By Zeena Johar, President – ICTPH
With 80% of Indian Healthcare managed by the private sector, primarily unorganized, defined the core problem SughaVazvhu set out to answer. Delivering standardized, evidence based care was the solution SughaVazhvu set out to deliver for remote rural Indian populations. A village-based physician-managed Rural Micro Health Centre (RMHC) provides access to primary care services to 10,000 rural Indian residents. With a vision of creating Disease Free Villages in Rural Thanjavur, SughaVazhvu Healthcare today serves a population of 50,000 people.
SughaVazhvu RMHC Network in Thanjavur District, Tamil Nadu (Launch dates highlighted in blue boxes). Five existing RMHCs serve a catchment population of 50,000 people. With a network of 10 RMHCs scheduled for launch in the next three months will allow our network to serve a catchment of a 100,000 village residents.
A careful understanding of the geographies we serve has led to two of our systematic house hold based enrolment programs. Enrolment that captures basic demographic information, inclusive of GPS marker and family composition of a House Hold (HH); followed by a systematic evaluation of adult risk factors through a mobile based HH screening protocol coined as Rapid Risk Assessment (RRA). CVD risk factors such as BMI, waist-hip ratio, blood pressure, age, personal history help identifying high risk individuals for follow-up care at the RMHC. Questions relating to post-coital and inter-menstrual bleeding help identifying women at high risk of reproductive health related diseases.
Refractive error screening, primarily for presbyopia is recommended through the RRA exercise for all individuals above 45 years of age. Anaemia assessment and a recommendation for nutritional supplementation through Sprinkles for all identified infants is also a part of the standard RRA protocol.
The AYUSH physician and the Health Extension Worker primarily based at the RMHC manage both acute walk-in patients along with carefully following up identified high risk individuals through activities such as RRA.
The fourth SughaVazhvu Rural Micro Health Centre (RMHC) in the Kavarapattu Village,
launched on December 05, 2012
We launched our first RMHC in Allakkudi on November 09, 2009 and have served 3,900 patient visits till date. Followed by the launch of our second RMHC in Karambayam (September 06, 2010) and third in Andipatti (May 02, 2011), where we have collectively served 4,783 patient visits. Our fourth RMHC went live in Kavarapattu on December 05, 2011 and our fifth RMHC went live yesterday February 01, 2012. Slowly and gradually through our journey of expanding our network and providing a suite of healthcare interventions, the RMHC that went live yesterday saw our basic services package accompanied by the ophthalmic care, women’s health and CVD care package.
Launch of the Kavarapattu RMHC by the Village President
Upon arrival a patient follows a systematic risk assessment protocol similar to the RRA but more comprehensive to capture a larger set of conditions, which is then followed by consultation with a physician. In-house diagnostic capability, with a runner managing blood serum movement across the network of RMHCs allows better management of chronic conditions.
The current suite of interventions allow for a patient to be screened by a health extension worker. All sexually active women above 30 years of age are offered the VIA/VILLI screening for cervical cancer and other reproductive tract infections (RTI). Treatment is provided for basic RTIs at the RMHC itself, under the supervision of a physician and positive VIA/VILLI patients are referred for further testing to a secondary hospital.
Innovative interventions such as ophthalmic and oral care, facilitated through a primary care physician are clear differentiators for SughaVazhvu within the primary healthcare market. Refraction correction along with cataract detection and management are anchored by the RMHC physician. Dental scaling and ART are first line oral care interventions managed by the RMHC physician.
On the day of launch, as a part of the inaugural function the SughaVazhvu pledge reinstates
our vision for patient centric care
An organization driven by culture, prioritizing patient wellbeing and community wellness is critical on our path to provisioning patient centric care to populations we serve. RMHC as the anchor point for all village based activities, allows for effective engagement with communities. A systematic community engagement methodology through a calendar of community events such as SHG meeting, and school based interventions help the SughaVazhvu medical team to integrate with communities, enhancing trust and acceptance.
Inaugural event of our fifth RMHC in Okkanadu Melaiyur on February 01, 2012. The function was presided by the village President and close to 70 local residents attended the proceeding. On the day of the launch, SughaVazhvu RMHC managed 40 patient visits with 29 identified as high risk CVD, 10 cervical screenings for eligible women, and 4 diagnosed and prescribed glasses for distance vision.
Our four guiding principles driving the core of our work here at SughaVazhvu – Map, Risk Profile, Manage and Track, take us closer to our vision of Disease Free Villages. The field based enrolment and RRA allow us to prioritize high risk individuals, followed by RMHC based patient management, will demonstrate positive health outcomes as we follow our map to track care pathway.