PMC:7340764 / 45954-52940 JSONTXT

{"project":"LitCovid-PD-FMA-UBERON","denotations":[{"id":"T14","span":{"begin":0,"end":8},"obj":"Body_part"},{"id":"T15","span":{"begin":6784,"end":6788},"obj":"Body_part"}],"attributes":[{"id":"A14","pred":"fma_id","subj":"T14","obj":"http://purl.org/sig/ont/fma/fma14542"},{"id":"A15","pred":"fma_id","subj":"T15","obj":"http://purl.org/sig/ont/fma/fma9712"}],"text":"Appendix 2\n\nProposed additional measures to ensure success of AB-HWCs and to strengthen cPHC in India [34, 35, 60-66, 74]\n\nShift health planning unit from districts to sub-district levels.\nConsidering ‘Health’ is a state subject in India, it is appropriate that the discourse on health with financial protection and allocation by states for health services becomes part of state level policy dialogue. Health planning units in India are at district level as is the case in most other countries as well. However, in most countries, the districts are at population of 50,000 to 300,000. Considering that an average district in India is around 20 Lakh (2 million) population, even district level planning may not be detailed enough and to ensure planning for every 200,000 to 300,000; the ‘sub-district level health planning’ should be considered in India. A beginning can be made by selected Indian states and with time, there would be need for 8,000 planning units, one for each block, rather than nearly 760 at district level at present. This could help in equitable planning and allocation of funds, HR and infrastructure.\n\nInnovative approaches for setting up HWCs.\nThe states have used the opportunity to set up HWCs to develop appropriate and innovative approaches at various levels which includes, Partnerships with non-governmental organizations (NGOs) for Urban-PHCs in Karnataka; Public-Private Partnerships through E-urban PHCs in Andhra Pradesh \u0026 Telangana; as well as Medical Officer led models in Kerala, Tamil Nadu \u0026 Puducherry. On the similar line, the Community Health Officers (CHOs) are being selected amongst various approaches such as B.Sc Community Health equivalent in Assam and Chhattisgarh; Ayurveda Practitioners in Maharashtra and Nurses in states such as Jharkhand, Madhya Pradesh, Uttar Pradesh, Andhra Pradesh, Punjab, Karnataka, Telangana, West Bengal, Andaman \u0026 Nicobar Island, Dadar \u0026 Nagar Haveli and all North Eastern states except Assam. The selection of CHO is based upon a mix of health staff in Bihar, Odisha, Gujarat, Rajasthan, Jammu \u0026 Kashmir (J\u0026K) Uttarakhand, Haryana, Daman and Diu, and Unani Practitioners as well in J\u0026K and Maharashtra. The enactment of the National Medical Commission (NMC) Act, 2019 is become a supporting legal instrument for empowering community. The NMC act of 2019, which proposes to empower non-physician providers to prescribe a limited range of medicines. In wake of COVID-19 pandemic, the Board of Governors for Medical Council of India had released new tele-consultation guidelines, which opens a new opportunity for making health services accessible in under-served and difficult areas, in the time ahead. These, along with other opportunities should be used to re-design PHC system as team based and people centric. However, success and effective implementation of this initiative need a stronger focused monitoring of the process.\n\nRevival and expansion of community and civil society participation in health.\nThe engagement with communities, elected representatives, civil society organizations and interest groups in designing the system which people need, demanding for better health services and working together for common cause is increasingly being recognized. This is resulting in opening and supporting many new avenues which directly or indirectly may contribute to better health outcomes and systems in India. These include national knowledge platform; Innovation and learning centres; Ayushman Bharat Ambassadors \u0026 messengers in school; renewed focus on community clinics or frontline health service; health getting far more attention in media as well as Political agenda in general election. There are Sustained expert engagement, research and evidence and Strengthened CSO/CBO engagement for health; Development/revision of many operational guidelines, broadly supplemented by global dialogues and commitments for PHC strengthening.\n\nAppropriate use of digital and mobile health solutions.\nMaking PHC functional needs measuring the results of interventions and improving accountability. Digital technologies can be leveraged to address health challenges in remote areas, generate awareness about health entitlement, deliver preventive and promotive health services, empower people and support communities to look after their own health. Information and communication technology can be used for ensuring referral linkage; measuring results to enhance accountability is making information on health care entitlements and performance publicly available in a transparent manner. The planning and early role out needs to be supported by a robust IT enabled monitoring and evaluation process; real time dash boards, amongst others would be needed to ensure that program designs are implemented, facilities so created are being utilized, services scaled up, the bottlenecks are regularly being identified and corrective measures being taken to improve performance.\n\nStrengthen implementation and operational research capacity.\nThere are a few policy questions which need to be answered in due course. ABP should also be an opportunity to strengthen operational research to support scale up based upon evidence and understanding. There would be a very important role of technical support and implementation research for identifying operational questions and then seeking answers in a scientific way through operational and implementation research. Dept. of Health Research (DHR) and National Knowledge Platform (NKP) as proposed under NHM can play an important role in the process. The emerging policy questions with possible need for operational research need to be a focus. There is a role of evidence, implementation research and capacity building in the process. The institutional mechanisms at both national and sub-national level, with sufficient government funding to support implementation research would be needed. Such platforms should bring policy makers, academic researchers and program managers and all other stakeholders together.\n\nRenewed inter-sectoral collaboration between health and education.\nOne of the example of how HWC dialogue has broadened the scope of health beyond curative care and beyond health department is the concept of Ayushman ambassadors \u0026 Messengers. As part of HWCs initiative, a coordination has been established with department of education. Two teachers, preferably one male and one female, in every school were proposed to be designated “Health and Wellness or Ayushman Ambassadors”. Prior to that the teachers are to be trained in health promotion and disease prevention for one hour every week, through a pre-decided curriculum. The school children are selected as health and wellness or Ayushman messengers and key health messages such as vaccination and hand-washing are communicated to the families through school children. This idea and concept was further formalized with the formulation of guidelines for school health under HWCs, released in Feb 2020."}

