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03-Introduction to HWCs.pdf
- 1. . Presented by ShaziyaSheikh, PM, Public Health (THC) Introduction to Health & Wellness Centers
- 2. 2 05 Details about HR, Infrastructure& other Services Part 01 04 Essential Services at HWCs Part 01 03 Concept and Key Principles of HWCs, Key Elements of HWCs Part 01 02 Need for CPHC, Contribution of NHM, Ayushman Bharat – A Holistic Programme Part 01 CONTENTS 01 Current Scenario of Health in India Part -01
- 3. 3 OBJECTIVES At the endof session the fellows will be able to: Understand about the concepts and key components of Ayushman Bharat Enumerate key elements of Health and Wellness Centers (HWCs) & Services Understand about that, how a public healthcare system works in the community? How it protecting and improving the health of individual and the communities.
- 4. 4 “Our nation hasseen significant changes in the disease burden during the previous few decades” Good Progress in Reducing Maternal & Child Mortality in last 15 yrs IMR 30/1000 (SRS - 2019) 58/1000 (SRS 2002) Maternal Mortality Ratio 103/ one lakh live births (SRS 2017-19) 234/ one lack live births (SRS – 2004-06) Universal Immunization Program RCH under the NHM Nutritional Programmes & schemes U5MR 35/1000 (SRS – 2019) 74.3/1000 (SRS – 2005) Several initiatives for improving MH
- 5. 5 10–15 yrs agocommunicable disease along with maternal & nutritional disorders contributed to the major diseases burden…now we are seeing a change in this disease pattern? DEA TH These all NCDs accounts for nearly 62% of all mortality among men and 52% among women 01 NCD CANCER 02 NCD CVD – CARDIO VASCULAR DISEASES 04 NCD RESPIRATORY DISEASES 03 NCD DIABETES
- 6. 6 Mostly demand maximum health treatment at the levelof district hospitals
- 7. 7 The holistic programme Ayushman Bharat Selective Primary Healthcare– 20% Reduce OOPE Improving the utilization of Government health facilities – RU 28%, 21% Ensuring continuum of care Epidemiological Transition (62%) The first component involves upgrading of 1.5 lakh Sub Health Centers (SHCs) and Primary Health Centers (PHCs) into Ayushman Bharat - Health and Wellness Centers for the delivery of CPHC. • First Component Comprises of Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PMJAY) • Second Component AB - It comprises two inter-related components As a result, “the nation will be able to attain "Health for All" and Universal Health Coverage”
- 8. 8 02 • HWCs gobeyond MCH care services to include comprehensive health services to the vulnerable population, CP3R 01 • Healthcare for pregnant women, children • Reproductive health and communicable diseases 03 • Health system strengthening efforts, Expansion of health workforce & strengthened outreach services 04 • NHM developed the cadre of 1 mn ASHAs to expand outreach • Systems for registration, tracking & follow-ups Health and Wellness Centers Contribution of National Health Mission 05 • Follow-up of target groups, MNCH, FP, HRP, LBW, NRC • Mechanisms for referral & transport services, capacity building, free 3D, procurement & logistics
- 9. 9 is an initiative byGovt. of India to achieve UHC. It ensure to deliver a comprehensive range of services spanning preventive, promotive, curative, rehabilitative and palliative care. Under its 1st component, HWCs will be created to deliver CPHC, that is universal and free to users, with a focus on wellness & the delivery of an expanded range of services to the community. The 2nd component, is the PM-JAY, which provides health insurance cover of Rs. 5 lakh/yr to over 10 crore poor & vulnerable families for seeking secondary & tertiary care. It has 2 components which are complementary to each other. launched by Prime Minister on 27th September 2021. The ABDM aims to develop the backbone necessary to support the integrated digital health infrastructure of the country. A personal health record, patient can maintain and manage their health info.
