Health Services



State Standard Package of Health Services


Primary Health Care
  1. General consultation with prescribed drug from accredited primary health care facility
  2. Health Promotion and Education:
    1. Family planning education excluding provision of commodities
    2. Dental care
    3. HIV/AIDS
    4. Immunization
    5. Vitamin A supplementation
    6. Promotion of essential nutrients for children and pregnant women
    7. Promotion of personal, domestic and environmental hygiene
  3. Surgery
    1. Minor surgical procedures; incision and drainage, suturing of lacerations, minor burns, simple abrasions
    2. Circumcision of male infants
    3. Evacuation of impacted faeces
    4. Correction of simple polydactyl
    5. Drainage of simple paronychia
    6. Relief of urinary retention
  4. Eye Care
    1. Conjunctivitis
    2. Parasitic ailments
    3. Allergic ailments
    4. Simple contusion and abrasions
  5. Child Health Care
    1. Child welfare services
      1. Growth monitoring
      2. Routine immunization as defined by the NPHCDA
      3. Vitamin A supplementation
      4. Nutritional advice
      5. Health education
    2. Management of uncomplicated malnutrition
    3. Treatment of Helminthiasis
    4. Treatment of common childhood illnesses such as
    5. Malaria diarrhoeal disease
    6. Schistosomiasis
    7. Upper respiratory tract infections
    8. Uncomplicated pneumonia
    9. Urinary infections
    10. Simple otitis media
    11. Pharyngitis
    12. Childhood exanthemas
    13. Simple skin disease/infestations
    14. Other viral illnesses such as mumps
    15. Other febrile illnesses as may be listed from time to time by the ESA-UHC.
    16. Treatment of anaemia not requiring blood transfusion.
  6. Treatment of Minor Ailments (Adult)
    1. Management of simple infections/infestations
    1. Malaria
    2. Respiratory tract infections
    3. Urinary tract infections
    4. Gastroenteritis
    5. Primary Ear, Nose and Throat infections
    6. Diarrheal diseases
    7. Enteritis/typhoid fever
    8. Schistosomiasis
    9. Skin infections/infestations - chicken pox, scabies, lice/tick infestation, acne, cutaneous larva migrans, Tineavesicolor (Malassezia furfur), Tinea Capitis, Measles
    10. Emergency management of bites stings e.g. snake bite, scorpion, bee and spider stingsDiarrheal diseases

      11. B. Management of simple anaemia (not requiring blood transfusion).

      C. Screening & referral for Diabetes Mellitus, Hypertension and other chronic diseases.

      D. Treatment of simple arthritis and other minor musculoskeletal diseases.

  7. HIV/AIDS, Sexually Transmitted Diseases/Infections
    1. Counselling and Referral
    2. Treatment of STD’s
  8. TB
    1. Referral for diagnostic testing
    2. Follow up AFB test
  9. Community Mental Health, Counselling and Referral
    1. Anxiety neurosis
    2. Psychosomatic illnesses
    3. Insomnia
    4. Other illnesses as may be listed from time to time by the ESA-UHC.
  10. Dental Care Education
    1. Oral care and hygiene
  11. Dental Care Education

    A. Antenatal care

    1. Routine antenatal (4 clinic visits)
    2. Routine drugs to cover the duration of pregnancy
    3. Routine urinalysis and blood tests (PCV, Blood Group and HIV Screening
    4. RReferral services for complicated cases of pregnancy

    B. Delivery services

    1. Spontaneous vaginal delivery by skilled attendant including repair of birth injuries and episiotomy
    2. Essential drugs for Emergency Obstetric Care (EmOC).

    C. Postnatal services

    1. New-born care up to 6 weeks; (Cord care, Eye care, Management of simple neonatal infections)

  12. Emergency

    The primary level emergency care (including First Aid treatment) before referral. These shall include:-

    1. Establishing an intravenous line
    2. Management of convulsion, seizures, coma
    3. Control of bleeding
    4. Cardio-pulmonary resuscitation
    5. Assisted respiration (e.g. Ambu bag, etc.).
    6. Immobilization of fractures (using splints, neck collars, etc.)
    7. Aspiration of mucus plug to clear airways
  13. Basic laboratory investigations
    1. Malaria parasite
    2. Widal test
    3. Urinalysis
    4. Haemoglobin
    5. Stool microscopy
    6. Urine microscopy
    7. Pregnancy test
    8. Blood sugar test
    9. Other conditions as may be listed by ESA-UHC from time to time


