Registrations till Dec 2020: 24,298

Wayand District saw its first cases of COVID-19 in Feb 2020. Since then a combination of fear of infection, and a series of lockdowns has resulted in patients turning up at the health facilities only for emergencies. Also, the directives from the State confined routine outpatients to their homes. In addition, delivery of drugs to the houses of the patients were not, and are still not documented. However, there has been a reversal from zero registrations and over the last three months the upward trend continues, though it is yet to reach pre-COVID-19 levels.

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Registrations across Facility Type: Types = SDH, FHC & PHC

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 were held in these facilities.

However, new advisories from the State restarted the NCD program at these facilities with due precautions to reduce COVID-19 transmission. Accordingly, an upward trend in registration is expected. Also, the rising trend in PHCs for the last three months is encouraging.

PS: Mouse over the column-graph to see data for each facility type or month.



Treatment Analysis: cards=800


Though Missed visits contribute to a little over three-fourth (624 out of 800), it has dropped from the over 80 percentile mark of Nov 2020. Only if more patients resume their monthly visits to the Hospitals the 14% Control rate from 110 out of 800, will improve.

PS: Mouse over the pie- graph to see the data.


Supportive Supervision: n=16 Facilities

Details No. %
Functional Digital BP Monitor 16 100%
Designated Nurse 1 6%
Opportunisitc Screening 2 13%
Card Storage System 12 75%
Defaulter Retrieval System 2 13%
Drugs given for >30 days 16 100%
Facilities with new Regd 3 19%

Areas of improvement are facilities accounting for low percentages of which the most important is the low number of 3 out of 16 or 19% facilities recording new registrations. Normally this must be 100%


No. of facilities with risk of stock-outs: n=37 Facilities

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


There is no column graphs for the first two drugs namely ARB and CCB as there were no stock-outs.

Most of the hospitals having stock out for Chlorthalidone 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 Warehouse Manager.


PS: Mouse over the bar-graphs to see the data.
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Achievements, Recommendations

  1. The upward trend seen in new Registration which started in Nov 2020 has remained static at 139 for Dec 2020 as well.
  2. With more patients visiting facilities the NCD drugs distributed to the patients at their houses, will reduce in the next few months.
  3. However, as most patients still feared transmission of COVID-19, the trend of doorstep delivery will most likely continue.
  4. More Tribal Mobile Medical Units could cater to the 22% Tribal populace.


High & Low Performers

  • The highest registration for Dec 2020 was of 60 hypertensives from THQH Bathery
  • 26 facilities recorded zero registrations.

    If there is a reduction in the number of COVID-19 cases, then those CHC and SDH, which have been designated as COVID-19 hospitals or FLTC, could be converted back to regular hospitals, and the NCD clinics in them restarted.
  • NCD clinics most likely to restart by mid or end Jan 2021. Directive form the State authorities to this effect is expected in Mid-Jan.


Facilities without drugs

Diuretics:

Zero Stock in Porunnanore & Vythiri.

There were no stock outs in any facility for ARB and CCB

Notes:

Training of pharmacists on Morbidity pattern forecasting due

Virtual training in view of COVID-19 planned

PS: Mouse over the card to see the additional notes.


Facilities <30-day stock of drugs

Diuretics:

Less than 30-day stock only in Padinjarathara

Facilities with less than 60-day stock was Appapara, Vengapally, and Pozhuthana.

Notes:

Wayanad consistently has shown no stock outs in CCB and ARB

Diuretics:

Facilities having stock out for diuretics do not have patients who require it.

PS: Mouse over the card to see the additional notes.


Facilities with least registrations

Zero Registrations:

Only 11 facilities had one or more registrations.

26 of the 37 facilities did not register any new cases in the month.

Zero Registratons:

Except for Vazhikatty, Vengapally, Noolpuzha, Pozhuthana, Meenangady, Vellamunda, Thondernad, Vazhavatta, Edavaka, Moopainad, and Bathery, all other facilities had zero registrations.

PS: Mouse over the card to see the additional notes.


Staffing

BP apparatus & NCD Nurse

Two CHCs are having designated nurse, and they cover only eight hours in a day.

The distribution of 25 Professional Digital BP apparatus in the district was completed, and will cater to just over 75% of all facilities.

NCD Nurse: continued

In addition:
Some staff nurses are on COVID-19 duty, and some others on quarantine.

A designated NCD nurse is a must for NCD and IHCI integration in Wayanad

PS: Mouse over the card to see the additional notes.


Stock of Drugs at Facilities   n=37 Facilities

NoFacility NameRegd till dateAmlo 5mgAmlo 10mgStock in days AmloTelmi 40 mgTelmi 80 mgLosar 25 mgLosar 50 mgStock in days ARBHCTZ 25 mgChlor 12.5 mgStock in Days Diuretics
1Appapara62586500120012710000 1000300001001500 48
2Munderi479170001000353000 45001000205002000104
3Vazhikatty (Kalpetta)117829654617000251200150 9870045003326280064001175
4Panamaram10583860002140036262200 2530020000138300010900263
5Porunnannore4721475001400033214400 3000034700209  0
6Meppady15702470001100015336000 5000200005740006000127
7Vengapally424108000900026539000 8500 157200100057
8Periya763128000500016155000 15000 126100004600383
9Pulpally4091510000330109900 19800 45111000 538
10Noolpuzha12972342001200017861900 200022500101150010500185
11Ambalavayal998300000500027736000  70006632002500114
12Thariode505181000300033120000 800010500105 8000317
13Poothady65123200013000354108800 3000 26170006000399
14Meenangady135320120027000168109000 3000020000164 7000103
15Vellamunda956158000300015318000 50004000097 6000126
16Varadoor42210890030002437400 1000040006010007000379
17Pozhuthana636143600480021538000 1000040001141000 31
18Thondernad570121500200019714400 165001890011270004500404
19Cheeral11161807001300016546000 13000 72100007500314
20Pakkom18396500047121700 40004500237200091001213
21Kappukunnu2083000080013610800 700060001501000 96
22Padinjarathara377141000100033920000 300010000129500 27
23Valad540107000200018417900 500062007640003500278
24Vazhavatta9361900001200020420800 2000100005270015500346
25Chulliyode67216900045002378800 740020003340004500253
26Sughandhagiri812250050025913000 190045003501100800321
27Chethalayam27280000100026935000 100001000028315008700750
28Mullankolly17415890020008368500 50001000018630005000920
29Kottathara2459810015003687500 2500180066 3400278
30Kurukanmoola226136000200055333600 560040002755005500531
31Edavaka7431291002400021325800  200058 28550769
32Nallurnad1367750080051923000 3000380032015003000662
33Begur703132000300017510000 25001000047 3500100
34Moopainad445214500400044617200 100030007210005000270
35Bathery97829540020000306112340 1600021200223 5000102
36Mananthavady116727190010500224179000 5240064000355500012000291
37Vythiri45315455076003357750 200670049  0
Facilities Total24298593259626260024015618400433800416800141149500174000269
Stock at district warehouse1644750185000751487004730021200016227009430097
District Total242987577346447600315171054047300455000416800156.881,72,200268300367
NoFacility NameRegd till dateAmlo 5mgAmlo 10mgStock in days AmloTelmi 40 mgTelmi 80 mgLosar 25 mgLosar 50 mgStock in days ARBHCTZ 25 mgChlor 12.5 mgStock in Days Diuretics
The brown color used for background in cells of this table indicate that the particular stock of the drug was less than the required Stock in patient days (SID) for that facility.

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.


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IHCI
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