{"project":"LitCovid-PD-UBERON","denotations":[{"id":"T9","span":{"begin":5164,"end":5169},"obj":"Body_part"},{"id":"T10","span":{"begin":6784,"end":6788},"obj":"Body_part"}],"attributes":[{"id":"A9","pred":"uberon_id","subj":"T9","obj":"http://purl.obolibrary.org/obo/UBERON_0002542"},{"id":"A10","pred":"uberon_id","subj":"T10","obj":"http://purl.obolibrary.org/obo/UBERON_0002398"}],"text":"Appendix 2\n\nProposed additional measures to ensure success of AB-HWCs and to strengthen cPHC in India [34, 35, 60-66, 74]\n\nShift health planning unit from districts to sub-district levels.\nConsidering ‘Health’ is a state subject in India, it is appropriate that the discourse on health with financial protection and allocation by states for health services becomes part of state level policy dialogue. Health planning units in India are at district level as is the case in most other countries as well. However, in most countries, the districts are at population of 50,000 to 300,000. Considering that an average district in India is around 20 Lakh (2 million) population, even district level planning may not be detailed enough and to ensure planning for every 200,000 to 300,000; the ‘sub-district level health planning’ should be considered in India. A beginning can be made by selected Indian states and with time, there would be need for 8,000 planning units, one for each block, rather than nearly 760 at district level at present. This could help in equitable planning and allocation of funds, HR and infrastructure.\n\nInnovative approaches for setting up HWCs.\nThe states have used the opportunity to set up HWCs to develop appropriate and innovative approaches at various levels which includes, Partnerships with non-governmental organizations (NGOs) for Urban-PHCs in Karnataka; Public-Private Partnerships through E-urban PHCs in Andhra Pradesh \u0026 Telangana; as well as Medical Officer led models in Kerala, Tamil Nadu \u0026 Puducherry. On the similar line, the Community Health Officers (CHOs) are being selected amongst various approaches such as B.Sc Community Health equivalent in Assam and Chhattisgarh; Ayurveda Practitioners in Maharashtra and Nurses in states such as Jharkhand, Madhya Pradesh, Uttar Pradesh, Andhra Pradesh, Punjab, Karnataka, Telangana, West Bengal, Andaman \u0026 Nicobar Island, Dadar \u0026 Nagar Haveli and all North Eastern states except Assam. The selection of CHO is based upon a mix of health staff in Bihar, Odisha, Gujarat, Rajasthan, Jammu \u0026 Kashmir (J\u0026K) Uttarakhand, Haryana, Daman and Diu, and Unani Practitioners as well in J\u0026K and Maharashtra. The enactment of the National Medical Commission (NMC) Act, 2019 is become a supporting legal instrument for empowering community. The NMC act of 2019, which proposes to empower non-physician providers to prescribe a limited range of medicines. In wake of COVID-19 pandemic, the Board of Governors for Medical Council of India had released new tele-consultation guidelines, which opens a new opportunity for making health services accessible in under-served and difficult areas, in the time ahead. These, along with other opportunities should be used to re-design PHC system as team based and people centric. However, success and effective implementation of this initiative need a stronger focused monitoring of the process.\n\nRevival and expansion of community and civil society participation in health.\nThe engagement with communities, elected representatives, civil society organizations and interest groups in designing the system which people need, demanding for better health services and working together for common cause is increasingly being recognized. This is resulting in opening and supporting many new avenues which directly or indirectly may contribute to better health outcomes and systems in India. These include national knowledge platform; Innovation and learning centres; Ayushman Bharat Ambassadors \u0026 messengers in school; renewed focus on community clinics or frontline health service; health getting far more attention in media as well as Political agenda in general election. There are Sustained expert engagement, research and evidence and Strengthened CSO/CBO engagement for health; Development/revision of many operational guidelines, broadly supplemented by global dialogues and commitments for PHC strengthening.\n\nAppropriate use of digital and mobile health solutions.\nMaking PHC functional needs measuring the results of interventions and improving accountability. Digital technologies can be leveraged to address health challenges in remote areas, generate awareness about health entitlement, deliver preventive and promotive health services, empower people and support communities to look after their own health. Information and communication technology can be used for ensuring referral linkage; measuring results to enhance accountability is making information on health care entitlements and performance publicly available in a transparent manner. The planning and early role out needs to be supported by a robust IT enabled monitoring and evaluation process; real time dash boards, amongst others would be needed to ensure that program designs are implemented, facilities so created are being utilized, services scaled up, the bottlenecks are regularly being identified and corrective measures being taken to improve performance.\n\nStrengthen implementation and operational research capacity.\nThere are a few policy questions which need to be answered in due course. ABP should also be an opportunity to strengthen operational research to support scale up based upon evidence and understanding. There would be a very important role of technical support and implementation research for identifying operational questions and then seeking answers in a scientific way through operational and implementation research. Dept. of Health Research (DHR) and National Knowledge Platform (NKP) as proposed under NHM can play an important role in the process. The emerging policy questions with possible need for operational research need to be a focus. There is a role of evidence, implementation research and capacity building in the process. The institutional mechanisms at both national and sub-national level, with sufficient government funding to support implementation research would be needed. Such platforms should bring policy makers, academic researchers and program managers and all other stakeholders together.\n\nRenewed inter-sectoral collaboration between health and education.\nOne of the example of how HWC dialogue has broadened the scope of health beyond curative care and beyond health department is the concept of Ayushman ambassadors \u0026 Messengers. As part of HWCs initiative, a coordination has been established with department of education. Two teachers, preferably one male and one female, in every school were proposed to be designated “Health and Wellness or Ayushman Ambassadors”. Prior to that the teachers are to be trained in health promotion and disease prevention for one hour every week, through a pre-decided curriculum. The school children are selected as health and wellness or Ayushman messengers and key health messages such as vaccination and hand-washing are communicated to the families through school children. This idea and concept was further formalized with the formulation of guidelines for school health under HWCs, released in Feb 2020."}

{"project":"LitCovid-PD-MONDO","denotations":[{"id":"T29","span":{"begin":2232,"end":2235},"obj":"Disease"},{"id":"T30","span":{"begin":2317,"end":2320},"obj":"Disease"},{"id":"T31","span":{"begin":2438,"end":2446},"obj":"Disease"},{"id":"T32","span":{"begin":3759,"end":3762},"obj":"Disease"}],"attributes":[{"id":"A29","pred":"mondo_id","subj":"T29","obj":"http://purl.obolibrary.org/obo/MONDO_0005563"},{"id":"A30","pred":"mondo_id","subj":"T30","obj":"http://purl.obolibrary.org/obo/MONDO_0005563"},{"id":"A31","pred":"mondo_id","subj":"T31","obj":"http://purl.obolibrary.org/obo/MONDO_0100096"},{"id":"A32","pred":"mondo_id","subj":"T32","obj":"http://purl.obolibrary.org/obo/MONDO_0015469"}],"text":"Appendix 2\n\nProposed additional measures to ensure success of AB-HWCs and to strengthen cPHC in India [34, 35, 60-66, 74]\n\nShift health planning unit from districts to sub-district levels.\nConsidering ‘Health’ is a state subject in India, it is appropriate that the discourse on health with financial protection and allocation by states for health services becomes part of state level policy dialogue. Health planning units in India are at district level as is the case in most other countries as well. However, in most countries, the districts are at population of 50,000 to 300,000. Considering that an average district in India is around 20 Lakh (2 million) population, even district level planning may not be detailed enough and to ensure planning for every 200,000 to 300,000; the ‘sub-district level health planning’ should be considered in India. A beginning can be made by selected Indian states and with time, there would be need for 8,000 planning units, one for each block, rather than nearly 760 at district level at present. This could help in equitable planning and allocation of funds, HR and infrastructure.