Registrations till August 2021: 27,037

The low registrations due to lockdowns namely that of 139 in Nov and Dec 2020, had improved to 248 in Feb 2021, till 445 in Mar 2021, and has now stepped up to 472 in Aug 2021, despite the resurgence of COVID-19.

To view data table, full screen, download pdf, svg, excel formats, or print this graph, and for other options, click the hamburger menu on the right top corner of this graph.


Regn by Facility: n (Types) = 3

The reason for lesser registrations at the SDH and CHC is that these were converted into COVID-19 First Line Treatment Centers or full-fledged COVID-19 designated centers, and so no NCD clinics are held in these facilities.

However, new registrations in PHCs have picked up in Jun 21 after the resurgence of COVID-19 had stopped registration since Mar 21.

PS: Mouse over the column-graph to see data for each facility type or month. Also, to view data table, full screen, download pdf, svg, excel formats, or print this graph, and for other options like zoom in, zoom out, selection zoom, panning, click the hamburger menu on the right top corner of this graph.



Innovations from the field-II: Noolpuzha & Varadoor

For just over two months both FHC Noolpuzha, and PHC Varadoor have begun giving their IHCI registered patients, whose BP are controlled drugs for two months. This is a change from the standard paractice of giving patients drugs for one month. The advantages of this scheme are:

FHC Noolpuzha pharmacy
Fig.1 - Reduced crowds and relaxed services at Noolpuzha FHC

Benefits Reported:

Noolpuzha:

  1. Nearly 300 patients per month have benefited from this 2-month drug distribution scheme.
  2. In addition, Noolpuzha has started documenting in excel sheet with Unique ID No, Date of Controlled BP measured, with Columns for noting months, and BP measurement, when these patients come to the facility.
  3. Patients getting 2 months drugs are glad that they do not have to undergo antigen test before entering the facility.
  4. In August Noolpuzha has seen less patients eligible for 2 month drug supply, than the month before

 

Varadoor:

  1. Eligible BP controlled Patients are getting 2 months drugs supply when they attend the facility on NCD days, which is conducted once a week.
  2. Like Noolpuzha, Varadoor also will start documenting but as hard copy, due to shortage of staff presently. The format would be with Unique ID No, Date of Controlled BP measured, Columns for noting months, and BP measurement, when they come to the facility. This would be digitalized periodically
  3. Due to staff shortage, even updating of IHCI cards and registers are done by the MO-in-charge.

PS: To inform similar innovations by mail Click Here  or to call the Wayanad CVHO Click Here



Outcome Analysis: by Blocks


Shown is the Treatment Outcomes of the various blocks compared with that of Wayanad District for the month of Aug-21.

Wayanad District has 26% control, and uncontrol is 23% with the remaining 51% having missed their visits to their facilties.

The best control % of 46% is in Porunnanore block, while all or 100% of the cards reviewed in facilities for Thariode block were that of missed visits.

PS: Mouse over each bar in the Stacked 100% bar graph to see the data for that month.


Innovate & Call

We are
starting this series to
share practices that can help achieve better treatment of NCD.
Any human interest stories narrating a positive impact on a patient’s life can also be sent to us.
To, inform stories and innovations by mail Click Here 
or to call
the Wayanad CVHO
Click Here


So, any intervention that reduced missed visits, and lost to follow-up, or increased new registrations, or distributed better the patient load over the month like the Innovation story from Poothady featured in the row above, can be highlighted.


Anti-hypertension Drug Status: n=37 Facilities


Click on the triangle on left to see 'What is Stock in Patient Days?'

The Stock in Patient Days or Stock in Days(SID) is the number of days that the present stock of the protocol drug would last for the number of patients registered in the program.


IHCI Drugs Stock Summary in Aug-21:

Available stock on the last day of Aug 2021 versus requirement for next three months is shown in the following table, both in actual stock as well as in Patient Days:

Aug-21 Summary Amlodipine ARB Diuretics
Available stock
Stock in Patient Days
Three months requirement

IHCI Drugs in Patient Days from Oct 2020 till Aug-21:

Available stock in Patient days is shown in the following line graph, since Oct 2020, till the last day of Aug 2021:

PS: Mouse over each point vertically above a particular month on the line graph to see the data for that month.


Details of Drugs Stock out in Facilities in Aug-21:

The following data table and column graph details the stock out and near stock out positions in the 37 facilities in Wayanad in Aug 2021:

Drugs Nil Stock High-risk
<30 days		 Medium-risk
<60 days		 Low-risk
<90 days
Amlodipine 0 1 2 3
Telmisartan+Losartan 0 0 5 6
HCTZ+Clorthalidone 0 3 0 6


Do note that there are no column graphs for the drugs without stock-outs. Thus, we would have no graph above if Wayanad has stock of all IHCI drugs for more than ninety days in all 37 facilities!

Thus, there is no stock out or nil stock of IHCI drugs shown by the absence of blue color columns, in any facility in Wayanad.

Accordingly, drug stock is best in Telmi with no facilities having less than thirty days stock in Telmi, as seen by the absence of black color columns in the Telmi section.

The highest number of six facilities with less than ninety days stock, as shown in orange color columns, occurs in Chlorthalidone, but these facilities do not have patients who require Chlorthalidone or diuretics.

