Stresses on effective advance preparations for ensuring robust health infrastructure and efficient clinical management of COVID
The ministry of health reviewed preparations under the recently approved, Rs 23,123 crores “India COVID-19 Emergency Response and Health Systems Preparedness Package: Phase II” with health secretaries and senior officials of all states and union territories (UTs), through a video conference (VC) today.
During the review meeting, states and UTs were guided on policies and guidelines from the health ministry on different aspects of COVID management which would help the states and UTs in strengthening their healthcare infrastructure to streamline COVID-19 response. States/UTs were requested to send their expenditure proposals at the earliest to enable expeditious approval and sanctioning from the union government.
Apart from it, the following were focussed:
- Need for ramping up test, track, treat and isolate strategy
- Requirement for scaling up testing capacity, additional beds, including for paediatric care and makeshift hospitals in sub-district levels
- Ensuring availability of critical drugs, testing kits and PPE
- Enhancing oxygen availability and strengthen home and village/community isolation centres/COVID care centres
- Sustaining and enhancing skilled medical and para-medical HR in line with the new guidelines issued by the health ministry in consultation with the National Medical Commission (NMC) and the Indian Nursing Council (INC)
Besides, the following objectives of ECRP: Phase-II were also reiterated:
- Support the states to establish dedicated paediatric care unit in all 736 districts of the country for responding to the needs of paediatric COVID-19 management
- Support the states to establish paediatric Centre of Excellence in each state/UT (either in state medical colleges or state hospitals or central hospitals such as AIIMS, Institute of National Importance, etc.) for providing tele-ICU services, mentoring and technical hand-holding to these district paediatric units.
- Increase the availability of ICU beds including 20 per cent paediatric ICU beds as per evolving needs
- Support to states to have 1,050 Liquid Medical Oxygen (LMO) storage tanks, along with Medical Gas Pipeline System (MGPS) (at least one per district) to augment the availability of medical oxygen in public healthcare system
- Strengthen teleconsultation platform to provide up to five lakh teleconsultation services per day, duly augmenting the availability of spokes and hubs
- Support the states in implementation of Hospital Management Information System (HMIS) in all the district hospitals, duly strengthening the national architecture
- Increase access to ambulance services to eliminate delays in transport and referral of COVID-19 patients
- Enhance testing capacity and corresponding supportive diagnostics at the public healthcare facilities, closer to the public
- Support the states to utilise the UG and PG interns, final year MBBS, BSc and GNM nursing students for effective management
In addition, states and UTs were also advised to conduct a quick gap analysis for various infrastructure components under the scheme, including their IT infrastructure readiness. The hub and spoke model for teleconsultation services may be improved, including for the services at the COVID Care Centres, through district-level hubs. The final year MBBS students, UG interns and PG residents may be utilised under the supervision of the faculty as per the NMC guidelines for providing services of mild COVID management through teleconsultation. Similarly, final nursing graduates (BSc and GNM) may be utilised for full-time COVID nursing duties at government facilities under the supervision of senior faculty as per the INC guidelines and support of remuneration/incentives to these human resources for health under the ECRP-II may be leveraged by the states effectively in the times of need.
All facilities in the District (COVID/non-COVID), Health and Wellness Centers (HWCs), eSanjeevani OPD, Common Service Centers (CSCs) and other healthcare facilities like Sub-Centres (SCs), Primary Health Centres (PHCs), Community Health Centres (CHCs) etc., are required to be connected with district hospitals as spoke.
It was also pointed out that procurement of drugs for effective COVID management is an essential component of ECRP-II; guidelines on procurement and buffer stocks have been already shared with the states which may be adopted for this purpose. Guidance can be tweaked to local needs and states must come with their own assessments based on stocks and costs involved.