Prevention of Muskuloskeletol Disorder
State AYUSH Society - Tamil Nadu
National Program for prevention and management of Muskuloskeletol Disorders
Objectivies:
- To provide Siddha treatment for people of any age with chronic musculoskeletal disorder through coordinated Siddha Community wellness centres.
- To provide education, counselling and self-management support to people about Siddha preventive principles.
- To provide access to Siddha medical officer trained in the management of Musculoskeletal disorder for effective Siddha care.
- To provide timely assessment and best therapies for the management of musculoskeletal disorders.
Strategy:
- Chronic musculoskeletal disoders requires coordinated holistic Siddha care and where ever Siddha OPD is co located will provided Siddha treatments which streamline the access to the Siddha health service.
- Based on the lifestyle, occupation, socio-economic status, morbidity, genetic factors etc. the population will be categorized into high risk, medium risk and low risk for onset of musculoskeletal disorders particularly Osteoarthritis for planning the appropriate interventions.
- The activities will be carried out through AYUSH Health & Wellness Centres (HWCs), Siddha dispensaries, co-located units, , teaching hospitals and other linked health facilities.
- The major activities will be generating awareness on preventive measures, screening of population, employing yoga, diet, lifestyle, clinical consultations, KayaKarpam, periodical cleansing procedures , Varma therapy, referral and follow up.
Levels of service delivery
i) At community level
ii) First level health care facility
- Siddha dispensaries, Siddha co-located facilities will cater to primary healthcare need, however, based on the proximity to the population, units of national institutes, teaching hospitals and other AYUSH facilities may also be considered as first level health care facility.
- Management of patients by judicious use of Siddha interventions along with Siddha diet, Siddhar Yogam and Siddha nutritional supplementation.
- The first level health facility may also be an allopathic dispensary or hospital if the person falls in that severity category as per the referral criteria mentioned in Annexure-I.
Referral facility:
The patients requiring further diagnostics and specialized treatment like Thokkanam/Varmam/specialized procedures/physiotherapy or surgery will be referred to AYUSH hospitals, teaching hospitals, national level institutions etc. as per the referral criteria mentioned in Annexure – I.
State Ayush Society – Tamil Nadu
National Program for prevention and Management of Musculoskeletal disease in Siddha system of medicine
The continuum of care of all the patients will be ensured through referral to higher centers and reverse referral to first level healthcare facility.
Modalities of implementation
| Activities to be done | |
|---|---|
|
Monday |
Health sub centre |
|
Tuesday |
Block Primary Health Centre / Community Health Centre / Upgraded PHCs |
|
Wednesday |
Additional Primary Health Centre |
|
Thursday |
School / College |
|
Friday |
Govt. Institutes (like Collectorate, Local bodies), Old age Home, |
|
Saturday |
Anganwaadi workers / Local bodies / Public / Self help Groups |
Prioritized conditions:
Osteoarthritis (hips, knees, ankles, or feet) and other conditions Musculo-skeletal disorders (such as rheumatoid arthritis, gouty arthritis, non-healing fractures, sprains, and tendinitis etc.) may also be included wherever possible and reported periodically to Ministry of AYUSH.
Interventions:
- Preventive measures: Healthy diet, lifestyle, yoga, exercises and specific practices such as oil massage, home remedies.
- Clinical management: Single or different customized combination of essential Siddha medicines would be used as per the individual need and suitability to the patients. Therapeutic procedures will be employed only for moderate to severe cases.
i) Diet and lifestyle Modification: General diet and lifestyle recommendations, home based ennai poochu (oil application followed by hot fomentation)will be advised to the patients.
ii) Siddha External Therapies /Thokkanam procedure based therapies,Varma therapy. Based on adaptability of individual patients clinical conditions, therapeutic procedures like Ottradam,Vedhu, poochu, EnnaiKattu, Pattru may also be judiciously administered.
iii) Counseling on diet and lifestyle.
iv) Physiotherapy and Yoga.
Target population:
- It is targeted to focus on the population above middle age and elderly in 385 blocks of TamilNadu over a period of 05 years.
