Ayushman Bharat HWC PPT.pdf
•
3 likes•4,056 views
The document discusses Ayushman Bharat-Health and Wellness Centres, which aims to transform India's primary healthcare system by providing comprehensive and affordable primary care services close to communities through Health and Wellness Centres. It outlines key issues with the current selective primary healthcare package and low utilization of public health facilities. The initiative will establish 150,000 Health and Wellness Centres by upgrading Sub Health Centres and Primary Health Centres to provide expanded services covering maternal and child health to non-communicable diseases and geriatric needs. It focuses on developing a continuum of care through these centres, community involvement, and leveraging technology for service delivery.
Report
Share
More Related Content
What's hot
What's hot (20)
Similar to Ayushman Bharat HWC PPT.pdf
Similar to Ayushman Bharat HWC PPT.pdf (20)
Recently uploaded
Recently uploaded (20)
Ayushman Bharat HWC PPT.pdf
- 1. AYUSHMAN BHARAT- HEALTH AND WELLNESS CENTRES
- 2. Epidemiologic Transition - death from the four major NCDs - cancer, CVD, diabetes and COPD accounted for nearly 62% of all mortality among men and 52% among women; of which 56% is premature. Primary healthcare package was selective: limited to RCH and communicable diseases Low utilization of public health facilities - 11% in rural and 3% in urban areas Over 70% of OOPE is on non-hospitalised care, of which 70% on medication Overburdened secondary and tertiary facilities, increased costs and compromised quality Need for reorganization of primary healthcare to address the chronic care needs • Universal • comprehensive • Whole of society • Family centric • Quality • Continuum of care Background
- 3. AYUSHMAN BHARAT – HEALTH AND WELLNESS CENTRES AYUSHMAN BHARAT-HEALTH AND WELLNESS CENTRES “PHC is a whole-of-society approach to health that aims at ensuring the highest possible level of health and well-being and their equitable distribution by focusing on people’s needs and as early as possible along the continuum from health promotion and disease prevention to treatment, rehabilitation and palliative care, and as close as feasible to people’s everyday environment”. (World Health Organisation) Comprehensive Primary Health Care through Ayushman Bharat Health and Wellness Centres - 8C 1st point of Contact Continuity Comprehensive Convergent and Coordinated Care Client Centred Cost free Communitisation
- 4. 4 Universal Health Coverage: Ayushman Bharat PRIMARY SECONDARY TERTIARY CONTINUUM OF CARE – CPHC & PMJAY Existing services: RMNCH+A • PMJAY empaneled Public & Private Healthcare facilities • CHCs/SDHs/District Hospitals/Medical Colleges Referral/Gatekeeping Preventive, Promotive, Curative, Rehabilitative & Palliative Care (Progressively for 12 packages) Unmet need: NCDs/other Chronic Diseases Comprehensive Primary Health Care through HWCs Follow-up
- 5. PHC SHC SHC SHC SHC SHC OUR PRIMARY HEALTH CARE SYSTEM EACH PHC Covers 30,000 population; Tribal and Hilly Area - 20,000 population Each SHC Cover 5000 population; Tribal and Hilly Area - 3000 population AYUSHMAN BHARAT-HEALTH AND WELLNESS CENTRES Each UHWC Covers 15,000-20,000 population Each UPHC Covers 50,000 population; UPHC UHWC UHWC UHWC RURAL URBAN
- 6. Key ElementsTransforming SHC, PHC & UPHC to AB-HWC Shift from i. Selective Primary Care to Comprehensive Primary Health Care ii. ‘illness’ focus to ‘wellness’ focus - Services For ALL PEOPLE throughout the life-cycle iii. Fragmented Care to Continuum of Care 9-point reform: multiple reforms, spanning all aspects of the health systems such as service delivery, HR, financing, access to medicines and diagnostics, community participation and ownership and governance. Institutionalize community ownership and management of health centres through Jan Arogya Samitis (JAS) 15th Finance Commission and PM-ABHIM health grants in addition to National Health Mission Grants to strengthen and plug the critical gaps in the primary health care and involvement of local government to make health system more accountable to the people
