Institutional level health care facilities in Nepal were extended up to village level. However, utilization of services provided by health facilities, especially preventive and promotive services, has been found to be limited because of hard-to-reach geographic condition. Therefore it was felt that services should be expanded closer to the community. Thus Primary Health Care Outreach (PHC/ORC) services was initiated and established in 1994 (2051 BS).

The aim of PHC/ORC is to improve access to some basic health services including family planning and safe motherhood closer to rural households. These clinics are the extensive service sites of PHCCs, HPs and SHPs up to community level. The primary responsibility to conduct these clinics lies with MCHWs and VHWs at SHP level and ANMs, AHWs and VHWs at PHCC and HP level. Other staffs of HP/PHCCs help to conduct the PHC/ORC. Female Community Health Volunteers (FCHVs) and other local NGOs/CBOs support health workers to conduct the clinics and also support in recording/reporting and other support activities.

Based on the local needs PHC/ORCs are conducted every month at fixed locations of the VDC on specific dates and time. The clinics are conducted within half an hour’s walking distance for the population residing in that area.

VHWs and MCHWs or ANMs/AHWs provide basic PHC services. According to PHC/ORC strategy, following services are provided from the clinic.

Safe Motherhood & Newborn Care

  • Antenatal, postnatal, and newborn care
  • Iron distribution
  • Referral if danger signs identified

Family Planning

  • DMPA, (Depo-Provera) pills and condom
  • Monitoring of continuous users
  • Education and counseling on FP methods and emergency contraception
  • Counseling and referral for IUCD, implant and VSC service
  • Tracing defaulter

Child Health

  • Growth monitoring of under 3 children
  • Pneumonia treatment
  • Diarrhoea treatment

Health Education and Counseling

  • Family planning
  • Maternal and newborn care
  • Child health
  • STI, HIV/AIDS
  • Adolescents’ sexual and reproductive health
  • Others

First aid treatment

  • Minor treatment
  • Referral for complicated cases