\n\nInnovative approaches for setting up HWCs.\nThe states have used the opportunity to set up HWCs to develop appropriate and innovative approaches at various levels which includes, Partnerships with non-governmental organizations (NGOs) for Urban-PHCs in Karnataka; Public-Private Partnerships through E-urban PHCs in Andhra Pradesh \u0026 Telangana; as well as Medical Officer led models in Kerala, Tamil Nadu \u0026 Puducherry. On the similar line, the Community Health Officers (CHOs) are being selected amongst various approaches such as B.Sc Community Health equivalent in Assam and Chhattisgarh; Ayurveda Practitioners in Maharashtra and Nurses in states such as Jharkhand, Madhya Pradesh, Uttar Pradesh, Andhra Pradesh, Punjab, Karnataka, Telangana, West Bengal, Andaman \u0026 Nicobar Island, Dadar \u0026 Nagar Haveli and all North Eastern states except Assam. The selection of CHO is based upon a mix of health staff in Bihar, Odisha, Gujarat, Rajasthan, Jammu \u0026 Kashmir (J\u0026K) Uttarakhand, Haryana, Daman and Diu, and Unani Practitioners as well in J\u0026K and Maharashtra. The enactment of the National Medical Commission (NMC) Act, 2019 is become a supporting legal instrument for empowering community. The NMC act of 2019, which proposes to empower non-physician providers to prescribe a limited range of medicines. In wake of COVID-19 pandemic, the Board of Governors for Medical Council of India had released new tele-consultation guidelines, which opens a new opportunity for making health services accessible in under-served and difficult areas, in the time ahead. These, along with other opportunities should be used to re-design PHC system as team based and people centric. However, success and effective implementation of this initiative need a stronger focused monitoring of the process.\n\nRevival and expansion of community and civil society participation in health.\nThe engagement with communities, elected representatives, civil society organizations and interest groups in designing the system which people need, demanding for better health services and working together for common cause is increasingly being recognized. This is resulting in opening and supporting many new avenues which directly or indirectly may contribute to better health outcomes and systems in India. These include national knowledge platform; Innovation and learning centres; Ayushman Bharat Ambassadors \u0026 messengers in school; renewed focus on community clinics or frontline health service; health getting far more attention in media as well as Political agenda in general election. There are Sustained expert engagement, research and evidence and Strengthened CSO/CBO engagement for health; Development/revision of many operational guidelines, broadly supplemented by global dialogues and commitments for PHC strengthening.\n\nAppropriate use of digital and mobile health solutions.\nMaking PHC functional needs measuring the results of interventions and improving accountability. Digital technologies can be leveraged to address health challenges in remote areas, generate awareness about health entitlement, deliver preventive and promotive health services, empower people and support communities to look after their own health. Information and communication technology can be used for ensuring referral linkage; measuring results to enhance accountability is making information on health care entitlements and performance publicly available in a transparent manner. The planning and early role out needs to be supported by a robust IT enabled monitoring and evaluation process; real time dash boards, amongst others would be needed to ensure that program designs are implemented, facilities so created are being utilized, services scaled up, the bottlenecks are regularly being identified and corrective measures being taken to improve performance.\n\nStrengthen implementation and operational research capacity.\nThere are a few policy questions which need to be answered in due course. ABP should also be an opportunity to strengthen operational research to support scale up based upon evidence and understanding. There would be a very important role of technical support and implementation research for identifying operational questions and then seeking answers in a scientific way through operational and implementation research. Dept. of Health Research (DHR) and National Knowledge Platform (NKP) as proposed under NHM can play an important role in the process. The emerging policy questions with possible need for operational research need to be a focus. There is a role of evidence, implementation research and capacity building in the process. The institutional mechanisms at both national and sub-national level, with sufficient government funding to support implementation research would be needed. Such platforms should bring policy makers, academic researchers and program managers and all other stakeholders together.\n\nRenewed inter-sectoral collaboration between health and education.\nOne of the example of how HWC dialogue has broadened the scope of health beyond curative care and beyond health department is the concept of Ayushman ambassadors \u0026 Messengers. As part of HWCs initiative, a coordination has been established with department of education. Two teachers, preferably one male and one female, in every school were proposed to be designated “Health and Wellness or Ayushman Ambassadors”. Prior to that the teachers are to be trained in health promotion and disease prevention for one hour every week, through a pre-decided curriculum. The school children are selected as health and wellness or Ayushman messengers and key health messages such as vaccination and hand-washing are communicated to the families through school children. This idea and concept was further formalized with the formulation of guidelines for school health under HWCs, released in Feb 2020."}

{"project":"LitCovid-PD-CLO","denotations":[{"id":"T250","span":{"begin":103,"end":105},"obj":"http://purl.obolibrary.org/obo/CLO_0001302"},{"id":"T251","span":{"begin":107,"end":109},"obj":"http://purl.obolibrary.org/obo/CLO_0001000"},{"id":"T252","span":{"begin":213,"end":214},"obj":"http://purl.obolibrary.org/obo/CLO_0001020"},{"id":"T253","span":{"begin":854,"end":855},"obj":"http://purl.obolibrary.org/obo/CLO_0001020"},{"id":"T254","span":{"begin":1338,"end":1351},"obj":"http://purl.obolibrary.org/obo/OBI_0000245"},{"id":"T255","span":{"begin":1989,"end":1992},"obj":"http://purl.obolibrary.org/obo/CLO_0002421"},{"id":"T256","span":{"begin":1989,"end":1992},"obj":"http://purl.obolibrary.org/obo/CLO_0052479"},{"id":"T257","span":{"begin":1989,"end":1992},"obj":"http://purl.obolibrary.org/obo/CLO_0052480"},{"id":"T258","span":{"begin":1989,"end":1992},"obj":"http://purl.obolibrary.org/obo/CLO_0052483"},{"id":"T259","span":{"begin":1989,"end":1992},"obj":"http://purl.obolibrary.org/obo/CLO_0052484"},{"id":"T260","span":{"begin":1989,"end":1992},"obj":"http://purl.obolibrary.org/obo/CLO_0052485"},{"id":"T261","span":{"begin":2007,"end":2008},"obj":"http://purl.obolibrary.org/obo/CLO_0001020"},{"id":"T262","span":{"begin":2257,"end":2258},"obj":"http://purl.obolibrary.org/obo/CLO_0001020"},{"id":"T263","span":{"begin":2276,"end":2286},"obj":"http://purl.obolibrary.org/obo/OBI_0000968"},{"id":"T264","span":{"begin":2397,"end":2398},"obj":"http://purl.obolibrary.org/obo/CLO_0001020"},{"id":"T265","span":{"begin":2568,"end":2569},"obj":"http://purl.obolibrary.org/obo/CLO_0001020"},{"id":"T266","span":{"begin":2861,"end":2862},"obj":"http://purl.obolibrary.org/obo/CLO_0001020"},{"id":"T267","span":{"begin":2872,"end":2879},"obj":"http://purl.obolibrary.org/obo/CLO_0009985"},{"id":"T268","span":{"begin":3058,"end":3071},"obj":"http://purl.obolibrary.org/obo/OBI_0000245"},{"id":"T269","span":{"begin":3533,"end":3538},"obj":"http://purl.obolibrary.org/obo/CLO_0009985"},{"id":"T270","span":{"begin":3943,"end":3950},"obj":"http://www.ebi.ac.uk/efo/EFO_0000881"},{"id":"T271","span":{"begin":4077,"end":4084},"obj":"http://www.ebi.ac.uk/efo/EFO_0000881"},{"id":"T272","span":{"begin":4543,"end":4544},"obj":"http://purl.obolibrary.org/obo/CLO_0001020"},{"id":"T273","span