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Village Health Programme

COVID care through the intensive village programme

The wide-spectrum of activities carried out by the Village Health Workers (VHW) have been instrumental in making health care accessible in the remotest forest villages, which are very poorly connected to the nearby public health care facilities. In locations, where basic health care facilities are scarce, battling a pandemic like the one we are currently in, is much more difficult. Current availability of COVID care services is unfortunately only restricted to specific COVID care facilities at the district level (may be 80km away) usually requiring a difficult 3-4 hours of travel. Keeping in mind the possibility of increase in the number of cases and the huge imbalance in the available resources and patients needing care, JSS implemented an alternative plan a few months back to manage COVID at village/community level at least for mild and non-severe cases so that those who require oxygen or ventilatory support will get the appropriate care at the district-facilities. Home isolation for non-severe COVID cases with close monitoring being the key.

In the wake of the pandemic, we have been training our VHWs, for a few months now, to take on this additional responsibility. Training and information sessions were conducted on COVID-19, home quarantine, identifying sick patients using the red flag signs, hand hygiene, mental health support etc, managing mild cases, and referring moderate to severe ones.

(Follow this link to our online training session for frontline health workers: Click Here)

They have now taken on responsibility of COVID care alongside their other work that includes checking on patients with other chronic illnesses like diabetes, hypertension, RHD, seizure disorders, etc, handing over their medicines and ensuring that their condition is stable; regular check-ups of ANC patients through home-visits; assisting Senior Health Workers with home-based check-ups for patients with chronic illnesses. Services and medicines are being provided free of cost to patients, where lockdown and lack of livelihood opportunities had left the daily wage earners vulnerable.

They are playing a crucial role by carrying out activities specific to COVID care in addition to their regular responsibilities:

  • Spreading awareness about COVID-19, hand-hygiene practices, physical distancing at hamlet level
  • Carrying out first level screening for patients with fever and/or respiratory symptoms
  • Advising isolation to patients with mild symptoms and allied care to be taken by the patient and family members i.e. check-ups with monitoring temperature, pulse, respiratory rate and SPO2 and continued supply (through refills) of medications
  • Monitoring these patients through the duration of their isolation. We also intend to provide dry rations during the period of 2 weeks of home isolation
  • Referring severe cases to the COVID-care facility at the district level
  • Assisting Cluster Coordinators in identifying volunteers at hamlet level to be trained in managing COVID along with the members of village health and nutrition committee (VHSNC). 
  • Making and distributing masks and sanitizers and thus safeguarding people at public places

Senior Health Workers (SHWs), or Mid-level care providers, act as an important link between the Village Health Workers and the doctors involved in COVID care. They run the OPD at the subcentre, follow up on chronic disease patients, perform some lab investigations among other things, as their role has evolved to include activities specific to COVID care:

  • Running the COVID OPD at the subcentre and home isolation of suspects
  • Home-based care to patients i.e. check-ups of high-risk patients, continued supply (through refills) of medications for serious chronic illnesses such as diabetes, hypertension, seizure disorders, sickle cell disease, RHD, TB, leprosy among others
  • Referral of moderate to severe cases that cannot be managed at subcentre level to COVID care facilities
  • Mentoring VHWs in screening and management of (suspected) COVID patients
  • Supporting VHWs in decision making related to management of COVID patients

These initiatives ensure successful screening and management of mild cases at village level. However, there would be some moderate to severe cases that would need oxygen and other care or ventilator support that will be provided at the JSS referral centre in Ganiyari.