Pregnant Women Archives - InnoHEALTH magazine

LaQshya Programme for Pregnant Women & New Born

InnoHEALTH Magazine — Fri, 27 Jul 2018 07:26:03 +0000

With an aim for improving quality of care in labor room and maternity operation theatres, the Union Ministry of Health and Family Welfare has recently announced the launch of program ‘LaQshya’.
The Program aims at implementing ‘fast-track’ interventions for achieving tangible results within 18 months. Under the initiative, a multi-pronged strategy has been adopted such as improving infrastructure upgradation, ensuring availability of essential equipment, providing adequate human resources, capacity building of health care workers and improving quality processes in the labor room.
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Informatively, India has come a long way in improving maternal survival as Maternal Mortality Ratio (MMR) has reduced from 301 maternal deaths in 2001-03 to 167 in the year 2011-13, an impressive decline of 45% in a decade. India is further committed to ensuring safe motherhood to every pregnant woman in the country.
A transformational improvement in the quality of care around childbirth relating to intrapartum and immediate postpartum care shall dramatically improve maternal and newborn outcomes.
According to official sources, the Program will improve quality of care for pregnant women in labor room, maternity operation theatre and obstetrics intensive Care Units (ICUs) and High Dependency Units (HDUs).
LaQshya program is being implemented at all Medical College Hospitals, District Hospitals and First Referral Units (FRU) and Community Health Centers (CHCs); it will benefit every pregnant woman and newborn, delivering in public health institutions.
‘LaQshya’ will reduce maternal and newborn morbidity and mortality, improve quality of care during delivery and immediate post-partum period and enhance the satisfaction of beneficiaries and provide Respectful Maternity Care (RMC) to all pregnant women availing public health facilities.
To strengthen critical care in Obstetrics, dedicated Obstetric ICUs at Medical College Hospital level and Obstetric HDUs at District Hospital are operationalized under LaQshya program.
The Quality Improvement in the labor room and maternity OT will be assessed through NQAS (National Quality Assurance Standards). Every facility achieving a 70% score on NQAS will be certified as LaQshya certified facility.
Furthermore, the branding of LaQshya certified facilities will be done as per the NQAS score. Facilities scoring more than 90%, 80%, and 70% will be given Platinum, Gold and Silver badge accordingly. Facilities achieving NQAS certification, defined quality indicators and 80% satisfied beneficiaries will be provided the incentive of Rs. 6 lakh, Rs. 3 lakh and Rs. 2 lakh for Medical College Hospital, District Hospital, and FRUs respectively.

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Rural healthcare: Solutions lie in innovations

InnoHEALTH Magazine — Mon, 23 Apr 2018 11:10:53 +0000

It has become imperative to make rural and remote areas healthy and free of diseases and infections to make ‘National Health Mission’ a success. There are still many parts of the country where medical services are still not accessible. With the iKure’shealthcare delivery system, the dream of providing minimum health service to the rural parts of the country has become true. Armed with Wireless Health Incident Monitoring Systems, Community Health Workers have been at forefront to provide doorstep solutions at minimal cost. iKure’shealthcare has become a new frontier to drive innovations in rural healthcare delivery

There are over 330 CHWs who are trained and strategically deployed across six states in rural India and have been rendering services under iKure’shealthcare delivery system.

Jayashree is one the CHW who works relentlessly in her village Hubli(Karnataka). One day, she visited a woman named Pushpa who was in her first trimester and looked quite unwell.On enquiring, Pushpa was found to suffer from Epilepsy. Her family also revealed that she has been prescribed with medicines by a local doctor, but she didn’t take them regularly.

Epilepsy is a disorder of the nervous system and such patients during pregnancy have major concerns. Jayashree felt the need and promptly captured her vitals on her smartphone loaded with Wireless Health Incident Monitoring Systems, (WHIMS), and pushed the patient’s vitals on to the cloud for a quick doctor reference.

For the next few days, Jayashree monitored and screened her closely and counselled her and family about different preventive measures pertaining to her health conditions. Soon after, Pushpa recovered and gave birth to a healthy child.

In the context of rural settings, it is never possible to create doctors or health clinics as required. To bridge the gap, the grassroots community members are empowered to provide clinical careenabled through WHIMS.The technology application is designed with an intuitive graphics user interface that can be efficiently used by a health worker even with a basic education.

For instance, WHIMS screen has a complete photograph of a human body.When a health worker clicks on the head, WHIMS gives options of potential symptoms of the head, such as ache, dizziness, seeing dark spots, and so on.

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Usually with the standard diagnostic tool, low accessibility and portability remain a huge constrain. WHIMS is accompanied with low-cost portable instruments to measure basic statistics and loaded on a tablet is carried by the CHWs in the remotest villages to diagnose patients. The patients pay an affordable rate for basic diagnostics and consultations, through which they earn additional income.

Unlike the Accredited Social Health Activists (ASHA workers) who work as community mobilizer and not authorized to deliver clinical services, these CHWs meet both the ends.

