NATIONAL PROGRAMME FOR THE HEALTHCARE OF THE ELDERLY (NPHCE)

Introduction :

The population of elderly persons is rapidly increasing globally. As per Census 2001, total population above 60 years of age in India was 76.6 million (7.5 %). The data of 2011 Census is yet not available, but as per projection, the elderly population as on date is expected to be around 98 million. At present pace of growth, it is likely to rise more rapidly in the coming years due to further increase in life expectancy. According to estimated projection, the population of elderly will be around 12.4 % of the total population by 2025.

The normal physiological aging process results in decrease in body stamina as well as immunity. This makes elderly more prone to diseases and disabilities. Around 8% elderly are bed ridden as per National Sample Survey Organization (NSSO). Elderly people suffer from complex health problem involving multiple organ and body system. Many of these require long term treatment or expensive interventions. The General health care delivery system which the elderly populations use at present is unable to meet the special needs of elderly population. Apart from this, with degradation in social and family values, the elderly are left alone to manage their own health problems. A dedicated health care system for elderly population is, therefore, essential.

Under such circumstances, it becomes the responsibility of the State to make suitable health care arrangement for the ailing elderly. It is high time the health care is geared to serve the requirements of the elderly and to meet the future challenge of rapidly increasing ageing society.

The objective of the NPHCE are :-

To provide easy access to preventive, promotive,

To make use of the community based primary health curative and rehabilitative services to the elderly care approach and strengthen capacity of the medical and paramedical professionals as well as the care-takers within the family for caring practices of the elderly.

To identify health problems in the elderly and provide appropriate health interventions in the community with a strong referral backup support

To provide referral services to the elderly patients through district hospital, medical colleges and strengthen health manpower development in the field of geriatric medicine.

Development of treatment models for the elderly persons in our country.

Strategies :

Preventive & promotive care

Management of illness

Health Manpower Development for geriatric services

Medical rehabilitation & therapeutic intervention

Developing appropriate training courses for medical and paramedical health professional in geriatric care

Promotion and encouraging basic, clinical, epidemiological and applied research in ageing and the health care of the elderly.

Integrating other systems of medicine such as AYUSH in provision of health care to the elderly

IEC

Packages of services to be made available at different levels under NPHCE

Health Facility Packages of services Sub-centre Health Education related to healthy ageing Domiciliary visits for attention and care to home bound/bedridded elderly persons and provide training to the family care providers in looking after the disabled elderly persons. Arrange for suitable calipers and supportive devices from the PHC to the elderly disabled persons to make them ambulatory.

Linkage with other support groups and day care centres etc. operational in the area

Primary Health Centre Weekly geriatric clinic run by a trained Medical Officer Maintain record of the Elderly using standard format during their first visit Conducting a routine health assessment of the elderly persons based on a simple clinical examination relating to eye, BP, blood sugar, etc.

Provision of medicines and proper advice on chronic ailments.

Public awareness on promotional, preventive and rehabilitative aspects of geriatrics during health and village sanitation day/camps.

Referral for diseases needing further investigation and treatment, to Community Health Centre or the District Hospital as per need.

Community Health Centre First Referral Unit (FRU) for the Elderly from PHCs and below. Geriatric Clinic for the elderly persons twice a week. Rehabilitation Unit for physiotherapy and counseling

Domiciliary visits by the rehabilitation worker for bed ridden elderly and counseling of the family members on their home-based care.

Health promotion and Prevention.

Referral of difficult cases to District Hospital/higher health care facility

District Hospital Geriatric Clinic for regular dedicated OPD services to the Elderly. Facilities for laboratory investigations for diagnosis and provision of medicines for geriatric medical and health problems. Ten-bedded Geriatric Ward for in-patient care of the Elderly.

Existing specialities like General Medicine; Orthopaedics, Ophthalmology; ENT services etc. will provide services needed by elderly patients.

Provide services for the elderly patients referred by the CHCs/PHCs etc.

Conducting camps for Geriatric Services PHCs/CHCs and other sites.

Referral services for severe cases to tertiary level hospitals.


Achivement during 2017-2018

1.    New facilities:-

·         1 new district – Champhai District

 

2.    Procurement:

a.    Physiotherapy equipment :- Shortwave Diathermy, Stabilizer, Ultrasound Therapy, Cervical Traction Machine, Pelvic Traction Machine, Traction Bed, Transelectric Nerve Stimulator (TENS), Interferential Therapy IFT, Adjustable Walker, Muscles Stimulator, Cervical Traction Manual, Shoulder Wheel, Shoulder Pulley, Adjustable walking sticks, Walker, Elbow crutch, Auxillary crutch) – under process

     

b.    Hospital Furniture & Appliances (Fowler Bed, Ward bedside locker, Revolving Stool, Drip stand, Ward Screen Four Folds, Oxygen Cylinder Trolley, Hand Stretcher Folding Type, Examination Table, OPD & Ward tables, Chairs, Almirah, Mattress, Blankets, Bed sheets, Bed cover, Pillows with cover, Nebuliser, ECG Machine, Pulse Oximeter, Weighing machine)- under process

 

c.    Drugs Tab. Amlodipine, Tab. Atorvastatin, Tab. Clopidogrel, Tab. Metformin, Digital Weighing Scale, Tab. Enalapril , Tab. Glimepride 1mg, Tab. Glimepride 2mg , Tab. Amlodipine, Tab. Metformin       

 

3.    Review Meeting/ Training:-

·         2 Review Meeting – 9th May 2017,  4th  December 2017

 

4.    Achievements during FY 17-18:-

 

REPORTING PERFORMA FOR NPHCE



I. COMMON DISEASES UNDER NPHCE

Total no. of patients atended at Heriatrics Clinic in the reporting month (new + follow up)

MALE

FEMALE

TOTAL

 

 

8903

No. of newly diagosed with

i. DM

346

395

741

ii. HTN

727

772

1499

iii. DM+HTN

377

371

748

iv.  COPD

374

426

800

v. Osteoarthritis

191

284

475

vi. Presbyopia

43

46

89

vii. Cataract

333

349

682

viii. Presbyacusis

126

221

347

ix. Psychiatric disorder

27

22

49

x. Others

1701

1772

3473

 

No. of newly diagosed cases initiated on Rx

i. DM

346

395

741

ii. HTN

727

772

1499

iii. DM+HTN

377

371

748

iv.  COPD

374

426

800

v. Osteoarthritis

191

284

475

vi. Presbyopia

43

46

89

vii. Cataract

333

349

682

viii. Presbyacusis

126

221

347

ix. Psychiatric disorder

27

22

49

x. Others

1701

1772

3473

 

Suspected cases of cancer

i. Oral

2

1

3

ii. Breast

0

10

10

iii. Cervical

0

4

4

iv.  Others

55

22

77

 

No. of patients admitted in ward

i.COPD

201

259

460

ii. CKD

69

99

168

iii. CVD

100

54

154

iv.  Stroke

101

63

164

v. Cancer

158

106

264

vi. Others

185

280

465

 

No. of patients underwent physiotherapy

731

632

1363

No. of laboratory tests undertaken

2713

2535

5248

No. of cases died in hospital

44

37

81