• Wed. Jun 19th, 2024

Consultation on ‘A Sustainable Dialysis Care Ecosystem in the NER’ held at Guwahati

A brainstorming session on Sustainable Dialysis Care Ecosystem in the North-East region (NER) with all stake holders from Northeast states and private service providers engaged in delivery of dialysis services in the country was undertaken at Guwahati today.

In this session, Vishal Chauhan IAS Joint Secretary (Policy), MoHFW, Government of India deliberated upon the different issues related to NER.He also emphasised that funding is not a problem; if there is a need of fund for site preparation for the dialysis centres, the fund in the NHM pool can be utilized and also get eligible for further release of release of fund.

Vishal Chauhan further re-iterated that the objective of the meeting is to develop a sustainable dialysis care ecosystem in the NER with the help of private service partners in the Public-private partnership model. States/UTs are supported by MoHFW under the National Health Mission for implementation of Pradhan Mantri National Dialysis Programme (PMNDP) at all the District Hospitals. All BPL patients are getting free of cost dialysis services under PMNDP.

PMNDP was announced by the Ministry of Health & Family Welfare in 2016 under the National Health Mission (NHM).The PMNDP aims at strengthening of District Hospitals by providing affordable dialysis services. The first phase of program was envisaged for setting up of haemodialysis centers across all the districts of country.

Availability of nephrologists and proximity to multi-specialty hospitals are other parameters to consider as Chronic Kidney Diseases (CKDs) patients are usually in a fragile state of health and the likelihood of any life-threatening emergency arising anytime need to be addressed. Huge opportunity exists in NER in providing reliable dialysis services for all and in ensuring better accessibility.

Every year about 2.2 Lakh new patients with end-stage renal disease get added in India resulting in additional demand for 3.4 crore dialysis each year. As per a study in 2016, “Health of the Nation’s States: India State-Level Disease Burden”, NCDs accounted for nearly 61.8 per cent of the total deaths, while communicable, maternal, and nutritional diseases caused 27.5 per cent of deaths. However, the proportion of total disease burden for NCDs amongst the NER states ranged from 51.2% to 57.5% in 2016 as per the said report. Chronic Kidney Disease was one among the top 10 disease causing Years of Life Lost (YLL).

The number of dialysis patients are increasing as a greater number of dialysis centre established in the State. Nearly 14500 new patients with CKD had been registered in the different public Dialysis Centres in NER during April to October 2022 and 1.40 Lakhs dialysis sessions have been conducted in addition to the services availed at private sector. A Central Registry will be of immense help.

Moving towards the Central Registry and for maintenance of health records of a patients, ABHA (Ayushman Bharat Health Account) number is a 14-digit number that will uniquely identify a patient in India’s digital healthcare ecosystem. A portal for creating state registry using ABHA IDs is already operational which offers visibility and portability of the dialysis patient to avail dialysis free of cost in any district of the state in case a vacant slot is available. This concept of ‘One State-one Dialysis’ will eventually progress to ‘One Nation -One Dialysis’ in the country.

The NER traditionally suffers from poor supply chain due to connectivity and transportation issues. Non-availability of a favourable dialysis ecosystem in the Northeast, may be due to various factors like lack of Nephrologists, poor supply chain regarding equipment & consumables, lack of trained staff (dialysis technicians), poor after sales service/spare availability etc.

Assam, Sikkim & Tripura are expected for providing dialysis services in all the districts by 2022-23 but still lagging in other five North Eastern States viz. Arunachal Pradesh, Manipur, Meghalaya, Mizoram, and Nagaland. At present 9 district out of 25 in Arunachal Pradesh, 26 out of 33 districts in Assam, 9 out of 16 in Manipur, 3 out of 11 in Meghalaya, 4 out of 9 in Mizoram, 3 out of 12 in Nagaland, 3 out of 4 Sikkim and 7 out of 8 districts in Tripura PMNDP are available to cater dialysis services in the States. In the NER, the programme is being implemented in 72 Public Health facilities across 64 districts with deployment of 400 machines as of October 2022.

The state of Arunachal Pradesh and Assam have implemented the programme through Public Private Partnership and Tripura has implemented it in mixed model, and State of Manipur, Meghalaya, Nagaland, and Sikkim have implemented it in In-house mode.

The journey towards ‘One Nation, One Dialysis’ has already started in NER under National Health Mission. To intensify the effort in NER, the central team from MoHFW and the service partners in PPP model had an extensive discussion for building a robust ecosystem for scaling up dialysis services in the Northeast region.

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