Also, borrowing between facilities within the district has helped to tide over all deficits so far.

Credit for monitoring this IHCI protocol drug distribution system without stock outs goes to the Pharmacists motivated by the Warehouse Manager.


PS: Mouse over each column in the graph to see the number of facilites without stock for that particular drug. To view data table, full screen, download pdf, svg, excel formats, or print this graph, and for other options, click the hamburger menu on the right top corner of this graph.




Control by Facility: n = 37

Ratio of Total Regn/Monthly OPD against %BP Control

This scatter plot is based on Data from analysis of Annual review 2020.

This Scatter plot graph presents the relationship between Registration ratio to OPD load as one varaiable while the other is Control percentage.

Furthermore the markers for the facilities are colored in three groups depending on the control%. Accordingly, those with control less than 15% are blue, while the 15% to 30% are coloured orange, and above 30% Control are coloured light green.

PS: Mouse over the column-graph to see data for each facility type or month. Also, to view data table, full screen, download pdf, svg, excel formats, or print this graph, and for other options like zoom in, zoom out, selection zoom, panning, click the hamburger menu on the right top corner of this graph.



Low Perofrmers:

  • Nallurnad,
  • Kottathara,
  • Panamaram,
  • Periya, and
  • Meppady did not register any new case.


High Performers:

  1. Cheeral - 88 Registrations
  2. Poothady - 69 Registrations
  3. Thariode - 56 Registrations



Registrations Vs Estimated Hypertensives: till Aug 2021

The Estimated Hypertensives for each block is calculated based on its Population above the age group of thirty, using data from the DLHS.

Column graph represents the hypertensive patients registered in each block, while the line graph represents the percentage of the estimated hypertensives that has been registered till Aug-21.

PS: Mouse over the graph to view data. In order to view data table, full screen, download pdf, svg, excel formats, or print this graph, and for other options, click the hamburger menu on the right top corner of this graph.


Diabetic Registrations: n = 14,690


19.27% of the total estimated 76,229 Diabetics registered.

The Diabetic Registrations are at par with the Hypertension ones which is only one percentile higher in the proportion of registered versus estimated patients.

The key point is:

  1. The percentage of diabetics in the adult population in Wayanad is around 20%, which is lower than elsewhere in Kerala, as per the latest DLHS.

PS: Mouse over the column-graph to see data for the Diabetic Registrations in the respective months.



Diabetic Report: Co-morbidity Analysis


14,690 DM or 19.27% of the total estimated 76,229 Diabetics are registered in IHCI

The Diabetes Co-morbidity Chart shows three different series types combined in a single chart. The chart is using a set of column series for the monthly registrations of hypertension with diabetes (HD) in light blue, and diabetes (D) in black, above which is a green line that shows the total of HD and D for the respective months. Finally, there is a pie series that gives the break-up of the total H, and HD registered so far since the start of IHCI. Thus, the green line is illustrating the monthly column totals, while the pie is showing the cummulative total of all the months.

The key points are:

  1. The percentage of Diabetic patients having hypertension is 68%
  2. Remaining 32% of diabetics do not yet have hypertension.

PS: Mouse over the column-graph to see data for the Co-morbidity analysis.



Ranks Vs Registrations at Facilities   n=37 Facilities

Facility Ranking is based on the Registrations in the month under consideration, namely for Aug 2021. BP Control percentage is actually the ideal for ranking. However, due to COVID-19, five facilities recorded zero registrations, and so ranking of facilities for Aug 2021 is as per the number of new registrations.
Rank Facility Pts in Care Regd in Aug Coverage %
1 Cheeral 1235 88 38
2 Poothady 749 69 10
3 Thariode 578 56 27
4 Ambalavayal 1179 34 20
5 Moopainad 560 32 12
6 Porunnannore 506 18 11
7 Edavaka 937 17 25
8 Munderi 419 14 17
9 Vythiri 493 13 75
10 Mananthavady 1224 12 87
11 Noolpuzha 1403 11 30
12 Vellamunda 1030 10 20
13 Bathery 1148 10 100
14 Varadoor 501 9 10
15 Vazhavatta 1065 9 19
16 Vengapally 468 8 25
17 Kappukunnu 249 8 13
18 Begur 770 7 31
19 Pakkom 216 6 8
20 Valad 587 6 19
21 Chulliyode 762 6 18
22 Padinjarathara 432 5 17
23 Vazhikatty 1170 4 24
24 Appapara 647 3 28
25 Meenangady 1165 3 25
26 Sughandhagiri 116 3 4
27 Pulpally 418 2 15
28 Pozhuthana 692 2 24
29 Thondernad 733 2 19
30 Mullankolly 183 2 4
31 Kurukanmoola 258 2 4
32 Chethalayam 290 1 5
33 Panamaram 1055 0 20
34 Meppady 1081 0 24
35 Periya 764 0 23
36 Kottathara 252 0 9
37 Nallurnad 140 0 21
Rank Facility Pts in Care Regd in Aug Coverage %


PS: To inform suggestions or corrections by mail Click Here  or to call the Wayanad CVHO Click Here



IHCI
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