Traversing difficult terrain of Arunachal Pradesh

Testing of a model to strengthen Emergency Care Services at Primary health care setting in South – East Asia Region

According to WHO, about 930 million people worldwide are at risk of falling into poverty due to out-of-pocket health spending of 10% or more of their household budget and scaling up primary health care (PHC) interventions across low and middle-income countries could save 60 million lives and increase average life expectancy by 3.7 years by 2030.

Taking this into account, the World Health Organization Collaborating Centre for Emergency and Trauma Care (WHO CCET), Department of Emergency Medicine, JPN Apex Trauma Centre – All India Institute of Medical Sciences (AIIMS), New Delhi, conducted a pilot study to test a model to strengthen Emergency Care Services at Primary Health Care settings during 1st phase of COVID -19 at two sites(CHCs), Wakro and Mechuka (Arunachal Pradesh), which are located in one of the most difficult terrains of Arunachal Pradesh where access to health & emergency services and internet connectivity is constrained.

Selection of the sites for implementation of emergency care model was done under the directions of Ministry of Health, Arunachal Pradesh. Under the leadership of the WHO CCET team at AIIMS, New Delhi via virtual support, the WHO CCET on site coordinators conducted baseline gap assessment and developed the need based standardised model intervention packages to install an efficient and effective emergency care system. The emergency care area was reorganized & designated as per the patient flow by the site coordinators. The team provided regular capacity building trainings for the CHC staff, covering a variety of topics such as triage, organization of emergency care area, resuscitation, management of emergency conditions & Point of care ultrasound (POCUS), ECG, resuscitation, and specific conditions such as bites and stings etc. Virtual knowledge and skill sessions, case discussions, and both tele and on- site simulations were used to train the staff. The site coordinators also conducted community awareness programs for emergency care at schools, health fairs and other community gatherings.

As a result, the goal of the study to develop a low-cost, practical, and replicable emergency care system at two locations was met successfully.

In addition to this, WHO SEARO offered support to these CHCs by providing necessary equipment to ensure that patients visiting with emergency complaints receive excellent, fast, and effective emergency care. WHO CCET – SEAR delivered training and guidance documents on how to use and handle the equipments and medical devices provided by WHO – SEARO in order to continue using them in the future.