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Good presentation is very important

Good presentation is very important

Good presentation is very important and I apply this concept”. This is said by one laboratory technician working in a Primary Health Center (PHC). He believes that if he provides his laboratory services in a presentable way, he can earn the trust of the people. “People will come to me and they will not go to private laboratory unnecessarily where they have to pay more for the same kindof laboratory test which I can provide them free of cost”

This he is doing by simply giving the laboratory test report in a format developed by him and using the print copy of that to give report of the patients. Simple thing can make differences. He developed separate format for ANC and separate for other general laboratory test.

He is keeping all daily and monthly chart update. Well maintained registered. Neat and clean laboratory.

While talking to him and observing all these, immediately in my mind I was relating him to my recent experience with private hospitals recording system during my father’s checkup where they gave all medical records of my father in a folder and also while my friend was admitted in a hospital, nurse was visiting her after every two hours, checking her BP, temperature and putting it down in a diagnosis sheet. That time I was impressed and felt good and was thinking why these kinds of services are not available in Government health facilities.

And now when I am relating my experience with this, I am wondering if he is having the knowledge of importance of “good presentation” or good patient documentation. Why not other has this knowledge?  Are they do not know its importance and how it will benefit them? Why cannot do they do their bit like him? Is it due to they need training on it? Or they are over burden?

Anyway, I personally realized and learned from him that if I can do my bit by presenting my research work or field experience in a presentable way (through blog, article etc) and share, it can benefit the society to a large extent and also to me 

Good presentation is very important

Is health camp an effective stratergy

Health ‘camps’ are one of the strategies adopted by both government and non-government organizations. This literally means that a team of health professionals ‘camp’ in an area to carry out a limited health intervention. For instance, government organizes sterilization camps for women. Or an NGO organises a diabetes screening camp. Or a private hospital organises a blood donation camp. Unfortunately government pays little attention to the quality of sterilization service and tends to focus on targets. Or there are NGOs which conduct camps just as an activity, which do not yield quality.

KG Halli is one of the 198 wards in the greater Bangalore metropolis with a 45000 population, and we from IPH work with the community to improve the quality of health care in this area. Last year a grass root NGO which is working with the slum inhabitants requested our support in mobilizing the community for an eye camp. To our surprise, it was only screening without any follow up. After the camp, people from the community started asking us whether we would give them any material aid like spectacles and so on. We told them they need to ask the organizers- the hospital which did the screenings. Unfortunately they were advised to purchase the spectacles at their own cost.

Many times, a health camp run by with a private hospital becomes a business gimmick. The poor attend the camp with the aim of free check up and free treatment. When they do not get free treatment or subsidy for treatment they stop follow up. While organizing health camps follow up becomes one of the important ingredient in quality health camps.

Either targeted approach without quality services or an activity without follow up will not improve the health status of the patients and will not develop trust between the community and the NGOs involved in such camps

Therefore we to organize camps and at the same time we cannot ignore offers to organize camps when there is quality in it.

We could not say no to Doctor Santhosh Benjamin from CSI (Christian of South India hospital), when he requested us to ally with them in organizing an eye camp in KG Halli for cataract surgery. We UHT (Urban Health Team) wanted put this opportunity into best use. Hence we planned the eye camp with three phase pre health camp task, actual health camp and post health camp task.

We took up publicity through announcement in different language (Kannada, Tamil and Urdu), besides distribution of leaflets. Our community health assistants announced in three different languages. We had coordination with CSI, BBMP & UHC (BBMP run Urban Health Center), and got permission letter from BBMP to use the UHC premises for the eye camp. We purposely selected UHC to do eye camp, in order to strengthen the link between the government facility and the community. The message was eye camp followed with surgery was free.

The camp program began on time, as a result of two days publicity we were able to mobilize 89 patients. All the patients were registered with their name, address, with contact number for follow up. The activity went up to 3.00 pm. Out of 89, 19 were screened for cataract surgery and were given appointments by the doctor. The appointments dates stretched till 30th of May 2012.

In the midst of the camp the next door CHC (State run Community Health Center) staff wanted to ruin the spirit of eye camp, and went to the CSI doctor to tell her-“This eye camp is waste, the people from this area will never turn up, we have been conducting regular eye camp in CHC, anyway they give address and contact number but will not come”. Josphine (CHA) who followed him gave assurance to the doctor. “Since we are doing home visit and we knew all the patients we will make sure that they visit CSI hospital for surgery”.

However the patients who were asked for surgery did not wait for us to remind them. They promptly visited CSI for surgery. Out of nineteen patients 13 underwent surgery, two were sent back home because one has heart problem (he was asked to get report and letter from his doctor) and another person is diabetic (He was given medicine to control his sugar level). We are following it up with the other four patients. Both Josphine and Nagrathana met CSI doctor to ensure the visit of patients for surgery.

