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Group 1- Sub Health Centre- HWC

Group 1- Sub Health Centre- HWC. Human Resources. Adequate HR- 1 MPW-F, 1 MPW-M and 1 CHO Training- All CHOs have attended six months Certificate Program in Community Health NCD training of CHOs in UP, JH, GJ (few centres) Multiskilling-

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Group 1- Sub Health Centre- HWC

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  1. Group 1- Sub Health Centre- HWC

  2. Human Resources • Adequate HR- 1 MPW-F, 1 MPW-M and 1 CHO • Training- • All CHOs have attended six months Certificate Program in Community Health • NCD training of CHOs in UP, JH, GJ (few centres) • Multiskilling- • ASHAs, MPW-F trained in universal screening for NCDs • Not all CHOs trained in universal screening for NCDs at visited HWCs • ANM-CHO coordination: Mixed findings-issue observed in few places • MPW-M- not involved in expanded service delivery

  3. Medicines • EML displayed at SHCs in Gujarat, UP • EML for SHC available with PHC pharmacists, but not with CHOs at MH • Different dosages of medicines not available • DVDMS up to PHC at MH and up to CHC in UP, Bihar, Jharkhand • State specific E- Arogya application at UTs- indenting of medicines at SHC-HWC, (NCD and RCH data, HR recruitment) • Standard treatment protocols- • Clarity about protocols for initiation and continuation of treatment for Hypertension and Diabetes by CHOs observed • Standard protocols for antibiotics prescription not used at SHC-HWC- metronidazole being prescribed as first line treatment for diarrhoea by CHO at MH

  4. Diagnostics • MH,UP- 5, JH, DNH, GJ- 7, Bihar- 1 (Hb) • Hub and spoke- at MH, planned to be expanded upto SHC • Consumable shortage- at SHCs in Maharashtra • Diagnostic list displayed at SHCs in GJ

  5. Universal Screening for NCDs • Population enumeration- Family folders being filled at Bihar, UP, MH • GJ- Family Health Survey (ImTecho) information being used • CBAC forms- being filed at all visited SHC-HWCs • Few ASHAs having smartphones at GJ • Use of CBAC forms- variation observed- prioritization for screening taking place at UP, GJ, MH • Fixed day NCD services- at GJ, MH • Cancer screening- • Symptom based examination for oral cancer, breast cancer at most places • Isolated SHCs- universal screening for oral and breast cancer

  6. IT HWC portal • Facility based ID- not available at MH • GJ- daily reporting using smartphones CPHC-IT application • UP- issues with application- slow uploading

  7. Infrastructure and Branding • Storage for medicine- issues with unavailability of space and good storage practices • UTs- 7 rooms at SHC-HWC • Deficiency of space for wellness- UP, MH Branding • MH, UP- underway • UTs, GJ- present

  8. Wellness • Bihar- SarvaShikshaAbhiyan- Instructors planned to be used for Yoga • UP- Yoga instructor not available • GJ- CHOs and SHC-HR trained and conducting daily Yoga sessions • MH- Yoga sessions weekly by CHOs • GJ- Kitchen gardens, medicinal plants

  9. RCH activities • UP- labour room at SHC- a good practice • ANC, RI- regular at all visited SHCs • Adolescent health- to be strengthened • PMSMA- observed at all • MH- Twice in a month

  10. Best Practices • ECHO at Maharashtra and Gujarat for CHOs • ArogyaSamanvay training for CHOs- Yoga and Ayurvedic, Naturopathy practices (21 days) at 9 Ayurveda Colleges • Jharkhand- NCD kit for fixed day outreach visits • Gujarat- follow up and referral registers for NCD being maintained • PSC at UP- • CHO dashboard in GJ-

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