- 7. Care in Pregnancy & Childbirth Childhood & Adolescent Healthcare Services Screening Prevention & Control of NCDs Management of Communicable Diseases Neonatal & Infant Healthcare Services Reproductive & Family Planning Services Outpatient Care for Acute Simple Illness Mental Health Care Oral Care Elderly & Palliative Care Emergency Care Eye and ENT Care Expanded Package of Services ALL WELLNESS & ILLNESS Services For ALL PEOPLE From Head to Toe & From Womb to Tomb POPULATION BASED APPROACH
- 8. 8 • Health & Wellness Centre – SHC (@5000 in plain areas and 3000 in hilly and tribal areas) SHC Team Community Health Officer: BSc/ GNM or Ayurveda Practitioner, Trained in 6 months Certificate Programme in Community Health/ Community Health Officer (BSc-CH) 2 MPW (either 1 Female and 1 Male or Both females) 5 ASHAs (@1 per 1,000 population) • Health & Wellness Centre – PHC (@30,000) / UPHC (@50,000) PHC team as per IPHS – Minimum Requirement- 1 MBBS Doctor 1 Staff nurse 1 Pharmacist 1 Lab Technician LHV Rural- 1 MPW + 5 ASHAs Urban- 5 MPWs (@1 per 10,000 population) and 20-25 ASHAs (@1 per 2,000-2,500 population) Expanding HR- Comprehensive Primary Health Care Team AYUSHMAN BHARAT-HEALTH AND WELLNESS CENTRES
- 9. Urban Ward • Population Enumeration • Outreach Services • Community Based Risk Assessment • Awareness Generation • Counselling: Lifestyle changes; treatment compliance UHWC UPHC-HWC Poly Clinic/CHC/SDH/DH Follow up post secondary and tertiary care Upward referral Upward & downward referral Upward & downward referral •First Level Care • NCD Screening • Use of Diagnostics • Medicine Dispensation • Record keeping • Tele-health • Referral to PHC in case of complication • Diagnosis for NCDs • Prescription and Treatment Plan • Gate Keeping role for outpatient and inpatient referral / PMJAY • Teleconsultation with specialists • Advanced diagnostics • Complication assessment • Hospitalization • Tertiary linkage/PMJAY Maintaining Continuum of Care – Ayushman Bharat
- 10. Free medicines 105 @SHC-HWC 172@PHC-HWC Free diagnostics 14 @SHC-HWC 63 @PHC-HWC Robust IT system Teleconsultation services Key Elements: Drugs, Diagnostics andTechnology Solutions
- 11. Patient Support Groups (PSGs) Formation of PSGs is helpful in ensuring treatment compliance by reducing social stigmas and increasing acceptance towards the disease. Some of the key advantages of PSGs are: • Helping the patients: realizing that they are not alone- to boost the social support and acceptance towards one’s disease. This realization will bring relief, and further encouragement to seek care. • Creating awareness: these support groups may act as a platform for IEC sessions on topics relevant to that group. The added advantage of such platforms is that it will offer lots of practical tips and resources for coping up. • Reducing distress: As the patient discusses her/his query in a group, this reduces stress and anxiety about the outcomes. • Increased self-understanding: with more and more IEC, there is a scope to learn more effective ways to cope and handle situations. AYUSHMAN BHARAT-HEALTH AND WELLNESS CENTRES
- 12. 12 Illness toWellness- Services For ALL PEOPLE throughout the life-cycle Preventive healthcare Screening/ follow- up Hypertension, diabetes and 3 common cancers Tuberculosis & leprosy Promotive Healthcare Eat Right Fit India Movement Yoga/Wellness Activities 42 health calendar days celebrated by AB-HWCs Curative healthcare Diagnosis Treatment Follow up and treatment compliance
- 13. • Conducting regular yoga sessions by empanelled Yoga experts • Zumba and other forms of physical fitness and dance form are used to educate youth • Observing 42 health & wellness days through the year for spreading awareness • Promotion of healthy and safe eating practice through ‘Eat Right’ toolkit • Health promotion sessions in co-curricular activities of the school by Health & Wellness Ambassadors • Leveraging community platforms for planning and improving health services • AB-HWC will be fulcrum for many health & wellness activities all of which lead to Fit India Yoga/ wellness activity Eat Right Health & Wellness Ambassador Community Platform Fit India Health Promotion Health promotion through AB-HWC
