Registrations till Oct 2021: 28,051

The low registrations due to lockdowns namely that of 139 in Nov and Dec 2020, had improved to 518 in Sep 2021, except for May 2021. However, in Oct 2021 there is a slight dip to 496.

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 since Jun 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.



Quarterly Review: Q1 and Q2 2021

Quarterly blood pressure control is the proportion of patients whose blood pressure is controlled in that quarter among the patients registered in the previous quarter.


Shown is the Treatment Outcomes of Q1 2021, and Q2 2021. There is all round improvement in the Quarterly review percentages, the best gains being in the Control percentage which is around 40% .
Reduction in the COVID-19 resurgence has improved these back to the Q4 2020 levels.
The gains are primarily due to restaring of documentation. Accordingly, if all the visits and BP readings of the hypertensive patients are recorded, the control rate will further improve.

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

Effect of COVID-19:

  1. Due to the pandemic, health workers delivered the medications at home, or patients arranged other people to collect their medicines from the facilities, by proxy. Thus, in both situations BP could not, and was not documented.
  2. Consequently, a drop in control percentages from the Pre-COVID-19 times is expected and accepted.
  3. Furthermore, as in 2020 due to COVID-19, Q1 enrolled patients in 2021 also are assessed in Q3 for outcomes.

 

Definitions for Q1 2021:

  1. Quarter: The quarter mentioned is a three-month period in which the patients are registered, and in this example the patients registered in Q1 2021.
  2. R or Registered patients: Number of hypertensive patients registered, namely both H & HD in Q1 2021.
  3. Y or Controlled patients: Out of R, number of patients whose BP was documented to be less than 140/90 in Q2 2021, namely April to June 2021.
  4. N or Uncontrolled patients: Out of R, number of patients on treatment whose BP was documented to be more than or equal to 140/90 in Q2 2021, namely April to June 2021.
  5. MV or Missed Visit patients: Out of R, number of patients number of patients who missed their visits* in Q2 2021, namely April to June 2021.
    *Patients who did not visit the health facility even once in the quarter Q2 2021, namely April to June 2021.

PS: To clarify or ask any doubt on Quarterly Review by mail Click Here  or to call the Wayanad CVHO Click Here



A Way: to get Missed Visits

IHCI Card Retreival System at Vazhavatta.
Vazhavatta: Reducing Missed Visits


Vazhavatta has improvised its IHCI card stacking and retreival system. As shown in the picture, cards are kept in sets of plastic trays that have their number range earmarked. When the patient visits, their card is taken from the top tray, BP and other details entered, but card is put back in the tray below which is marked as: "Visited". So, at the end of the month, the cards remaining in the top tray, are those who missed their visits, and needs to be called up.

PS: It is the simple things that count!


Innovate & Call

We started
this series to
share practices that
can help achieve better
treatment of NCD. 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, can be highlighted.

Also, any human interest stories narrating a positive impact on a patient’s life can be sent to us.


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 Oct-21:

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

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

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

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

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

Drugs Nil Stock High-risk
<30 days		 Medium-risk
<60 days		 Low-risk
<90 days
Amlodipine 0 1 1 2
Telmisartan+Losartan 0 0 5 9
HCTZ+Clorthalidone 3 1 1 1


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 CCB and ARB, as 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 nine facilities with less than ninety days stock, as shown in orange color columns, occurs in Telmisartan.

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, and
  • Periya
  • did not register any new case.


High Performers:

  1. Ambalavayal - 55 Registrations
  2. Varadoor - 52 Registrations
  3. Cheeral - 41 Registrations



Registrations Vs Estimated Hypertensives: till Oct 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 Oct-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 = 15,335


20.12% 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


15,335 DM or 20.12% 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 Oct 2021. BP Control percentage is actually the ideal for ranking. However, two facilities recorded zero registrations, and so ranking of facilities for Oct 2021 is as per the number of new registrations.
Rank Facility Pts in Care Regd in Oct Coverage %
1 Ambalavayal 1247 55 22
2 Varadoor 580 52 12
3 Cheeral 1341 41 39
4 Thondernad 798 27 19
5 Thariode 640 27 28
6 Porunnannore 555 26 12
7 Moopainad 621 24 12
8 Padinjarathara 463 21 17
9 Vellamunda 1071 17 20
10 Chulliyode 788 16 18
11 Valad 622 15 19
12 Vythiri 518 15 75
13 Bathery 1172 14 100
14 Kurukanmoola 278 14 4
15 Poothady 792 13 10
16 Pulpally 445 13 15
17 Vazhavatta 1090 13 19
18 Panamaram 1067 12 21
19 Edavaka 967 11 25
20 Mananthavady 1241 9 87
21 Begur 791 8 31
22 Chethalayam 306 8 5
23 Nallurnad 147 7 21
24 Meppady 1091 6 24
25 Pozhuthana 709 5 24
26 Pakkom 230 5 8
27 Vengapally 476 4 25
28 Sughandhagiri 122 4 4
29 Kappukunnu 263 3 13
30 Munderi 429 3 17
31 Noolpuzha 1424 2 30
32 Kottathara 261 2 9
33 Vazhikatty 1175 2 24
34 Mullankolly 190 1 4
35 Meenangady 1167 1 25
36 Appapara 648 0 28
37 Periya 764 0 23
Rank Facility Pts in Care Regd in Oct Coverage %


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



IHCI
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