A NEW DEVELOPMENT AT THE HEALTH SUB CENTRE, AZIZNAGAR:
COLLABORATIVE PROGRAM BETWEEN KMRF & HEALTH SUB CENTRE, AZIZNAGAR.
A new C.H.O. (Community Health Worker) has been appointed for attending certain health issues of Aziznagar village community like Hypertension, Diabetes, Thyroid, Cancer and needs of Physiotherapy. She is working at the health sub centre in Aziznagar from 9 am to 4pm.
The program that has been introduced and presently running is in line with the program –(DIABETES CARE PROGRAM) that KMRF has been initiated in the year 2016 in the villages KASIMBOWLI, in Aziznagar and Murthuzaguda in the year 2018 and running as of now.
The KMRF is now collaborating with the CHO, Aziznagar for this program and helping with the data of diagnosed cases of BP/ DIABETERS / BOTH in Aziznagar village.
THE PURPOSE GOALS AND TARGET OF THE PROGRAM IN THE SUB CENTRE:
Ø A daily target of 40 cases of different health issues like BP, Diabetes, thyroid, Cancer etc.
Ø The present target is to attend BP/ Diabetes /Both cases as there is no medicine or testing procedures available for the other areas.
THE FOLLOWING PROCEDURE IS BEING FOLLOWED AT THE CENTRE.
Ø Motivated BP/DIABETIC cases by Asha workers visit to the sub centre, Aziznagar
Ø She records the history of their health status and the complaint they have come for.
Ø All the patients are checked for their BP—if they are hypertensive
Ø If they are new cases, they are asked to visit the centre for 2-consecutive days for checking and recording the readings in their BP.
Ø If they are found to be existing patients with BP / DIABETES/ BOTH- they are also being checked for their BP.
Ø She checks if they are having medicines already if so the information on the mode of getting medicines by Pvt or from Govt hospitals /104 services etc is being recorded.
DIABETES CASES:
Ø The test on RBS (Random Blood Sugar) is done if they are already having Diabetes, if the value is found to be high they are being asked to come the next day with empty stomach and the FBS ( fasting blood sugar test) is done
Ø Similar procedure is being followed for the new cases too.
ISSUE OF MEDICINES
Ø The existing BP/Diabetes/ Both----cases if they are regularly taking medicine privately they are being asked to continue with the same medicine. (the patients to visit the sub centre with their Adhar card and the medicines that they are using already)
Ø And also motivates the cases to continue with the same medicine If they can afford and willing to buy outside
Ø Other cases to whom the medicines are being issued:
· If they show the medicines what they have been taking and presently they do not have or purchased or no stock at home and that happens to be the same medicine that the sub centre has enough stock of them like Atenolol - 50 mg / Amlodipine -5 mg) and
(if only she has enough stock of it she gives to such cases.)
Ø If she is convinced that they are poor/ cannot afford and somewhat regular in taking medicines and presently not able to buy she gives the medicines if they are the same as available in the sub centre.
Ø In the same way METFORMIN -500 MG is given to the Diabetic cases.
Ø She also said that she has a supply of tablets--- Thelma 40 & 80 mg too.
THE CRITERIA FOR ISSUE OF MEDICINES BY C.H.O. AS WE UNDERSTAND
Ø As of now the issue of medicine is very limited though we see many of them are not affordable cases for the following valid reasons
(a) Program being new, wants to observe for some time for the type of medicines that the patients are already taking.
(b) Sub centre has a limited stock of medicines.
Ø We heard that in MEHBUB NAGAR—the same program is being followed and the issue of medicines happening to large number of cases.
On the positive approach that has been observed.
Ø We think as the program has been just started it is good that it is happening in slow pace but to some extent with genuine approach.
Ø Since the ANM now allocated is only for this program and she is designated as C.H.O- Community Health Officer. So she is daily attending the cases at the sub-centre
Ø She is also given another village for this program ---NAGIREDDYGUDA--- nearby village 20 mts drive from Aziznagar. As there is no health sub centre she attends the cases from the Anganwadi centre.
Ø She said that she will be getting more stock and different medicines too.
ADDED SERVICE & GOOD NEWS:-- RESUMPTION OF 104—SERVICES— FROM JANUARY 2021- UNDER DMHO, HYDERABAD
Ø The 104 –services was stopped for more than a year due to non-availability of mobile –van they use regularly
Ø 104- more or less does the same job--- like
1) Recording patients history for their health status—BP/DIABETES/ BOTH
2) I f so they are tested for both BP/sugar etc
3) If they bring the medicines that they are using AND with the evidence of tested values ---they issue medicines to both cases.
4) The medicines that they regularly issue are :
------ For BP—ATENOLOL -50 mg AND AMLODIPINE -5 mg
------ For DIABETES – METFORMIN – 500 mg, GLIMEPIRIDE ½ mg
5) Good thing that they do is that they give a slip of paper notifying the reading and name of medicine they have issued to them with the date of issue.
6) This is a good record for the patient and a kind of motivation and they are being asked to bring it on their next visit so that they get medicine automatically.
7) And also they are checked for BP/ sugar every time they visit 104 –services
8) The 104 – services happen once in a month in certain villages in Moinabad Mandal.
A SENSIBLE COLLABORATION BETWEEN THE CHO, AZIZNAGAR & 104 SERVICES:
Ø THELMA -40 MG / BP--- GLIBENCLAMIDE -5 MG
Ø THE C.H.O—directs the patients to 104 services if they were prescribed for or already having the above tablets
Ø Hence there is an opportunity for the interested / keen people visiting health centre to get the medicines that they have been prescribed for.
Ø 104 –VISIT DAY- once a month on every 2nd Wednesday in AZIZNAGAR
104 – VISIT TO OUR OTHER DIABETES CARE PROGRAM PROJECT VILLAGES:
Ø Murthuzaguda ---------2nd FRIDAY
Ø Kasimbowli--- the 104 comes to nearby village Yenkapally not to Kasimbowli.
KMRF-ROLE AND COLLABORATION WITH ANM –AZIZNAGAR
Ø Due to COVID situation — no checking of cases of BP/ sugar by KMRF team as normally done.
Ø The C.H.O takes the reading again for record and her reference.
Ø KMRF—motivate the project—cases on 3-areas (BP/DIABETES/ HAVING BOTH) to visit to the sub centre for medicine
Ø Those who are poor and cannot afford to buy medicines are the ones getting benefited
Ø The KMRF-team sits with the CHO and shows the records and explain their financial status and recommend for medicine when the motivated cases visit to sub centre
Ø The motivated patients are getting medicine.
Ø And a good number of people turned out for medicines and check up as they cannot go anywhere else due to COVID.
Ø The C.H.O. COPERATES WITH US AND EASY TO COLLABORATE WITH HER TOO.
Ø We are finding more ways to strengthen the program and help the community and the CHO and make her work easier to be able to target more cases.
(a) Providing a small notebook to each of our project case with their name, map number, family code, last readings, medicines prescribed for, updated information on medicine and on the status of their regularity in having medicines etc.
(b) The patients will take them to the sub centre and show to the ANM (presently we noticed that no chit or slip are being given to the visiting patients. Obviously she may not know KMRF—project cases too.