VIVEK SANJIVANI

An Initiative for Healthcare and Education

VIVEK SANJIVANI: An Overview

VIVEK SANJIVANI: An Overview

VIVEK SANJIVANI is An Initiative for Healthcare and Education of Ramakrishna Mission Home of Service, Luxa, Varanasi. This department offers Telemedicine services through Eleven Centres in which five Stationary Telemedicine Units (STUs) are fixed at a place and six Mobile Telemedicine Units (MTUs) are roaming. During 2022-23 we served 27,875 patients through our Stationary Telemedicine Units and Mobile Telemedicine Units and conducted Non-communicable Disease Screening (NCDS) for 18,878 patients. So, altogether we offered services to 46,753 patients which covered three districts including one aspirational district of Eastern Uttar Pradesh and one aspirational district of Uttarakhand.

We extended our Telemedicine services to patients among which 55.25% were women and 83.93% were needy and under-privileged people from OBC, SC, and ST communities. NCDS were done for 18,878 New Beneficiaries in which 12015 were women. Psychiatrist’s consultations for Common Mental Disorder and Severe Mental Disorder (SMD) patients were done for 4432 in which 1930 were women patients. Treatments offered to epilepsy patients who visited 2306 times. 556 women received Antenatal care (ANC). Most of the patients saved nearly Rs. 600 per visit for Doctor’s consultation, diagnostic tests, and medicine. We tried to propagate Value Education to bring Overall Wellness in life for all the people. We extended Health education to promote healthy living among the rural mass.

Vivek Sanjivani is also engaged in “Shishu Tirth”- A Non-formal Primary Education programme to cater holistic education to kids, Health Education-based and Value education-based film Development, publication of books and research programmes. It conducts Foundation courses in Science and Mathematics, online teachers’ training, and teachers’ workshops. Multimedia-based Online Science and Communicative English classes are now being regularly conducted for rural children.   

1. Telemedicine Services: Our Real-time telemedicine solutions offers a virtual alternative to the in-person doctor’s visit. It expands access to quality patient care, especially to remote areas and underserved populations that need it the most. It provides a way to cut down on healthcare spending and keep connected patients throughout the year. It is gradually showing the potential to change the healthcare delivery system for the better especially in the rural areas.

Stationary Telemedicine Units (STUs) of Vivek Sanjivani: Five Stationary Telemedicine Units (STUs) have been established at different locations viz., Majhawan, Kalwari and Naugawan (district Mirzapur), Hinauta (district Sonbhadra) of Uttar Pradesh and Bakhpur (district Udham Singh Nagar) of Uttarakhand for providing medical services to the poor, needy and underserved people. These centres except Kashi provide telemedicine services generally three days per week on a regular basis. In our Telemedicine services we use internet communications and Cloud-based Realtime software solutions to provide clinical services to patients without an in-person visit at the Doctor’s chamber. 

Prefabricated Stationary Telemedicine Unit:

One Prefabricated Stationary Telemedicine Unit has been installed at Kalwari, District Mirzapur. It is fully powered by Solar Power Backup system. These are supported under Corporate Social Responsibility (CSR) Healthcare Project of Tata AIG General Insurance Co. Ltd. We are thankful to them.

Telemedicine Database Software:

IIT Kharagpur has developed ‘Matri Seva’- a database software, free of cost for keeping patients’ details. The software has been hosted in the Microsoft Cloud-based server to provide easy access to all our centres and doctors.

The physician’s consultations are done from the Hub of Vivek Sanjivani in Varanasi or from the Doctor’s dwelling place. Several Physicians from Kolkata, Anand (Gujarat), Pune and Noida are extending help in treatment of patients. The total number of people treated during April 2022 to March 2023 was 16079 through STUs. All received free medicine from the remote STUs except in a few cases. Pathological tests like Blood Pressure, haemoglobin% by colour card, Random Blood Sugar (RBS) are done for the patients above 30 years of age. Total number of patients treated in villages through Stationary Telemedicine Units (STUs) during April 2022 to March 2023 is given in a table:

Outcome: 3890 New patients started while 12189 old patients continued to receive telemedicine services in the year 2022-23 from STUs. We extended our Telemedicine services through STUs to patients among which 49.76% were women and 84.24% were needy and under-privileged people from OBC, SC, and ST communities.

Specialist Services offered through Telemedicine at the door step of village people: Psychiatrist, Gynaecologist, ENT, Medicine, Oncologist, Community Medicine.

Four fundamental benefits from Vivek Sanjivani Telemedicine services

1. Improved Access – For the last three years, telemedicine has been used to bring healthcare services to patients in distant locations of Eastern Uttar Pradesh. Not only does telemedicine improve access to patients but it also allows physicians including specialists and health facilities to expand their reach, beyond their own working places. Our telemedicine has a unique capacity to increase service to many numbers of new patients.

2. Cost Efficiencies – Reducing the cost of healthcare is one of the most important reasons for funding and adopting telemedicine technologies. Our Telemedicine has shown reduction in cost of healthcare and increased efficiency through better management of chronic diseases, shared health professional staffing, reduced travel times specially for the specialist doctors who can provide treatment from far off places.

3. Improved Quality – Our experiences have consistently shown that the quality of healthcare services delivered via telemedicine are as good as those given in traditional in-person consultations.

4. Within the reach of Patients – Over the last three years, our study and experiences have shown satisfaction about recovery of the patients through our telemedicine services. The services offered to our patients at the rural areas might not be available to them otherwise at their door steps, and they must travel long distances.

