The public health system places a Primary Health Centre (PHC) to serve a population of about 30,000 people, one for every 10-12 villages and a Health Sub Centres (HSC) for a population of about 5000 people (about 2 villages). As a primary healthcare provider, one of the biggest design challenges we constantly faced in the run-up to setting up the Rural Micro Health Centres (RMHC) was the placement of our RMHCs within the community. The question is primarily two-fold:
- The financial/feasibility with respect to the set-up and operational cost of RMHC
- The physical accessibility of the RMHC, primarily ensuring that the farthest House Hold (HH) within the catchment is accessible on foot.
As we went ahead with the RMHC expansion, we conceptualised (and built) RMHCs which serve a population of 10,000 people or about 2000 households. We’ve been monitoring how many of these people have actually visited us and what sort of difference does distance make to the likelihood of a household seeking care with us.
Preceding the launch of a RMHC, we deploy a unique marketing and population based enrolment tool which enables us to geo-tag all Households(HH) and identify their residents. A bar coded Household based identity cards is linked to all the collected data and distributed to each household. This provides us with a systematic data base for provisioning continual care to the population. Upon their visit to the RMHC, these bar coded cards allow us to map utilization of our services across the catchment area, along with epidemiological trends and transition. Another field based tool, the Rapid Risk Assessment (RRA) allows the RMHC to build further on the risk profile of the population served as they identify high risk individuals through Household(HH) visits, for example for cardiovascular diseases (CVD) (based on height, weight, blood pressure, tobacco consumption, and waist and hip circumference as risk markers), and reproductive tract infections (amongst women) are exhorted to seek treatment at the RMHC immediately.
Through this post we share with you basic data insights from four of our RMHCs namely – Andipatti, Alakuddi, Kavarapattu and Okkanadu Melaiyur. All the data presented has been extracted from the Health Management Information System (HMIS), as developed by ICTPH and deployed by SughaVazhvu Healthcare. Listed below are interactive maps as developed using the GeoCommons platform of data illustration. These maps deal with only visit data and we’ve tried to map visit data around our clinics to see the distribution of the people accessing our services in the community. You will see two kinds of illustrations presented below:
- Total Coverage Map: These maps have been made by plotting all the households in our catchment area in each of our clinic in blue against the households which have visited us atleast once at the RMHC in a different colour (graded according to the number of visits from each households). The total coverage maps for Andipatti, Alakuddi, Kavarapattu and Okkanadu Melaiyur RMHCs are illustrated below.
- Time Line Map: The timeline map primarily aims to illustrate the month-on-month uptake of our services from within the catchment population. With the initial months limiting utilization to the immediate proximity of 1-2km, within 10 months the utilization of services was seen to show a radial distribution of up to 3-5km. The time line map of Andipatti is illustrated below.
All the maps indicated are interactive and you can select the layers you want to see on them. The layers for March, 2012 have been colour graded according to the number of total visits made by the household to the RMHC.
Mapping visit data is useful because it gives us a sense of how well placed, our RMHC’s are with respect to the catchment population. We envision all sorts of maps being looked at, by the physicians in the near future, allowing them to make better decisions pertaining to the provision of care based upon the sort of disease trends they see on these maps.
Kavarapattu Map – This is our 4th RMHC, it was launched on December 5th, 2011.
Okkanadu Melaiyur Map – This is our latest RMHC which was launched on February 1st, 2012.
Alakuddi Map – This is our oldest clinic, but this data pertains only to the time since the enrolment process, i.e. June, 2011.
Andipatti Map – In this map, there are layers of data for households who have visited us until May (2011), June (2011), August (2011), October (2011), January (2011) and March (2011). Andipatti is also our diagnostic hub, where all our diagnostics are done.