- 10. 10 A cover ofINR 5 lakh per family per year Over 10 crore poor and vulnerable families eligible States given flexibility to decide on mode of implementation Benefits will be portable across the country Entitlement based scheme 1. Family ID no. (MP) 2. Identity card (any one - Adhar), mobile number, e-mail id) 3. Ayushman Mitr, CCC, 4. Pmjay.gov.in 7 days pre and 10 days post hospitalization – free drugs, diagnostics and screening Important Documents for AB Card - Ayushman Bharat Helpline No - 14555
- 11. 11 CP3R Govt. & Private(under AB-PMJAY) SDH, DH, M&CH, other specialty hospitals (both in public & private) Follow-up CPHC through AB-HWCs
- 12. 12 Health & WellnessCenters are envisaged to deliver expanded range of services that go beyond Maternal and Child health care services to include comprehensive health services to the vulnerable population. The first Health and Wellness Center was launched by Hon’ble Prime Minister at Jaangla (HWC), Bijapur, CG on 14, April 2018. Definition HWCs - To ensure delivery of CPHC services, existing Sub Centers covering a population of 3000-5000 would be converted to Health & Wellness Centers, with the principle being “time to care” to be no more than 30 minutes.
- 13. 13 Existing Building SHCs +PHCs + UPHCs = CPHC through AB-HWCs
- 14. 14 People Centered ExpandedPackage of Services Health Promotion & Wellness Ensuring Continuum of Care Reaching the Last Mile Term & Team Based Approach ‘Time to Care’ – to be more than 30 minutes High Quality, Standard TT&PC CP3R
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- 16. 16 New cadre of non-physicianHW Critical role in provision of expanded range of essential package Lead – Primary health care team (SHC) Provide clinical management & ambulatory care Important coordination link Objectives of CHO Improve access to Healthcare in rural/remote area Reduce OOPE Increase utilization of PH services at PC level Reduce fragmentation of care Reduce work load of secondary & tertiary care
- 17. 17 01 STEP 06 01 STEP 05 01 STEP 04 01 STEP STEP 03 01 STEP STEP 02 01 STEP STEP 01 01 STEP STEP 01 . Expanding HR –MLHP & Multi skilling Expanding Diagnostics Point of Care & New Technologies Expanded Service Delivery at HWC Health Promotion Continuum of Care – Tele health / Referral Infrastructure
- 18. 19 09 08 07 01 STEP 06 01 STEP 05 01 STEP 04 01 STEP STEP 03 01 STEP STEP 02 01 STEP STEP 01 01 STEP STEP 01 . Robust IT System EssentialDrugs & Supplies Financing / Provider Payment Reforms
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- 20. 21 1. Care inPregnancy & Child-birth 2. Neonatal & Infant Health Care Services 3. Childhood & Adolescent Health Care Services 4. Family Planning, CC Services & Reproductive HCS 5. Management of Communicable Diseases: NHP 6. General OP Care for Acute Simple Illness & Minor Ailments 7. Screening, Prevention, Control & mgmt of NCDs 8. Care for Common Ophthalmic & ENT Problems 9. Basic Oral Health Care 10. Elderly & Palliative Care Services 11. Emergency Medical Services 12. Screening & Basic Mgmt. of Mental Health Ailments
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- 25. 26 FPCC Let’s Do SomeExercise - OOOM EENN
- 26. 27 Managerial functions – effective functioning of HWC Publichealth functions – health promotion disease prevention/surv eillance Clinical functions – provide out- patient care & management 1. Early detection & screening 2. Referral 3. Follow-up care 4. Counselling support, 5. Teleconsultation 1. Ensure collection of population-based data – planning services 2. CA for health promotion 3. Disease surveillance 1. Recording, reporting & monitoring 2. Administration 3. Supportive Supervision – HWC team
- 27. 28 Branding – As perfacility branding instructions of GOI Citizen Charter A HWC should have space for – Examination room with adequate privacy & Telehealth Diagnostics Medicine dispensation Storage of documents, health cards and registers Wellness: Yoga, Physiotherapy, Group meetings Waiting area IEC display Labor room at delivery points
- 28. 29 HWCs TEAM MLHP/Community HealthOfficer (one) ANM/MPW (two female) or ANM/MPW – female) & MPW – male ASHA (one for 1000 population) Other requirements - Assured water & electricity supply Proper system for drainage Deep burial / sharp pit for bio-medical waste management Internet connectivity Display boards Contact details of the team Details of referral centers Jurisdiction of gram Panchayat / Urban local body
