who sear regional consultation on strengthening frontline...

Dr. Manoj Nesari, Advisor

Ministry of AYUSHGovt. of India

WHO SEAR Regional Consultation on Strengthening Frontline Services for

Universal Health Coverage

23-25th July, 2019

17/23/2019Dr. Manoj Nesari, Advisor, Ministry

of AYUSH


of AYUSH

Taditional Medicine in Public HealthThe National Health Policy – 2017 of India lays

due emphasis on mainstreaming of Traditional Medicine i.e. Ayurveda, Unani, Siddha, Yoga, etc. (AYUSH) in Public Health for increasing outreach and to attend the target of Universal Health Converge which is in line with WHO Traditional Medicine strategy 2014-2023.

Sustainable Development Goals (SDGs) – The Government of India has identified Ministry of AYUSH as collaborating agency with Ministry of Health for implementing various initiatives to achieve the SDG 2 and SDG 3. MoA has taken many steps in this regard. 37/23/2019

Dr. Manoj Nesari, Advisor, Ministry of AYUSH

Traditional Medicine in Public Health – Service sectorRecognition: Ayurveda, Unani, Siddha and Sowa Rigpa are recognized

under Indian Medicine Central Council Act, 1970 and Homeopathy recognized under HCC Act 1973

Practitioners: More than 700,000 qualified Ayurveda, Unani, Sidha and Homeopathy doctors available.

Undergraduate course – 5½ years duration. (4½ + 1yr) Postgraduate degree - 3 years duration (specialization in 22 subjects in

Ayurveda) Integrated Course: Doctors of Ayurveda, Unani, Siddha and

Homeopathy are also trained in modern scientific advances.Capacity Building: Training for doctors and paramedical staff like

pharmacist, etc. through CMESupport staff (therapists etc) are recognized under Skill Council of India.


of AYUSH

*Coverage: About 5.89 AYUSH practitioners per 10,000 population (as on 1/4/2017) 5

Registered Practitioners (ASU&H) 7,73,668

Total Teaching Institutions (ASU&H): (A-338, U-49, S-9, H- 201)

622

Postgraduate Institutions (ASU&H): (A-138, U-14, S-3, H-52)

210

Annual Intake in Degree courses: (A-21,387, U-2,705, S- 520, H-13909)

40,151

Annual Intake in PG courses: (A-4,269, U-202, S-140, H-1170)

5,826

Hospitals in Government Sector 3,948

Dispensaries in Government Sector 27, 698

Drug Manufacturing units (A-7439, U- 585, S-235, H-408)

9,0387/23/2019


Ensuring Quality:

Drugs and Products: Drugs and Cosmetics Act of India Ayurveda/ Unani/Siddha Pharmacopoeia of India GMP

Services – Standard treatment guidelines Ayurveda protocol for Ante-natal Care, Ayurveda Guidelines for prevention and control of

Diabetes


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Ensuring Quality cntd…Ayurveda guidelines for Geriatrics

careStandard Yoga protocolsQuality of Hospitals- NABH accreditation

standards for Ayurveda Hospitals and Day care centres.

WHO benchmarks for Training in AyurvedaIndian Public Health Services Standards


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Flagship Initiatives

National Health Mission: Aimed at vertical and horizontal strengthening of health services and accountable health systems including mainstreaming of AYUSH .

National AYUSH Mission: Aimed at augmenting AYUSH sector in terms of health services, educational standards, drugs quality control and sustainable development of medicinal plants.

Central Sector Schemes: For direct funding of projects related to promotion and development of AYUSH sector.

Ayushman Bharat Yojana: Largest initiative for Public Health taken by the Government of India in which AYUSH Systems are integrated to promote the Heath of people

AYUSH in PM-JAY

Health and Wellness Centres through AYUSH 7/23/2019 8


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Integration in Public HealthNational AYUSH Mission

Increase in number of AYUSH Hospitals and Dispensaries. 20% of total available resources are earmarked for need based activities in the States/UTs. The new initiatives under NAM include:-

Preventive and promotive healthcare School Health Programme through AYUSHPublic Health outreach activity Adoption of villages through AYUSH Gram


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National AYUSH Mission (NAM)

• Aimed at augmenting AYUSH sector in terms of health services, educational standards, drugs quality control ands sustainable development of medicinal plants. Launched in 2014

• AYUSH Gram- one village per block is selected for adoption of AYUSH way of life and interventions for health care. 356 units are supported under NAM


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AYUSHMAN BHARAT

Launched on September 23, 2018.Pradhan Mantri Jan Arogya Yojana (PM-JAY) : To provide health insurance coverage upto Rs. 5 lakh per year to each of the selected 10 Crore poor families at the level of secondary and tertiary health care levelSetting up of 1.25 lakh health and wellness centers (HWCs) : To ensure comprehensive primary healthcare to the poor & vulnerable familiesTen percent of the total HWCs (12,500) under Ayushman Bharat will be developed and operated by the Ministry of AYUSH through AYUSH systems.


