KOCHI: In an effort to provide comprehensive diagnostic services at public health institutions and thereby reduce out-of-pocket expenditure of patients, the state government is set to launch Nirnaya (Nava Kerala Integrated Referral Network for Advanced Diagnostics And Care).
The initiative, which is expected to be rolled out by April 2025 by the Aardram Mission, aims to introduce standardisation and ensure people-friendly services at health centres.
“We aim to standardise the lab network at public health facilities with the setting up of a stipulated number of tests at each level and hub laboratories at primary and secondary levels. The network will be introduced in all health blocks to address gaps in testing at primary facilities,” Health Minister Veena George said.
She added that an electronic-reporting solution for laboratory tests will also be rolled out wherein patients will be intimated on test reports and sent quantifiable primary test results.
“All basic tests will be made available at primary health centres with the launch of Nirnaya. The first phase of the project aims to ensure standardisation of labs and that the 62 basic tests, according to the checklist, are available at the primary level,” a top official with the state Directorate of Health Services (DHS) said.
“Blood samples can be collected at the peripheral-level labs, at primary and family health centres. Necessary logistics facilities will be arranged so that the samples can be sent to hub-level labs at taluk hospitals, district hospitals and medical colleges on the same day,” he added. Sample transportation facilities will be arranged by health centres or local self governments.
The initiative will be bankrolled using the National Health Mission fund, finance grants and local self-government funds.
“We have around 885 family health centres and five primary health centres, 152 block-level health centres, 88 taluk hospitals, 36 district-level hospitals and nine women and child hospitals. The labs will be set up at these institutions based on the the hub-and-spoke model.
Services will be provided free of cost to the most economically disadvantaged families. For others, costs will be calculated based on norms,” an official with Aardram Mission Kerala said. A system to send reports to patients will be introduced. “Discussions are ongoing on launching a portal, through which patients can access reports. We hope to launch the facility at a later phase,” the official added.
Hub & Spoke Model
Primary hub to be based at community health centres (CHCs)
Secondary hub to be preferably located at district hospitals/general hospital laboratories or district public health/regional public health laboratories, as per requirements of each district
Tertiary hub shall be a referral laboratory (national/state/regional) located outside districts
No of tests available at various hubs
Spokes - 62
Primary - 89
Secondary - 96
Tertiary - 131