PMC:7340764 / 14624-22587 JSONTXT 11 Projects

Annnotations TAB TSV DIC JSON TextAE

Id Subject Object Predicate Lexical cue
T101 0-117 Sentence denotes Table 2 Challenges in PHC system, provisions through AB-HWCs and complementarity with NHM in India [1, 3, 27, 28, 31]
T102 118-287 Sentence denotes Health System Function Challenges in PHC system (Indicative) AB-HWC and related initiatives Ongoing and other proposed initiatives (including NHM & other state specific)
T103 288-417 Sentence denotes Service provision and delivery ▪ Narrow range of six services (mostly focused on Maternal & child health and infectious diseases)
T104 418-446 Sentence denotes ▪ Curative care predominance
T105 447-618 Sentence denotes ▪ ‘Continuum of care’ mostly for maternal and child health services ▪ Stronger focus on service delivery with an enhanced package of 12 services (from existing 6 services)
T106 619-755 Sentence denotes ▪ Attention on preventive and promotive health services; focus on wellness and lifestyle modification, specifically for chronic diseases
T107 756-905 Sentence denotes ▪ Integration with Indian systems of medicine, AYUSH, including the promotion of Yoga as form of lifestyle change to tackle non-communicable diseases
T108 906-980 Sentence denotes ▪ Population based screening for common conditions including three cancers
T109 981-1095 Sentence denotes ▪ Attention on quality and patient safety; Develop standard treatment flows (STF) for peripheral health facilities
T110 1096-1156 Sentence denotes ▪ Extending prescription rights to CHO through legal process
T111 1157-1328 Sentence denotes ▪ Adopt ‘Resolve more & refer less’ approach at peripheral health facilities; strengthening of referral system to ensure continuity of care; Telemedicine and consultations
T112 1329-1511 Sentence denotes ▪ Enhanced provision of point of care diagnostics at both levels HWC- HSC and HWC-PHC ▪ Community based network of ASHA and VHNSC to support preventive and promotive health services.
T113 1512-1582 Sentence denotes ▪ State specific models of service delivery to provide cross learnings
T114 1583-1661 Sentence denotes ▪ Build on systems for emergency referral and transport; established under NHM
T115 1662-1764 Sentence denotes ▪ Utilise strengthening of secondary care services & District hospitals for effective referral linkage
T116 1765-1849 Sentence denotes ▪ Build upon quality standards and mechanism for ensuring use of treatment protocols
T117 1850-1982 Sentence denotes ▪ Community Health Officers (CHO) proposed in the National Medical Commission (NMC) Act to strengthen public health service delivery
T118 1983-2066 Sentence denotes Human resources and infrastructure ▪ Shortage of infrastructure and human resources
T119 2067-2093 Sentence denotes ▪ Inequitable distribution
T120 2094-2212 Sentence denotes ▪ Health Sub-centres (HSCs) led by one or two Auxiliary nurse midwife (ANM) who has focus on Mother and child services
T121 2213-2403 Sentence denotes ▪ Narrow range of skills and services at lower level PHC facilities ▪ Provision of Mid-level healthcare provider (MLHP), trained in 6-month course at AB-HWCs to address common health problem
T122 2404-2473 Sentence denotes ▪ Institutional strengthening for increased annual production of MLHP
T123 2474-2564 Sentence denotes ▪ Task shifting to different cadre of healthcare providers and team-based service delivery
T124 2565-2647 Sentence denotes ▪ Proposal to change the roles of ANMs as multi-purpose workers (female) or MPW- F
T125 2648-2828 Sentence denotes ▪ Services at the HWC-HSC, to be delivered through a team, led by a new cadre of non-physician health worker, a MLHP or CHO, supported by one or two multipurpose workers, and ASHAs
T126 2829-2960 Sentence denotes ▪ Shift from doctor centric facilities to a team-based service delivery where provision of providers is dependent upon service need
T127 2961-3065 Sentence denotes ▪ AYUSH providers to be mainstreamed in PHC systems ▪ Recruitment of contractual providers in the system
T128 3066-3139 Sentence denotes ▪ Flexibility to states in salary for HR, under NHM to ensure recruitment
T129 3140-3194 Sentence denotes ▪ Institutionalize the mechanisms for training of MLHP
T130 3195-3323 Sentence denotes ▪ Consider an All India cadre of specialist doctors to tackle shortage of specialist doctors & that of public health specialists
T131 3324-3398 Sentence denotes ▪ Innovation in human resources including incentives to recruit and retain
T132 3399-3454 Sentence denotes Health financing ▪ Limited government funding on health
T133 3455-3514 Sentence denotes ▪ High OOPE to the range of 60% of total health expenditure
T134 3515-3559 Sentence denotes ▪ Budget mostly line item-based funding only
T135 3560-3606 Sentence denotes ▪ Limited use of strategic purchasing services
T136 3607-3770 Sentence denotes ▪ People get poor because of health expenditures ▪ Reforms on provider payment mechanisms including the introduction of performance-linked incentives in PHC system
T137 3771-3890 Sentence denotes ▪ Mechanisms to reduce cost of health seeking through assured provision of more medicines and point of care diagnostics
T138 3891-3971 Sentence denotes ▪ Performance-linked payments to the MLHP and to the team of front-line workers.