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AYUSH wellness package

Three components 1) Preventive and promotive

measures for Self care 2) Medicinal plants for Self

care- cultivation & home remedies

3) Management of common ailments under 12 service delivery framework


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12 Service delivery frameworkalready decided under Ayushman Bharat

1. Care in Pregnancy and Child-birth2. Neonatal and Infant Health care services. 3. Childhood and Adolescent Health care services. 4. Family Planning, Contraceptive Services and other

Reproductive Health Care Services. 5. Management of communicable Diseases: National Health

Programmers. 6. General out-patient Care for Acute Simple illnesses and

Minor Ailments. 7. Screening, Prevention, Control and Management of Non-

communicable Diseases. 8. Care for common ophthalmic and ENT Problems. 9. Basic oral health care. 10. Elderly and palliative health care services. 11. Emergency medical services including Burns and

Trauma. 12. Screening and basic management of mental health

ailments.


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Care in Pregnancy and Child-birth

• Preventive pregnancy care ( Garbhini Charya) – food and way of life for the woman and family

• Anemia• Morning sickness • Minor ailments


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Neonatal and Infant Health care services

Family and individual counselling .Whole body gentle massage of the babyMeasures and medicines to feeding mother

for augmentation of lactation


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Childhood and Adolescent Health care services

• Promoting healthy eating habits, lifestyle• Medicinal values of plants / kitchen items• Health promotion in children with frequent

infections or other problems• Eating & digestive problems, chronic and

recurrent Upper Respiratory Tract Infection

• Primary Dysmenorrhoea and Dysfunctional Uterine Bleeding (DUB)


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Screening, Prevention, Control and Management of Non-communicable Diseases

• Identification of Prakriti of the population for preventive and curative measures

• IEC on need for prevention, screening and benefits of early diagnosis

• Tobacco, substance use• Diet and healthy lifestyle for harmony and

health• Identification of risk factor, screening and

advice• Watch on compliance 177/23/2019


Elderly and palliative health care services

Family counseling, help in organizing group interactions, involve religious institutions

Health education related to healthy ageing YogaDinacharya, ritucharya specific to elderlyRasayana for general healthBenign prostate hyperplasia Other geriatric problems like Osteoarthritis

as per specific frameworkCare of elderly women specifically for

urogenital problems


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Villa

ge/U

rban

W

ard

ASHA/MPW• Population Enumeration

• Outreach Services• Community Based

Screening • Risk Assessment • Counselling: Lifestyle

changes; treatment , advice, Yoga compliance

• Herbal garden/ home remedies

AYUSH physician

AY

US

H H

WC

1st re

ferra

l

• First Level Care• Screening• Use of Diagnostics• Prescription -drug

Dispensation• Record keeping• Telehealth• Referral for

confirmation/higher care

• Diagnosis • Treatment including

procedures (in some)

• Referral• Telehealth

Secon

dary

/tert

iary

care

• Advanced diagnostics

• Advanced and critical care (Allopathic facility)

• Therapeutic procedures (AYUSH facility)

Continuum of Care- community level to super speciality

Continuum of Care- community level to super speciality


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Integration of AYUSH component with National Programme for prevention and Control of Cancer, Diabetes, Cardio-vascular disease and Stroke (NPCDCS)- in collaboration with MoHFW. In this programme 15,78,530 patient have been screened.

◦ AYUSH Ante-natal and Post-natal care services in Tamil-Nadu, Maharashtra and Haryana. (ongoing project)

Mainstreaming of Ayurveda for RCH- Himachal Pradesh & Maharashtra.

◦ Evidence through public health: Osteoporosis in Maharashtra State (3000 Female), Anemia in Andhra Pradesh (49353 population), Ante-natal Care in Ratnagiri Dist. (6000 enrolment/ 820 deliveries)

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Innovative integrated public health programs

7/23/2019Dr. Manoj Nesari, Advisor, Ministry of AYUSH

Developing Guidelines and ICE material

7/23/2019 22Dr. Manoj Nesari, Advisor, Ministry

of AYUSH

Know your self


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Non Communicable diseasesIntegration of AYUSH component with

National Programme for prevention and Control of Cancer, Diabetes, Cardio-vascular disease and Stroke (NPCDCS)- in collaboration with MoHFW.

About 1400, 000 patients have been screened and about 300,000 patients have been enrolled under Ayurveda, Homeopathy, Unani care supplemented with Yoga across 6 districts in 6 states.

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Initiatives of Government of India for Integration of Traditional Medicine in

Public health

Blood sugar level, before and after intervention


of AYUSH

Antenatal Care and Reproductive and Child Health Care

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AYUSH Ante-natal and Post-natal care

services in Tamil-Nadu by Health Department.(ongoing project).

Ante-natal Care in Ratnagiri Dist. (6000 enrolment/ 820 deliveries

Mainstreaming of Ayurveda for RCH- Himachal Pradesh & 30 PHCs of Gadchiroli Dist., Maharashtra.

Anemia: In Andhra Pradesh, Maharashtra, Himachal Pradesh etc.

