Group 1 Sub Health Centre HWC Human Resources

Group 1 - Sub Health Centre. HWC

Human Resources • Adequate HR- 1 MPW-F, 1 MPW-M and 1 CHO • Training • All CHOs have attended six months Certificate Program in Community Health • NCD training of CHOs in UP, JH, GJ (few centres) • Multiskilling • ASHAs, MPW-F trained in universal screening for NCDs • Not all CHOs trained in universal screening for NCDs at visited HWCs • ANM-CHO coordination: Mixed findings- issue observed in few places • MPW-M- not involved in expanded service delivery

Medicines EML displayed at SHCs in Gujarat, UP EML for SHC available with PHC pharmacists, but not with CHOs at MH Different dosages of medicines not available DVDMS up to PHC at MH and up to CHC in UP, Bihar, Jharkhand State specific E- Arogya application at UTs- indenting of medicines at SHCHWC, (NCD and RCH data, HR recruitment) • Standard treatment protocols- • • • Clarity about protocols for initiation and continuation of treatment for Hypertension and Diabetes by CHOs observed • Standard protocols for antibiotics prescription not used at SHC-HWC- metronidazole being prescribed as first line treatment for diarrhoea by CHO at MH

Diagnostics • MH, UP- 5, JH, DNH, GJ- 7, Bihar- 1 (Hb) • Hub and spoke- at MH, planned to be expanded upto SHC • Consumable shortage- at SHCs in Maharashtra • Diagnostic list displayed at SHCs in GJ

Universal Screening for NCDs • Population enumeration- Family folders being filled at Bihar, UP, MH • GJ- Family Health Survey (Im. Techo) information being used • CBAC forms- being filed at all visited SHC-HWCs • Few ASHAs having smartphones at GJ • Use of CBAC forms- variation observed- prioritization for screening taking place at UP, GJ, MH • Fixed day NCD services- at GJ, MH • Cancer screening • Symptom based examination for oral cancer, breast cancer at most places • Isolated SHCs- universal screening for oral and breast cancer

IT HWC portal • Facility based ID- not available at MH • GJ- daily reporting using smartphones CPHC-IT application • UP- issues with application- slow uploading

Infrastructure and Branding • Storage for medicine- issues with unavailability of space and good storage practices • UTs- 7 rooms at SHC-HWC • Deficiency of space for wellness- UP, MH Branding • MH, UP- underway • UTs, GJ- present

Wellness • Bihar- Sarva Shiksha Abhiyan- Instructors planned to be used for Yoga • UP- Yoga instructor not available • GJ- CHOs and SHC-HR trained and conducting daily Yoga sessions • MH- Yoga sessions weekly by CHOs • GJ- Kitchen gardens, medicinal plants

RCH activities • UP- labour room at SHC- a good practice • ANC, RI- regular at all visited SHCs • Adolescent health- to be strengthened • PMSMA- observed at all • MH- Twice in a month

Best Practices • ECHO at Maharashtra and Gujarat for CHOs • Arogya Samanvay training for CHOs- Yoga and Ayurvedic, Naturopathy practices (21 days) at 9 Ayurveda Colleges • Jharkhand- NCD kit for fixed day outreach visits • Gujarat- follow up and referral registers for NCD being maintained • PSC at UP • CHO dashboard in GJ-