Tuesday, Aug 31, 2010
Experimental community-based health-care delivery system at Vattiyoorkavu

• Polyclinic is the cornerstone of the Cuban model
• A community under the care of a doctors' team

Thiruvananthapuram: The Health Department has set up a polyclinic at the Vattiyoorkavu primary health centre on an experimental basis as part of its pioneering project to set up a Cuban-model community-based primary health-care delivery system in the State.

The polyclinic is the cornerstone of the Cuban model of health care, providing an array of services in various medical specialties to a population of nearly 30,000 in a specific geographical region. Along with the unit of a family doctor and a nurse, the polyclinic has a role in community health education and in encouraging preventive medicine by helping people follow a healthy lifestyle. The idea is that a team of doctors will be responsible for the health of a small community. For instance, every child in the community will have the same paediatrician.

A Government Order has been issued to rope in doctors from the Government Medical College Hospital and major government hospitals for running the outpatient clinics from 9 a.m. to 1 p.m. at the polyclinic

Schedule
The schedule drawn up says that on Mondays, a physician and diabetes specialist will be in attendance at the polyclinic; Tuesdays, gynaecologist and paediatrician; Wednesdays, surgeon and orthopaedic; Thursdays, ENT specialist and ophthalmologist; and Fridays, specialists in neurology, cardiology, endocrinology, psychiatry and so on. These will be conducted in rotation through the month.

Doctors from the General Hospital, Women and Children's Hospital and the Government Hospital, Peroorkada, will attend the weekly clinics, while for super-specialties such as cardiology and neurology, doctors from the medical college will be called in.

Only outpatient clinics will be conducted, while a sterile theatre for minor surgical or gynaecology procedures is being planned. The patients who require surgeries or delivery services can be referred by the doctor to the institution where he or she originally serves.

“The Cuban model has essentially four concepts. We have already set up the clinical registry and the polyclinic. We are working on setting up the family-doctor-nurse unit and a palliative medicine unit,” a senior Health Department official said.

The government decided to rope in government and medical college doctors to ensure quality of service and sustainability. However, the district health authorities say that though only two weeks have passed since the polyclinic was launched, they were facing stiff resistance from doctors, as they refuse to serve at the primary health centre.

“It is only a half-day, once-a-week clinic for streams such as gynaecology or surgery. For super-specialties such as cardiology and neurology, it will be just one half-day clinic once a month. We also have vehicles to pick up doctors and drop them back,” an official says.