":{"begin":4622,"end":4623},"obj":"http://purl.obolibrary.org/obo/CLO_0001020"},{"id":"T274","span":{"begin":5020,"end":5021},"obj":"http://purl.obolibrary.org/obo/CLO_0001020"},{"id":"T275","span":{"begin":5227,"end":5228},"obj":"http://purl.obolibrary.org/obo/CLO_0001020"},{"id":"T276","span":{"begin":5364,"end":5365},"obj":"http://purl.obolibrary.org/obo/CLO_0001020"},{"id":"T277","span":{"begin":5494,"end":5497},"obj":"http://purl.obolibrary.org/obo/CL_0000825"},{"id":"T278","span":{"begin":5649,"end":5650},"obj":"http://purl.obolibrary.org/obo/CLO_0001020"},{"id":"T279","span":{"begin":5651,"end":5656},"obj":"http://purl.obolibrary.org/obo/CLO_0009985"},{"id":"T280","span":{"begin":5667,"end":5668},"obj":"http://purl.obolibrary.org/obo/CLO_0001020"},{"id":"T281","span":{"begin":6135,"end":6138},"obj":"http://purl.obolibrary.org/obo/CLO_0051582"},{"id":"T282","span":{"begin":6300,"end":6301},"obj":"http://purl.obolibrary.org/obo/CLO_0001020"},{"id":"T283","span":{"begin":6315,"end":6318},"obj":"http://purl.obolibrary.org/obo/CLO_0051582"},{"id":"T284","span":{"begin":6395,"end":6399},"obj":"http://purl.obolibrary.org/obo/UBERON_0003101"},{"id":"T285","span":{"begin":6395,"end":6399},"obj":"http://www.ebi.ac.uk/efo/EFO_0000970"},{"id":"T286","span":{"begin":6408,"end":6414},"obj":"http://purl.obolibrary.org/obo/UBERON_0003100"},{"id":"T287","span":{"begin":6631,"end":6632},"obj":"http://purl.obolibrary.org/obo/CLO_0001020"}],"text":"Appendix 2\n\nProposed additional measures to ensure success of AB-HWCs and to strengthen cPHC in India [34, 35, 60-66, 74]\n\nShift health planning unit from districts to sub-district levels.\nConsidering ‘Health’ is a state subject in India, it is appropriate that the discourse on health with financial protection and allocation by states for health services becomes part of state level policy dialogue. Health planning units in India are at district level as is the case in most other countries as well. However, in most countries, the districts are at population of 50,000 to 300,000. Considering that an average district in India is around 20 Lakh (2 million) population, even district level planning may not be detailed enough and to ensure planning for every 200,000 to 300,000; the ‘sub-district level health planning’ should be considered in India. A beginning can be made by selected Indian states and with time, there would be need for 8,000 planning units, one for each block, rather than nearly 760 at district level at present. This could help in equitable planning and allocation of funds, HR and infrastructure.\n\nInnovative approaches for setting up HWCs.\nThe states have used the opportunity to set up HWCs to develop appropriate and innovative approaches at various levels which includes, Partnerships with non-governmental organizations (NGOs) for Urban-PHCs in Karnataka; Public-Private Partnerships through E-urban PHCs in Andhra Pradesh \u0026 Telangana; as well as Medical Officer led models in Kerala, Tamil Nadu \u0026 Puducherry. On the similar line, the Community Health Officers (CHOs) are being selected amongst various approaches such as B.Sc Community Health equivalent in Assam and Chhattisgarh; Ayurveda Practitioners in Maharashtra and Nurses in states such as Jharkhand, Madhya Pradesh, Uttar Pradesh, Andhra Pradesh, Punjab, Karnataka, Telangana, West Bengal, Andaman \u0026 Nicobar Island, Dadar \u0026 Nagar Haveli and all North Eastern states except Assam. The selection of CHO is based upon a mix of health staff in Bihar, Odisha, Gujarat, Rajasthan, Jammu \u0026 Kashmir (J\u0026K) Uttarakhand, Haryana, Daman and Diu, and Unani Practitioners as well in J\u0026K and Maharashtra. The enactment of the National Medical Commission (NMC) Act, 2019 is become a supporting legal instrument for empowering community. The NMC act of 2019, which proposes to empower non-physician providers to prescribe a limited range of medicines. In wake of COVID-19 pandemic, the Board of Governors for Medical Council of India had released new tele-consultation guidelines, which opens a new opportunity for making health services accessible in under-served and difficult areas, in the time ahead. These, along with other opportunities should be used to re-design PHC system as team based and people centric. However, success and effective implementation of this initiative need a stronger focused monitoring of the process.\n\nRevival and expansion of community and civil society participation in health.\nThe engagement with communities, elected representatives, civil society organizations and interest groups in designing the system which people need, demanding for better health services and working together for common cause is increasingly being recognized. This is resulting in opening and supporting many new avenues which directly or indirectly may contribute to better health outcomes and systems in India. These include national knowledge platform; Innovation and learning centres; Ayushman Bharat Ambassadors \u0026 messengers in school; renewed focus on community clinics or frontline health service; health getting far more attention in media as well as Political agenda in general election. There are Sustained expert engagement, research and evidence and Strengthened CSO/CBO engagement for health; Development/revision of many operational guidelines, broadly supplemented by global dialogues and commitments for PHC strengthening.\n\nAppropriate use of digital and mobile health solutions.\nMaking PHC functional needs measuring the results of interventions and improving accountability. Digital technologies can be leveraged to address health challenges in remote areas, generate awareness about health entitlement, deliver preventive and promotive health services, empower people and support communities to look after their own health. Information and communication technology can be used for ensuring referral linkage; measuring results to enhance accountability is making information on health care entitlements and performance publicly available in a transparent manner. The planning and early role out needs to be supported by a robust IT enabled monitoring and evaluation process; real time dash boards, amongst others would be needed to ensure that program designs are implemented, facilities so created are being utilized, services scaled up, the bottlenecks are regularly being identified and corrective measures being taken to improve performance.\n\nStrengthen implementation and operational research capacity.\nThere are a few policy questions which need to be answered in due course. ABP should also be an opportunity to strengthen operational research to support scale up based upon evidence and understanding. There would be a very important role of technical support and implementation research for identifying operational questions and then seeking answers in a scientific way through operational and implementation research. Dept. of Health Research (DHR) and National Knowledge Platform (NKP) as proposed under NHM can play an important role in the process. The emerging policy questions with possible need for operational research need to be a focus. There is a role of evidence, implementation research and capacity building in the process. The institutional mechanisms at both national and sub-national level, with sufficient government funding to support implementation research would be needed. Such platforms should bring policy makers, academic researchers and program managers and all other stakeholders together.\n\nRenewed inter-sectoral collaboration between health and education.\nOne of the example of how HWC dialogue has broadened the scope of health beyond curative care and beyond health department is the concept of Ayushman ambassadors \u0026 Messengers. As part of HWCs initiative, a coordination has been established with department of education. Two teachers, preferably one male and one female, in every school were proposed to be designated “Health and Wellness or Ayushman Ambassadors”. Prior to that the teachers are to be trained in health promotion and disease prevention for one hour every week, through a pre-decided curriculum. The school children are selected as health and wellness or Ayushman messengers and key health messages such as vaccination and hand-washing are communicated to the families through school children. This idea and concept was further formalized with the formulation of guidelines for school health under HWCs, released in Feb 2020."}

