Registrations till Jan 2021: 24,488

The good news is that the upward trend seen in new Registration which started with 139 in Nov and Dec 2020 has improved to 190 in Jan 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 confined routine outpatients to their homes, which can only be reversed by a fresh directive. In addition, 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.

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 four months is encouraging, with the figure of 171 in Jan 2021 surpassing the figure of 129 in March 2020, when COVID-19 had been in the district for just a month.

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



Treatment Analysis: cards=775


Though Missed visits contribute to 65% (503 out of 775), it has dropped from the over 80% mark of Nov 2020. Only if more patients resume their monthly visits to the Hospitals the 24% Control rate got from 186 out of 503, will improve to the pre-COVID-19 levels of 40%.

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


Supportive Supervision: n=24 Facilities

Details No. %
Functional Digital BP Monitor 24 100%
Designated Nurse 2 8%
Opportunisitc Screening 6 25%
Card Storage System 14 58%
Defaulter Retrieval System 2 8%
Drugs given for >30 days 24 100%
Facilities with new Regd 13 54%

Areas of improvement are facilities accounting for low percentages of which the most important is the low number of 13 out of 24 or 54% 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 1 0 0
Telmisartan+Losartan 0 2 10 0
HCTZ+Clorthalidone 2 0 1 2


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 190 in Jan 2021
  2. Wayand District hailed as a model one for PSM with good last mile availability of IHCI protocol drugs.
  3. NCD and IHCI combined refresher training of all Field Health Staff was completed by DNO in Jan 2021.


High & Low Performers

  • The highest registration for Jan 2021 was of 37 hypertensives from Chulliyode.
  • 16 facilities recorded zero registrations. This is an improvement over the previous month, when more than 25 facilities recorded zero.
  • Accordingly, it would benefit, if these facilities could use the methods of Chulliyode to get back their clientele.
  • NCD clinics in these facilities most likely to restart by mid or end Feb 2021


Facilities without drugs

Diuretics:

Zero Stock: Sughandagiri & 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: Cheeral & Moopainad

The ten facilities with less than 60-day stock was Panamaram, Meppady, Periya, Poothady, Pozhuthana, Thondernad, Cheeral, Vazhavatta, Kottathara, Begur, Moopainad 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:

Panamaram, Porunnannore, Meppady, Ambalavayal, Thariode, Meenangady, Varadoor, Cheeral, Pakkom, Kappukunnu, Sughandhagiri, Mullankolly, Kurukanmoola, Nallurnad, Mananthavady, Vythiri

Zero Registratons:

16 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.

The distribution of 25 Professional Digital BP apparatus in the district was completed in Dec 2020, 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
1Appapara63696500 13510000 2000250008730004800245
2Munderi48110000 197000 50012000625002700133
3Vazhikatty (Kalpetta)1202250146700019641000 34150131900243523006400977
4Panamaram10583290002140031428000 10000400054 400076
5Porunnannore4721680001400037110800 2000025000149 16500699
6Meppady1570196000600011818000 50002000040 13200168
7Vengapally427111000900027024000  8000115 100047
8Periya76496000500012426400   53 6600173
9Pulpally412191000 41489900 7500 35060005200544
10Noolpuzha13372532001200018524600 20004900086300010200197
11Ambalavayal9982660005000247300005000 1000077 5000100
12Thariode505181000300033140000 1300010500174 8000317
13Poothady6731960001000028720000   46 6000178
14Meenangady13591582002200013389000 1700030000144 27000397
15Vellamunda964201000 18618800 50003500090 25200523
16Varadoor422122300300027118000 1000011000124 6000284
17Pozhuthana65210200048001538000 75001000051 300092
18Thondernad63711820020001712900 85001490053690010500546
19Cheeral1116246000 19710000   14500047700944
20Pakkom18376500 37311700   98200091001213
21Kappukunnu20825000 1079400 500059001321000 96
22Padinjarathara379135000100032320800 30001000013150010200565
23Valad54596000200016427900 50001220012025007700374
24Vazhavatta9541920001800021324200  1000055 35600746
25Chulliyode7091310005000178200006000 95009010005700189
26Sughandhagiri819000 9910000 1000 199600 0
27Chethalayam27480000 26135000 50001000026715006700599
28Mullankolly174169600 87010000 5000 111 3000345
29Kottathara24696000 3487500   47 3400276
30Kurukanmoola226121000200049420000 31004000174 4500398
31Edavaka79695700900012848300 29004000104 24500616
32Nallurnad13669000 45318000  3700245 1000147
33Begur709105000 13210000 2500500035 230065
34Moopainad473200000 3781200   4 5000211
35Bathery10902453002000023457940 157006090017975005000229
36Mananthavady116725640010500212117200 2840050000239350011000249
37Vythiri4531443501360033810800  70039  0
Facilities Total2448855383962053002179763401100021875058220010696800343700360
Stock at district warehouse131275019200062104865063250455016340084129009120085
District Total2448868511463973002792024990742502233007456001901,09,700434900445
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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