- 29. 30 HWCs - SHC OneCommunity Health Officer 2 Multi purpose workers – male/ female 5 ASHAs for outreach HWCs – PHC / UPHC PHC team as per IPHS norms - (at least – 1 MBBS doctor, 1 staff nurse, 1 pharmacist, 1 LT and LHV) + MPW+ASHAs At PHCs, where cervical cancer screening is being planned an additional staff nurse can be posted5 ASHAs for outreach HWCs - FLWs ASHAs – 5 day in NCD training package in 1st phase + Refresher and newer package annually (15 days) MPWs – 4 days for NCD package & new package for additional services Reporting and recording information using digital Application, need base joint training of MPWs with ASHAs HWCs – MO & Staff Nurses 3 days for NCD screening & management 14 days for screening for cancer – VIA for Ca Cervix Online training through Massive Open Online Courses (MOOC) & ECHO Certificate courses in NCD mngt./MCH care/Elderly care/Mental health Partnership with AIIMS/regional Cancer centers/ Knowledge networks to act as training resource centres
- 30. 31 Drugs & Supply- Essential drug lists (with expanded drugs for NCDs) MLPs to dispense medicines for chronic diseases on prescription of MO Uninterrupted availability of medicines to ensure adherence and continuation of care DVDMS expansion to level of HWCs - PHCs, UPHCs, SHCs Point to care diagnostics – 7 investigations at SHC (Hb blood sugar, Nischay kit, RDT for Malaria & Dengue, Sputum for AFB, Urine Protein & Urine Sugar) & 19 at PHC HWC Blood collection point for Hub & Spoke model at different levels
- 31. 32 Program Manager - Dashboards Providemonitoring reports to assess performance for payments Patient Centric – Unique individual ID & individual health record Family health folder Facilitates continuum of care through alerts Service Provider – Tablet for MPW & MLHP with ANMOL app/ RCH portal and NCD module of CPHC IT system uploaded Facilitates use of platform like ECHO Internet connectivity Integration of existing IT System – RCH portal / NCD app / NIKSHAY (TB)/ IDSP/HMIS
- 32. 33 Phased introduction toteleconsultation – as a mechanism for improved referral and ensuring continuum of care HWC staff to be equipped for tablets / smart phones / laptops for teleconsultation Capture and transmit images, prescriptions & diagnostic reports Use of teleconsultation for : Emergency consultation – at appropriate levels Dedicated time for specialist consultation Capacity building Standing orders for prescription
- 33. 34 Close coordination withMinistry of AYUSH / Department of AYUSH at the state and district level Training & certification of local yoga teachers to be steered by Department of AYUSH Pool of local yoga sessions for community yoga training at HWCs Provision for additional remuneration to in house yoga teacher or in sourced yoga instructor Population enumeration & family folder - entire population of the village Filling up of the CBAC (community based assessment check list) from – 30 yrs & above Raising public awareness of HWC & CPHC by ASHA Fixed day screening in HWC & community for common NCD Yearly screening for HTN & DM 5 yearly screening for CA oral cavity, CA cervix & CA breast Referral & follow up – Maintaining continuum of care
- 34. 35 National CPHC guideline Bookleton CPHC, and Health and Wellness Centers by NHSRC, NIHFW, New Delhi
- 35. 36 During your fieldvisit, visit the Health and Wellness Centers and keep an eye on the work being done by the Health and Wellness Centers, and collect information by interacting with the staff there. Take a few home visits and inquire about the programs and services offered by the health and wellness center and include the answer in your project report. Write your project report in these points – 1. Introduction, 2. Background, 3. Objectives, 4. Survey, 5. Analysis (Data / Interpretation), 6. Discussion, 7. Problems & Challenges, 8. Conclusion, 9. Suggestion & Recommendation (include 3-4 photographs only) Report should be in 1500 words (maximum 3 pages, & 1 page extra for photographs) Total duration & Last date to submit assignment – 15 days (15th July 2022)
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- 37. • ICDS, NationalNutrition Mission & Convergence THANK YOU