{"project":"LitCovid-PD-CHEBI","denotations":[{"id":"T48725","span":{"begin":6395,"end":6399},"obj":"Chemical"}],"attributes":[{"id":"A49668","pred":"chebi_id","subj":"T48725","obj":"http://purl.obolibrary.org/obo/CHEBI_30780"}],"text":"Appendix 2\n\nProposed additional measures to ensure success of AB-HWCs and to strengthen cPHC in India [34, 35, 60-66, 74]\n\nShift health planning unit from districts to sub-district levels.\nConsidering ‘Health’ is a state subject in India, it is appropriate that the discourse on health with financial protection and allocation by states for health services becomes part of state level policy dialogue. Health planning units in India are at district level as is the case in most other countries as well. However, in most countries, the districts are at population of 50,000 to 300,000. Considering that an average district in India is around 20 Lakh (2 million) population, even district level planning may not be detailed enough and to ensure planning for every 200,000 to 300,000; the ‘sub-district level health planning’ should be considered in India. A beginning can be made by selected Indian states and with time, there would be need for 8,000 planning units, one for each block, rather than nearly 760 at district level at present. This could help in equitable planning and allocation of funds, HR and infrastructure.\n\nInnovative approaches for setting up HWCs.\nThe states have used the opportunity to set up HWCs to develop appropriate and innovative approaches at various levels which includes, Partnerships with non-governmental organizations (NGOs) for Urban-PHCs in Karnataka; Public-Private Partnerships through E-urban PHCs in Andhra Pradesh \u0026 Telangana; as well as Medical Officer led models in Kerala, Tamil Nadu \u0026 Puducherry. On the similar line, the Community Health Officers (CHOs) are being selected amongst various approaches such as B.Sc Community Health equivalent in Assam and Chhattisgarh; Ayurveda Practitioners in Maharashtra and Nurses in states such as Jharkhand, Madhya Pradesh, Uttar Pradesh, Andhra Pradesh, Punjab, Karnataka, Telangana, West Bengal, Andaman \u0026 Nicobar Island, Dadar \u0026 Nagar Haveli and all North Eastern states except Assam. The selection of CHO is based upon a mix of health staff in Bihar, Odisha, Gujarat, Rajasthan, Jammu \u0026 Kashmir (J\u0026K) Uttarakhand, Haryana, Daman and Diu, and Unani Practitioners as well in J\u0026K and Maharashtra. The enactment of the National Medical Commission (NMC) Act, 2019 is become a supporting legal instrument for empowering community. The NMC act of 2019, which proposes to empower non-physician providers to prescribe a limited range of medicines. In wake of COVID-19 pandemic, the Board of Governors for Medical Council of India had released new tele-consultation guidelines, which opens a new opportunity for making health services accessible in under-served and difficult areas, in the time ahead. These, along with other opportunities should be used to re-design PHC system as team based and people centric. However, success and effective implementation of this initiative need a stronger focused monitoring of the process.\n\nRevival and expansion of community and civil society participation in health.\nThe engagement with communities, elected representatives, civil society organizations and interest groups in designing the system which people need, demanding for better health services and working together for common cause is increasingly being recognized. This is resulting in opening and supporting many new avenues which directly or indirectly may contribute to better health outcomes and systems in India. These include national knowledge platform; Innovation and learning centres; Ayushman Bharat Ambassadors \u0026 messengers in school; renewed focus on community clinics or frontline health service; health getting far more attention in media as well as Political agenda in general election. There are Sustained expert engagement, research and evidence and Strengthened CSO/CBO engagement for health; Development/revision of many operational guidelines, broadly supplemented by global dialogues and commitments for PHC strengthening.\n\nAppropriate use of digital and mobile health solutions.\nMaking PHC functional needs measuring the results of interventions and improving accountability. Digital technologies can be leveraged to address health challenges in remote areas, generate awareness about health entitlement, deliver preventive and promotive health services, empower people and support communities to look after their own health. Information and communication technology can be used for ensuring referral linkage; measuring results to enhance accountability is making information on health care entitlements and performance publicly available in a transparent manner. The planning and early role out needs to be supported by a robust IT enabled monitoring and evaluation process; real time dash boards, amongst others would be needed to ensure that program designs are implemented, facilities so created are being utilized, services scaled up, the bottlenecks are regularly being identified and corrective measures being taken to improve performance.\n\nStrengthen implementation and operational research capacity.\nThere are a few policy questions which need to be answered in due course. ABP should also be an opportunity to strengthen operational research to support scale up based upon evidence and understanding. There would be a very important role of technical support and implementation research for identifying operational questions and then seeking answers in a scientific way through operational and implementation research. Dept. of Health Research (DHR) and National Knowledge Platform (NKP) as proposed under NHM can play an important role in the process. The emerging policy questions with possible need for operational research need to be a focus. There is a role of evidence, implementation research and capacity building in the process. The institutional mechanisms at both national and sub-national level, with sufficient government funding to support implementation research would be needed. Such platforms should bring policy makers, academic researchers and program managers and all other stakeholders together.\n\nRenewed inter-sectoral collaboration between health and education.\nOne of the example of how HWC dialogue has broadened the scope of health beyond curative care and beyond health department is the concept of Ayushman ambassadors \u0026 Messengers. As part of HWCs initiative, a coordination has been established with department of education. Two teachers, preferably one male and one female, in every school were proposed to be designated “Health and Wellness or Ayushman Ambassadors”. Prior to that the teachers are to be trained in health promotion and disease prevention for one hour every week, through a pre-decided curriculum. The school children are selected as health and wellness or Ayushman messengers and key health messages such as vaccination and hand-washing are communicated to the families through school children. This idea and concept was further formalized with the formulation of guidelines for school health under HWCs, released in Feb 2020."}