Secondary Health Care


Includes:
  1. Consultation with prescribed drugs for referred patients from Primary Healthcare providers
  2. Emergency cases outside place of residence within the state in accredited HCF
  3. Admission for maximum of 10 days cumulative per year for medical admission and 15 days cumulative per year for surgical admissions
  1. Comprehensive Obstetric Care
    1. Management of postpartum heamorrhage
    2. Caesarian section
    3. Management of preterm/pre-labour rupture of membrane (P/PROM)
    4. Detection and management of hypertensive diseases in pregnancy
    5. Management of bleeding in pregnancy
    6. Pre-Eclampsia / eclampsia
    7. Operative management for ectopic gestation
    8. Cervical cerclage
    9. Management of intra-uterine fetal death
    10. Management of puerperal sepsis
    11. Instrumental deliveries
    12. High risk deliveries – 1st deliveries, and 5th deliveries, multiple deliveries, and other complications
  2. Surgery
    1. Appendectomy
    2. Hernia repair
    3. Management of testicular torsion
    4. Hydrocelectomy
    5. Management of urinary retention by suprapubic cystostomy
  3. Dental Care
    1. Amalgam filling
    2. Simple tooth extraction
  4. Paediatrics
    1. Treatment of moderate to severe infections/infestations
      1. Respiratory infections
      2. Urinary tract infections
      3. Diarrheal disease with moderate to severe dehydration
      4. Enteric fever
      5. Severe malaria
      6. Septicaemia
      7. Meningitis
      8. Severe measles
    2. Management of childhood non-communicable diseases
      1. Nephritis
      2. Asthma
    3. Management of severe anaemia requiring blood transfusion (not exceeding 2 pints of blood)
    4. Management of neonatal infections and conditions
      1. Neonatal sepsis
      2. Birth asphyxia
      3. Neonatal jaundice
      4. Baby from diabetic mothers
  5. Internal medicine (Adult)
    1. Treatment of moderate to severe infections and infestations
      1. Management of severe malaria
      2. Management of meningitis
      3. Septicaemia
      4. Management of complicated Respiratory Tract Infections
    2. Management of non-communicable diseases
      1. Management of Diabetes Mellitus and Hypertension
      2. Peptic ulcer Disease.
      3. Management of Sickle cell disease
    3. Treatment of cardiovascular conditions
      1. Hypertension
      2. Heart failure
    4. Renal diseases
      1. Nephritis
      2. nephrotic syndrome
    5. Liver diseases (Hepatitis), amoebic liver abscess
    6. Endocrine conditions (Diabetes Mellitus)
    7. Management of severe anaemia (not exceeding two pints of blood)
    8. Severe musculoskeletal conditions
    9. Treatment of snake bites
  6. Psychiatric Care
    1. Anxiety neurosis
    2. Psychosomatic illnesses
    3. Insomnia
    4. Schizophrenia
    5. Depression
    6. Bipolar Affective Disorder
    7. Other mental illnesses as may be listed from time to time by the ESA-UHC
  7. Gynaecological Intervention
    1. Bartholin cyst marsupialisation
  8. Ophthalmology
    1. Eye problems e.g. major trauma
    2. Removal of foreign bodies
  9. Physiotherapy
    1. Management of palsies within 15 days after initial treatment with a maximum of 3 sessions
  10. Laboratory Investigations
    1. Genotype
    2. Cerebrospinal fluid biochemistry
    3. Occult blood in stool
    4. Blood grouping and Cross matching (not exceeding 2 pints of blood)
    5. Full Blood Count
    6. Urea/electrolyte/creatinine
    7. Bilirubin (total and conjugated)
    8. Microscopy/Culture/Sensitivity
      1. Urine, Blood, stool, Sputum, Aspirate, Cerebrospinal fluid, Cervical swab, High vaginal swab, Liver function test
  11. Radiology
    1. X-ray of the Abdomen, Chest
    2. Skull & Extremities
    3. Dental X-rays
    4. Abdominopelvic & obstetric scan
    5. Other services as may be listed by ESA-UHC from time to time
  12. Radiology
    1. X-ray of the Abdomen, Chest
    2. Skull & Extremities
    3. Dental X-rays
    4. Abdominopelvic & obstetric scan
    5. Other services as may be listed by ESA-UHC from time to time

Exclusions


Total Exclusions
  1. Occupational/industrial injuries to the extent covered under the Workmen Compensation Act
  2. Injuries resulting from natural disasters, e.g. earthquakes, landslides, conflicts, social unrest, riots, wars
  3. Epidemics
  4. Family planning commodities, including condoms
  5. Injuries arising from extreme sports, e.g. car racing, horse racing, polo, mountaineering, boxing, wrestling, etc
  6. Drug abuse/addiction
  7. Domiciliary visit
  8. Mammoplasty
  9. Provision of contact lens.
  10. Anti-tuberculosis drugs
  11. Treatment of congenital abnormalities requiring advanced surgical procedures e.g. TOF, ASD, VSD.
  12. Artificial insemination, including IVF and ICSI
  13. Post Mortem examination
Partial Exclusions
    (beneficiary pays a co-payment of 50% of the cost)
  1. High technology investigations e.g. CT scan, MRI
  2. Dialysis for acute renal failure (max. 6 sessions)