National Program for Health Care of Elderly NPHCE

National Program for Health Care of Elderly (NPHCE) NHM & Tertiary Components Ministry of Health & Family Welfare

Programme Strategies • Community based primary health care approach including domiciliary visits • Dedicated services at PHC/CHC level including provision of machinery, equipment, training, additional human resources (CHC), IEC, etc. • Dedicated facilities at District Hospital with 10 bedded wards, additional human resources, machinery & equipment, consumables & drugs, training and IEC. • Regional Geriatric Centers to provide dedicated tertiary level medical facilities and PG courses in Geriatric Medicine 3/9/2021

Package of services under NHM • Sub Centre: – Health Education related to healthy ageing, environmental modifications, nutritional requirements, life styles and behavioral changes. – Special attention to home bound / bedridden elderly persons and provide training to the family health care providers in looking after the disabled elderly persons. • Primary Health Centre: – A weekly geriatric clinic at PHC level by trained Medical Officer, Conducting Health assessment of the elderly persons and simple investigation including blood sugar, etc. 3/9/2021

Package of services under NHM • Community Health Centre – Biweekly geriatric Clinic and Rehabilitation services to be arranged by trained staff and rehabilitation worker at CHCs. – Domiciliary visits by the rehabilitation worker for bedridden elderly and counseling to family members • District Hospitals: – Dedicated Geriatric OPD services, In-door admissions through 10 bedded geriatric ward, laboratory investigations and rehabilitation services. – Referral Services 3/9/2021

Package of Funds at Each level Amount in Lakh of INR S. No. Items DH CHC PHC SHC 1 Construction 80 2 Equipments 10 1 0. 5 0. 3 3 Drugs 10 4 Training 0. 8 1. 2 0. 3 5 IEC activities 2 6 Manpower 28. 2 1. 8 Total 131 4 0. 8 0. 3 3/9/2021

Progress in implementation Level of Facility S. No 1 2 3 4 3/9/2021 Operational Sanctioned District hospitals CHCs PHCs SCs providing home based care & supportive appliances OPD Indoor wards Physiotherapy units 713 496 459 411 2933 1825 NA 893 12301 5012 NA NA 38322 14257 NA NA

Issues To address the challenges faced by the existing National Program • Operationalize all approved facilities for provision of geriatric care services. Status of operationalization of Geriatric OPD in approved facilities: Ø Less than 50% at District level : 3 States (J&K, Jharkhand, Telangana). Ø Less than 50% at CHC level : 7 States (Himachal Pradesh, Bihar, Jharkhand, Orissa, Tamil Nadu, Telangana, Nagaland). Ø Less than 50% at PHC level : 11 States (Himachal Pradesh, J&K, Bihar, Jharkhand, Orissa, West Bengal, Kerala, Tamil Nadu, Telangana, Nagaland, Sikkim, ). 3/9/2021

Geriatric Facilities at Tertiary Level • Regional Geriatric Centers: – – – • Provide tertiary level services for complicated/serious Geriatric Cases Conduct post graduate courses in Geriatric Medicine - 2 MD geriatrics every year. Providing training to the trainers Developing/and updating Training modules, guidelines . Research on specific elderly diseases. 19 RGCs sanctioned National center for Ageing: – High level tertiary care with multidisciplinary approach – Special clinics like memory clinic, fall and syncope clinic, frail elderly clinic, aids and appliances clinic, implants and cosmetic clinic. – Day care centre for : Investigations, rehabilitation, respite care, dementia care, continence care – In patient care : Intensive care, acute rehabilitation, diagnostic and therapeutic services, long term rehabilitation service. – Human resources development in all sub-specialties of Geriatric Medicine – Developing evidence based treatment protocols – Special focus on care for 75+ aged population – 2 NCAs sanctioned at AIIMS, New Delhi and Madras Medical College, Chennai 3/9/2021

Package of Funds at RGC Amount in Lakh of INR S. No. Component Non-Recurring 1 2 3 4 5 Construction/renovation/extension of th existing building and furniture of department of Geriatrics with 30 bds and OPD facilities including academic and research wing Machinery & Equipment Drugs & Consumables Research Activities Human Resources (Contractual) 6 Training to faculty members & doctors from district hospitals Total 3/9/2021 Recurring (PA) 200 50 250 10 20 40 88. 44 5 163. 44

Progress in implementation • 19 Regional Geriatric Centres (RGCs) and 2 National Centre of Ageing (NCAs) are sanctioned. Progress in Operationalization S. No 3/9/2021 Institutions operationalised 1 RGCs 2 NCA OPD Indoor wards 18 16 Physiotherapy Laboratory units services 13 To be operationalized by March 2020 12

Issues To operationalise all the services in the 19 Regional Geriatric Centers. – Indoor wards to be set up at RGC: Patna and Kolkata – Physiotherapy unit be set up at RGC: Patna, Kolkata, Hyderabad (Nizam) and Cuttack – Laboratory services to be started at RGC: Patna, Kolkata, Hyderabad (Nizam) and Cuttack • Development of Manpower in RGCs through 2 PG seats of MD Geriatric Medicine, is in operation at only 2 RGCs i. e. AIIMS, New Delhi and MMC, Chennai. • The two National Centers For Aging i. e. : Madras Medical College Chennai & AIIMS Delhi to be operationalised by 2020. • 3/9/2021

RGCs Yet to Start MD in Geriatric Medicine RGCs SEK IMS Srinagar Rajendar IMS Ranchi GMC Trivandrum Kolkata MC Kolkata BJ Medical college Ahmedabad Agartala MC Agartala Nizam's IMS Hyderabad Patna MC Patna SCB Medical College Cuttack Rajendra Prasad GMC HP 3/9/2021

THANK YOU 13