Sughavazhvu Healthcare works at the interface of human resource and technology innovation to provide basic healthcare to the inaccessible populations in India. With a focus on accessibility, affordability and quality, Sughavazhvu has implemented the ICTPH model for provisioning primary healthcare to remote rural Indian populations, through its rural primary healthcare network in the district of Thanjavur, Tamil Nadu. The network is anchored by Rural Micro Health Centres (RMHC) and a central diagnostic facility, that form the first point of reference to provide evidence based primary care in a rural context. Additionally, our healthcare providers initiate community engagement activities to promote health awareness, undertake population risk profiling and offer affordable disease management alternatives.
The Rural Micro Health Centre (RMHC) stands at the core of Sughavazhvu’s ‘proactive’ physician enabled healthcare delivery model, assisted by a village-based Health Extension Worker (HEW). The SughaVazhvu health clinic, which houses a well-stocked pharmacy, provides the broadest possible range of healthcare services (including cervical cancer screening, vision screening and dispensation of glasses, and management of chronic diseases) at a primary level reaching out to the remotest doorsteps of rural India. Our centres are also fully computerized and also use mobile technology to assist with patient-centric services.
The site for launch of an RMHC is selected based on appropriate criteria such as accessibility, connectivity, private and public healthcare provider landscape. Each RMHC caters to a catchment population of 8000 – 10000 people, which roughly translates into 2500 households (HHs). Prior to the launch of a clinic, the entire catchment population is geo-tagged, enrolled and issued bar coded ID cards to create seed databases for each clinic. SughaVazhvu Healthcare launched its first rural clinic in the village of Alakkudi on November 09, 2009 and till date has seen more than 40,000 patient visits through its clinics network.
Advanced & cost-efficient diagnostic capability is available at all rural clinics. The clinics facilitate blood collection, and sample preparation either whole blood, or blood serum for transportation to the SughaVazhvu Diagnostic Hub for processing and evaluation. Most significantly haematology and biochemical parameters such as blood glucose, urea, creatinine, uric acid, lipid profile, liver function test, HbA1C, Magnesium is available through the entire rural clinic network with a turn-around time of 24 hours.
The clinical activities at Sughavazhvu are supported by a robust community engagement program. In an effort to engage more actively with the communities served by us, community clinics and camps and community based screening interventions such as the RRA have been launched.
Weekly community clinics are conducted by each clinic at a pre-determined location within their catchment. The physician offers medical consultation, while the Health Extension Worker (HEW) and an additional resource are engaged in clinical assistance and conducting non-invasive screening measurements and theme-based health awareness talks. Vision clinics are also conducted as part of exercise at monthly intervals.
A women’s health program was launched in the community, with an emphasis on cervical screening using the VIA/VILI tests. Given the invasive nature of this examination, and the cultural sensitivity of the region, an active community engagement strategy was followed by reaching out to the women through local self-help groups (SHGs). Before conducting the screening, the women were invited to participate at regular meetings and discussions on women’s health topics and the services offered at our clinics, thus enabling them with the tools to make the right decision. Women were told about the importance of regular cervical screening, and about signs and symptoms they should look out for; a video demonstrating the examination was shown to allay any fears and to prepare women for what they should expect during screening. Similar target interventions such as community based cardiovascular disease (CVD) specific interventions and school based anaemia interventions have been launched.
In addition to the community based risk screening interventions and weekly community clinics conducted by every rural clinic, health education activities are also carried out by engaging key opinion leaders and self help group within the communities, by trained Health Extension Workers (HEWs) armed with appropriate education materials. The HEWs also ensure regular follow-up, compliance and patient satisfaction through periodic phone calls and home visits.
Rapid Risk Assessment (RRA) is a community based intervention conducted within the catchment with the objective of identifying high risk sub-populations as target groups for specific interventions. The android mobile phone based exercise captures Marital Status, Pregnancy, Blood Pressure, Anthropometric Measures – weight, height, waist and hip circumference, Personal History – diabetes and blood pressure, tobacco consumption (chewing or smoking). All adult individuals identified at risk, primarily for CVD and pregnancy are offered diagnostic assessments, treatment and lifestyle modification advice at the RMHC.
Target : Chronic Diseases (Diabetes, Hypertension and Hyperlipidemia)
SughaVazhvu has developed subscription based models of services for Diabetes, Hypertension and Hyperlipidemia. Patients who are diagnosed with chronic diseases are offered an annual subsidized treatment package. The subscription based care is a paid service, where the patient pays for the entire year of disease management. On enrollment, the patient is issued a health passbook which systematically mentions the medical services to be provided to the patient for one year. This systematic treatment defines all the Physician consultations, diagnostic tests and medicines that can be availed by the patient. It also includes patient education and counseling on lifestyle modification and health promotion. The advantage of this comprehensive disease management package is the savings benefit involved. The subscription based treatment will cost around 30 percent of what the patient will spend if he/she pays for similar services with alternate care providers, labs and pharmacies over the span of a year.