The Amrita Community Health Training Centre, Njarakkal is the rural field practice area of the Department of Community Medicine, Amrita Institute of Medical Sciences, Kochi. It caters to a population of about 50,000 of two local self administartion units, (Njarakkal and Nayarambalam panchayats).

Vision 

To create a healthy, empowered community with sustainable initiatives.

Objectives 

To provide comprehensive health services to the people of Njarakkal and Nayarambalam panchayat of Vypin block of Ernakulam District.

To provide training to MBBS,MD and students of other allied specialities.
To conduct community based research.

  • Comprehensive Health Services

ACHTC is providing primary care to the people of Njarakkal and Nayarambalam Panchayat in particular and to Vypin Block in general. A Community Medicine specialist leads the team of two Medical Officers, Medico-social workers, Junior public health nurse, Junior health inspector, etc in providing primary care OP. Specialist services of the Psychiatrist, Ophthalmologist, Gynaecologist and Physician are available on a weekly basis. The Community Medicine specialist who is also the Administrative Medical Officer reports to Professor & Head, Community Medicine.

The services of the health centre include providing medical care, health education, implementing national health programs, taking care of endemic diseases, providing reproductive and child health care services and providing laboratory services. Reproductive and child health services including Family Planning, Immunisation, Adolescent care are given. Medical care of acute conditions like exacerbation of bronchial asthma, fever etc and chronic conditions like hypertension, diabetes and minor surgical procedures like wound management, suturing, management of injuries are also carried out. Special services like tobacco cessation clinic are also provided.

Behaviour change exercises for sustainable behaviour change are also  carried out in the community. These activities are also a part of the training of MBBS & MD students.

  • Training

MBBS students are allotted a family as part of their training to understand the bio-psycho-social model of disease causation first hand. They follow up this family over the years and develop a rapport with them. As far as the family is concerned it is an opportunity for them to improve their knowledge on health-related conditions as well as to get screening services like  vision, blood pressure at their doorstep. Students also carry out service programmes in the area such as assisting and motivating the community to adopt source reduction to prevent breeding of Aedes mosquitoes and, therefore, Dengue and Chikungunya.

MD residents get actively involved with community programmes and conduct antenatal home visits, monitor growth and development of under-five, follow-up on patients with non-communicable disease like hypertension, diabetes and geriatric patients at their homes. MD Residents of other specialties also are posted as a result of which people of this area get these services close to their homes.

GNM & BSc Nursing students also carry out surveys and community action programs in the area.

National Service Scheme students of the Government schools are also provided training on first aid at the centre.

AMRITA SeRVe

The health centre is also at the forefront of providing training to health workers throughout India. The training programme was started as part of AMRITA SeRVe initiative.

Amrita SeRVe is a program of holistic development of the villages envisaged by AMMA. The Mata Amritanandamayi Math (MAM) has selected 101 villages throughout India with the goal of helping them become self-reliant role-model villages for the country. When asked about why Amma was starting Amrita SeRVe, Amma said that villages are India’s foundation—its life-force—and that it is society’s responsibility to take care of them. ““It is our villages that, in fact, sustain us by providing we, who live in the cities, with the vegetables and other forms of nourishment we need to in order to survive,” Amma said.

A group of 21 health workers from various northern states of Uttarakhand, Rajasthan, Bihar and Chhattisgarh were trained in providing basic health care at the grassroots level to supplement and complement the services of the existing health system in their states. They were named Mitr or “Amrita Swasthya Mitr”. A curriculum for the training was prepared and a practical hands-on training was imparted over a period of one month in January 2015 to tackle primarily the upstream determinants of health like sanitation, nutrition etc.

A refresher training was also conducted for the “Amrita Swasthya Mitr” trainees from Wayanad and Palakkad in May 2015.

