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Innovative approaches for mitigating COVID 19 risk in Jammu and Kashmir

With a surge in COVID-19 cases and its gradual ingress in peri-urban, rural and tribal areas, the Government of Jammu and Kashmir has adopted an innovative approach to manage and contain the pandemic in these areas. The government has established a 5-bedded COVID Care Centre (CCC) in every panchayat with one oxygen supported bed (equipped with an oxygen concentrator) and other basic facilities in collaboration with the local Panchayat Raj Institutions (PRIs), Departments of Health & Medical Education, Social Welfare and Education. The centers are equipped with necessary medical kits and mapped to nearby health facilities with provision of medical consultation, testing, ambulance services and isolation of positive patients. Medical care shall be provided by Medical Staff, Support staff (ANMs, ASHAs & Anganwadi workers/AWW) and the volunteers from other identified partner departments in these set ups. Patients requiring isolation shall be identified by the Panchayats/ concerned Medical Staff and ASHA workers. This approach is part of a larger response strategy in the management of COVID-19 pandemic and is likely to ease pressure for generalized care from the secondary and tertiary care facilities currently overwhelmed with an influx of large number of non-critical patients. This innovative initiative will provide an added layer of support to citizens in various panchayats to access medical care without any delay and also provide space for isolation of COVID-19 infected patients running short of space in their homes. To operationalize these COVID Care Centers at the earliest and to prepare for the anticipated 3rd wave, the Jammu and Kashmir government felt that it was imperative to hold training of the staff deputed at these centers.

The NIPI team facilitated and provided technical support to the NHM & Directorate of Health Services, Kashmir in successfully organizing a 5-day training across the UT held between May 27th-June 1st 2021, the training was inaugurated by the Financial Commissioner, Health & Medical Education, at JLNM Hospital Srinagar in the presence of Divisional Commissioner, Kashmir/ Deputy Commissioner, Srinagar & Director Health Services, Kashmir.

NIPI team supported in drafting the training material along with videos for enhanced understanding among all participating health care workers including frontline workers of other departments. The Directorate of Health Services, Kashmir organized in person Training of Trainers (ToT) in Kashmir Division. Two teams of experts were constituted to conduct ToTs at district level, covering two districts per day (10 districts of Kashmir division) with all related topics and a total 250 trainers were trained. These trainers are now conducting trainings of related staff supporting COVID Care Centers/ COVID Hospitals in their respective districts and blocks and the trainings will continue till all the COVID care facilities are saturated with trained manpower.

In Jammu division, NHM planned 5 days’ training of staff involved at COVID Care Centers virtually from 28th May to 1st June 2021 which was initiated by welcome note by MD NHM. Related staff from all 10 districts of Jammu Division participated in the sessions which covered all related topics/ modules day wise. A total 1000 participants (287 MLPHs, 226 ANMs, 390 ASHAs and 97 AWW) attended the training. A hands on training on Rapid Antigen testing (RAT) for the participants for increasing quality testing at the COVID Care Centers was also conducted.

The trainings focused on infection prevention and control measures at COVID care facilities, bio-medical waste management, use of PPE, awareness regarding nutrition, basics of COVID-19, identification of early warning signs & referral and community engagement. They also highlighted the rational use of oxygen at COVID facilities, use of pulse oximeter, oxygen concentrator, oxygen cylinders, infrared thermometer, and described preparedness regarding management of COVID in pediatric age group, management of Mucormycosis in COVID and tackling of emerging mental health issues due to COVID-19 pandemic.

Apart from the power point sessions, various skill stations were also set up for demonstration of all techniques as well as proper use of all the equipment essential in management of COVID-19 in Kashmir Division. The training in Jammu division concluded with the closing remarks by the Program Manager-NHM.

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