtunkhwa.

5. The Principal Secretary to Chief Minister, Khyber Pakhtunkhwa.

6. The Advocate General, Khyber Pakhtunkhwa.

7. The Director General, Health Services Khyber Pakhtunkhwa

8. PSO to Chief Secretary Khyber Pakhtunkhwa.

9. The Manager, Government Printing Press & Stationary Department Peshawar for publication in the Government t Official Gazette after publication 10 copies may be forwarded to this Department.

10. The Director Information Khyber Pakhtunkhwa Peshawar

11. The Deputy Director (IT) Health Department for uploading in the official website.

12. PS to Secretary Health Department.

(Kashif Iqbal Jillani)

Section Officer (E.II)