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Mobile Medical Services

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Providing access to medical services to patients, especially those residing in remote areas has always challenged public health experts. In Telangana State, there are several pockets in districts and even in urban centres that are underserved. Recognising the need to reach out to such underserved patients, in the last few years the health authorities had launched a bouquet of mobile medical services.

In addition to the existing 108 emergency ambulances, the scope of mobile medical services was expanded and new initiatives including hearse vehicles, 102 Amma Vodi vehicles, Tika Bandi and the yet to be launched Bike Ambulances were added.

Hearse Vehicle:

Amongst all the mobile medical services, the hearse vehicle service is a unique concept in which bodies of the deceased are transported free of cost to native towns and villages. The initiative is to help relatives and attenders who can’t afford expensive private ambulance service to transport bodies. Since the introduction of the hearse services in 2016, they have remained popular and within a year the fleet of 50 hearse vehicles 13,061 trips.

102 Amma Vodi Ambulances

To reach out to pregnant women residing in inaccessible locations, authorities are preparing ground to scale-up 102 Amma Vodi ambulance scheme. In the coming months, the 102 Amma Vodi ambulances will increase from 41 to 200 vehicles all over the State. The unique aspect of these vehicles is their ability to cover the entire gamut of medical services that fall under Mother and Child Health (MCH). According to figures available with authorities, ever since the introduction of the scheme in December, 2016, the existing 102 Amma Vodi ambulances have already completed 15,141 trips.

The vehicles will be equipped with medical infrastructure, will have trained field level workers to track high-risk pregnant women, conduct ante-natal and prenatal check-ups and administer vaccines to infants.

New posts in Medical and Health Department

While in the past there have been several attempts to recruit and create new posts in Medical and Health Department, this is for the first time that a large scale recruitment drive is being taken up to fill vacant posts and at the same time create new ones. In the coming months, the State Government is preparing the ground to fill a whopping 13,496 posts at various levels and cadres in the public health sector. This is for the first time in decades that such a massive exercise of filling vacancies and at the same time create new ones has been taken up.

40 dialysis centres and 268 dialysis machines

Access to affordable dialysis services has always been a major challenge for scores of patients suffering from kidney ailments. Less than 5 per cent of the kidney patients are able to afford regular dialysis in Telangana State, while the rest of the patients eventually die with kidney failure.

Such desperate situation is set to change, as highly advanced 40 free dialysis centres are being set up by the State government in all districts. The 40 centres will have 268 dialysis machines, which will provide treatment to 2,100 kidney ailment patients. The health authorities will be providing close to 25,000 dialysis sessions free of cost to the kidney patients every year. This is for the first time in the Country that single user dialyser, with an aim to reduce infections, will be used to provide dialysis service to patients.

Infections, especially Hepatitis C is common among chronic kidney patients who are on long term dialysis support. Chances of infections are more when tubes and dialysers, which are vital parts of dialysis machine, are used multiple times on multiple patients.

Typically, such dialysers are used for at least 10 times on a single patient before going for a fresh hollow fibre or dialyser. However, now, these single-used dialysers will be used only once for a single session of dialysis on a patient. In the last few months, the health authorities have already inaugurated specialised-dialysis centres in Malakpet, Sircilla, Vanaparthi, Gadwal, Siddipet, Sangareddy and Vanasthalipuram.


In the last one year, we have laid intense focus on health of infant and pregnant women. At the same time, we have upgraded ICUs and are establishing dialysis centres for chronic kidney patients. By January, we will start taking care of diabetics and hypertension patients by supplying them with free medicines, said Dr C Laxma Reddy, Health Minister.


Financial aid to pregnant women

Among the many initiatives that were launched in the last one-year by the State government, the KCR Kits scheme, aimed at providing financial incentives to pregnant women along with a kit containing goodies for the newborn, has managed to catch everyone’s imagination.
Launched on June 3 by Chief Minister, K. Chandrashekhar Rao, the scheme quickly became the ‘showcase’ initiative for health authorities. Within months, as the scheme stabilised, the authorities started recording a noticeable spike in the number of pregnant women approaching Government hospitals for admissions.

Immediately after the launch, there was a 20 per cent rise in the number of pregnant women approaching public health institutions. In the coming year, there could be an increase of 40 per cent to 50 per cent in institutional deliveries, which will put a lot of pressure on the existing infrastructure and manpower.

