Health Systems  Approach   May 17, 2011
The Partnership
The Context
The Value Proposition
Rural Micro Health Centre                                             Power Back-up                                      ...
Assessment                                                              New                                               ...
Pre-Enrollment & Risk Screening   Demography – Address with pre-  populated street and village details   Household Geo-t...
Pre-Enrollment                                       DAY 2      DAY 1Andipatti, RMHC Catchment:                           ...
Pre-Enrollment                                       Chelampatti      Pachur                       Uppundarpetti          ...
PISP Age Based (Non-Invasive) – Infant, Child, Adolescent, Adult Demography Acute Conditions – Persistent Cough, Fever,...
Diagnostics Haematology: Complete Blood Count (Sysmex KX-21Autoanalyzer) Biochemistry: Blood Glucose, Urea, Creatinine, ...
Consultation and Medication                                ICTPH Essential Drug List – 67 Single Formulations             ...
SughaVazhvu RMHC Catchment Population                                                     Cohort Management               ...
Interventions:                            Infant Nutrition Supplementation                               Is your child bet...
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ICTPH Introductory Presentation

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ICTPH is a not-for-profit Research Organization working in close collaboration with its Thanjavur based SughaVazhvu Healthcare to establish sustainable primary healthcare systems for remote rural Indian Populations.

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ICTPH Introductory Presentation

  1. 1. Health Systems Approach May 17, 2011
  2. 2. The Partnership
  3. 3. The Context
  4. 4. The Value Proposition
  5. 5. Rural Micro Health Centre  Power Back-up  6 Days a Week; 09:30am – 06:00pm Village-based, along with KGFS Catchment Population – 10,000 people Human Resource – Doctor, Nurse,Extension Worker Technology – Internet, Computers, HMIS,Blood Collection
  6. 6. Assessment New Patient Screening Protocol Community Based Check-out free free Comprehensive Pre-enrollment Rapid Screening Screening ONLY FOR ADULTS Pre-enrollment, Rapid ++; Vitals, Detailed Demography, HH geo-tag, Ht., Wt., WC, HC, BP, Smoking Physical Examination, Mental Health, VA, Family Composition & Alcohol Habits, Pregnancy Acute Illness. Status, Sudden Wt., Family & Adolescents, Children and Infants – Personal History Pre-enrollment, Standardized PISP Pre-RMHC based Repeat Patient Consultation Consultation Ht., Wt., WC, HC, BP SOAP Process: (Targeted Vitals: Temp., Pulse, RR, Heart & Lung Sound Physical Exam) Infants: MUAC, Head Cir. Check-out Emergency Cases! Disease/Emergency Protocol
  7. 7. Pre-Enrollment & Risk Screening  Demography – Address with pre- populated street and village details  Household Geo-tag  Family Composition – Members, Age, Relationship Risk Screening: Height, Weight, WC, HC, BP, Smoking & Alcohol Habits, Pregnancy Status, Sudden Wt. Loss, Family & Personal History GPS Enabled Android Mobile Phones
  8. 8. Pre-Enrollment DAY 2 DAY 1Andipatti, RMHC Catchment: DAY 3 12,000 people (2,500HH) mapped infour days
  9. 9. Pre-Enrollment Chelampatti Pachur Uppundarpetti ThekkuAyyampatti Kotaitheru Adanakottai Karkaripatti Andipatti & Mudalipatti Andipatti, RMHC Catchment Area
  10. 10. PISP Age Based (Non-Invasive) – Infant, Child, Adolescent, Adult Demography Acute Conditions – Persistent Cough, Fever, Diarrhea,Weakness, Fatigue, Vomiting, Worms in Stool, DifficultyBreathing, Pain in Abdomen, Genital Ulcers, Painful Urination,Swelling in Ankles, Difficulty Hearing, Skin Problems/Irritation,Chest Pain, Paralysis, Night Sweats, Weight Loss Chronic Conditions – Height, Weight (BMI), WaistCircumference, Blood Pressure History – Family and Personal Visual Acuity Infant – Immunization and Feeding Practice & MUAC Nicotine Dependence (Tool - Fagerstrom ToleranceQuestionnaire) Alcohol Dependence (Tool – FAST)
  11. 11. Diagnostics Haematology: Complete Blood Count (Sysmex KX-21Autoanalyzer) Biochemistry: Blood Glucose, Urea, Creatinine, Uric Acid,Lipid Profile (triglycerides, total cholesterol, HDL), LiverFunction Test (LFT) (SGOT, SGPT, Albumin, Bilirubin Total,Bilirubin Direct), HbA1C, Magnesium (Semi-autoanalyserCHEM-7) Strip Tests: Malaria, Pregnancy, Urine
  12. 12. Consultation and Medication ICTPH Essential Drug List – 67 Single Formulations  12 Categories: Endocrine System, Cardiovascular System, NSAID, Respiratory System, Gastro-Intestinal Tract, Immune System, Anti-infectives, Nutritional, Vaccines, Local Anesthetics, CNS, Skin.  Others: ORS, IV-electrolytes, RL, DNS, D5, NS and Vitamin B-Complex capsules ICTPH Essential Drug ListTHERAPEUTIC ACTIVITY CLASS NUCLEUS MOLECULE FORMULATION STRENGTHENDOCRINE SYSTEMAnti Diabetic Biguanide Biguanide Metformin HCl Tablet (500 mg)Anti Diabetic Sulfonyl Urea Sulfonyl Urea Glibenclamide Tablet (5 mg)Anti Diabetic Sulfonyl Urea Sulfonyl Urea Glimepiride Tablet (1 mg; 2 mg)CARDIO VASCULAR SYSTEMAnti Anginal Isosorbide trinitrate Tablet (10 mg)Anti Hypertensive Calcium Channel Blocker Dihydropyridine Amlodipine Tablet (5 mg; 2.5 mg)Anti Hypertensive Angiotensin II Antagonist Losartan pottassium Tablet (50 mg)Anti Hypertensive Beta 1 Receptor Blocker Napthalene Atenelol Tablet (50 mg) Tablet (40 mg); InjectionDiuretic / Anti Hypertensive Loop Diuretic Anthranilic Acid Frusemide (10 mg / ml)Diuretic / Anti Hypertensive Sodium Chloride Symporter Benzothiadiazine HydrochlorthiazideHyperlipidemia HMG-CoA Reductase Statin Atorvastatin Tablet (10 mg)
  13. 13. SughaVazhvu RMHC Catchment Population Cohort Management Pre-enrollment Name, Age, Family Members, HMIS Relationship, HH GPS PISP Wellness Management Dashboard ~ 10,000 people Age related risk biomarkers 1. ----- 2. ----- CVD Daily Activity Index 1. ------ Diabetes 2. ------ 3. ------ 1. ------ Infants 2. ------ 3. ------ 1. ------ Pregnancy 2. ------ Absence of Measurable Risk Factors
  14. 14. Interventions: Infant Nutrition Supplementation Is your child between We recommend Sprinkles 6-24 months old? micronutrient powder Iron (12.5 mg) Zinc (5 mg) Unless you child has one of the following: Folic Acid (160 µg) Vitamin A (300 µg) Vitamin C (30 mg) Acute infection Severe Anaemia Severe Acute Malnutrition
  15. 15. Thank You!
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