Registrations till June 2021: 26,131

With the Lockdown lifted in June 2021 and the delivery of drugs to the houses of the patients reducing, there is an upward trend in registraton across most facilities. Thus, the upward trend seen in new Registration which started with 139 in Nov and Dec 2020, and which had improved to 248 in Feb 2021, till 445 in Mar 2021, has once again reached the 424 mark in June 2021, with a dip in between due to the intervening 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: FHC Poothady

The NCD clinics were restarted after lockdowns were lifted in the third week of June 2021. Accordingly, FHC Poothady revamped its conduct of NCD clinic, as outlined.

Table showing the respective appointment days of each of the wards under FHC Poothady, in Wayanad District, Kerala.
Days fixed for Wards Mon Tue Wed Thu Fri Sat Sun
1st Week Wd:1 Wd:2 Wd:3 Wd:4 Wd:5 Wd:6  
2nd Week Wd:7 Wd:8 Wd:9 Wd:10 Wd:11 2nd Sat  
3rd Week Wd:12 Wd:13 Wd:14 Wd:15 Wd:16 Wd:17  
4th Week Wd:18 Wd:19 Wd:20 Wd:21 Wd:22 Others  
5th Week M visit M visit M visit        

Changes made:

  1. The NCD paitents of say Ward 1 will be visiting FHC Poothady on the first Monday. Similarly, NCD patients of Ward 2 will visit on first Tuesday, and so on till all the 22 odd wards to which FHC Poothady caters, are covered during the working days of the month.
  2. The First responsible person is JHI in the JHI-JPHN-ASHA Team. This JHI-JPHN-ASHA Team of the Subcentre and its wardwill present themselves at FHC Poothady on the appointed day of their ward, and be responsible for recording the BP and updating it in the IHCI cards.
  3. The fourth Saturday is earmarked for NCD patients from other panchayats
  4. After the appointed 22 days are over, patients from any ward would be seen on the remaining free days
  5. Though patients from other wards and panchayats would be seen on the days not appointed for them, preference would be for those patients from the appointed ward for that given day

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



Annual Review 2018 to 2020 n = 22,987 Registered Patients


Outcomes of Annual Review 2018 to 2020 & Q4 2020

2018-20
14% 16% 10% 60%
Q4-2020
26% 22% 34% 18%
  • Controlled
  • Un-controlled
  • Missed Visits
  • LTFU

For the Annual Review, all treatment cards registered since the begining of the program in 2018 till the last day of 2020 were reviewed. Subsequently the Treatment outcomes were measured in Q1 2021 for all the 22,987 patients registered in the period under review.

The keys for the Treatment Analysis are:

  1. Controlled (C) – Number of Hypertensive patients with BP less than 140/90 at their most recent visit in Q1 2021
  2. Not Controlled (NC) - Number of Hypertensive patients with BP greater than or equal to 140/90 at their most recent visit in Q1 2021
  3. Missed Visits (MV) - Number of Hypertensive patients with No visits in Q1 2021
  4. Lost to Follow Up (LTFU) - Number of Hypertensive patients who had not visited the facility for an year or more.

In addition the 510 patients registered from 1 Oct 2020 to 31 Dec 2020, were reviewed separately as the Quarter-4 Review of 2020. Similarly, the Treatment outcomes were measured in Q1 2021 for these 510 patients registered in Q3 2020. Thus, the percentages of patients with controlled BP are shown in the stacked bar graph.

PS: Mouse over the stacked bar-graph to see data for the Annual and Quarterly Reviews.



Comparison of: Q4 2020 & 2021 Monthly


Shown is the comparions of the Treatment Outcomes of Q4 2020, with the Treatment Outcomes from the Monthly Reviews during Jan 2021 to April 2021. The Missed visits had gone down from around 95% in Nov 20 to 79% in Feb 21 and to 45% in Apr 21. The biggest dip in control was in Feb 21 which however improved to 30% in Mar 21. Reduction in the COVID-19 resurgence has improved these back to the Q4 2020 levels. So, if all the visits and BP readings of the hypertensive patients must be recorded, the control rate will improve.