Output Analysis: 2022-23:

Outcome/Impact Analysis: 2022-23:

2. Mobile Telemedicine Units (MTUs): Health on Wheels:

In rural Uttar Pradesh nearly 60 percent of the total rural population lives below the poverty line. Our Mobile Telemedicine Units offer flexible and viable options to offer healthcare facilities to these vulnerable groups. Our Mobile Telemedicine Units (MTUs) help to conduct screenings, basic diagnosis and provide primary healthcare services to complex medical treatments closer to people’s homes. 

New Mobile Telemedicine Unit vans: Two new Mobile Telemedicine Unit vans have been inaugurated to strengthen the Telemedicine services in rural areas of Eastern Uttar Pradesh. The vans are purchased with financial support from the CSR fund of Tata AIG General Insurance Company Limited. Our sincere thanks and gratitude to them.

Currently we have six Mobile Telemedicine Units (MTUs) touching several parts of Mirzapur district of Uttar Pradesh. Total number of patients treated in villages through Mobile Telemedicine Units (MTUs) during April 2022 to March 2023 is given in a table:

3. Non-Communicable Disease Screening (NCDS):

Screening done for Hypertension (HTN), Diabetes (DM), Oral Cancer (OCE), and Breast Cancer (BCE) among the target age group of 30 years and above through Stationary Telemedicine Units (STUs) and Mobile Telemedicine Units (MTUs) on the first day of the registration of the patient and some cases NCDS were done in the villages. Below are the details of screenings done during April 2022 to March 2023:    

4. Manasik Soundarya (मानसिक सौंदर्य) (Community Mental Health Program):

The community Mental Health Programme is devoted to the evaluation and improvement of public mental health of poor people affected by mental disorders, emotional disturbances and/or addictions. The patients from Patewar, Kalwari, Naugawan, Hinauta, Majhawan, Manikpur, Ramnagar, Gaura, Jalalpur and Deepnagar and other villages are receiving 3 tiered comprehensive psychiatric and neurological treatment for (i) Common Mental Disorders like Depression, Anxiety, Obsessive Compulsive Disorder (OCD) (ii) Severe Mental Disorders including Psychosis, Bipolar Disorder, Schizophrenia and Major Depression and (iii) Epilepsy. During 2022-23 we offered treatments to 6738 mental health and neurological patients among which 2360 OBC, 2897 SC and 516 ST patients were served. A tabular representation is added for better understanding:

Common Mental Disorders (CMD): Visit-wise

Severe Mental Disorders (SMD): Visit-wise

Epilepsy (EPI): Visit-wise

Common Mental Disorders (CMD): No. of Patient-wise

Severe Mental Disorders (SMD): No. of Patient-wise

Epilepsy (EPI): No. of Patient-wise

5. Eye care:

Cataract and refractive errors are two major public health problems in the context of ocular health in developing countries like India. Currently, India is the second highest country next to China in contributing to the total burden of world blindness. Cataract is the most common cause of blindness (62.4%) followed by uncorrected refractive error (16.65%). Of this total burden of blindness more than eighty five percent of them are preventable if appropriate eye care services are provided.

The new cutting-edge technology 3nethra (a compact, portable, and easy-to-use non-mydriatic digital imaging device) is used in visual check-up for diabetic and hypertensive patients. It is designed to acquire, display, store, and transmit images of the posterior, and anterior surfaces of the human eye. It assists clinicians in the evaluation, diagnosis, and documentation of visual health. During 2022-23 with the help of 3nethra 37 patients were investigated in which 5 patients were detected with Retinopathy. They were advised to get further investigation and treatments from Eye specialist.

Eye Camps for Cataract Surgery:

6. General Movement Assessment in Neonates and infants for Early intervention, family Support and Health awareness (G.A.N.E.S.H.)

The unique feature of this project is General Movement Assessment of children especially up to 5 months of age. In this year a total of 92 GMA Screening took place and 6 infants suspected for abnormal development were detected, 13 infants were followed up, and referred to Neurologist for special treatments and advice. Prof. Christa Einspieler of Austria is providing the special training and guidance to our Healthcare workers.

7. Distribution of Nutritional Food Supplements

Distribution of Nutritional Food Supplements are continuing uninterrupted till date. Nutritional food supplement items (Kaju, Bajra, Soyabean, Besan, Ground Nut, Jaggery and Mustard Oil) are regularly being distributed on a monthly basis to on an average 270 poor, pregnant, lactating mothers, and malnourished children of villages of Mirzapur and Sonbhadra districts which provide 750 kcal/day and 37g of additional proteins every day to each woman and child.

8. Promotion of Health Education

The purpose of our Health education is to positively influence the health behaviour of individuals and communities as well as the living and working conditions that influence their health and empower them to lead healthy lives. Health education activities should enhance the overall goal of the health promotion and disease prevention program. It can trigger far-reaching health improvements in serving vulnerable groups. Films are developed for health education programs which are culturally appropriate and tailored for the rural populations to ensure acceptance of the messages. In developing films, we are addressing cultural and linguistic differences, potential barriers to health promotion and disease prevention in rural areas to increase control over and improve their health through attitudinal, behavioural, social, and environmental changes.

Films based on Health education developed by our department were screened in different areas, which were viewed by villagers including students during 2022-23:

9. Antenatal Care: Total number of Antenatal Care (ANC) given to 556 in 7 villages. We provided minimum five check-ups in respect to Ante-Natal Care, two Tetanus Toxoid injections, minimum 90 iron tablets with folic acid, minimum 90 calcium tablets, training regarding nursing of infants to 80 would-be mother.

10. Gynecare: Our trained women Health Educators and Assistant Health Educators provided 269 women with gynaecological examination and subsequent treatments offered by the doctors. 

11. Tuberculosis Patients: These patients received free medicine and other Govt. benefits from our department.