  • Community Based Research 

Screening practices of common cancers among women in reproductive age group.
Coverage and compliance of Mass Drug Administration in Filariasis.
Chikungunya;A  post epidemic study of vector indices.
Monitoring vector indices of Aedes aegypti and measuring the impact of an educational intervention

Others:

Interventional programmes:

  • QUIT TOBACCO INDIA (2008-2014)  QTI  is a smoking cessation research collaborative based in India and Indonesia that is engaged in clinic and community based tobacco education and cessation programs. In India, it is a collaborative of five medical colleges in Kerala and Karnataka coordinated by the public health wing (AMCHSS) of Sree Chitra Institute of Medical Sciences and Technology, Trivandrum  funded by NIH through the Arizona University, USA. This collaborative aimed at introducing tobacco modules through a modular  lego approach in the medical curriculum and in testing the proof of concept of ‘smoke free homes’ in the community.
    In the community the concept of ‘ tobacco-smoke free homes’ was introduced. The community and the local stake holders came together in a series of meetings and decided to declare two wards (600 households approximately) smoke free. After a year of being declared as smoke free, an assessment was carried out which showed a 50% reduction in indoor smoking. Another assessment is on now to understand the status of the smoke free households and to understand the perceptions of the people.
  • Improving  infant and young child feeding practices through a behavioral  change communication intervention(2011-12)  supported by UNICEF, Chennai.

    Following a baseline survey of the infant and young child feeding practices among antenatal women and  mothers of under three children, influencers and health workers, a behavior change communication strategy was fashioned. The active involvement of the stakeholders like Integrated Child Development Services, Govt of India was ensured. The behavior change communication strategy consisted of a series of mothers meetings at the anganwadi by using flip chart, flash card, street plays, one to one support by anganwadi workers for exclusive breast feeding to lactating mothers. The anganwadi  workers were trained   regarding the key messages  to be conveyed in mothers meeting through flip charts.
    At the end of  study period of an year,  knowledge levels had significantly improved among the antenatal and mothers of under three children. Though the practice levels indicated a trend towards improvement, it was not significant. This may be especially so as a longer  study period is required  to show its effect on practice levels.
  • A Randomized Control Trial  of the effect of Yoga and Peer Support  on Glycaemic Outcomes, quality of life in women with Type II Diabetes Mellitus:A feasibility study (2011-12) (Trial registry No: CTRI /2011/12/002227) 
    Funded by Fogarty International Centre,NIH as part of ASCEND research network 
    An open label three armed (peer support, yoga, control group) RCT was conducted among women for a period of three months with two intervention arms and a control arm.
    Supervised yoga therapy sessions were conducted for 60 min on two days a week by a trained yoga instructor. The patient were also asked to maintain a log sheet of food eaten, drugs consumed and exercise particulars on the previous day of the instructor conducted yoga sessions. This was  reviewed every month.
    Peer support intervention : Three peer mentors were identified from the community and were  trained.. In a ratio of 1 peer mentor to 14 patients, Peer Mentors Training was conducted by a physician, nutritionist and psychologist.
    The control group received the usual standard of care.
    The outcomes monitored at baseline and endline were FBS, HbA1c,total cholesterol and quality of life, pharmacological adherence.
    The results are awaited though preliminary reports indicate decreasing trends  in glycaemic indicators like HbA1c in Peer and Yoga group.

Sustainable Initiatives:

The health centre is also actively involved in providing sustainable initiatives to the people of Njarackal and adjoining villages.

A number of environmentally sustainable initiatives are also carried out like, smoke-free chulhas to reduce environmental pollution and for efficient use of firewood. Vermi-composting and biogas plant are also used to demonstrate to the community, ways and  means of  good waste management by  the conversion of biodegradable waste into useful manure. Thus rotting of waste in the open can be prevented thus preventing diseases like diarrhea, typhoid etc. Mosquitoes are a perennial problem in this coastal community, therefore larvivorous fish like guppy are maintained and distributed in the community. Kitchen garden is another way of ensuring and propagating organic farming in the light of reports on the high levels of pesticides in vegetables. Organic farming is also promoted with the health centre having its own vegetable  garden. Thus a holistic emphasis on health is aimed at.

Women Empowerment is also a focus of the health centre. Initially started in 2009 as ‘Amrita Sree’ a group of 9 women were trained on value addition of fish products by Central Marine Fisheries Research Institute and ACHTC who subsequently started making fish pickles, wafers etc. On the lack of sustained demand for fish products, they have now diversified into organic farming.

Miscellaneous: Visitors and public health students from all over the world like Europe, UK, USA visit ACHTC to understand public health and health care delivery in a low middle income country.

207
PROGRAMS
OFFERED
6
AMRITA
CAMPUSES
15
CONSTITUENT
SCHOOLS
A
GRADE BY
NAAC, MHRD
8th
RANK(INDIA):
NIRF 2018
150+
INTERNATIONAL
PARTNERS