The eye camp program for the community has increased the trust on us and our work. The people from the community are demanding for more such programs. 

Good presentation is very important

Training for district supervisors for post-hospitalisation survey in November 2012

Post-hospitalisation survey training conducted at Bangalore

Post-hospitalisation survey training conducted at Bangalore


 
The Health Inc Karnataka team organized training on 8th and 9th November 2012 at Vishranti Nilayam, Bangalore for district supervisors from all four districts on administering a questionnaire to survey respondents who had been hospitalized in the last few months, also called form 3.  This training was organized to train them in administering the survey questionnaire, reviewing the Kannada version of the questionnaire, and orienting them regarding hospitalizations and the related expenditure incurred by any patient. The district coordinators conducted the training using a mix of lectures, role-plays and group discussions with inputs from Bangalore team members. This survey was aimed at collecting details of the hospitalization experience for the patient, and his/her bystanders (before admission, during the stay and at discharge), and details of utilization of RSBY during the hospitalization episode using a semi-structured questionnaire.

 

Trainers from the Health Inc Karnataka team demonstrate how to administer the questionnaire

Trainers from the Health Inc Karnataka team demonstrate how to administer the questionnaire

Good presentation is very important

What the numbers do not account for…..night beat in KG Halli

 Life has its unique ways of showing you what you might be looking for. As a purely logistic decision, it made more sense for me to stay overnight in the community centre and this gave opportunity to observe a different side to KGHalli….after dusk. Suddenly “urban” lifestyle took on new meaning for me in the context of health planning.

A walk down Tannery road at 10 pm is like walking down any other big street in Bangalore at 7pm. Like the jaws of a aging man, dark gaps where the bike workshops punctuate the shining rows of shops, many with brightly lit interiors, the city seems to swallow one up. I notice most of the people walking the street are men; the rare family, but as a single unaccompanied woman, I do not draw many glances. This is a world where anonymity is the norm. People are very occupied, earning their living. Every street corner has a hole in the wall eatery with the owner dishing out hot chicken wings from a frying hot ‘kadhai’. Large neon signs in every colour advertise “goodies” of all kinds, from clothes to shoes to accessories to ….and here we have it…. to medicines. As I strolled along, three large, glass- fronted pharmacies caught my attention, the window displays abundantly showcasing expensive and (to my mind), unnecessary products. The vitamins of old have been successfully replaced by “sugar-free” and equivalent products meant to lull the obese patient into the ‘soft’ pill option.

It is well known that many hospitals have their own pharmacies – convenience for the patient being the supposed rationale. By extension, the small clinics often have a drugstore next door. However, by a strange twist, the unstated, unpalatable truth is that the drugstore has the clinic and therefore the doctor. So it was with a great sense of curiosity that I wandered into the newly built 15 bedded hospital adjacent to the large glass fronted pharmacy. I had met the Managing Director , a twenties- something doctor when the hospital opened an hour ago, but community feedback was that it had not really take off. So I was surprised to see three patients in the ’emergency’ ward, all on ‘glucose drips’ , two of these being children. I caught sight of two ‘duty doctors’ identifiable by their stethoscopes and slightly preoccupied air. Evidently the beds are slowly filling up, although there is no permanent staff in place.

As I continued down the road I greeted an older homeopathy doctor known to me. When our team did a survey of existing service providers he had said he comes only once a week. Now, he sheepishly told me ,he comes every night between 9 and 10 pm, this is clear understanding with his regular patients.

And as I continue to walk down Tannery road, every clinic locked in the daylight hours when we have been visiting has been magically opened…with functioning health service providers. It appears they have each created their little niche with specific timings and patient profiles.

When we sit and plan the number of doctors required to serve a particular population ….24/7 services and continuity of care, my lesson from this night would be “Beware the oversimplifying standardisations…..you need to factor in the ingenuity of the human being in his need for survival, where he will not just meet a demand, but unblinkingly create it!’

So one more challenge to the complexity of local health systems……

Take a walk, my friend, take a walk……..

Training for district supervisors and field investigators for follow-up survey in September 2012

The Health Inc Karnataka team organized a two-day training on 24th and 25th September 2012 for both district supervisors and field investigators at Vishranti Nilayam, Bangalore. The main objectives of the training were to train the field teams from all four districts on administering the follow-up survey questionnaire or form 2, to review the Kannada version of the questionnaire, and to orient them regarding their role and responsibility in the next stage of data collection in the field. The district coordinators along with the Bangalore team members conducted the training using a mix of lectures, role-plays, and group discussions. The district supervisors also participated in additional sessions on generating micro-plans, and maintaining financial records.  This survey was aimed at collecting details of significant events in the preceding month in survey households if any, and was to be conducted monthly till December 2012.