- 14. Eat Right toolkit available at AB-HWC
- 15. ASHA Awareness, Identification and mobilization Population enumeration in the village ● Ensuring Screening ● follow up for compliance to treatment through regular home visits ● Facilitate conducing meetings of patient support groups. ANM/MPW Support Awareness, Identification and mobilization ● Ensure and Support in Population enumeration in the village by ASHAs ● Organize and conduct screening ● Counselling ● Support Home based care ● Organize patient support groups ● Support treatment adherence Community Health Officer (CHO) • Mentoring ASHAs and MPWs on all expanded package of services • Ensure 100% population enumeration • Provide facility based services - Carry out basic clinical and public management • facilitate referrals at a higher-level facility/teleconsultation with a specialist as required • Lead the team of MPWs and ASHAs • Report to PHC Medical Officer Coordinated Primary Health Care Delivery – Roles of AB-HWC team members
- 16. Convergence -Various stakeholders Convergence with Women & Child Development Youth Affairs & Sports AYUSH PRIs & NRLM; ULBs & NULM Education
- 17. AYUSHMAN BHARAT-HEALTH AND WELLNESS CENTRES
- 18. Inputs implemented: 1. HR in place + 2. NCD Training + 3. Medicines + 4. Diagnostics+ 5. Infrastructure strengthening / Branding + Inputs + Service Delivery rolledout: 1. HR in place + 2. NCD Training + 3. Medicines + 4. Diagnostics+ 5. Infrastructure strengthening/Branding+ 6. Screening of NCDs- Hypertension / Diabetes/ /Oral Cancer /Breast Cancer Conditionality Criteria
- 19. AYUSHMAN BHARAT-HEALTH AND WELLNESS CENTRES
- 20. PLP vsTBI Chart Title 60% 40% PERFORMANCE LINKED PAYMENT - SALARY 100% TEAM BASED INCENTIVE P L P INCENTIVE – is over and above salary Based on performance SALARY Based on attendance
- 22. Jan Arogya Samitis Service providers/ System functionaries JAS SHC- 8 JAS PHC- 9 Elected Representatives JAS SHC-5 JAS PHC-7 Civil Society JAS SHC-3 JAS PHC- 3 Service recipients JAS SHC-2 JAS PHC- 0 At least 50% representation of women to be ensured Vulnerable and marginalized population to be at least 33% represented
- 23. • Serve as institutional platform of AB-HWC for community participation in governance, management and accountability for health services • Support AB-HWC team for health promotion and action on social & environmental determinants of health • EngageVHSNCs of its area, in community level interventions of AB-HWCs • Leverage existing organized volunteers (NSS, NCC, Red Cross Scouts, Youth Groups) for patient follow up, counselling, community mobilization, conducting surveys and other related actions • Act as grievance redressal platform for families who access health services • Support & facilitate the conduct of activities pertaining to social accountability at AB-HWC in coordination with VHSNCs Jan Arogya Samitis
- 24. Composition of JAS-PHC Composition Designation SHC-HWC PHC - HWC Chairperson Sarpanch of the Headquarter Panchayat Zila Panchayat Member/Janpad Panchayat Member Co-Chair Medical Officer of the concerned PHC-HWC of the area Block Medical Officer Member Secretary Community Health Officer (CHO) Medical Officer In-charge of PHC Members • All Multi-Purpose health Workers of HWC • Sarpanches of the other GPs of AB-HWC area • Chairpersons of allVHSNCs under HWC area • Member Secretary (ASHA) of allVHSNCs in HWC area • President of one SHG from each GP in the HWC area • School Health Ambassador in the HWC area • Senior Peer Educator in the HWC area • Other Medical Officer / AYUSH Medical Officer of PHC • Senior Staff nurse / LHV / ANM of PHC • Chairperson of Janpad Panchayat’s Health Sub-committee • Sector Supervisor of Dept. of Women and Child (DWCD) / ICDS of the area • Block level officer of Dept. of Public Health Engineering Dept. (PHED) • Block level officer of School Dept. / Principal / Headmaster of local School • Block level officer of DWS • Block level officer of PWD • Chairpersons of all JAS of SHC level AB-HWCs of PHC area (may be up to 5-6) • Block level representative from NYK/Youth volunteers • 2 Civil society representatives Composition of JAS