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 Jun-21:

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

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

IHCI Drugs in Patient Days from Jul 2020 till Jun-21:

Available stock in Patient days is shown in the following line graph, since Jul 2020, till the last day of Jun 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 Jun-21:

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

Drugs Nil Stock High-risk
<30 days		 Medium-risk
<60 days		 Low-risk
<90 days
Amlodipine 0 0 1 3
Telmisartan+Losartan 0 0 5 6
HCTZ+Clorthalidone 2 0 1 4


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!

Accordingly, drug stock is best in Amlo and Telmi with no facilities having nil stock.

The two facilities 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 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.




Low Perofrmers:

  • Appapara, Panamaran, Meppady, Periya, Pulpally, Meenangadi, Cheeral, Edavaka, and Nallurnad did not register any new case.


High Performers:

  1. Thondernad - 73 Registrations
  2. Thariode - 60 Registrations
  3. Kappukunnu - 45 Registrations



Registrations Vs Estimated Hypertensives: till June 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 June-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.


Stock of Drugs and Registrations at Facilities   n=37 Facilities

Facility Ranking is based on the Registrations in the month under consideration, namely for June 2021. BP Control percentage is actually the ideal for ranking. However, due to COVID-19, nine facilities recorded zero registrations, and so ranking of facilities for June 2021 is as per the number of new registrations.
Rank Facility Block Total Regd Pts in Care Regd in Jun Coverage % CCB ARB Diuretic
1 Thondernad Porunnanore 765 681 73 19 124 169 541
2 Thariode Thariode 565 497 60 27 265 90 88
3 Kappukunnu Thariode 274 218 45 13 39 102 146
4 Ambalavayal Meenangady 1186 1095 37 20 197 107 0
5 Varadoor Meenangady 527 479 24 10 200 65 228
6 Pakkom Pulpally 238 204 20 8 343 126 1185
7 Vengapally Thariode 492 455 18 25 163 96 73
8 Moopainad Meppady 534 504 18 12 318 37 401
9 Vazhavatta Meenangady 1063 1040 16 19 180 63 292
10 Valad Porunnanore 598 577 12 19 108 169 234
11 Mananthavady Porunnanore 1216 1196 11 87 214 109 99
12 Poothady Pulpally 683 673 10 10 269 178 0
13 Padinjarathara Thariode 439 422 10 17 319 208 364
14 Mullankolly Pulpally 195 178 8 4 916 225 769
15 Bathery Meppady 1149 1136 8 100 181 195 400
16 Vazhikatty Meppady 1224 1160 7 24 189 348 998
17 Noolpuzha Pulpally 1390 1381 7 30 152 106 112
18 Munderi Meppady 504 398 6 17 55 67 103
19 Vythiri Meppady 488 466 6 75 383 99 102
20 Vellamunda Porunnanore 1027 1002 5 20 184 303 136
21 Pozhuthana Thariode 692 685 5 24 147 56 145
22 Chulliyode Meenangady 745 740 5 18 209 59 67
23 Kurukanmoola Porunnanore 253 247 5 4 395 180 435
24 Begur Porunnanore 764 750 3 31 88 155 84
25 Porunnannore Porunnanore 481 472 2 11 429 359 644
26 Sughandhagiri Meppady 116 108 1 4 65 119 259
27 Chethalayam Pulpally 284 281 1 5 198 352 599
28 Kottathara Thariode 257 252 1 9 389 120 506
29 Appapara Porunnanore 645 642 0 28 147 76 93
30 Panamaram Porunnanore 1058 1054 0 20 310 144 127
31 Meppady Meppady 1573 1573 0 24 95 85 38
32 Periya Porunnanore 764 764 0 23 122 77 196
33 Pulpally Pulpally 418 415 0 15 254 386 1148
34 Meenangady Meenangady 1359 1359 0 25 172 120 265
35 Cheeral Meenangady 1124 1124 0 38 176 54 347
36 Edavaka Porunnanore 901 901 0 25 82 38 400
37 Nallurnad Porunnanore 140 140 0 21 478 388 929
Rank Facility Block Total Regd Pts in Care Regd in Jun Coverage % CCB ARB Diuretic
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.


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



IHCI
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