Health Systems

Approach

May 17, 2011

The Partnership

The Context

The Value Proposition

Rural Micro Health Centre

Village-based, along with KGFS

Catchment Population – 10,000 people

Human Resource – Doctor, Nurse,

Extension Worker

Technology – Internet, Computers, HMIS,

Blood Collection

Power Back-up

6 Days a Week; 09:30am

– 06:00pm

Pre-enrollment Rapid ScreeningComprehensive

Screening

Community Based

Consultation

Disease/Emergency Protocol

New Patient

Repeat Patient

Pre-

Consultation

RM

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Demography, HH geo-tag, Family Composition

ONLY FOR ADULTSHt., Wt., WC, HC, BP, Smoking & Alcohol Habits, Pregnancy Status, Sudden Wt., Family &

Personal History

Pre-enrollment, Rapid ++; Vitals, Detailed Physical Examination, Mental Health, VA,

Acute Illness.

Adolescents, Children and Infants –Pre-enrollment, Standardized PISP

Ht., Wt., WC, HC, BPVitals: Temp., Pulse, RR, Heart & Lung Sound

Infants: MUAC, Head Cir.

SOAP Process: (Targeted Physical Exam)

Emergency Cases!

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Screening Protocol

Assessment

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

DAY 1

DAY 2

DAY 3

Pre-Enrollment

Andipatti, RMHC Catchment:

12,000 people (2,500HH) mapped in

four days

Chelampatti

KarkaripattiAndipatti & Mudalipatti

Ayyampatti

Pachur

Kotaitheru

UppundarpettiThekku

Adanakottai

Pre-Enrollment

Andipatti, RMHC Catchment Area

PISP Age Based (Non-Invasive) – Infant, Child, Adolescent, Adult

Demography

Acute Conditions – Persistent Cough, Fever, Diarrhea,

Weakness, Fatigue, Vomiting, Worms in Stool, Difficulty

Breathing, 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), Waist

Circumference, Blood Pressure

History – Family and Personal

Visual Acuity

Infant – Immunization and Feeding Practice & MUAC

Nicotine Dependence (Tool - Fagerstrom Tolerance

Questionnaire)

Alcohol Dependence (Tool – FAST)

Diagnostics

Haematology: Complete Blood Count (Sysmex KX-21

Autoanalyzer)

Biochemistry: Blood Glucose, Urea, Creatinine, Uric Acid,

Lipid Profile (triglycerides, total cholesterol, HDL), Liver

Function Test (LFT) (SGOT, SGPT, Albumin, Bilirubin Total,

Bilirubin Direct), HbA1C, Magnesium (Semi-autoanalyser

CHEM-7)

Strip Tests: Malaria, Pregnancy, Urine

Consultation and Medication

THERAPEUTIC ACTIVITY CLASS NUCLEUS MOLECULE FORMULATION STRENGTH

ENDOCRINE SYSTEM

Anti 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 SYSTEM

Anti 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)

Diuretic / Anti Hypertensive Loop Diuretic Anthranilic Acid Frusemide

Tablet (40 mg); Injection

(10 mg / ml)

Diuretic / Anti Hypertensive Sodium Chloride Symporter Benzothiadiazine Hydrochlorthiazide

Hyperlipidemia HMG-CoA Reductase Statin Atorvastatin Tablet (10 mg)

ICTPH Essential Drug List

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

Cohort ManagementS

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Absence of Measurable Risk Factors

HMIS

CVD

Diabetes

Infants

Pregnancy

Pre-enrollment

PISP

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Wellness Management Dashboard

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Daily Activity Index

Interventions:

Infant Nutrition Supplementation

Is your child between

6-24 months old?

We recommend Sprinkles

micronutrient powder

Unless you child has one of the following:

Acute infection Severe Anaemia Severe Acute Malnutrition

Iron (12.5 mg)

Zinc (5 mg)

Folic Acid (160 µg)

Vitamin A (300 µg)

Vitamin C (30 mg)

Thank You!