- 25. Undertake health promotion and wellness activities in coordination withVHSNCs Enable quality service delivery at SHC-HWCs Enable and facilitate smooth conduct of social accountability of its AB-HWC (in both SHC and PHC) Act as grievance redressal mechanism for services at SHC-HWCs Support the HWC team in effective community level implementation of Programmes like, Population Based Screening for NCDs, Eat Right Campaign etc. Roles and Responsibilities of JAS
- 26. • The purpose of the untied fund is to make available a flexible fund, to cater to unanticipated minor requirements, based on decisions taken at the AB-HWC level, in consultation with JAS • Ensuring basic amenities and services and supporting community level health promotion are two cornerstones for prioritizing expenditures from untied funds. • Under Ayushman Bharat, an annual untied fund is provided @ Rs. 50,000 for SHC level AB--HWCs and Rs.1,75,000 for PHC level AB-HWCs. Do’s •Emergency Referral transport •Supplies in case of disruption •Essential drugs & diagnostics •Health promotion •Maintenance of HWC infrastructure •Upkeep of HWC premises •Patient amenities Don’ts • Regular maintenance services • Cost of human resources/personnel • Purchase of drugs, reagents and equipment not listed • Expenses on activities for which resources and provisions already exist • Expenses on building open-air or indoor gymnasium or other exercise equipment. Untied fund for JAS
- 27. • Meeting Register - Record of proceedings of the JAS committee meetings • Financial Account Register – Maintaining Cash Book Record Keeping and Financial Management
- 28. • Provide mechanism for the community to be informed of health programmes and voice health needs, experiences and issues • Empower panchayats with the understanding to play their role in governance of health and public services • A multi-stakeholder committee in every village, Chaired by the Panchayat member of the village and has 50% of women members - also a Sub-committee of the GP Standing Committee on Health • ASHA is the member secretary. Untied grant – Rs 10,000 pa, authorised to mobilise additional resources locally • Largely focused on health influencing issues in the village like water, sanitation, disease profile, enabling and monitoring nutritional supplementation program • Develops Village Health Plan Village Health Sanitation & Nutrition Committee (VHSNC)
- 29. • Provide mechanism to participate in the planning and implementation of health-related programmes • Organise or facilitate community level services and referral linkages for health services • MAS members elect the chairperson of the group • ASHA is the member secretary. Untied fund – Rs 5000 pa. • One MAS for every 50 to 100 HHs Mahila Arogya Samitis
- 30. 2-3 Panchayati Raj Institutions (PRIs) Jan Arogya Samitis @ SHC-HWC Jan Arogya Samitis @ SHC-HWC Jan Arogya Samitis @ SHC- HWC Jan Arogya Samitis @ SHC-HWC Jan Arogya Samitis @ SHC-HWC VHSNC/revenue village Action on social determinants of health Health Promotion JAS @ PHC-HWC Together We Are 500 Members – WE COMMIT TO REACH HEALTH TO ALL PEOPLE in our area AB-HWC Ecosystem
- 31. Improved Population Coverage Reduced Out of pocket expenditure Decongestion of secondary & tertiary health facilities Outcome
- 33. 33 Roll out Plan of Health and Wellness Centres 2018-19 2019-20 2020-21 2021-22 Dec, 2022 15000 15000 15000 15000 15000 25000 25000 25000 25000 30000 30000 30000 40000 40000 40000 40,000 70,000 1.1 Lakh 17149 52744 ACHIEVE- MENT 74947 117440 1.5 Lakh 120322 As on 05-09-2022 AYUSHMAN BHARAT-HEALTH AND WELLNESS CENTRES