PROPOSAL FOR THE DEVELOPMENT

IMPROVEMENT OF HEALTH CARE SERVICES AT Gn.

2010

Fathuhulla Naseem

G. Atoll Hospital

1/1/2010

PROPOSAL FOR THE DEVELOPMENT

IMPROVEMENT OF HEALTH CARE SERVICES AT Gn.

ATOLL HOSPITAL

2010

Fathuhulla Naseem

G. Atoll Hospital

PROPOSAL FOR THE DEVELOPMENT

IMPROVEMENT OF HEALTH CARE SERVICES AT Gn.

Introduction

Gn. Atoll Hospital plays a key role in creating and enhancing public awareness, providing

medical facilities for the people of the island and is responsible for managing all aspects of

preventive and curative health care of the Atoll. The Atoll hospital was established in the

year 2001 comprising of 21 beds along with 45 dedicated staff members. The hospital is

open 24 hours a day, seven days a week. Specialty consultation services ranging from

Obstetrics and Gynecology, General Surgery, Orthopedics and Pediatrics are run in the

hospital with a view to cater the public with the maximum of possible health care.

Furthermore 24 hours laboratory and Radiology services are made available in the interest

of the patients, alongside inpatient and outpatient services running back to back. Much

effort is put in controlling communicable and non communicable diseases within the island.

Developing and optimizing the existing health care services is a major challenge the Atoll

hospital is facing at present. Lack of certain equipments / instruments and trained

personnel’s in and around the field is the major loophole the hospital is facing at the

moment. Identifying these problematic areas, to adequately improvise the provision of

services, mainly provision of equipments / instruments, training and getting the best of

services from the concerned personnel’s are to be focused. Human resource capacity

building is of priority to meet the demands of the population.

Gn. Atoll Hospital is in dire need for in receipt of medical equipment and instrument for

provision of effective health care services to cater to its emergent population.

Aim

This paper is put together as a result of the meeting held at Gn. Atoll office on 6th

August

2009 to identify the important areas to be developed by improving the health care services

in Gn. Atoll Hospital under the Grant Assistance Program initiated by the Atoll Development

Committee, and is aimed at;

- Informing the Atoll Development Committee about the priority needs of the Health

care services in the Hospital.

- Proposing a rational justification for improving the services in the identified areas.

1. Identified Areas for Developing

The following areas are highlighted to bring to notice the most important seven areas,

where the hospital needs improvement, further developing and optimizing.

Service Areas

Area to be

developed Objective

Priority

level Level

Requirement Justification

Description Qty Price

ICU (intensive

Care Unit)

To provide essential

medical care for

critically ill patients by

enhancing its facilities

Periphera

l

1. Patient Monitor 02 • In the near future the

existing services of this

hospital will be transferred

to the new hospital

building which has a 2

bedded ICU department

without necessary

equipment.

• A single set of critical care

equipment is available at

present, which is been

used in both the theatre

and wards. So it is difficult

treat 2 patients

simultaneously.

2. Pulse oxymeter 02

3. Suction Machine 02

4. Defibrillator 01

5. ECG Machine

6. Ventilator

7. Portable

Ventilator

01

01

01

Labour Room To decline maternal and

fetal mortality and

morbidity by improving

the prenatal and

perinatal care.

Periphera

l

1. NST Machine

2. Fetal Doppler

3. Episiotomy

scissor

4. Allis Forceps

01

02

02

06

• 33% of the patients are

posted for caesarian

sections, in view of

maternal complications

and/or fetal distress. To

evaluate and manage such

cases and to get a good

perinatal outcome in high

risk pregnancies.

NICU (Neonatal

Intensive Care

Unit)

To provide essential care

for newly born babies in

critical conditions and

those babies who are

brought to hospital in

critical conditions.

1. Baby warmer +

Neonatal

resuscitator

2. Infant

Incubator

01

01

• Presently there is only one

set of machines but, it is

utilised to treat two babies at

the same time and so

difficulties have been

encountered to provide equal

care for two babies at the

same time.

Orthopedic To provide essential

care for patients with

traumatic injury and

chronic Orthopedic

pathological disorders

and develop a basic

rehabilitation centre.

1.Short Wave

Diathermy Machine

2.Interferential

Therapy Machine

3.Wax Bath Tub

4. Lumbar Traction

Set with pulley &

weights.

