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Alternatives for Remote Districts: AYUSH Practitioners Experience in Orissa

This article discusses the experience of AYUSH practitioners in remote districts of Orissa, where there is a shortage of doctors. It explores the steps taken to increase the acceptance of AYUSH and the impact of AYUSH doctors in providing healthcare services.

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Alternatives for Remote Districts: AYUSH Practitioners Experience in Orissa

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  1. HR alternatives for Remote Districts -AYUSH Practitioners Experience - ORISSA -MD NRHM, Orissa

  2. ..….2007-08 State: PHCs (Below Block -1162) with no Doctor - 22 % Block PHCs (314) with single Doctor - 37 % Remote Districts …. even worse… PHCs (Below Block -348) with no Doctor - 39 % Block PHCs (112) with single Doctor - 54 %

  3. Surplus AYUSH Doctors in 2008-09….. • Ayurveda • 6 Medical Colleges (3 Govt + 3 Pvt) – 180 candidates/yr • Homeopathy • 6 Medical Colleges (4 Govt + 2 Pvt) – 160 candidates/yr • Last 10 yrs: No recruitment by Govt. in ADs(619), HDs(560) • SURPLUS: ~4000

  4. Planned Move….. 1st Phase: Co-Location of AYUSH Wing at all Block PHC/CHC (314) 2nd Phase: AYUSH Doctor at PHC(N)s -Managing Institutions independently (Inducted only after AYUSH stream gained acceptance of common people)

  5. First(1st ) Phase Co-Location of AYUSH Wing at all Block PHC/CHC (314)

  6. Steps taken for acceptance of AYUSH by the common people Encourage cross-system referral of patients

  7. Steps taken for acceptance of AYUSH by the common people • Practice own system of medicine • Focus on treatment of chronic illness • Advocate achievements of AYUSH Wing

  8. Steps taken for acceptance of AYUSH by the common people • AYUSH Practitioners in Programme Implementation –Rapport established with general people

  9. Skill Development Training – Initiated & found useful • SAB Training – For managing Normal Delivery • IMNCI- For treatment of Childhood illness & in time referral

  10. Second (2nd) Phase AYUSH Doctor at PHC(N)s

  11. …… & then a band of AYUSH Doctors(1162) inducted at PHC(N)s, in one go…….. (Time Gap between 1st Phase & 2nd Phase – Almost 1 yr)

  12. Recruitment Process…. Recruitment Process for 2nd phase – Done Centrally • Open advertisement- Over 4000 applications received • Scrutiny Committees formed(14)- taking representatives from all the Deptt.(DIMH, DFW,DHS, Mission Directorate) • Selection done entirely on career marking • Merit List- hosted in the Website. • Posting was done on merit cum option basis Engagement order-Issued by the District (Zilla Swasthya Samiti )

  13. …. found the need for revising ToR & Remuneration • To Independently manage Hospitals (PHC-N) • Need for prescription of modern medicine for minor ailment/First aid during emergency • ToR changed- accordingly • Differential Remuneration: • Remote dists (14,000/month) • Other dists (12,000/month)

  14. …..to further Strengthen their position… RogiKalyanSamiti • Holding the position of Member Secretary in single doctor Institutions(in absence of MBBS doctor) • Other Institutions i.e. PHC(N) -Asst. Member Secretary Declared head of the Institution- in the absence of MBBS doctor

  15. …..to further Strengthen their position… • Technical Guidance – AYUSH Inspectorate • Monthly Review- District level by CDMO

  16. Training Programmes for AYUSH Doctors • Induction training of AYUSH Doctors ( 6 days)-810 • Thematic Training on different NDCP – 756 • TOT on IMNCI – 30 • SBA Training(21 days) -556 • Training on School Health programme-206

  17. The Result…..

  18. Now, they are…. • Handling OPDs (at 1367 facilities) • Average OPD cases - 18 in 1st year …. increased to 48 in 2009-10

  19. Now, they are engaged in…. • Mobile Health Units(194)- reaching out people in difficult & hard to reach areas

  20. Now, they are involved in …. Various Training Programmes – ASHA , VHND, IMNCI, Pustikar Divas, FP, etc.

  21. Now, they are looking after….School Health programme • Residential Schools(1681) – For regular health checkup • School Health Screening team- Visit Half yearly to non residential schools

  22. Now they are at…. • Labour Room- Conducting normal deliveries • Trained- 506 • Independently conducting delivery- 256 • New Born Care

  23. Now they are into…. IMNCI Programme • Trainers(30) • Practitioners – Following Treatment/ Referral Protocols

  24. Now they are …. Monitors: • For all National Health Programmes • Also into regular programme monitoring-VHND,FID,IMNCI…..

  25. ……2010-11 • All Institutions in remote districts (PHCs) have at least one Doctor • & • All Block PHCs in remote districts have more than one Doctor

  26. Thank You…

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