The financial benefits, which include Rs. 12,000 to pregnant women who have delivered a boy and Rs. 13,000 who had delivered a girl, are the major drivers of KCR Kits. The money is directly transferred to the bank accounts of pregnant women in four phases during various stages of pregnancy.

Due to the massive scale of the KCR Kits project, the health officials have been facing many challenges in efficient implementation of the scheme. The financial incentives linked to KCR Kits are supposed to be released in four phases of Rs. 3,000 each during the entire cycle of pregnancy.

However, due to massive scale of the initiative, the ground staff involved in implementing the scheme initially struggled to release the funds on time. However, after six months of implementing the scheme, the pace of issuing kits has picked-up and the scheme has also touched the landmark of distributing 1,00,000 KCR Kits since its launch in June.

KCR Kits recruitment

To strengthen implementation of KCR Kits scheme in the State, the health authorities recently have issued orders creating 131 additional posts. The State government will incur an expenditure of close to Rs. 3.5 crore every year towards salaries for the 131 posts created for KCR Kits scheme. To make the scheme sustainable in the future, officials have also decided to form high-powered State and district level committees comprising senior health authorities and district officials.

The KCR Kits scheme entails a lot of data entry work, as the case sheets of individual pregnant women are first hand written by health care workers. The cases sheets are later digitised and fed into the special software known as Mother and Child Tracking System (MCTS).

The entire financial benefit scheme is Aadhar card based, which means money will be transferred to individual bank accounts of pregnant women who have Aadhar cards. For the entire process to run smoothly, especially the software and huge amounts of digital data, there was a need to have technical manpower. To this effect, authorities have created 41 IT posts that include recruiting a Project Manager (IT), Assistant Project Manager, three Project Engineers, five Project Associates and 31 District IT Managers, who will exclusively posted in districts.
There was also a need to have a large force of data entry operators, who are needed to understand and decipher the handwriting and medical advice of doctors who note down the prescription in the individual case files of pregnant women.

Speciality ICUs

Before bifurcation, the Infant Mortality Rate (IMR), which is defined as the number of infants that die for 1,000 live births, in Telangana State was close to 39. Within a few years after statehood, the IMR dropped to 31. Recently, the Ministry of Health and Family Welfare (MOHFW) ranked TS second in the Country and first in South India for providing top quality ICU services to the new born.

The top billing for Telangana State and decreasing IMR levels is a clear vindication for the efforts of authorities to improve critical care services for infants in the State. In co-ordination with National Health Mission (NHM), the State health authorities had carried out a systematic process of upgrading and setting-up Special Newborn Care Units (SNCU). In all, 21 hi-tech SNCUs in the State were started, which had saved lives of 23,000 infants between January and December of 2016.

The upgrading of ICUs and SNCUs can be considered as a major infrastructure upgrade in the last few years, taken up by health authorities. There was a great need to improve post-operative care to save lives of pregnant women at the tertiary State-run maternity care hospitals in Hyderabad.

To address this issue, ICUs meant for pregnant women have come up in all the teaching hospitals including maternity hospitals at Petlaburj, Sultanbazaar and Niloufer Hospitals. A state-of-the-art general 65-bedded ICU facility was recently inaugurated at Gandhi Hospital in Hyderabad.

To be able to support the annual 6, 50, 000 deliveries that happen every year in various State-run health institutions, the health authorities have also decided to increase from the proposed 21 ICUs to 31 intensive care units. To make salaries of the specialised duty doctors on par with those being offered by private hospitals, the health authorities will offer a monthly salary that starts from Rs 80,000.

VOICE FOR KCR KITS

23-year-old Ramya is all smiles, as she readies herself for getting discharged from Gandhi Hospital and go home, along with her days-old boy and of course the KCR Kit. When the authorities handed over the KCR Kit to Ramya, immediately her mother pulls out the baby towel from the Kit and wraps it around the infant.

“The kit has things that meet specific needs for the baby. Of course, the financial incentives are great but the KCR Kits and the things inside for the baby do matter a lot. It makes a lot of difference, says Ramya, who resides in Narapally along with her husband Shekhar, who is a businessman. Her father-in-law Shankar points out that already the first instalment of Rs. 3,000 was transferred to the account of Ramya. “The amount is transferred directly to the mother’s account, which itself is quite empowering. I am blessed with a grandson and we are glad that we came to a Government hospital,” says Shankar.

 

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