ID-5184 Wonca Abstracts supplement A-K 13-10-23 - Flipbook - Page 15
WONCA 2023 Supplement 1: WONCA 2023 abstracts (A–K)
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Caring for disadvantaged urban communities in India:
The role of community health workers in a multidisciplinary
team of family medicine
Dr Sunil Abraham, Khare Manorama, Archna Gupta
Christian Medical College, Vellore
Aim
To describe an effective family medicine model to care for the urban disadvantaged population in India.
Content
Universal healthcare should provide everyone access to effective health services built on a foundation
of primary care with appropriate referral systems. The hospital-based, specialist-driven healthcare
model in India without a network of effective primary care is expensive and focuses on treatment of
diseases, ignoring prevention, early detection and long-term management.
The Low Cost Effective Care Unit (LCECU) of Christian Medical College (CMC), Vellore, is a 48-bed unit
for disadvantaged urban communities of Vellore town. Functioning under the Department of Family
Medicine, the unit provides them highly subsidised inpatient and outpatient services. Following a
strategic planning exercise in 2015, the providers recognised that many poor patients did not come to
the unit despite offering subsidised care. To respond to this a shift was made towards a communityoriented primary care model. Three community health workers (CHWs) were employed to work in
five designated communities and trained about common health problems, engaging the community
and working with family physicians and other health professionals. Their work included enumeration
of residents in the communities, screening for diabetes and hypertension and maintaining a registry
of patients with chronic disease, biweekly visits to homes in each community, organising weekly or
fortnightly clinics and providing health education. Along with volunteers from the communities, the
CHWs became key players in a primary care network that has expanded over the past six years
to seven communities with five CHWs. The network includes a team of physicians, a nurse, social
workers and volunteers from the community to respond to any urgent health needs or follow-up with
patients discharged from the unit. The LCECU multidisciplinary model demonstrates the role of CHWs
in providing a connecting vital link.
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