Tribal Health Care Research Project (THCRP)- A total population 8,42,959 of 1003 villages have been covered. (ongoing project)

ANC services are also being given in Ayurveda, Unani, Siddha teaching Hospitals


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TM in Public Health cntd…

Management of Osteoporosis through Ayurveda in menopausal women: in Maharashtra State (3000 Female),

Swasthya Raskhana Programme for promotion of Health in 19 states.(ongoing project)-IEC and health care services through community outreach

Poshan Abhiyaan- To improve nutrition of children through Ayurveda intervention in collaboration with Ministry of Women & Child Development

Other projects on Ay/U/S/H intervention under PHI scheme ongoing in various states of India included

Malaria Diarrhoea, Upper respiratory tract infection DM etc.


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Year wise themes related to Public Health

Every year on the occasion of Ayurvead day, Ministry of AYUSH chooses a theme based special drive on Public Health problems through Ayurveda etc. Few of theme chosen by the Ministry in the past includes

Mission Maduhmah 2016, Pain Management 2017 Public health 2018.

This year, in view of the health promotive properties of Guduchi (Tinospora Cardifoloa), a National campaign “Amrtia Abhiyan’ has been launched. Saplings of Amrita (Giloy) are distributed free all over country to promote cultuivation and use of Guduchi for promotion of health . It has been initiated on National Ayurveda Day by National Medicinal Plants Board, Ministry of AYUSH


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Initiation of Govt. of India for communicable disease

• AYUSH -64 Malaria (Patent by CCRAS)• Role of Ayurveda in Dengue management

(ongoing research proposal by CCRAS)• Chikunguniya (ongoing project under PHI scheme

of Ministry of AYUSH)• Malaria, Dengue, Chickunguniya, influenza like

illnesses (Ongoing studies proposals by CCRH)• Tuberculosis, Dengue (ongoing research proposal

by CCRUM)


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Promoting tertiary care: • Institutions such as AIIA, New Delhi,

National Institute of Ayurveda, Jaipur, IPGT&RA Jamnagar, Banaras Hindu University, National Institute for Unani Medicine, Bengaluru, National Inst. of Siddha, Chennai, National Inst. of Homoeopathy, Kolkata,

• 34 Centre of Excellence are supported in 13 states for areas such as Eye care, MCH, Neurology, Cancer and management of Anorectal diseases through Kshar Sutra etc. 327/23/2019


Expansion of AYUSH Health Services in other Ministries


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Digital infrastructure

• AYUSH Hospital Management Information System (AHMIS)

• E NAM• NAMASTE Portal• AYUSH Research Portal• E Charak• E Prakriti• AYUSH GRID


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Standardised Ayurvedic TerminologiesNAMASTE Portal

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National AYUSH Morbidity And Standardized Terminologies

Electronic Portal (NAMASTE Portal) – An AYUSH Informatics

Initiative for centralised collection of morbidity statistics pertaining to various systems of medicine under the Ministry of

AYUSH7/23/2019Dr. Manoj Nesari, Advisor, Ministry

of AYUSH

NAMASTE Portal• Vision - Develop a comprehensive web-portal on AYUSH

Morbidity Codes, Inter-Linkages with WHO-ICD 10/11 and Standardized Ayurveda, Siddha and Unani Terminologies.

• Highlights-

– Dual coding system for reporting in the case of A-S-U systems.– Homoeopathy and Yoga & Naturopathy system of medicine

may report by single coding system by ICD – 10/11 of World Health Organization.

– Registered institutions have been given their own user ids and passwords for secure access.

– Standardized terminologies of respective systems can be accessed through the portal.

– Coding of International Classification of Disease – 10 of WHO can be referred through this portal.


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E NAMMEghraj Cloud Technology Architecture


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User Management

District Role District Administrator

State Administrato

r

CentralMinistry of

AYUSH Administrato

rs

AYUSH Officers

Dashboard & Reports Viewers


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Users

Roles

Profiles

Privileges

User Managemen

t SMS / OTP

Email

Screen Alerts

Notification

Management

Dashboard

User

Dashboard

Reports

Dashboard & MIS

Login Logs

Audit Logs

Error Logs

Logs

Standard Modules


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Dashboard• To view the

complete status of entire Portal functionality

• Track the progress of SAAP

Master Management• Documents

checklist• State and

UT’s Master Data

• Workflow Stages master

• Workflow Timeline master

User Mgmt.• Activate/dea

ctivate User-id

Messaging Mgmt.• Prepare

Email Message Template

• SMS Template

• Send Emails /TXT

• View Message Sent

Admin Module


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Home Page

Login with username and password


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Dashboard


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Click on user management and Select “Add State Administrator”


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Masters

On clicking facilities we will go facility details. There is list of facility. We can search facility with the help of filters. This is very easy on selecting drop down and single click on search button.7/23/2019 45


State Administrator


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Create district program officer


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Show all state user list


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Thank you

[email protected]/23/2019 50Dr. Manoj Nesari, Advisor, Ministry

of AYUSH