{"project":"LitCovid-PD-GO-BP","denotations":[{"id":"T17","span":{"begin":3455,"end":3463},"obj":"http://purl.obolibrary.org/obo/GO_0007612"}],"text":"Appendix 2\n\nProposed additional measures to ensure success of AB-HWCs and to strengthen cPHC in India [34, 35, 60-66, 74]\n\nShift health planning unit from districts to sub-district levels.\nConsidering ‘Health’ is a state subject in India, it is appropriate that the discourse on health with financial protection and allocation by states for health services becomes part of state level policy dialogue. Health planning units in India are at district level as is the case in most other countries as well. However, in most countries, the districts are at population of 50,000 to 300,000. Considering that an average district in India is around 20 Lakh (2 million) population, even district level planning may not be detailed enough and to ensure planning for every 200,000 to 300,000; the ‘sub-district level health planning’ should be considered in India. A beginning can be made by selected Indian states and with time, there would be need for 8,000 planning units, one for each block, rather than nearly 760 at district level at present. This could help in equitable planning and allocation of funds, HR and infrastructure.\n\nInnovative approaches for setting up HWCs.\nThe states have used the opportunity to set up HWCs to develop appropriate and innovative approaches at various levels which includes, Partnerships with non-governmental organizations (NGOs) for Urban-PHCs in Karnataka; Public-Private Partnerships through E-urban PHCs in Andhra Pradesh \u0026 Telangana; as well as Medical Officer led models in Kerala, Tamil Nadu \u0026 Puducherry. On the similar line, the Community Health Officers (CHOs) are being selected amongst various approaches such as B.Sc Community Health equivalent in Assam and Chhattisgarh; Ayurveda Practitioners in Maharashtra and Nurses in states such as Jharkhand, Madhya Pradesh, Uttar Pradesh, Andhra Pradesh, Punjab, Karnataka, Telangana, West Bengal, Andaman \u0026 Nicobar Island, Dadar \u0026 Nagar Haveli and all North Eastern states except Assam. The selection of CHO is based upon a mix of health staff in Bihar, Odisha, Gujarat, Rajasthan, Jammu \u0026 Kashmir (J\u0026K) Uttarakhand, Haryana, Daman and Diu, and Unani Practitioners as well in J\u0026K and Maharashtra. The enactment of the National Medical Commission (NMC) Act, 2019 is become a supporting legal instrument for empowering community. The NMC act of 2019, which proposes to empower non-physician providers to prescribe a limited range of medicines. In wake of COVID-19 pandemic, the Board of Governors for Medical Council of India had released new tele-consultation guidelines, which opens a new opportunity for making health services accessible in under-served and difficult areas, in the time ahead. These, along with other opportunities should be used to re-design PHC system as team based and people centric. However, success and effective implementation of this initiative need a stronger focused monitoring of the process.\n\nRevival and expansion of community and civil society participation in health.\nThe engagement with communities, elected representatives, civil society organizations and interest groups in designing the system which people need, demanding for better health services and working together for common cause is increasingly being recognized. This is resulting in opening and supporting many new avenues which directly or indirectly may contribute to better health outcomes and systems in India. These include national knowledge platform; Innovation and learning centres; Ayushman Bharat Ambassadors \u0026 messengers in school; renewed focus on community clinics or frontline health service; health getting far more attention in media as well as Political agenda in general election. There are Sustained expert engagement, research and evidence and Strengthened CSO/CBO engagement for health; Development/revision of many operational guidelines, broadly supplemented by global dialogues and commitments for PHC strengthening.\n\nAppropriate use of digital and mobile health solutions.\nMaking PHC functional needs measuring the results of interventions and improving accountability. Digital technologies can be leveraged to address health challenges in remote areas, generate awareness about health entitlement, deliver preventive and promotive health services, empower people and support communities to look after their own health. Information and communication technology can be used for ensuring referral linkage; measuring results to enhance accountability is making information on health care entitlements and performance publicly available in a transparent manner. The planning and early role out needs to be supported by a robust IT enabled monitoring and evaluation process; real time dash boards, amongst others would be needed to ensure that program designs are implemented, facilities so created are being utilized, services scaled up, the bottlenecks are regularly being identified and corrective measures being taken to improve performance.\n\nStrengthen implementation and operational research capacity.\nThere are a few policy questions which need to be answered in due course. ABP should also be an opportunity to strengthen operational research to support scale up based upon evidence and understanding. There would be a very important role of technical support and implementation research for identifying operational questions and then seeking answers in a scientific way through operational and implementation research. Dept. of Health Research (DHR) and National Knowledge Platform (NKP) as proposed under NHM can play an important role in the process. The emerging policy questions with possible need for operational research need to be a focus. There is a role of evidence, implementation research and capacity building in the process. The institutional mechanisms at both national and sub-national level, with sufficient government funding to support implementation research would be needed. Such platforms should bring policy makers, academic researchers and program managers and all other stakeholders together.\n\nRenewed inter-sectoral collaboration between health and education.\nOne of the example of how HWC dialogue has broadened the scope of health beyond curative care and beyond health department is the concept of Ayushman ambassadors \u0026 Messengers. As part of HWCs initiative, a coordination has been established with department of education. Two teachers, preferably one male and one female, in every school were proposed to be designated “Health and Wellness or Ayushman Ambassadors”. Prior to that the teachers are to be trained in health promotion and disease prevention for one hour every week, through a pre-decided curriculum. The school children are selected as health and wellness or Ayushman messengers and key health messages such as vaccination and hand-washing are communicated to the families through school children. This idea and concept was further formalized with the formulation of guidelines for school health under HWCs, released in Feb 2020."}

{"project":"LitCovid-sentences","denotations":[{"id":"T325","span":{"begin":0,"end":10},"obj":"Sentence"},{"id":"T326","span":{"begin":12,"end":121},"obj":"Sentence"},{"id":"T327","span":{"begin":123,"end":188},"obj":"Sentence"},{"id":"T328","span":{"begin":189,"end":401},"obj":"Sentence"},{"id":"T329","span":{"begin":402,"end":502},"obj":"Sentence"},{"id":"T330","span":{"begin":503,"end":584},"obj":"Sentence"},{"id":"T331","span":{"begin":585,"end":853},"obj":"Sentence"},{"id":"T332","span":{"begin":854,"end":1037},"obj":"Sentence"},{"id":"T333","span":{"begin":1038,"end":1123},"obj":"Sentence"},{"id":"T334","span":{"begin":1125,"end":1167},"obj":"Sentence"},{"id":"T335","span":{"begin":1168,"end":1541},"obj":"Sentence"},{"id":"T336","span":{"begin":1542,"end":1971},"obj":"Sentence"},{"id":"T337","span":{"begin":1972,"end":2181},"obj":"Sentence"},{"id":"T338","span":{"begin":2182,"end":2312},"obj":"Sentence"},{"id":"T339","span":{"begin":2313,"end":2426},"obj":"Sentence"},{"id":"T340","span":{"begin":2427,"end":2679},"obj":"Sentence"},{"id":"T341","span":{"begin":2680,"end":2790},"obj":"Sentence"},{"id":"T342","span":{"begin":2791,"end":2906},"obj":"Sentence"},{"id":"T343","span":{"begin":2908,"end":2985},"obj":"Sentence"},{"id":"T344","span":{"begin":2986,"end":3243},"obj":"Sentence"},{"id":"T345","span":{"begin":3244,"end":3396},"obj":"Sentence"},{"id":"T346","span":{"begin":3397,"end":3680},"obj":"Sentence"},{"id":"T347","span":{"begin":3681,"end":3922},"obj":"Sentence"},{"id":"T348","span":{"begin":3924,"end":3979},"obj":"Sentence"},{"id":"T349","span":{"begin":3980,"end":4076},"obj":"Sentence"},{"id":"T350","span":{"begin":4077,"end":4326},"obj":"Sentence"},{"id":"T351","span":{"begin":4327,"end":4564},"obj":"Sentence"},{"id":"T352","span":{"begin":4565,"end":4947},"obj":"Sentence"},{"id":"T353","span":{"begin":4949,"end":5009},"obj":"Sentence"},{"id":"T354","span":{"begin":5010,"end":5083},"obj":"Sentence"},{"id":"T355","span":{"begin":5084,"end":5211},"obj":"Sentence"},{"id":"T356","span":{"begin":5212,"end":5429},"obj":"Sentence"},{"id":"T357","span":{"begin":5430,"end":5563},"obj":"Sentence"},{"id":"T358","span":{"begin":5564,"end":5657},"obj":"Sentence"},{"id":"T359","span":{"begin":5658,"end":5748},"obj":"Sentence"},{"id":"T360","span":{"begin":5749,"end":5905},"obj":"Sentence"},{"id":"T361","span":{"begin":5906,"end":6027},"obj":"Sentence"},{"id":"T362","span":{"begin":6029,"end":6095},"obj":"Sentence"},{"id":"T363","span":{"begin":6096,"end":6271},"obj":"Sentence"},{"id":"T364","span":{"begin":6272,"end":6365},"obj":"Sentence"},{"id":"T365","span":{"begin":6366,"end":6509},"obj":"Sentence"},{"id":"T366","span":{"begin":6510,"end":6656},"obj":"Sentence"},{"id":"T367","span":{"begin":6657,"end":6854},"obj":"Sentence"},{"id":"T368","span":{"begin":6855,"end":6986},"obj":"Sentence"}],"namespaces":[{"prefix":"_base","uri":"http://pubannotation.org/ontology/tao.owl#"}],"text":"Appendix 2\n\nProposed additional measures to ensure success of AB-HWCs and to strengthen cPHC in India [34, 35, 60-66, 74]\n\nShift health planning unit from districts to sub-district levels.