Equipped with a medical kit that consists of devices including BP machine, stethoscope, pulse oximeter, thermometer, first aid kit, weight machine, Height measuring scale and gloves,they carry medicines for basic common ailments, non-invasive hemoglobin meter, haemoglobin kit, mobile phone based sphygmomanometer, urine analyzer, calorimeter, ECG, flipcharts/ Hoardings & registers.

Through these CHWs, every patient is also provisioned with Digital Health Card (DTH) encrypted with a QR (Quick Response) code and during home visits. DTH gets updated with latest clinical indicators. The health data obtained from the health cards is synced to a cloud for effective utilization in the upward heath chain at both secondary and tertiary levels.

CHW’s contact and familiarity within the community drive effective community mobilization measures. As they become an integral part of the healthcare delivery model, CHWs act as a catalyst to drive behavioral change. While they interacts and communicates the necessity on the ground and identifies appropriate health needs, it is through street plays, hoardings and message dissemination on mobile phones, theymobilize patients at different levels. They are also attuned to provide nutritional counselling, and spectacle services based on the community needs.

Further, WHIMS is upgraded with robust supply chain management framework, innovative algorithm, and Data Warehousing solutions. Driven by its CHWs, iKure aims to bring efficiency in public system & programe and improve lives.

The CHW model of empowering the women community and gender mainstreaming represents transformational change in rural healthcare delivery. As they champion tech-savvy cultural values in otherwise austere facilities, and limited supply of doctors, such effort has established inspirational leaders driving catalyst change in sustainable rural development.

“For a basic diagnostic long distance travel time, high cost of services and prolonged waiting hours at the local PHCs was a huge burden for these rural residents. Use of P-O-C devices is extremely portable, affordable with high accuracy rate and can be used by any health worker with a short training. This has been a critical step in rural healthcare delivery with a positive outcome on prevention, curative care and treatment procedures”.

Dr. Ajay Agrawal, Medical
Director-iKure

“Initially when I used to visit pregnant women, they were apprehensive and reserved. But repeated visits have given them confidence to open up. They ask many questions, show doctor’s report and ask for medicines. I have a joint family and few among them are pregnant, even they are educated, but they would consult me and ask for my opinion. I feel valued and found a voice through iKure”.

Gayathri Acharya
iKure CHW, Hubli, Karnataka

(Author: Dr. Tirumala Santra Mandal is a research and communication analyst at iKure. With a doctorate degree in corporate communication from IIT Kharagpur, she has worked in diverse fields of communications such as lie detection, multimedia communication, communicative English. Prior to working with iKure, she has worked as an editor and authored several publications in referred and business journals both at national and international levels.)

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FETAL MEDICINE TREATMENT

InnoHEALTH Magazine — Wed, 03 Jan 2018 07:59:37 +0000

Fetal medicine makes treatment of abnormalities in the unborn child possible

Medical advancements in heart treatments have taken giant steps and is poised to treat congenital problems in the heart of a fetus today. However, due to a severe lack of awareness in India about what problems can be detected at fetal stages, expectant mothers are in oblivion about the health of their unborn child. This leads to an uniformed decision and many children are born with challenges that could have been detected and treated even before they were born.

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In India where Fetal medicine is still an upcoming discipline, the pregnant women aren’t much aware about its scope from diagnosis to therapy. Fetal medicine pertains to the use of Ultrasound, genetic tests, MRI etc. in the pregnancy period to determine the health of the newborn. Though fetal experts in India usually restrict themselves to treating complications of Identical twins, bladder outlet obstruction , fetal anaemia , the horizon for diagnosis has touched the Western mark. The motive is diagnosis of birth and chromosomal defects as early as possible so as to offer a fair chance to the couple on deciding fate of pregnancy. Fetal echo-cardiography is one worth mentioning which can pick up most early manifesting cardiac problems in the unborn in expert hands.

Fetal medicine practitioners try to spread awareness and say that one needs to see a fetal medicine specialist if they have any of the following conditions:

• Recurrent pregnancy loss/ death of baby in womb/death immediately after birth or delivery before date.
• Mothers who’s blood group is Rh negative
• Known genetic disease in family
• Pregnancy with previous child or family member affected by thalassemia/ haemophilia etc
• Pregnancy with h/o fever with rash/chickenpox
• Pregnancy with Diabetes/high BP/heart disease//Systemic Lupus Erythematosus (SLE), Sjogren’s syndrome, Rheumatoid arthritis
• Pregnancy with hepatitis/ cancer/seizure/organ transplant
• Pregnancy with slow growth of fetus.
• Pregnancy with previous history of structural defect in the baby in previous pregnancy or in the family
• Pregnancy with previous history of mental retardation or heart defects in previous pregnancy or in the family
• IVF conceived pregnancy

Latest studies reveal that approximately 3-4% of pregnancies are diagnosed with a fetal defect. This can either be a genetic defect or a structural defect. With a lack of awareness in mothers; lack of exact diagnosis and monitoring this can result in a severe mental or physical handicap in a new-born and can prove to be traumatic for the family and pose a significant mental burden on the new mother. So India, now is the time to look up, ask and use the available expertise to join hands for the healthy next generation.

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