Under the National Health Mission (NHM), which of the following is the correct hierarchical structure of the health system at the grassroots level in rural India?

Explanation

## NHM Health System Hierarchy – Rural India **Key Point:** The three-tier health system in rural India forms the backbone of primary and secondary care delivery under NHM. ### Correct Hierarchical Structure ```mermaid flowchart TD A[Sub-center<br/>Population: 3000-5000<br/>Staff: 1 ANM-F, 1 ANM-M]:::outcome B[Primary Health Center<br/>Population: 10,000<br/>Staff: 1 Auxiliary Nurse Midwife + Male Health Worker]:::outcome C[Community Health Center<br/>Population: 40,000-80,000<br/>Staff: Specialist doctors, 30 beds]:::outcome D[District Hospital<br/>Population: 500,000+<br/>Staff: Multiple specialists, 100+ beds]:::outcome A --> B B --> C C --> D ``` ### Tier-wise Details | Level | Population Served | Staff | Beds | Function | |-------|-------------------|-------|------|----------| | **Sub-center** | 3,000–5,000 | 1 ANM-F, 1 ANM-M | 0 | Immunization, maternal health, basic curative care | | **PHC** | 10,000 | 1 Auxiliary Nurse Midwife + 1 Male Health Worker | 4–6 | Maternal health, family planning, basic investigations | | **CHC** | 40,000–80,000 | Specialist doctors | 30 | Referral center, emergency obstetric care, surgery | | **District Hospital** | 500,000+ | Multiple specialists | 100+ | Tertiary care, teaching, research | **High-Yield:** The sub-center is the most basic unit and serves as the first contact point for villagers. PHC is the first referral unit (FRU) for sub-centers. **Clinical Pearl:** Every sub-center should have at least one female ANM for maternal and child health services, as per NHM guidelines. [cite:Park 26e Ch 3]