Saturday, May 30, 2020

National Formulary of India (NFI)



The need of a national level drug database has been recognized as a priority by the government in recent times. Even though it has gained government's attention it will take some time for a national level Drug Index to be available. Hence, we recommend the use of National Formulary of India (NFI) as a standard drug database. NFI has been adopted from World Health Organization (WHO) Model Formulary. For the promotion of rational use of drugs, the Indian Pharmacopiea Commision publishes National Formulary of India (NFI) at regular time intervals. The Formulary enlists the generic drugs, their classification, dosage, availability, indications, contradictions,precautions. To facilitate the use of NFI, the branded drugs can be mapped against the specific generic drugs or generic drug combinations and use relevant MDDS data elements and Code directories to prescribe their usage in a standardized format. 
  • CSV Format NFI: 
    https://drive.google.com/file/d/1vJUIWg971MIVreMrbBhZ3cQ--IpL_bG0/view?usp=sharing
  • PDF Format NFI: 
    https://drive.google.com/file/d/1xJK9X1rHnbdloHTvpQUH92w4reMOGZFd/view?usp=sharing
  • PDF Format NFI Update: 
    https://drive.google.com/file/d/11V8XjQRLfqjN2PoiRzorCtrdrcOdIlsH/view?usp=sharing
The document also consists of a proposed Drug Index template beyond the NFI. Since, the availability of a standardized drug database is of utmost priority in the present scenario. The structure of the template is largely based on MDDS with some added custom fields. The template consists of the following fields. 

Drug Classification
Drug Unique Code
Generic Drug Code 
Generic Drug Name
Brand Drug Code
Brand Drug Name
Manufacturer 
Drug Form
Strength Value
Drug Frequency
Route of administration
Drug Restriction (Max Dosage)
Drug Drug Interaction
Alternate Drug (generic drug)
Medication package type 

Note: NFI is a list of Drug Generic Names only. It is left to the users, vendors and the industry to get together and populate the Drug Brands etc. at the time of implementation and/or based on the Physician preferences.

Thank You for your continuous association with us.

-- ACCESS Health Digital --

Contact for Clarifications:
Access Health Digital
digital.health@accessh.org

Friday, May 22, 2020

ASHA: Health Worker Registry

 


Download the Full Report Here.

A federated health worker registry is proposed that will be maintained by the Central Government and will store “identified minimum required informative fields” and will assign a “unique identification number” for every ASHA worker. The ASHA registry will have pointers to the state ASHA enrollment repositories or databases (DBT, HR etc) that will push relevant data to the central registry for every new ASHA enrollment, any information updation or change in employment status or location.

Whenever a new ASHA health worker gets selected for final recruitment, gets enrolled through an online common cloud-based portal or application by a trained staff appointed by the district health dept or a private enrollment agency at the PHC or assigned anganwadi center maintained at village or district level. 

The enrollment process mandates ADHAAR card number authentication with the UIDAI and assigns a unique health worker identification number in the centralized registry. This Unique ID is unique across the country and ensures the portability of health workers from one district or state to another and provides a global mapping of the health worker ID with services delivered at the health and in various vertical health and nutrition IT programs.

This enrollment process may include an enroller-approver flow to get a final approval from the nodal/district health officer to foolproof the recruitment process and only after the approval a new ASHA can be assigned the Unique ID.

The DBT database at state level is required to be linked to the centrally maintained registry for every new enrollment as a prerequisite for activating the DBT service. Since an ADHAAR number is already a mandatory requirement for authenticating the DBT account, the same ADHAAR number should be used to authenticate every new ASHA enrollment and will facilitate single source for non-repudiable data.

It is suggested that a DBT account of the newly recruited ASHA will only be created after the unique ID is assigned to her. Unique ID becomes a pre-requisite for DBT payments. Any national or state program that requires assistance from ASHA on various health or nutrition activities, will have to use a look up service to the central registry to enroll the ASHA in their respective application and program that task tracking and workload assessment for payments can be made easier and automated. 

For all the existing ASHAs for whom information is maintained currently by states either in the DBT database or ASHA soft etc would be required to push data to the central registry for the identified minimum required fields.

The enrollment agency or district department whoever is responsible for the end to end enrollment or data migration work, will be required to setup a maker-checker workflow so that, only verified or correctly mapped information gets uploaded in the central ASHA registry.

A registry update process/mechanism on regular intervals precisely annually will be required to be implemented. Central registry may trigger annual reminder like that in vase of Voter update system for updation or confirmation of the updated information to ensure reliability of information. These reminders will be part of the workflow that can be sent to the assigned enrollment agency or the district health department that will be responsible for enrollment and updation.

Services for self-updation will also be required similar to in the address etc update process in ADHAAR at the anganwadi or PHC centers with OTP service or on approval by the district health.

For every critical process (like Mobile no. updation, last name change, village/district change etc in case of transfers or inactive ASHA update) in the entire the lifecycle of an ASHA that affects the information in the central registry directly or indirectly will have associated manual and electronic form and processes that will have to be completed through the same common portal or application with role based access.