Despite Puducherry being already rich in healthcare services, the National Health Mission has helped make the delivery of services still more effective and faster, says Dr K V Raman, Director, Department of Health & Family Welfare Services, Government of Puducherry, in conversation with Souvik Goswami of Elets News Network (ENN)
As the Mission Director of the National Health Mission (NHM), Puducherry, could you elaborate on the initiatives that are there to provide better healthcare services?
The Health Department in Puducherry exists for more than 50 years and some of the hospitals are nearly 200 years old. Owing to the French legacy, Puducherry was famous for its healthcare services and people from other regions used to come in. When NHM came, it did not have much of an impact because all the services were already being provided by the government. However, it did help fill the gaps, which had not been taken care of by the State Government. For example, there are some technical positions such as treatment supervisors, treatment laboratory supervisors in tuberculosis and data entry operators in NHM, which cannot be solely taken care of by the State Government.
Puducherry has eight major hospitals, four Community Healthcare Centres (CHCs), 39 Primary Healthcare Centres (PHCs) and 81 sub-centres for a population of 2.5 lakh people. Given the rich healthcare facility, people from other regions also visit Puducherry for healthcare services. We have done a networking of PHCs, as they are now equipped with computers and internet connections that enable them to give feedbacks or reports. This also makes the working of PHCs more streamlined.
How NHM has helped in streamlining the healthcare services in Puducherry?
Puducherry is divided into four different regions with its small pieces stretching up to different states, thus making the administration difficult. But now under NHM, we are able to streamline things with the advantages of speedy monitoring. Earlier, manual reports from all hospitals would come, but now with online reporting facility, it is easier to move ahead with the facility-based reporting (sub-centre level) and the data is monitored very closely.
Now, through NHM, the Government of India is able to monitor the health facilities of the states. Prior to this, each state used to have a different level of healthcare, but now they are bridging the gap and creating an average or even a better healthcare system. The NHM monitoring is so good that they find the districts with below par immunisation and family welfare, and prioritise them accordingly. Similarly in immunisation, wherever deficit is there, they are covered under a new scheme called ‘Indradhanush’.
What are the major initiatives of NHM in terms of providing healthcare services in Puducherry?
We have brought down the infant mortality rate because NHM has supported the antenatal care and also the pregnancy and delivery care. They are funding and giving facilities to patients to visit the hospitals and go back, and also bringing children to hospitals. A major advantage to the people is that now they are visiting major hospitals instead of going to PHCs for delivery. This is because of the good transport services and the level of care hiked up in these institutional deliveries, making people opt for hospitals. The institutional deliveries have gone up beyond 99.5 per cent.
We have brought down the infant mortality rate (in Puducherry) because the National Health Mission (NHM) is supporting the antenatal care and also the pregnancy and delivery care
Moreover, we are looking after the smallest of things to decrease child mortality rate. For instance, children born with congenial diseases, unless they are treated in the first year, are likely to die. To prevent this, we have started a unique process in Puducherry, called Cardiac Screening Care, where every child born is screened for cardiac defects. We also have tie-ups with Chennai hospitals, who visit thrice a week to screen and diagnose children with cardiac defects, and those with defect are taken to respective hospitals for treatment. We also have a revolving funding at NHM to pay for it.
Another initiative that we have undertaken is for non-communicable diseases by screening every person above 30 years. The non-communicable diseases were alarming in Puducherry. We did a pilot study of three PHCs and were able to get the basic data of 16 to 33 per cent infection. After this awareness, people are visiting us for screening. Our requirement for drugs has gone up, for which the National Rural Health Mission (NRHM) is supporting us.
Besides, the complications of the non-communicable diseases are being planned to be taken care of as well. We have also opened a diabetic clinic in the major hospitals and in every PHC, operating twice a week. Under NRHM, we are going to set up a cardiac care unit, a geriatric care unit and a palliative care unit to the terminally ill patients.
What are the initiatives undertaken in Puducherry in terms of providing mHealth services?
All the pregnant ladies are registered under mother-child tracking system and their check-ups are channelised through mHealth mechanism every three months. Mobile numbers of the patients are fed into the computer that is connected to the headquarters. The data is saved in the server on a daily basis and the ANMs receive alerts on when to call the patient. The payment of their services is done through NRHM. We have submitted a proposal of 400 crore eHealth project to the Ministry of Health that includes every electronic facility for health starting from recording all the data at the PHC level, transmitting the data to any hospital and providing smart cards to the patients, using which they can access any hospital which can further access their data through any PHC. We are hopeful to get the project this year. Prior to this, on a trial basis, we are trying to provide five PHCs with tablets having enabled software to record the patient data quickly. The data can be shared with the patients over e-mail and the patients would be given a unique number through which they can access their data at any hospital.