INDIA. Mumbai: The Union Cabinet chaired by Prime Minister Narendra Modi approved a new scheme ‘India COVID-19 Emergency Response & Health System Preparedness Package (ERHSP): Phase-II’ amounting to Rs. 23,123 crore for Financial Year 2021-22, on Thursday.
The package has been worked out with a focus on immediate needs for the next nine months of FY 2021-2022 to provide support to Central government hospitals/agencies and to state/Union territories Governments to augment their existing response to the second wave and the evolving pandemic, including at district and sub-district levels in peripheral facilities.
In March 2020, when the country was faced with the first wave of the pandemic, the PM had announced a Central Sector Scheme of Rs. 15,000 crore for the “India COVID 19 Emergency Response and Health Systems Preparedness Package”, to provide a critical impetus to the efforts of the Union Ministry of Health and Family Welfare and states/Union Territories, catalyzing health systems activities for pandemic management. Since mid-February 2021, the country is experiencing a second wave with spread into rural, peri-urban, and tribal areas.
The ERHSP would be implemented from the current month till March 31, 2022, with central and state share as -Central share–Rs.15,000 crore and states’ share- Rs.8,123 crore. The scheme aims ait accelerating health system preparedness for immediate responsiveness for early prevention, detection, and management, with the focus on health infrastructure development including for Paediatric Care, with measurable outcomes. The package has Central Sector (CS) and Centrally Sponsored Schemes (CSS) components.
The Central Sector component
Under the Central sector component, support would be provided to Central Hospitals, AIIMS, and other Institutions of National importance under the Union Department of Health and Family Welfare for repurposing 6,688 beds for COVID management under Pradhan Mantri Swasthya Suraksha Yojana.
The hospitals include Vardhman Mahavir Medical College & Safdarjung Hospital, Lady Hardinge Medical College and Smt Sucheta Kriplani Hospital, Ram Manohar Lohia Hospital. Delhi, Regional Institute of Medical Sciences, Imphal,Manipur, North Eastern Indira Gandhi Regional Institute of Health & Medical Sciences, Shillong, Meghalaya, Post Graduate Institute of Medical Education and Research, Chandigarh, Jawaharlal Institute of Postgraduate Medical Education & Research, Puducherry and AIIMS Delhi (existing AIIMSs) and new AIIMSs under Pradhan Mantri Swasthya Suraksha Yojana.
NCDC to be strengthened
National Centre for Disease Control (NCDC) would be strengthened by providing Genome Sequencing machines, besides sanctioning Scientific Control room, Epidemic Intelligence Services (EIS), and INSACOG Secretariat support.
Support would be provided for the implementation of the Hospital Management Information System (HMIS) in all the district hospitals across the country. At present, HMIS is implemented only in 310 district hospitals. The HMIS would be implemented in district hospitals through NIC-developed E-Hospital and CDAC developed E-Shushrutsoftwares. This will be the biggest impetus for the implementation of the National Digital Health Mission (NDHM) at the district hospitals. This support includes the support provided to the district hospitals towards the augmentation of the hardware capacity, as per Government statement.
Tele-consultations with the COVID-19 patients
Support would also be provided for expanding the National Architecture of eSanjeevani Tele-consultation platform to provide up to 5 lakhs teleconsultations per day as against existing 50,000 Tele-consultations per day. This includes support to the states/Union Territories to enable teleconsultations with the COVID patients at the COVID Care Centres (CCCs) by strengthening hubs for eSanjeevani Teleconsultation.The support would also be provided for IT interventions, including strengthening the Central War room at the Department of Health and Family Welfare, strengthening the Country’s COVID-19 Portal, 1075 COVID helplines, and COWIN platform.
The efforts are aimed at strengthening district and sub-district capacities for an effective and rapid response to the pandemic. The states/union territories would be supported to: Create Paediatric units in all 736 districts and also, to establish Paediatric Centre of Excellence (PaediatricCoE) in each State/UT, either in Medical Colleges, State Govt. Hospitals or Central Hospitals such as AIIMS, INIs, etc, for providing Tele-ICU services, mentoring and technical hand-holding to the District Paediatric units.
The package seeks to augment 20,000 ICU beds in public healthcare system out of which 20% will be Pediatric ICU beds. Provide care closer to the community due to the ingress of COVID-19 in rural, peri-urban and tribal areas, by creating pre-fabricated structures for adding additional beds at the existing Community Health Centres, Primary Health Centres and Sub Health Centres (6-20 bedded units) and support would also be provided to establish bigger field hospitals (50-100 bedded units) depending on the needs at tier-II or Tier-III cities and district HQs.
The package also includes installation of 1050 Liquid Medical Oxygen Storage Tanks with Medical Gas Pipeline System (MGPS), to support at least one such unit per district. The existing feet of ambulances will be augmented by adding 8,800 ambulances. Under the scheme, the undergraduate and post-graduate medical interns and final year MMBS, BSc, and General Nursing Midwifery (GNM) nursing students will be engaged for effective COVID-19 management.
As “Test, Isolate and Treat” and following-up COVID Appropriate Behaviour at all the times is the national strategy for effective COVID-19, support is provided to the states. The scheme seeks to provide a flexible support to the districts for meeting the requirement of essential medicines for COVID-19 management, including the creation of buffer stock.