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Hari Prasad Pradhan is 54. He has hypertension, gastritis and gout. He is also diabetic and has been taking four kinds of medicines for sometime now. He is one of the 68 patients under regular treatment at Dunglagang Basic Health Unit (BHU) in Tsirang.

Two months ago, people-centred package of essential noncommunicable diseases (PEN) was reinforced in the dzongkhag. Hari Prasad Pradhan visits the BHU every month for the health assessment.

He said that the follow-up system was practical. “We are aware of the health condition because of the follow-up visits to BHU. The system ensures that we are healthy and our illnesses are kept under control.”

Dunglagang’s HA, Chakra Bhandari, said that about 143 patients were registered as of July 19. “With PEN programme, there is a strong follow-up system in place.” It ensures monitoring and assessment of the patient’s health condition.

Most common NCDs for which patients were entered under PEN programme were hypertension and diabetes mellitus, he said.

Chakra Bhandari said that those who missed the visits had to be called. “Most patients make it on time.”

Although it is too early to say anything about it, it would only benefit patients and the healthcare system of the country in the long run, he said.

There are about four registers for different kinds of NCDs and interventions in his office. Documentation in the beginning was time consuming, but after the documentation phase, work was expected to get easier as it would get systematic, he said. “After registration, the focus will be on reviewing and treatment.”

Ideally, patients are assessed for NCDs, body mass index (BMI) calculated and the patients categorised accordingly.

“If a patient is unable to visit BHU, we go to the patient,” he said.

Counselling is also provided to improve patients’ health. “We first try to talk in a separate room so that they can feel comfortable to share freely.”

Dzongkhag’s health officer, Lobzang Tshering, said that the PEN reinforcement programme was doing good in the dzongkhag with all the BHUs recording and monitoring patients’ health status and putting in diseases interventions.

During the Moenlam Chenmo last month, a total of about 613 patients were screened for consumption of alcohol, tobacco, and doma.

In 2016, the health ministry conducted a clinical audit where some of the challenges and shortcomings such as the gaps of prescription, inadequate follow-up, lack of strong system for monitoring and supervision and lack of system for recalls and referrals were found.

To address these gaps, the PEN reinforcement was rolled out in Tsirang and Punakha in a pilot phase.

Health officials said that most of the causes of the NCDs were related to excessive alcohol consumption, abuse of tobacco (including both smoke and smokeless), and poor physical activities and dietary habits. 

Barshong’s HA,  Duba Tshering, said that of about 70 patients registered, about 27 patients are under regular treatment. “People are grateful and seem content with the reinforcement.” 

In the past when patients were told to visit the hospital and when they didn’t turn up, it wasn’t followed and monitored, he said. “Most people are receptive about the follow-up and they visit the health facility whenever they need.” 

As of July 3, more than 1,928 patients had been screened so far in the dzongkhag.

Rinchen Zangmo | Tsirang

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