Community Health Directorate
The public health outreach programs are managed by Community Health Directorate (CHD) — the public arm of the Indus Hospital and Health Network (IHHN) — implementing community and facility-based programs across the country.
These programs focus on infectious diseases, Maternal and Neonatal Child Health (MNCH), non-communicable diseases, global surgery, mental health, and primary care programs across all campuses and in communities. The Directorate, with the support of some national and international stakeholders and donors is running multiple public health projects.
Its scope of service includes implementation at scale of public health programs and comprehensive primary care facilities across the country. Scaling-up innovative approaches, mobile health technology, and a strong network of community health workers, CHD’s service delivery in the community and at the primary level is closely coordinated with local secondary and tertiary care facilities. CHD successfully implemented interventions at hospital and community settings across Pakistan and have been able to impact over 1 million people, so far.
The antiretroviral therapy (ARV) treatment center at Indus Hospital & Health Network, Korangi focuses on scaling-up programmatic management of people who inject drugs affected by HIV, while new Intravenous Drug Users (IVDUs) are registered and put on ARV treatment.
The programmatic management approach introduced support to patients beyond clinical care by deploying a team that would facilitate regular follow-ups at the household; counseling for adherence, depression, and anxiety to help decrease the loss to follow-up.
Pakistan is facing an epidemic of HIV. Most of the victims are persons who inject drugs; men who have sex with men; transgender; and female sex workers. These populations have specific dynamics and they are the most marginalized groups. IHHN started a sole clinic for key affected population in October 2018. The HIV program incorporates Voluntary Counselling and Testing (VCT), Antiretroviral Therapy clinic and adherence, family counseling, and outreach.
HEPATITIS C (HCV) CONTROL PROGRAM
Since its inception in October 2016, the HCV Control program has been replicated across eight rural and urban sites of Pakistan. Approximately 122,478 patients (as of July 2020) above 13 years have been screened using WHO-approved rapid diagnostic test kits.
The majority of the patients fall between 35 to 44 years with 50 per cent being females. This has been possible through the training of up to family medicine doctors, nurses, and health workers across all eight rural and urban sites.
Decentralizing HCV screening through integration in routine patient process flow of family medicine clinics (at Primary Care Program sites), ‘Aao TB Mitao’ initiative, community-based activities run by Community Engagement Center (CEC) and Emergency Department services has helped identify confirmed cases, who could have gone undetected and possibly presented at a later untreatable stage of illness.
The program model has also been very instrumental to ensure linkage of suspected cases, identified incidentally during blood donation drives in Karachi.
The program continues to expand its scope of prevention, screening, and treatment activities to create awareness and actively identify suspected cases to slow down community-based transmission, hence contributing to curb this silent epidemic — a public health emergency in Pakistan.
SAFE CIRCUMCISION PROGRAM
The Safe Circumcision Program is a service delivery program based within the Sheikh Saeed Memorial Campus, Karachi. It is a pilot program that uses the concept of task sharing whereby Community Health Workers (CHWs), technicians, and midwives are trained by the pediatric surgeons to perform safe circumcisions on male babies under three months of age, using the “plastibell technique” and adhering to stringent infection control practices under close supervision and monitoring.
Since its inception, more than 7,000 babies (as of July 2020) have been circumcised.
- Sheikh Saeed Memorial Campus, Karachi: started in June 2016
- Recep Tayyip Erdogan Hospital, Muzaffargarh: started in December 2017
PATIENT MONITORED SURGICAL SITE INFECTION STUDY
Initiated in October 2015, the study is designed to determine effective methods to identify the presence of a Surgical Site Infection that has a minimum burden on a low-resource health system. The study was conducted at Indus Hospital, Korangi. In phase II, it was extended to Sheikh Saeed Memorial Campus, Korangi. As a result, WHO recommended “Safe Surgery Checklists” were implemented in both campuses.
VASCULAR ANOMALIES CENTER
In January 2017, Indus initiated a multidisciplinary, facility-based treatment program by the name of ‘Vascular Anomalies Center’ at Indus Hospital & Health Network, Korangi, under the direct supervision of the Pediatric Surgery Department.
Vascular anomalies are complex conditions commonly seen in children and can be disfiguring. This program provides a comprehensive, one-stop diagnostic, and treatment center.
A PDL laser machine – V Beam Perfecta, was donated to Indus Hospital & Health Network in January 2017 for the treatment of vascular anomalies.
This program is jointly run by Pediatric Surgery, Dermatology, and Radiology departments with expertise from other departments being provided as needed. International experts have contributed to the capacity building of the Indus team.
DIABETES MANAGEMENT PROGRAM
Initiated in September 2014, at Indus Hospital & Health Network, Korangi, the Diabetes Management Program enrolls all eligible diabetic patients and provides them with comprehensive diabetes management including annual eye and foot screening; diabetes education; individualized nutritional counseling; and helpline services. The objective of the program is to assist people with diabetes helping them manage the disease, provide relief from symptoms, and improve their quality of life by reducing and delaying the onset of complications.
The digital registry of ‘Zindagi Mehfooz’ was launched in October 2012 to improve the timely vaccination coverage status of children visiting TIH for immunization. Since 2012, vaccinators at Expanded Programme on Immunization centers in Korangi Town have also been incorporated into the program. Children visiting any of these centers for immunization are similarly added to the registry for SMS reminders.
FAMILY PLANNING PROGRAM
CHD launched a Family Planning program in collaboration with the Population Welfare Department and Government of Punjab through the Public Health Initiative at Recep Tayyip Erdogan Hospital.