\nConsidering ‘Health’ is a state subject in India, it is appropriate that the discourse on health with financial protection and allocation by states for health services becomes part of state level policy dialogue. Health planning units in India are at district level as is the case in most other countries as well. However, in most countries, the districts are at population of 50,000 to 300,000. Considering that an average district in India is around 20 Lakh (2 million) population, even district level planning may not be detailed enough and to ensure planning for every 200,000 to 300,000; the ‘sub-district level health planning’ should be considered in India. A beginning can be made by selected Indian states and with time, there would be need for 8,000 planning units, one for each block, rather than nearly 760 at district level at present. This could help in equitable planning and allocation of funds, HR and infrastructure.\n\nInnovative approaches for setting up HWCs.\nThe states have used the opportunity to set up HWCs to develop appropriate and innovative approaches at various levels which includes, Partnerships with non-governmental organizations (NGOs) for Urban-PHCs in Karnataka; Public-Private Partnerships through E-urban PHCs in Andhra Pradesh \u0026 Telangana; as well as Medical Officer led models in Kerala, Tamil Nadu \u0026 Puducherry. On the similar line, the Community Health Officers (CHOs) are being selected amongst various approaches such as B.Sc Community Health equivalent in Assam and Chhattisgarh; Ayurveda Practitioners in Maharashtra and Nurses in states such as Jharkhand, Madhya Pradesh, Uttar Pradesh, Andhra Pradesh, Punjab, Karnataka, Telangana, West Bengal, Andaman \u0026 Nicobar Island, Dadar \u0026 Nagar Haveli and all North Eastern states except Assam. The selection of CHO is based upon a mix of health staff in Bihar, Odisha, Gujarat, Rajasthan, Jammu \u0026 Kashmir (J\u0026K) Uttarakhand, Haryana, Daman and Diu, and Unani Practitioners as well in J\u0026K and Maharashtra. The enactment of the National Medical Commission (NMC) Act, 2019 is become a supporting legal instrument for empowering community. The NMC act of 2019, which proposes to empower non-physician providers to prescribe a limited range of medicines. In wake of COVID-19 pandemic, the Board of Governors for Medical Council of India had released new tele-consultation guidelines, which opens a new opportunity for making health services accessible in under-served and difficult areas, in the time ahead. These, along with other opportunities should be used to re-design PHC system as team based and people centric. However, success and effective implementation of this initiative need a stronger focused monitoring of the process.\n\nRevival and expansion of community and civil society participation in health.\nThe engagement with communities, elected representatives, civil society organizations and interest groups in designing the system which people need, demanding for better health services and working together for common cause is increasingly being recognized. This is resulting in opening and supporting many new avenues which directly or indirectly may contribute to better health outcomes and systems in India. These include national knowledge platform; Innovation and learning centres; Ayushman Bharat Ambassadors \u0026 messengers in school; renewed focus on community clinics or frontline health service; health getting far more attention in media as well as Political agenda in general election. There are Sustained expert engagement, research and evidence and Strengthened CSO/CBO engagement for health; Development/revision of many operational guidelines, broadly supplemented by global dialogues and commitments for PHC strengthening.\n\nAppropriate use of digital and mobile health solutions.\nMaking PHC functional needs measuring the results of interventions and improving accountability. Digital technologies can be leveraged to address health challenges in remote areas, generate awareness about health entitlement, deliver preventive and promotive health services, empower people and support communities to look after their own health. Information and communication technology can be used for ensuring referral linkage; measuring results to enhance accountability is making information on health care entitlements and performance publicly available in a transparent manner. The planning and early role out needs to be supported by a robust IT enabled monitoring and evaluation process; real time dash boards, amongst others would be needed to ensure that program designs are implemented, facilities so created are being utilized, services scaled up, the bottlenecks are regularly being identified and corrective measures being taken to improve performance.\n\nStrengthen implementation and operational research capacity.\nThere are a few policy questions which need to be answered in due course. ABP should also be an opportunity to strengthen operational research to support scale up based upon evidence and understanding. There would be a very important role of technical support and implementation research for identifying operational questions and then seeking answers in a scientific way through operational and implementation research. Dept. of Health Research (DHR) and National Knowledge Platform (NKP) as proposed under NHM can play an important role in the process. The emerging policy questions with possible need for operational research need to be a focus. There is a role of evidence, implementation research and capacity building in the process. The institutional mechanisms at both national and sub-national level, with sufficient government funding to support implementation research would be needed. Such platforms should bring policy makers, academic researchers and program managers and all other stakeholders together.\n\nRenewed inter-sectoral collaboration between health and education.\nOne of the example of how HWC dialogue has broadened the scope of health beyond curative care and beyond health department is the concept of Ayushman ambassadors \u0026 Messengers. As part of HWCs initiative, a coordination has been established with department of education. Two teachers, preferably one male and one female, in every school were proposed to be designated “Health and Wellness or Ayushman Ambassadors”. Prior to that the teachers are to be trained in health promotion and disease prevention for one hour every week, through a pre-decided curriculum. The school children are selected as health and wellness or Ayushman messengers and key health messages such as vaccination and hand-washing are communicated to the families through school children. This idea and concept was further formalized with the formulation of guidelines for school health under HWCs, released in Feb 2020."}

