Prime Minister of Pakistan and WHO Hepatitis Eradication Initiatives and Hepatitis and Infection Control Program Improvements through PITB- EMR

By: Dr. Shaukat Chauhdary

In May 2016, the World Health Assembly endorsed the first Global Health Sector Strategy (GHSS) on viral hepatitis. The GHSS on viral hepatitis calls for the elimination of viral hepatitis as a public health threat by 2030 (SDGs) through the implementation of five core interventions (hepatitis B immunization, prevention of mother-to-child, the transmission of hepatitis B virus, blood and injection safety, harm reduction for people who inject drugs, and testing and treatment.

Hepatitis is a medical condition defined by the inflammation of the liver and characterized by the presence of inflammatory cells in the tissues of the organ. Hepatitis is acute when it lasts less than six months and chronic when it persists longer. In the year 2015, 1.34 million people died from the consequences of viral hepatitis infection. There are two types of Hepatitis: Acute Hepatitis: Initial features are of nonspecific flu-like symptoms include malaise, muscle, and joint aches, fever, nausea or vomiting, diarrhea, and headache. Chronic Hepatitis: Chronic hepatitis may cause nonspecific symptoms such as malaise, tiredness, and weakness. It is commonly identified on blood tests performed either for screening or to evaluate nonspecific symptoms. The presence of jaundice indicates advanced liver damage. Viral Hepatitis is a systemic disease involving primarily liver, caused by one of the following five agents, Hepatitis A virus, Hepatitis B virus (with requires hepatitis B to cause disease), Hepatitis C virus, Hepatitis D virus, Hepatitis E Virus Hepatitis viruses produce acute inflammation of the liver, resulting in clinical illness characterised by fever, GIT symptoms such as nausea and jaundice. Alcoholic Hepatitis: Excessive alcohol consumption is a significant cause of hepatitis and liver damage (cirrhosis). Autoimmune Hepatitis is a chronic disease caused by an abnormal immune response against liver cells. Electronic Medical Record (EMR) system for the Hepatitis control program to revolutionize the health sector. This EMR System with the earnest efforts of Punjab Information Technology Board (PITB) has been deployed since August 2017 at 120 healthcare facilities from the grassroots level at DHQ and THQ Hospitals, PKLI Hepatitis Clinics (HPTC) & Specialized Hepatitis Clinics all over Punjab and moving toward the specialized healthcare to connect all healthcare sectors digitally. PITB–EMR dashboard maintained all records from patient Registration to patient discharged in which total patient registered 1209255, total HCV & HBV Screening performed 1144684, PCR sample was collected 83942, total Hepatitis detected patients 183937 enrolled in treatment, total 2,24,369 patients vaccinated and total medicine dispensed 372703 through Electronic Medical record system.

Hepatitis Micro Elimination Project was launched in district Nankana sahib tehsil shahkhot in UC Panwana. This Micro Elimination project aimed to eliminate viral hepatitis from all districts population through implementation of a comprehensive model to Educate, Prevent, Test and Treat by building an online & offline hepatitis and infection control program App (EMR) for the care of hepatitis patients. To meet the goals of hepatitis elimination in Pakistan, there is a need for a substantial scale-up. PITB introduced systems like Centralized Barber & Salon License (CBSL) a mobile app project of Hepatitis control program and primary and secondary healthcare to preventing from all type of Hepatitis which are occurring through hairs and beauty salons, Blood Transfusion, Tracking & Response system which are also helpful to eradicate Hepatitis. PITB has also introduced E-Vacc system for tracking vaccinators, smartphones with applications to digitize their fieldwork and monitor attendance and performance.

There are 8 -11 Million Hepatitis patients in Pakistan in which 60-70% cases are in Punjab. To hepatitis free Pakistan PITB –EMR system is really helpful to maintain all records of preventions and treatment.

According to Pakistan’s Expanded Programme on Immunization (EPI), 27% of deaths among children under five years are caused by diseases that could be prevented through vaccinations. The government has announced the Prime Minister’s Programme for Hepatitis to eliminate viral hepatitis B and C infections from the country by 2030. The implementation will be overseen by the newly created NHSRC national task force to achieving targets under the global sustainable development goals which call for the eradication of hepatitis by 2030.

WHO and the Centers for Disease Control and Prevention are actively engaged in strengthening the national response to Hepatitis in the country. WHO Regional Action Plan 2017—2021, a National Hepatitis Strategic Framework has been developed, with the consensus of national and provincial stakeholders.

The competent authorities Primary & Secondary healthcare, Specialized Healthcare, PKLI (HPTC) WHO Hepatitis Control program and PITB Chairman Azfar Manzoor, DG (IT-Ops) Faisal Yousaf and its qualified team working in the healthcare facilities in Punjab must be applauded for their endeavors to make this system more acceptable, friendly and apprehend able for the users (healthcare professionals and administration) and beneficial for the public health. By providing the data of hepatitis through EMR the medical decision making at the lower level to the medical policymaking at a higher level has been revamped entirely. Thus, making this unprecedented model a success story is the only way we could fulfill our national obligation of universal healthcare and international commitment of SDGs 2030. PITB Working on Digital Pakistan according to the vision of Prime Minister Imran Khan & Health Minister Dr. Yasmeen Rashid to uplift the healthcare system according to western countries.

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