- The population will be served through Siddha Health facilities and hospitals, in a phased manner.
Outcome indicators:
- Promote Siddha based self-management strategies, especially active management strategies.
- Deliver clear Siddha public health messages about prevention and management of musculoskeletal health conditions.
- Establish an appropriate referral pathways which facilitate targeted interdisciplinary care, as appropriate, and enable timely and informed communication between those involved in co-management.
- Promote best Siddha practice assessment and management, particularly in primary care.
Progress reporting:
All the health facilities involved in the National Program for Prevention and management of Musculoskeletal Disorders will be required to send quarterly and annual physical/technical progress report to the Ministry of AYUSH as per the data reporting format available as Annexure-III. .
Data collection and Documentation:
The data shall be documented in pre-designed data capturing formats by the facility level Medical Officer and the same shall be recorded in electronic formats. The monthly/quarterly/ annual reports shall be submitted to the state coordinator.
Monitoring:
The district level and state level coordinator shall monitor the progress of the program under the intimation of central Monitoring unit and progress report may be submitted to the coordinator periodically.
Financial Assistance:
Recurring
| Man Power | Per month in Rs. | Months | Total |
|---|---|---|---|
|
Siddha Medical Officer |
40000 |
12 |
480000 |
|
Multi-Purpose Worker /
Therapist |
15000 |
12 |
180000 |
|
Expo / Training / seminar /
Awareness program |
10000 |
4 |
40000 |
|
Screening camp |
10000 |
4 |
40000 |
|
Mobility support |
10000 |
12 |
120000 |
|
|
Total |
8,60,000 |
|
Non Recurring
Non Recurring
IEC, training and contingency:
| Sl. No | Activity | Amount in Rs./year |
|---|---|---|
|
1 |
IEC materials PLA CARD, Pamphlets, Banner, Flex, |
50,000 |
|
2 |
Lump-sum Contingency
(Untied Fund) |
10,000 |
|
|
TOTAL |
60000 |
Referral criteria:
Referral is the transfer of care for a patient or person from one health care provider/ facility to another when a person/patient needs expert advice, further investigations, interventions or follow up. An ideal referral mechanism ensures that people receive the best possible care, promotes cooperation & complementation of primary, secondary & tertiary health facilities and offers continuity of treatment.
Health referral involves not only direct patient care but support services such as transportation to transfer patient from one health facility to another. It is a two-way relationship that requires cooperation, coordination and exchange of information between the care providers during the referral so as to maintain the continuum of care. The referral may be done from the community to nearby health centre or from one facility to other higher AYUSH or Allopathic centres as per the following criteria.
The Healthcare provider may take an appropriate decision according to the prevailing situation and ensure that the patient get the best care without suffering financial hardship.
Data reporting format:
Name of the State/ UT
| Sl. No | Name of Indicators | Status |
|---|---|---|
|
1 |
Total number of health facilities who initiated National Program for Prevention and management of Musculoskeletal Disorders |
|
|
2 |
Total number of outreach camps held by each facility (only total numbers and not each facility-wise) |
|
|
3 |
Total number of persons attended the camps |
|
|
4 |
Total number of persons attended the camps during the reporting period |
|
|
5 |
Total number of patients visited health facilities for musculoskeletal problems |
|
|
6 |
Number of patients who turned up for follow up |
|
|
7 |
Continuous supply of medicines for musculoskeletal problems (response should be yes or no) |
|
|
8 |
Number of referral health facilities with Panchakarma/Ilaj-bil-Tadbir |
|
|
9 |
Indicators for clinical improvement |
|
|
10 |
Improvement in signs and symptoms (mention number of patients only) |
|
|
10.1 |
Improvement in the quality of life with respect to pain, range of movement by goniometer, womac scale, vas score, activity, sleep, anxiety (mention number of patients) |
|
|
10.2 |
Reduction in the intake of allopathic medicines (mention number of patients) |
|
|
11 |
Number of patients with overall satisfaction SF6 questionnaire (mention number of patients) |
|