{"project":"LitCovid-PubTator","denotations":[{"id":"192","span":{"begin":2775,"end":2781},"obj":"Species"},{"id":"193","span":{"begin":1594,"end":1598},"obj":"Disease"},{"id":"194","span":{"begin":2438,"end":2446},"obj":"Disease"},{"id":"195","span":{"begin":1989,"end":1992},"obj":"CellLine"},{"id":"197","span":{"begin":3122,"end":3128},"obj":"Species"},{"id":"199","span":{"begin":4264,"end":4270},"obj":"Species"},{"id":"201","span":{"begin":5084,"end":5087},"obj":"Chemical"},{"id":"205","span":{"begin":6668,"end":6676},"obj":"Species"},{"id":"206","span":{"begin":6845,"end":6853},"obj":"Species"},{"id":"207","span":{"begin":6283,"end":6298},"obj":"Disease"}],"attributes":[{"id":"A192","pred":"tao:has_database_id","subj":"192","obj":"Tax:9606"},{"id":"A194","pred":"tao:has_database_id","subj":"194","obj":"MESH:C000657245"},{"id":"A195","pred":"tao:has_database_id","subj":"195","obj":"CVCL:0213"},{"id":"A197","pred":"tao:has_database_id","subj":"197","obj":"Tax:9606"},{"id":"A199","pred":"tao:has_database_id","subj":"199","obj":"Tax:9606"},{"id":"A205","pred":"tao:has_database_id","subj":"205","obj":"Tax:9606"},{"id":"A206","pred":"tao:has_database_id","subj":"206","obj":"Tax:9606"},{"id":"A207","pred":"tao:has_database_id","subj":"207","obj":"MESH:D007319"}],"namespaces":[{"prefix":"Tax","uri":"https://www.ncbi.nlm.nih.gov/taxonomy/"},{"prefix":"MESH","uri":"https://id.nlm.nih.gov/mesh/"},{"prefix":"Gene","uri":"https://www.ncbi.nlm.nih.gov/gene/"},{"prefix":"CVCL","uri":"https://web.expasy.org/cellosaurus/CVCL_"}],"text":"Appendix 2\n\nProposed additional measures to ensure success of AB-HWCs and to strengthen cPHC in India [34, 35, 60-66, 74]\n\nShift health planning unit from districts to sub-district levels.\nConsidering ‘Health’ is a state subject in India, it is appropriate that the discourse on health with financial protection and allocation by states for health services becomes part of state level policy dialogue. Health planning units in India are at district level as is the case in most other countries as well. However, in most countries, the districts are at population of 50,000 to 300,000. Considering that an average district in India is around 20 Lakh (2 million) population, even district level planning may not be detailed enough and to ensure planning for every 200,000 to 300,000; the ‘sub-district level health planning’ should be considered in India. A beginning can be made by selected Indian states and with time, there would be need for 8,000 planning units, one for each block, rather than nearly 760 at district level at present. This could help in equitable planning and allocation of funds, HR and infrastructure.\n\nInnovative approaches for setting up HWCs.\nThe states have used the opportunity to set up HWCs to develop appropriate and innovative approaches at various levels which includes, Partnerships with non-governmental organizations (NGOs) for Urban-PHCs in Karnataka; Public-Private Partnerships through E-urban PHCs in Andhra Pradesh \u0026 Telangana; as well as Medical Officer led models in Kerala, Tamil Nadu \u0026 Puducherry. On the similar line, the Community Health Officers (CHOs) are being selected amongst various approaches such as B.Sc Community Health equivalent in Assam and Chhattisgarh; Ayurveda Practitioners in Maharashtra and Nurses in states such as Jharkhand, Madhya Pradesh, Uttar Pradesh, Andhra Pradesh, Punjab, Karnataka, Telangana, West Bengal, Andaman \u0026 Nicobar Island, Dadar \u0026 Nagar Haveli and all North Eastern states except Assam. The selection of CHO is based upon a mix of health staff in Bihar, Odisha, Gujarat, Rajasthan, Jammu \u0026 Kashmir (J\u0026K) Uttarakhand, Haryana, Daman and Diu, and Unani Practitioners as well in J\u0026K and Maharashtra. The enactment of the National Medical Commission (NMC) Act, 2019 is become a supporting legal instrument for empowering community. The NMC act of 2019, which proposes to empower non-physician providers to prescribe a limited range of medicines. In wake of COVID-19 pandemic, the Board of Governors for Medical Council of India had released new tele-consultation guidelines, which opens a new opportunity for making health services accessible in under-served and difficult areas, in the time ahead. These, along with other opportunities should be used to re-design PHC system as team based and people centric. However, success and effective implementation of this initiative need a stronger focused monitoring of the process.\n\nRevival and expansion of community and civil society participation in health.\nThe engagement with communities, elected representatives, civil society organizations and interest groups in designing the system which people need, demanding for better health services and working together for common cause is increasingly being recognized. This is resulting in opening and supporting many new avenues which directly or indirectly may contribute to better health outcomes and systems in India. These include national knowledge platform; Innovation and learning centres; Ayushman Bharat Ambassadors \u0026 messengers in school; renewed focus on community clinics or frontline health service; health getting far more attention in media as well as Political agenda in general election. There are Sustained expert engagement, research and evidence and Strengthened CSO/CBO engagement for health; Development/revision of many operational guidelines, broadly supplemented by global dialogues and commitments for PHC strengthening.\n\nAppropriate use of digital and mobile health solutions.\nMaking PHC functional needs measuring the results of interventions and improving accountability. Digital technologies can be leveraged to address health challenges in remote areas, generate awareness about health entitlement, deliver preventive and promotive health services, empower people and support communities to look after their own health. Information and communication technology can be used for ensuring referral linkage; measuring results to enhance accountability is making information on health care entitlements and performance publicly available in a transparent manner. The planning and early role out needs to be supported by a robust IT enabled monitoring and evaluation process; real time dash boards, amongst others would be needed to ensure that program designs are implemented, facilities so created are being utilized, services scaled up, the bottlenecks are regularly being identified and corrective measures being taken to improve performance.\n\nStrengthen implementation and operational research capacity.\nThere are a few policy questions which need to be answered in due course. ABP should also be an opportunity to strengthen operational research to support scale up based upon evidence and understanding. There would be a very important role of technical support and implementation research for identifying operational questions and then seeking answers in a scientific way through operational and implementation research. Dept. of Health Research (DHR) and National Knowledge Platform (NKP) as proposed under NHM can play an important role in the process. The emerging policy questions with possible need for operational research need to be a focus. There is a role of evidence, implementation research and capacity building in the process. The institutional mechanisms at both national and sub-national level, with sufficient government funding to support implementation research would be needed. Such platforms should bring policy makers, academic researchers and program managers and all other stakeholders together.\n\nRenewed inter-sectoral collaboration between health and education.\nOne of the example of how HWC dialogue has broadened the scope of health beyond curative care and beyond health department is the concept of Ayushman ambassadors \u0026 Messengers. As part of HWCs initiative, a coordination has been established with department of education. Two teachers, preferably one male and one female, in every school were proposed to be designated “Health and Wellness or Ayushman Ambassadors”. Prior to that the teachers are to be trained in health promotion and disease prevention for one hour every week, through a pre-decided curriculum. The school children are selected as health and wellness or Ayushman messengers and key health messages such as vaccination and hand-washing are communicated to the families through school children. This idea and concept was further formalized with the formulation of guidelines for school health under HWCs, released in Feb 2020."}