Registrations till Feb 2021: 24,736

The good news is that the upward trend seen in new Registration which started with 139 in Nov and Dec 2020 has improved to 248 in Feb 2021.

For, 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 during the begining of the pandemic, confined routine outpatients to their homes. In additon, the recent resurgence has only added to the fear. Furthermore, delivery of drugs to the houses of the patients were not, and are still not documented.

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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.

Meanwhile, new advisories from the State restarted the NCD program at these facilities with due precautions to reduce COVID-19 transmission. However, strikes by doctors and Health staff has brought documentation to a halt across most facilities. Here the personal intervention of the DMO, and DNO, on a one-to-one basis with the Medical Officers of the non-documenting facilities, has helped to record an upward trend in registration. Thus, the rising trend in PHCs for the last five months, with the figure of 231 in Mar 2021 being almost double the figure of 129 in March 2020, when COVID-19 had been in the district for just a month, could be attributed to this official intervention.

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



Treatment Analysis: cards=475


The Missed visits have gone up to 79% in Feb 21 from 65% in Jan 21. and with control rates going down from 24% in Jan 21 to 10% in Feb 21, is a cause for concern. Only if the all the visits and BP readings of the hypertensive patients are recorded at the Hospitals the 10% Control rate, will improve to the pre COVID-19 control levels of 40%.

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


Supportive Supervision: n=19 Facilities

Details No. %
Functional Digital BP Monitor 10 53%
Designated Nurse 3 16%
Opportunisitc Screening 1 5%
Card Storage System 14 74%
Defaulter Retrieval System 2 11%
Drugs given for >30 days 19 100%
Facilities with new Regd 25 67%

Areas of immediate improvement are facilities not registering new cases, namely 12 out of 37 facilities. Normally this must be 0 facilities


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 2 0 1
Telmisartan+Losartan 0 2 5 0
HCTZ+Clorthalidone 6 0 2 1


Do note that there are no column graphs for the drugs without 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 Pharmacists motivated by 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 with 139 in Nov and Dec 2020 has improved to 248 in Feb 2021
  2. New registerations despite COVID-19 resurgence has gone up from 57% of facilities in Jan to 68% in Feb 2021.
  3. DMO, and DNO discussed on a one-to-one basis with the Medical Officers of the non-documenting facilities, which has helped to record an upward trend in registration.


High & Low Performers

  • The highest registration for Feb 2021 was of 28 hypertensives from Vazhavatta.
  • 12 facilities recorded zero registrations. This is an improvement over the previous month, when 16 facilities recorded zero.
  • Accordingly, it would benefit, if these facilities could use the methods of Chulliyode to get back their clientele.
  • Timely discussions by DMO & DNO has helped NCD clinics in these facilities most likely to restart by mid or end Mar 2021


Facilities without drugs

Diuretics:

Zero Stock: Ambalavayal, Cheeral, Sghandhagiri, Nallurnad, Begur, 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 with less stock of drugs

ARB:

Less than 30-day stock: Kottathara & Moopainad

The five facilities with less than 60-day stock was Munderi, Panamaram, Cheeral, Chulliyode, and Vythiri. .

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:

Munderi, Panamaram, Porunnannore, Meppady, Periya, Ambalavayal, Thariode, Poothady, Meenangady, Kappukunnu, Nallurnad, & Mananthavady.

Zero Registratons:

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

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.

There is no facility without a digital apparatus. However, 12 facilities do not have professional digital BP apparatus and are using home type digital BP apparatus.

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
1Appapara6381015009000167200003000 33000142 5800182
2Munderi4815000 9100001800500 44 2700112
3Vazhikatty (Kalpetta)120420979670001663831111040034150108900677503006400942
4Panamaram1058278000214002713600700010000800044 6500123
5Porunnannore4722080001000043130000 2000030000228 22500953
6Meppady15702060006000124400001000 60000100 300038
7Vengapally432118000900028161000   217 5000231
8Periya764136000 159732004000  164 6600173
9Pulpally41719090013000464100000 7500750041060009200729
10Noolpuzha13512300001200016819400 20004650076200011200195
11Ambalavayal9983060001200029554000  500091  0
12Thariode505235000300042634000 1300027000206 7000277
13Poothady6731860001000027374000   169 150045
14Meenangady13592282002200017981000 1700035000141400027000456
15Vellamunda9731880001200019530000  3000095 22200456
16Varadoor449116900300024414400 1000010000101 4000178
17Pozhuthana66114200010800221400001000750010000130 6000182
18Thondernad6521382008000211126003000935028900123 13500414
19Cheeral11242169501300019332500   44  0
20Pakkom18796500600051811700  50001372000151001829
21Kappukunnu20835000 15020000 5000200003142500 240
22Padinjarathara394165000700040650000 300070002285009000482
23Valad55896000200016027900 50001220011725004200240
24Vazhavatta9821920001800020745000  1000086 15500316
25Chulliyode726122600500016348008400 500056 5100140
26Sughandhagiri909000 8910000 1000 179600 0
27Chethalayam27670000 22635000 50001000026515005500507
28Mullankolly1792160001700012474000030005000590046819005500827
29Kottathara25096000 3432500   15 100080
30Kurukanmoola2341310002000515300003000200010000309 5500470
31Edavaka811797009000108314001000029002000104 23000567
32Nallurnad13669000 45313000  3700189  0
33Begur714 4400111900080025002000090  0
34Moopainad488192000 3512500   8 5000205
35Bathery10992146002000020771340 57005080017575005000227
36Mananthavady1167345400 264158500 2840049800293130011000211
37Vythiri45622385013600492104003000  55  0
Facilities Total24736579409628520023016958515940019650065120015982600270500285
Stock at district warehouse3277108800018103785018600006709390076
District Total24736612180637320024827337017800019650065120022682,600364400361
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.

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.


Drugs Stock Summary:

Available stock on last day of Feb 2021 versus requirement for next three months is shown in the following table:

SummaryAmlodipineARBDiuretics
Available stock
Three months requirement

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IHCI
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