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Rajasthan Strengthening Health System to Tackle COVID-19

Taking learnings from past few waves, Government of Rajasthan has planned to further strengthen and equip health systems efficiently and effectively to manage any potential COVID-19 waves in the future. National Health Mission (NHM) Rajasthan with support of Norway India Partnership Initiative (NIPI) and other development partners has conducted a state-wide assessment of the health facilities to measure COVID-19 preparedness.

The Mission Director, NHM, Rajasthan guided these state-wide assessments of health institutions (district hospitals, sub-district hospitals and community health centers) from 1st to 5th January 2022. For each of the 34 districts in the state, a team consisting of three members was constituted to assess 3 to 4 facilities in the assigned district. One member from each team was assigned as the team lead to coordinate the assessment in the allotted district as well as share the assessment findings with the district authorities. NIPI team led assessments at 14 facilities in four districts of Alwar, Chittorgarh, Jodhpur and Kota (4 each in Alwar & Jodhpur and 3 each in Chittorgarh & Kota).

Each assessment at a facility included examining the preparedness with respect to availability of trained manpower, formation of various recommended teams, availability of infrastructure such as (oxygen beds, oxygen concentrators and cylinders, oxygen generation plants), consumables (PPE kits, N-95 masks, surgical masks, test kits, sanitizer, hypochlorite solution), drugs, various instruments and COVID appropriate behavior.

For managing mild to moderate cases of COVID-19, enough oxygen concentrators, oxygen cylinders, N-95 masks, gloves, RAT kits and essential drugs were available in all 14 facilities assessed by NIPI team. The staff at these facilities have received the prescribed trainings related to COVID-19 (clinical management of COVID in adults and children, management of post-COVID complications and mucormycosis, operating oxygen concentrator and oxygen cylinder, orientation for rapid antigen test and community sensitization). Oxygen generation plants were sanctioned in 10 facilities (out of 14 assessed) but installation/final handover was pending in 8 facilities. However, all assessed facilities need to strengthen referral mechanism and ensure availability of bio-marker tests such as like D-dimer, IL6, procalcitonin, serum ferritin, C-reactive protein, lactic acid dehydrogenase and troponin).

Detailed feedback was shared with respective facility in-charges and a summary of key findings was shared at the district and the state levels. Recommendations consisting of carrying out mock drills to check facility preparedness, constituting outreach teams for contact tracing in communities and preparing plans for regular sanitization of facilities were shared with district authorities. It was also emphasized that facilities speed-up installation process of oxygen plants.