Non-Communicable Diseases Uttar Pradesh

Rajasthan • NCD screening

• Alliance for Saving • Health Systems
Communicable Diseases Mothers and Newborn Strengthening
• Awareness & Screening for
NCDs

RMNCH+A
Madhya Pradesh
• Sehat app
Health Systems • Lead Development Partner
Strengthening Odisha
- RMNCHA
• Malaria
Control
Mental Health & Substance Programme
Abuse Maharashtra
• Mental Health Programme Andhra Pradesh
• Urban PHC Strengthening • Mobile Medical Units for NCD
Elderly Care • NCD Screening screening
• NCD Screening Camps

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 C A. Identified catchment
B. Outreach and screening
C. Primary care through TMU and continuation of care
D. Provisioning of insurance coverage

B A

MMU Spoke

Breastfeeding awareness at Clinic Mobile portable lab

20 Telemedicine units covering - 1 District (Krishna), 2 Revenue Divisions (Nuzividu, Vijaywada), 4 Constituencies, 16 Mandals, 260 Grampanachayat, 400
Villages
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 20,00,000 population, consulting for 68000 so far

Medical Tele-
consultation consultation

Medicine Lab Medicine HTN & DM

dispensing
2 diagnosis dispensing
9
screening

M.M.U. T. M. U.

Ophthal
Counselling
screening
Follow up of POC for DM
treatment diagnosis
HTN, DM
and Cancer
Screening Counselling

Y0 Y2

Base
hospital
RKM
Screening DM HT Equipped MMU Patients inside View at Doctor’s desk View for TSU person Pt. experience

.
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 Digital Patient monitor
Multi purpose examination camera Digital Interactive Stethoscope

Trinethra Eye Examination Portable Laboratory, Point of Care tests Digital Colposcope
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 25,00,000 population in Nagpur A
Consultations 40,000

Process
realignment
A
Central Infrastructure
Laboratory ® upgradation

Model
UPHC
D B B C
Supply Chain Capacity
Management building Y1 Y2 Y3
C
Technology
Platform Single ERP for clinical, laboratory, inventory and administrative
purposes

17/ 26 UPHCs are connected for seamless provisioning of care

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 Essential diagnostics - match priority health care needs of the population
Disease Prevalence
 Public Health Relevance
 Clinical Utility & Accuracy (Sensitivity – Specificity)
 Comparative cost effectiveness
 In Vitro Diagnostics - Subset of medical devices
(Devices for the in-vitro examination of specimens for diagnosis or monitoring for compatibility purposes)
Reagents,
Calibrators,
Control Material and
Test Kits

WHO Strategic Advisory Group of Experts on In Vitro Diagnostics (SAGE IVD)

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 Medical devices
(Instruments, apparatus, implement, machine, appliance, implant, reagent for in vitro use,
software, material)
Diagnosis, Prevention, Monitoring, Treatment or Alleviation Of Disease
Diagnosis, Monitoring, Treatment, Alleviation of or Compensation For An Injury
Investigation, Replacement, Modification of Support of The Anatomy or of A Physiological Process,
Supporting or Sustaining Life
Control of Conception
Disinfection of Medical Devices; or
Providing Information by Means of In Vitro Examination Of Specimens Derived From The Human
Body

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The EDL is presented by health care facility level in two tiers

I. Community and health settings without laboratories, with two sections:

a. General IVDs for community and health settings without laboratories
b. Disease-specific IVDs for community and health settings without laboratories

II. Health care facilities with clinical laboratories, with three sections:
a. General IVDs for clinical laboratories
b. Disease-specific IVDs for clinical laboratories
c. Disease-specific IVDs for blood screening laboratories

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The EDL consists of 122 test categories

46 general IVD tests for routine patient care & for detection of diagnosis
69 IVDs intended for the detection, diagnosis and monitoring of specific diseases.
(The first EDL listed tests for HIV, tuberculosis, malaria and hepatitis B & C, syphilis and HPV infection)

The second EDL extends the diseases to

Non communicable diseases
Cancer tests,
Set of general tests, including a new anatomical pathology section
7 test categories intended for screening of blood donations.

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Screening Tests - Status
Diagnostic Tests – Verify, Confirm
Aid to Diagnosis – Verify Status
Monitoring – Assays for disease progression, Monitoring analyte
Prognostic – Clinical outcome
Surveillance Tests – Track progression
Staging Tests – State at time of diagnosis

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;
Local demographics and pattern of diseases
Treatment facilities
Training and experience of personnel
to collect specimens
to perform diagnostics tests,
to transport specimens,
to interpret test results and
to manage diagnostics laboratories

Local Gaps
Supply Chain
Quality assurance capacity
Local availability of treatments
Financial resources;
Available infrastructure and environmental factors

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 STRENGTHS WEAKNESSES
INNOVATIONS IN MEDICAL TECHNOLOGY - AI & IOT CAPACITY BUILDING – CLINICAL PROFESSIONALS
GIZMO FRIEDLY POPULATION REGULATORY AUTHORITY
COST EFFECTIVENESS PRODUCT ORIENTATION – CLINICAL UTILITY
OUTCOME ORIENTATION – PREDICTIVE ANALYTICS CONSEQUENTIAL & CONTEXTUAL
POLITICAL WILL RIGID MINDSET
ENTREPRENEURSHIP SERVICE SUPPORT
MARKETING (CORPLUS Dr CHRISTIAN)

OPPORTUNITIES THREATS
WELLNESS – CPHC & AYUSHMAN BHARAT RESEARCH AND DEVELOPMENT - INVESTMENT
SCREENING – ORGANISED & OPPORTUNISTIC POOR OR FUDGED CLINICAL TRIALS
HOME & PALLIATIVE CARE FOCUS
SELF MANAGEMENT & MONITORING VALIDATION
INCREASED AWARENESS – CUSTOMERS VALUE FOR MONEY
LATEST EVIDENCES AND PRODUCTISING THE CHALLENGE LACK OF ACCOUNTABILITY
PREDICTIVE ANALYTICS

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DIAGNOSIS RELATED TESTS - DSS – OPPORTUNISTIC SCREENING
DIMINISHING RETUNS OF DIAGNSOTIC CRITERIA
IDENTIFY INTENDED USE
PRODUCE EVIDENCE OF IMPACT
DEVELOPMENT & PROMOTION -PERFECT COMPETETION
ROBUST SUPPORT SERVICE – ONLINE
- DOWN TIMES KILL !

PORTABLE ANALYSER CUM CELL COUNTER – HIGH UTILITY

POC RAPID DIAGNOSTICS
PROCESS FAILURE – USER BIAS
FAILURE OF ALGORITHM
FAILURE OF THE REAGENT

COST TO COMPANY – COST TO CONSUMMER

COST TO HEALTH SYSTEMS

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THANK YOU

Dr SREERAM SISTLA
+91 9701440336
ssistla@tatatrusts.org

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