Ward Specialist Clinic:  A noble Approach To Community Healthcare

The Ward Specialist Clinic (WSC), operating under the supervision of Dhangadhi, Sub-Metropolitan City, has successfully entered its second year of operation and made significant strides in providing affordable and accessible healthcare to the community. This mobile clinic is patient-centric and offers both basic and specialised Healthcare services to residents of Dhangadhi. The WSC is scheduled to run in each ward of the sub-metropolitan city, providing services to individuals suffering from ailments as well as various noncommunicable diseases. Available services include ECG, blood glucose tests, and ultrasound screenings for pregnant mothers, among others. The WSC is unique in that doctors visit their patients at their doorstep. This approach has garnered great interest within the community, resulting in excellent patient adherence and overall satisfaction.

Dhangadhi Sub-Metropolitan City comprises 19 wards, with wards from 1 to 7 being central and peripheral. Each ward has basic healthcare facilities where residents receive essential health services. The addition of specialist Healthcare services has proven to be a valuable enhancement. Previously, people had to go to the hospital and wait in long queues, even for minor health issues, which created a substantial financial burden. Now, residents can access specialised care conveniently at their doorsteps.

The clinic is a pioneering effort in Nepal, where a local government has taken the initiative to provide additional specialist services alongside basic Healthcare. Despite its resource limitations, Dhangadhi Sub-Metropolitan City has demonstrated that political commitment can make a significant difference. In addition to general consultations, extended services such as ECG and ultrasound screenings are also available, enhancing timely clinical diagnosis and enabling prompt referrals to higher-level Healthcare centres. This is particularly crucial for pregnancy, where ultrasounds can detect early fetal abnormalities.

It is commonly known that local government often lacks sufficient resources. Despite these challenges, Dhangadhi Sub-Metropolitan City has proven that political commitment is the key. The free distribution of medicine is another crucial aspect of the specialist clinic, relieving a substantial financial burden for many. This is particularly beneficial for Dhangadhi residents, where much of the financial strain is caused by the cost of medicine. Many low-income individuals previously faced difficult choices, sometimes selling their livestock or assets to afford necessary medications. The clinic’s services have alleviated these hardships, allowing low-income populations’ access to essential treatments. Moreover, the time saved and transportation costs avoided are additional benefits, especially for elderly patients, who often struggle with prolonged waits and queues to see a doctor.

 The socioeconomic benefits to the people from the specialist ward clinic are immense. People who have started taking medicine for diabetes, hypertension, and other ailments have reported significant improvement in their symptoms, leading to an overall improvement in their quality of life. This has allowed them to reallocate resources previously spent on healthcare toward more productive purposes.

 Due to overwhelming participation, there is a need to add more facilities to meet the growing demand for quality services. Recent screening has revealed disease related to orthopaedic causes and a high prevalence of non-communicable disease. Numerous patients who complained of headaches were found to have high blood pressure. Similarly, diabetic patients were experiencing a tingling and burning sensation in their feet. Many patients who were initially experiencing shortness of breath were actually suffering from obstructive airway diseases, mainly attributable to smoking and reliance on biogas for cooking, highlighting problems associated with indoor pollution.

The clinic has proven its effectiveness when implemented correctly. Services have been expanded and tailored to meet community needs, with more comprehensive diagnostic and testing capabilities added over time. This has largely reduced the need for unnecessary tests and complicated diagnostic workups. The cyclical distribution of essential drugs free of cost for non-communicable diseases like hypertension and diabetes has proven to be beneficial. Patients receive enough medication for an entire month and can return for refills. The drug dose is also adjusted based on patients’ laboratory test results.

 The specialist clinic of this kind has had a profound impact on the socio-economic condition of individuals in the community. Health indicators for both patients and the community have improved, leading to an increase in overall well-being. It reduces the financial burden of healthcare expenditures. The promotion of good health hygiene and the health education imparted during the specialist clinic sessions have helped service users to adopt healthier lifestyles and opt for organic food intake.

Additionally, there is increased awareness that many non-communicable diseases can be prevented through the adoption of healthy lifestyles and dietary modifications. For those unable to control these conditions through lifestyle changes, pharmacological intervention can still effectively manage symptoms. A balanced approach involving medications, diet, and exercise is essential in preventing noncommunicable disease.

Various constraints, such as the pressing need for budget allocation to procure medicine and other logistics, as well as the lack of qualified and trained health professionals at the local level, remain major challenges. Despite these difficulties, the clinic remains a vital resource for individuals seeking affordable healthcare. This model can be replicated by other local governments aspiring to deliver specialised Healthcare directly to those who need it most. This would help build trust between the people and local government at the grassroots level.

In conclusion, the ward specialist clinic has been a resounding success, with increased participation, particularly among patients with non-communicable diseases. Many conditions that were previously undiagnosed or misdiagnosed are now being recognised, revealing the substantial public health burdens in the community. Other local governments can draw inspiration from this initiative and take necessary actions to promote and improve healthcare delivery. This will enhance public confidence in their local governance and foster a stronger bond between the two. The clinic represents an effective way for local governments to engage with and monitor the health of their communities. This initiative can be fruitful and sustainable, with a call to continue and expand these services in the future.

Dr. Rijal is a consultant physician at Dhangadi SMC.