5. Cervical traction

set.

6.Electric Cast

cutting machine

01

01

01

02

01

01

• Presently a large

population of the Atoll

population suffering from

chronic Orthopedic

conditions like Rheumatoid

Arthritis

/Osteoarthritis/Lumbar

and Cervical Spondylosis

for which physiotherapy

remains the mainstay of

management, further

number of people coming

post surgery either from

abroad or Male’ for their

post-op management and

rehabilitation in this

hospital.

• Previous Electric cast

cutting machine is not in

working condition.

General Surgery To provide possible

instant care, and

management of surgical

conditions which

require immediate

attention, and to

maintain a good post

*Please see

Appendix 1 (List of

Surgical

Instrument)

• Due to lack of certain

surgical /diagnostic

facilities and instruments

quite a number of people

has to be reffered further

on to Addu/ Male’ to get

the required surgery and

operative care. investigations done. And

only empirical treatment

can be started in such

cases in this hospital setup.

Diagnostic

Service

Diagnostic services will

enable the best

treatment for common

illnesses seen in this

Atoll effectively with

specialized

investigations.

1.Ultrasonography

2.Mammography

3.Bone

densitometry

4. Specialized

dental X-rays

5.Dental mirrors

6.Diagnostic set

with

Ophthalmoscope +

Otoscope

7.PAP smear

8. Cervical biopsy

• With the emergent new

hospital, facilities that

enhance further diagnosis

of certain commonly seen

conditions would be a

blessing. At present people

have to travel to Addu

/Male’ for these

investigations. The

unavailability of pathology

services in the laboratory is

a big hindrance for certain

screening tests to be

conducted.

2. Rationale

Certain limitations have been encountered while working towards the goal of developing the

hospital setup, the main downhill’s are due to untrained personnel’s running administrative and

managerial functions, and developing skills relying on their experience over the years, and the

abundance of expatriates in the health field. About 70-90 percent of expatriates provide their

services in this health sector, however due to a communication gap at times; the best of their

services is not sought.

One of the important aspects of quality care which is effective communication and coordination

among consumers of health care and health care providers are compromised due to language

barrier. Another major concern at present is standardized care for which the competence of the

health care professional comes into account. Due to the wide variation in workforce’s

educational background and skills, uniformity cannot be ensured.

3. Conclusion

At present the number of trained personnel’s in the health hospital does not meet the

requirement for providing health care services in this Atoll, thus limiting the provision of

effective, efficient and quality services. Therefore, it is important to look into opportunities to

pave a pathway to train and develop human resources and upgrade facilities for the betterment

of the health care services in this Atoll.

…………………………………………………

Appendix 1

List of Surgical Instrument

1- Sponge holders 6” Nos. 08

2- Sponge holders 8” Nos. 08

3- Curved artery forceps Nos. 06

4- Straight artery forceps Nos. 04

5- Babcocks Nos. 04

6- 6.Allis forceps Nos. 12

7- Mayo scissors Nos. 02

8- Small bowls Nos. 06

9- Small kidney tray Nos. 02

10- Towel clips Nos. 12

11- Bone cutter 6” Nos. 04

12- Mosquito arteries curved Nos. 12

13- Mosquito arteries straight Nos. 08

14- Scalpel handle no..4 Nos. 04

15- Scalpel handle no.3 Nos. 04

16- Dissecting forceps toothed 6” Nos. 04

17- Dissecting forceps plain 6” Nos. 04

18- Fistular probe with director Nos. 02

19- Proctoscope (adult size) Nos. 04

20- Proctoscope (pediatric size) Nos. 02

21- Sygmoidoscope Nos. 02

22- Needle holder 6” Nos. 02

23- Needle holder 8” Nos. 02

24- Skin grafting Humby’s Knife Nos. 01

25- Softratullae/Gelonet Pack 10

26- Sinus forceps Nos. 02

27- Prolene mesh Dozens 01

28- Surgicell Nos. 04

29- Abdominal retractors 6” Nos. 04

30- Abdominal retractors 8” Nos. 02

31- Intestinal clamp Nos. 02

32- Straight scissors 6” Nos. 01

33- Curved scissors 8” Nos. 02

34- Hernia ring Nos. 02

35- Hernia director Nos. 01