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Project Brief:
The project aims to improve early detection, referral, management, and follow-up of common chronic health conditions, including hypertension, diabetes and other common chronic conditions, through household-based care, community health camps, digital health technologies, and telemedicine-enabled primary healthcare services.
Job Description:
The Tele Nurse will support community mobilization, household enumeration, participant screening, and identification of Family Health Champions within the study villages. They will facilitate health education, behaviour change counselling, digital health onboarding, ABHA enrolment, teleconsultation services, and referral tracking through DigiSetu. The Tele nurse will also coordinate community health camps, conduct household follow-up visits, support medication adherence and goal setting, and ensure continuity of care for participants through regular monitoring and engagement.
Key Responsibilities
A. Community Outreach and Household Engagement
- Conduct household enumeration, participant registration, screening, follow-up visits, and health education activities in assigned villages.
- Mobilize community members for household visits, community health camps, teleconsultations, and referral services.
- Identify and engage Family Health Champions to promote healthy behaviours, digital health adoption, and continuity of care.
B. Screening and Service Delivery Support
- Conduct basic health assessments including blood pressure, blood glucose, anthropometry, and mental health screening as per study protocols.
- Support risk stratification, referral of moderate- and high-risk participants, and follow-up of referred individuals.
- Facilitate assisted teleconsultations and support participants in accessing healthcare services.
C. Community Health Camps and Digital Health Services
- Support planning and implementation of community health camps, including participant mobilization, registration, screening, and counselling activities.
- Assist with ABHA enrolment, DigiSetu registration, digital health literacy activities, and teleconsultation coordination.
- Maintain and update participant records in DigiSetu and other approved study platforms.
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