I. About Karuna Trust

Karuna Trust, established in 1986 is a public charitable trust based in Karnataka. Karuna Trust was established to respond to the widespread prevalence of leprosy in Yelandur Taluk. In appreciation of our efforts, in 1996, the Government of Karnataka engaged in a Public-private partnership with Karuna Trust to manage the Gumballi PHC and provide comprehensive primary health care to the rural and tribal population. Today, it is a model PHC to the entire nation, providing comprehensive health care to a population of about 25,000. Karuna Trust currently manages 71 Health Care Centres in 4 states of India- Karnataka, Orissa, Arunachal Pradesh, Meghalaya covering a population of about 1.5 Million. The interventions of Karuna Trust have been consistently through the Public Private Partnership (PPP) model with an objective of providing universal, affordable and comprehensive primary health care with the goal of ‘Reaching healthcare to the Unreached’, to the most underserved and poor population in remote tribal/ hilly and /or insurgency areas. Apart from primary healthcare, education, sustainable livelihoods, and advocacy have been the prime focus areas of Karuna Trust.

II. COVID-19 Response in Karuna Trust PHCs

Supervision and Monitoring of the Covid-19 Response

Karuna Trust under the guidance of our Secretary – Dr Sudarshan and Joint Secretary – Venkat Chekuri is carrying out a robust COVID-19 response through all our health centres. Joint Secretary is personally supervising the functioning of the health centres in the high alert zones. Our supervisory staff visit all the health centres at regular intervals to provide hand-holding, support and guidance to the health staff.

1. Fever/Flu/Influenza Clinics

In line with the Epidemic diseases act, all the Karuna Trust PHCs were enabled to function as fever clinics. Catering a population of about 1.5 million, the PHCs were nodal centres to disseminate appropriate information to the community and enforce infection control measures in the respective areas. Although the Government designated only a few health centres as fever clinics initially, a designated fever/ flu corner was put in place in all the Karuna Trust PHCs. The fever clinics attended to all symptomatic cases and did an early triage for COVID-19. The apprehensions among the community were attended to with extensive IEC and availability of health staff round the clock at the health centres.

2. Community Screening and Health Education

    A. Community Screening

Door to door visits by ASHA worker to identify the suspect cases. It is done with the help of a mobile app. The data from suspected cases will be entered, along with the automatically derived risk score for the patient. Action will be taken depending upon the risk score of patients.

    B. Teleconsultation

Symptoms of COVID-19 are very much like common flu. Treating all these patients under the same roof might accelerate the spread of infection. Also, most physicians could be inaccessible, busy in managing the high risk COVID-19 patient loads due to the pandemic.
We are augmenting the physician with well-informed ASHA and other front-line workers: With the help of the CERNER app, ASHA can categorize suspected cases in three categories viz, High, Moderate, and low risk. She can arrange a teleconsultation session with moderate-risk patients and physician at PHC

    C. Community surveillance

In pandemic such as the COVID-19 community, surveillance is of immense importance and is essential. It will help us to keep the track of confirmed cases, new suspected cases, contacts of suspected and confirmed cases, and migrants/immigrants so that the spread of disease can be curtailed. In Primary health centres managed by Karuna trust, we keep tight surveillance, so the chances of missing potential cases are minimized. Complete line listing of the suspected cases is maintained by the health workers so we can trace any case at any time. Keeping watch on immigrants from other cities, states, or countries. Following-up on their health condition via telephonic calls and providing them awareness and guidelines on proper health and hygiene management for the prevention of potential spread.

3. Testing and Diagnosis –

Point of Care Testing – TrueNAT MicroPCR

Karuna Trust was the first to de-centralize COVID testing to ward levels through our urban primary health centres. The Government has also adopted the same strategy now. Karuna trust with the support from donors established a state-of-the-art TRUENAT testing centre at the Adugodi Fever Clinic health centre. Patients who require RT-PCR testing for COVID from other urban health centres – Adugodi UPHC, Maternity Hospital, Tavarekere UPHC, Maternity Hospital, Nelamaheshwari, Yemaluru were referred to the fever clinic for the same. About 30 to 40 samples were being tested for COVID using TRUENAT. This expedites diagnosis, reduces waiting time and improves triage of cases at the grass-root level, bringing down the burden on tertiary care centres. Subsequently, 8 more urban PHCs were strengthened with TRUENAT MicroPCR testing facility. All the lab technicians were rigorously trained to conduct tests and we were able to issue reports within 4 hours from sample collection. Today, each of these centres conduct close to 20 to 30 tests/day for vulnerable and high-risk patients such as >60yrs, pregnant women, those with comorbidities, severe symptomatic etc.,

Mobile Testing Units:

With the aim of taking healthcare closer to the community in the most remote unreached areas, migratory population and slum dwellers, we have deployed four mobile Micro-PCR testing units. Mobile team including driver and lab technician reach out to the community and perform COVID-19 RTPCR testing. Reports are generated in less than a day and appropriate treatment is initiated by the PHC MO.

4. Home Management (Isolation)

In addition to tracking, tracing, testing, Karuna trust has emphasised on treatment at Primary care level. Our PHCs have taken full responsibility for follow up and management of all home isolated cases. A COVID-19 kit consisting of thermometers, pulse oximeters, sanitizer, masks, all essential medicines such as Vit C, Zinc, Paracetamol etc., where distributed to all positive cases in PHC area. Patients who had a smart phone were added to PHC’s dedicated COVID patients WhatsApp group and their vitals were monitored by PHC staff, including teleconsultation by medical officer. All other patients were visited by ASHAs or ANMs at least once daily and vitals were checked. Oxygen concentrators from the PHC is taken to the house of patients in need and they are administered O2 in the comfort of their home. Medical officer keeps a close watch on such cases and any deviation in vitals is immediately raised to the MO and appropriate referral is initiated.

5. Infrastructure Strengthening

    1. Oxygen concentrators: All Karuna Trust PHCs in Karnataka and Odisha are equipped with 1 Oxygen concentrator each to cater to the immediate needs of the community. This reduces apprehensions among the people and they can readily access O2 from the PHCs until referral to higher centres are arranged. This is also being used for mild to moderate cases to augment recovery and in children for nebulisation

    2. NCD diagnostic kits:

All subcentres have been equipped with a comprehensive NCD diagnostic kit, which  the ANMs and MHWs use for early diagnosis of NCDs among the community and identify high-risk population for COVID-19, target population for vaccination.


    3. DESIGNATED COVID ROOM in all PHCs with Oxygen facility and essential medicines

6. Referral Services and Hospitalisation

Our Health workers identify patients who need hospitalisation and make all necessaryarrangements including ambulance, personnel support etc

7. Vaccination

All the Karuna Trust managed health centres are actively taking part in COVID-19 vaccination. So far, nearly 60,000 beneficiaries have been vaccinated through our PHCs as on 30th Apr 2021

8. Continuum of care – