Existing Sub Health Centers serving a population of 3000-5000 will be converted to Health and Wellness Centers (HWC), with the guiding premise that "time to care" should not exceed 30 minutes. This would assure the implementation of Comprehensive Primary Health Care (CPHC) services. 

Additionally, Primary Health Centers in both urban and rural regions would be transformed into HWCs. The principle should be a continuous continuum of care that ensures the ideals of equity, quality, universality, and minimal financial hardship. Such care might also be provided/complemented by outreach services, Mobile Medical Units, health camps, home visits, and community-based contact.

The HWC at the sub-health center level would be outfitted with the necessary Primary Health Care staff, including Multi-Purpose Workers (both male and female), and ASHAs, and would be overseen by a Mid-Level Health Provider (MLHP). They will deliver a wider range of services while working together. 

Sub-health centers that had previously been upgraded to Additional PHCs now exist in various states. The same Additional PHCs will be converted to HWCs. For many illness situations, a Primary Health Center (PHC) connected to a group of HWCs would act as the initial point of referral for the HWCs within its purview. It would also be strengthened in its capacity as an HWC to provide a wider spectrum of primary care services.

The Medical Officer at the PHC is in charge of making sure that CPHC services are provided through all HWCs in the region as well as the PHC. The PHC's staffing levels and credentials would remain in accordance with the Indian Public Health Standards (IPHS). 

Support for training PHC staff (Medical Officers, Staff Nurses, Pharmacists, and Lab Technicians), provision of equipment for the "Wellness Room," necessary IT infrastructure, and resources for upgrading laboratory and diagnostic support to complement the expanded ranges of services would all be provided in order to strengthen PHCs into HWCs. States may decide to change HWC and PHC staffing in accordance with regional needs.

The HWC would provide a wider variety of services. Both SHCs and PHCs, which are converted into HWCs, would offer these services. The care pathways and standard treatment guidelines that will be released on a regular basis will reflect the fact that the level of complexity of services provided at PHCs is higher than at sub-health center levels.

The HWC's enhanced service offerings

1. Prenatal and postpartum care.
2. Services for newborn and infant health.
3. Services for pediatric and adolescent medical care.
4. Services for family planning, contraception, and other reproductive health care.
5. National Health Programs, including the management of communicable diseases.
6. Common Communicable Diseases Management and Outpatient Treatment for Acute Simple Illnesses and Minor ailments.
7. Non-communicable disease screening, prevention, control, and management.
8. Treatment of Common ENT and Ophthalmic Issues.
9. Fundamental dental care.
10. Services for palliative and elderly care.
11. Medical Emergency Services.
12. Mental health condition screening and basic management.

The primary health center would act as the administrative center and initial point of contact for sub-health centers in several states. However, in certain states, the Community Health Center (CHC) at the block level is directly connected to the Sub Health Center (which in some blocks is a role performed by the Block PHC). 

In all situations, it is necessary to make sure that an MBBS Medical Officer in a facility that is close to the cluster of HWCs and is set up to handle referral support for HWC is providing administrative, technical/mentoring, and referral support. Therefore, this might be a PHC or a CHC.

To provide Comprehensive Primary Health Care, Urban Primary Health Centres or Urban Health Posts, where they exist, would be strengthened as HWCs. One MPW-(F) for every 10,000 people, backed by four to five ASHAs, will allow for outreach services, preventative and promotive care, as well as home and community-based services. Therefore, in an urban setting, a team of MPWs (F) and ASHAs would be similar to a front-line provider team, with the UPHC serving as the initial point of referral for a population of around 50,000.

PHCs in metropolitan settings will be able to use all the fundamental HWC principles mentioned above. The first step in converting U-PHCs to HWCs would involve training staff and field workers in the new set of services. 

A population count, panelization, and disease screening would also be necessary. These could be used as a tactic to ensure continuity of care in many cities where experts' consultation is now made available through nighttime OPDs on pre-fixed days. States, however, are allowed to make changes that best suit their situations.

In order for the services provided at the primary health care level to fully live up to the promise of expanded range and commensurate with needs, states must pay close attention to improving geographic accessibility, ensuring the full complement of staff at each level, enabling regular capacity building and supportive supervision, ensuring uninterrupted supply of medicines and diagnostics, and maintaining a continuum of care that seamlessly links people to various levels of care. 

In order to successfully implement Comprehensive Primary Health Care through HWCs, strategic modifications of components of health systems at secondary and tertiary levels and reorganization of workflow processes would be required concurrently. This is because the principle of HWC is that they provide a continuum of care for all illnesses in the community.