T139 3972-4286 Sentence denotes ▪ MLHP to get salary on blended formula –a fixed component and incentives linked to key outcomes, measured through IT platform-based monitoring system with key performance indicators ▪ Increased government allocation for primary health care, through formula-based approach and sharing between union and state level
T140 4287-4336 Sentence denotes ▪ Capacity building of states in health financing
T141 4337-4472 Sentence denotes Medicines and vaccines ▪ Many states started free medicines and diagnostics scheme, yet govt spending as share on cost of medicines low
T142 4473-4569 Sentence denotes ▪ Medicines and access to diagnostics mostly at higher level facilities and no assured provision
T143 4570-4607 Sentence denotes ▪ Medicines major cost paid by people
T144 4608-4705 Sentence denotes ▪ Irrational use of medicines ▪ Revision and expansion of essential medicines & diagnostics lists
T145 4706-4815 Sentence denotes ▪ Assured provision of larger basket of medicines with inclusion of additional medicines for chronic diseases
T146 4816-4885 Sentence denotes ▪ Assured dispensing of medicines for longer duration of 4 wk or more
T147 4886-4955 Sentence denotes ▪ Attention on expanded range of diagnostic services of Point of Care
T148 4956-5057 Sentence denotes ▪ Proposal for rapid expansion of Pradhan Mantri Jan Aushadhi stores for low cost & generic medicines
T149 5058-5131 Sentence denotes ▪ Proposal for setting up state level procurement and supply corporations
T150 5132-5355 Sentence denotes ▪ Provision of dispensing medicines from HWCs, for patients who need long term treatment and initially attended care at higher level of facilities ▪ Provision of free medicines and diagnostics (as well as schemes) under NHM
T151 5356-5470 Sentence denotes ▪ Strengthening of Mission Indradhanush for increasing coverage with vaccines under Universal Immunization Program
T152 5471-5576 Sentence denotes ▪ Launch of state specific free medicines and free diagnostics schemes with enhanced budgetary allocation
T153 5577-5636 Sentence denotes Health information systems ▪ Weak health information system
T154 5637-5667 Sentence denotes ▪ Limited use of ICT platforms
T155 5668-5832 Sentence denotes ▪ Delay in recording and reporting of health data ▪ Attention to build a robust ICT system for population enumeration, enrolment, tracking and follow-up of patients
T156 5833-5904 Sentence denotes ▪ Attention on registration of beneficiaries at associated HWC facility
T157 5905-5969 Sentence denotes ▪ Increased use of mobile based technology and hand-held devices
T158 5970-6031 Sentence denotes ▪ Provision of tele-health and tele-medicine at each facility
T159 6032-6372 Sentence denotes ▪ Use of Digital technology and ICT platforms (proposed for) to ensure continuity of care through universal population empanelment and registration to a HWC, facilitating performance payments and ensuring continuity of care and also for improved recording & reporting system ▪ Telemedicine and tele-radiology services as per the local needs
T160 6373-6430 Sentence denotes ▪ Health Management Information System (HMIS) established
T161 6431-6474 Sentence denotes Governance and leadership ▪ Weak regulation
T162 6475-6525 Sentence denotes ▪ Limited transition of policy into implementation
T163 6526-6570 Sentence denotes ▪ Health state subject and variable priority
T164 6571-6747 Sentence denotes ▪ The job -descriptions of various health staff are not aligned with the activities they do ▪ High level political and administrative priority assigned to AB-HWCs at all levels
T165 6748-6833 Sentence denotes ▪ System and coordination mechanism being proposed to link PHC services with AB-PMJAY
T166 6834-6905 Sentence denotes ▪ National Knowledge Platform for implementation & operational research
T167 6906-6943 Sentence denotes ▪ Revisions of operational guidelines
T168 6944-6994 Sentence denotes ▪ Enhanced community-based monitoring for AB-HWCs.
T169 6995-7040 Sentence denotes ▪ Regular reviews on progress and performance
T170 7041-7307 Sentence denotes ▪ Revision in responsibilities of auxiliary nurse midwife to make them multi-purpose workers ▪ A number of governance and leadership mechanisms were established under NHM level including mission steering groups at top level to community based VHSNC at village level.
T171 7308-7374 Sentence denotes ▪ The Clinical Establishment Registration and Regulation Act, 2010
T172 7375-7446 Sentence denotes ▪ Stronger community and civil society participation in health services
T173 7447-7963 Sentence denotes AB-HWCs Ayushman Bharat- Health & Wellness Centres; AB-PMJAY Ayushman Bharat- Pradhan Mantri Jan Arogya Yojana; ASHA Accredited Social Health Activist; HR Human resources; HWC-HSC Health & Wellness Centres- Health Sub-Centers; HWC-PHC Health & Wellness Centres- Primary Health Care; ICT Information and communication technology; NHM National Health Mission; NMC Act The National Medical Commission Act; OOPE Out of pocket expenditure; PHC Primary Health care; VHNSC Village health, nutrition and sanitation committee