ICTPH is a not-for-profit Research Organization working in close collaboration with its Thanjavur based SughaVazhvu Healthcare to establish sustainable primary healthcare systems for remote rural Indian Populations.

1. Health Systems
Approach
May 17, 2011

2. The Partnership

3. The Context

4. The Value Proposition

5. Rural Micro Health Centre
 Power Back-up
 6 Days a Week; 09:30am
– 06:00pm
 Village-based, along with KGFS
 Catchment Population – 10,000 people
 Human Resource – Doctor, Nurse,
Extension Worker
 Technology – Internet, Computers, HMIS,
Blood Collection

6. Assessment New
Patient
Screening Protocol
Community Based
Check-out
free free Comprehensive
Pre-enrollment Rapid Screening Screening
ONLY FOR ADULTS Pre-enrollment, Rapid ++; Vitals, Detailed
Demography, HH geo-tag,
Ht., Wt., WC, HC, BP, Smoking Physical Examination, Mental Health, VA,
Family Composition
& Alcohol Habits, Pregnancy Acute Illness.
Status, Sudden Wt., Family & Adolescents, Children and Infants –
Personal History Pre-enrollment, Standardized PISP
Pre-
RMHC based
Repeat
Patient
Consultation
Consultation
Ht., Wt., WC, HC, BP SOAP Process: (Targeted
Vitals: Temp., Pulse, RR, Heart & Lung Sound Physical Exam)
Infants: MUAC, Head Cir.
Check-out
Emergency Cases! Disease/Emergency
Protocol

7. Pre-Enrollment & Risk Screening
 Demography – Address with pre-
populated street and village details
 Household Geo-tag
 Family Composition – Members, Age,
Relationship
Risk Screening: Height, Weight, WC,
HC, BP, Smoking & Alcohol Habits,
Pregnancy Status, Sudden Wt. Loss,
Family & Personal History
GPS Enabled Android Mobile Phones

8. Pre-Enrollment
DAY 2
DAY 1
Andipatti, RMHC Catchment:
DAY 3
 12,000 people (2,500HH) mapped in
four days

9. Pre-Enrollment
Chelampatti
Pachur
Uppundarpetti
Thekku
Ayyampatti
Kotaitheru
Adanakottai
Karkaripatti
Andipatti & Mudalipatti
Andipatti, RMHC Catchment Area

10. PISP
 Age Based (Non-Invasive) – Infant, Child, Adolescent, Adult
 Demography
 Acute Conditions – Persistent Cough, Fever, Diarrhea,
Weakness, Fatigue, Vomiting, Worms in Stool, Difficulty
Breathing, Pain in Abdomen, Genital Ulcers, Painful Urination,
Swelling in Ankles, Difficulty Hearing, Skin Problems/Irritation,
Chest Pain, Paralysis, Night Sweats, Weight Loss
 Chronic Conditions – Height, Weight (BMI), Waist
Circumference, Blood Pressure
 History – Family and Personal
 Visual Acuity
 Infant – Immunization and Feeding Practice & MUAC
 Nicotine Dependence (Tool - Fagerstrom Tolerance
Questionnaire)
 Alcohol Dependence (Tool – FAST)

11. Diagnostics
 Haematology: Complete Blood Count (Sysmex KX-21
Autoanalyzer)
 Biochemistry: Blood Glucose, Urea, Creatinine, Uric Acid,
Lipid Profile (triglycerides, total cholesterol, HDL), Liver
Function Test (LFT) (SGOT, SGPT, Albumin, Bilirubin Total,
Bilirubin Direct), HbA1C, Magnesium (Semi-autoanalyser
CHEM-7)
 Strip Tests: Malaria, Pregnancy, Urine

12. Consultation and Medication
ICTPH Essential Drug List – 67 Single Formulations
 12 Categories: Endocrine System, Cardiovascular System,
NSAID, Respiratory System, Gastro-Intestinal Tract, Immune
System, Anti-infectives, Nutritional, Vaccines, Local Anesthetics,
CNS, Skin.
 Others: ORS, IV-electrolytes, RL, DNS, D5, NS and Vitamin
B-Complex capsules
ICTPH Essential Drug List
THERAPEUTIC ACTIVITY CLASS NUCLEUS MOLECULE FORMULATION STRENGTH
ENDOCRINE SYSTEM
Anti Diabetic Biguanide Biguanide Metformin HCl Tablet (500 mg)
Anti Diabetic Sulfonyl Urea Sulfonyl Urea Glibenclamide Tablet (5 mg)
Anti Diabetic Sulfonyl Urea Sulfonyl Urea Glimepiride Tablet (1 mg; 2 mg)
CARDIO VASCULAR SYSTEM
Anti Anginal Isosorbide trinitrate Tablet (10 mg)
Anti Hypertensive Calcium Channel Blocker Dihydropyridine Amlodipine Tablet (5 mg; 2.5 mg)
Anti Hypertensive Angiotensin II Antagonist Losartan pottassium Tablet (50 mg)
Anti Hypertensive Beta 1 Receptor Blocker Napthalene Atenelol Tablet (50 mg)
Tablet (40 mg); Injection
Diuretic / Anti Hypertensive Loop Diuretic Anthranilic Acid Frusemide (10 mg / ml)
Diuretic / Anti Hypertensive Sodium Chloride Symporter Benzothiadiazine Hydrochlorthiazide
Hyperlipidemia HMG-CoA Reductase Statin Atorvastatin Tablet (10 mg)

13. SughaVazhvu RMHC Catchment Population Cohort Management
Pre-enrollment
Name, Age, Family Members,
HMIS
Relationship, HH GPS
PISP Wellness Management Dashboard
~ 10,000 people
Age related risk
biomarkers 1. -----
2. -----
CVD Daily Activity Index
1. ------
Diabetes 2. ------
3. ------
1. ------
Infants 2. ------
3. ------
1. ------
Pregnancy 2. ------
Absence of Measurable Risk Factors

14. Interventions:
Infant Nutrition Supplementation
Is your child between We recommend Sprinkles
6-24 months old? micronutrient powder
 Iron (12.5 mg)
 Zinc (5 mg)
Unless you child has one of the following:
 Folic Acid (160 µg)
 Vitamin A (300 µg)
 Vitamin C (30 mg)
Acute infection Severe Anaemia Severe Acute Malnutrition

15. Thank You!