Strengthening Comprehensive Primary Healthcare in Urban Areas
Ensuring delivery of a comprehensive range of services at urban health centers, focusing on TB healthcare, NCD screening, mental health care, and palliative care integration. Initiatives include specialist services, outreach programs, and leveraging community resources for enhanced healthcare access.
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Strengthening CPHC in urban areas 1. Ensuring delivery of comprehensive range of services at HWC- UPHC- RNTCP services Developing all U-PHCs as DOTS and DMC centres and data reporting in NIKSHAY Portal at all U-PHCs. Gujarat- TB Health visitor deploy in U-PHCs by Corporation to ensure management and follow-up of TB cases and reporting in NIKSHAY Portal Active case finding and proper follow-up for adherence by ASHA and MAS NCD screening For Population based screening in slum like habitations/non-slum, engagement of NGO/Volunteers, Staff Nurses, MSW students etc. may be explored. Tamil Nadu- team of Staff Nurse and woman health volunteers doing screening in absence of ASHA. NCD screening at facilities: NCD corner may be established at U-PHCs where every patient above 30 yrs will be screened for Hypertension and Diabetes by designated SN for NCD. Kerala- Designated SN responsible for taking B.P and recording history of the patients in pre-checkup room
Strengthening CPHC in urban areas Mental Health Care Mental health screening and referral - Use of screening tools by ANM, ASHA at community level and MO at facility level followed by complicated/unmanaged cases to higher facilities and follow-up. Manochaityna program in Karnataka and Manasikarogyam program in Kerala with involvement of Psychiatrist/DMHP teams at the U-PHCs. Linkages to de-addiction centres and OPD based management of de-addiction- Punjab Leverage MAS to generate community awareness through IEC/BCC activities for early identification of mental disorders. Palliative care Palliative care is to be integrated with U-PHCs. Kerala- Staff Nurse trained in visits patients listed by ANMs covering several facilities to provide palliative care. Telangana- Visit of Palliative care team established at District hospital to U-PHCs
Strengthening CPHC in urban areas Fixed Day Specialist Services: To decongest secondary and tertiary care facilities, fixed day specialist services can be started in U-PHCs for eye, skin, oral, mental health care etc. Evening polyclinics in TN with multi - specialty services, Odisha Special outreach camps to be planned in slum/slum like habitations where specialist services can be provided with a team of specialist/SN/LT
Strengthening CPHC in urban areas 2. Outreach services Special outreach camps to be planned in slum/slum like habitations where specialist services can be provided In addition to ASHA/MAS/AWW Public health managers to be responsible for strengthening outreach activities Involving Medical colleges in conducting specialist services, referral Performance team based incentives may also be provided to MAS along with ASHA and ANM Additional ANMs could be explored where there is high attrition of ASHA or where there is no ASHA or peri- urban/left out areas
Strengthening CPHC in urban areas 3. Strengthening Continuum of care Identification health problem and referral to U-PHCs and adherence of treatment by ASHA/MAS Referral linkages to be established for higher facilities (DH/Medical Colleges) and downward linkages by robust follow-up by ASHA/MAS. M.P- Referral book with 3 referral slips (1 kept at U-PHC, 1 for Patient and 1 for the higher centre) 4. Convergence with ULBs Regular reviews and co-ordination with ULBs. Streamlining NUHM/HWC concept into the ULB plan Leveraging resources available with ULBs for primary health care services eg. Infrastructure (in case of space paucity), Sanitation drives, Parks (for wellness activities), Schools (health & promotion activities) etc.
Strengthening CPHC in urban areas 5. PPP- Partnership with Not for Profit organization PPP partnership may be explored for activities related to service delivery, outreach, diagnostics, Community process etc. Andhra Pradesh- e-UPHC management, MEPMA for strengthening ASHA & MAS in Telangana ECHO platform to also be used in Urban areas for training/capacity building
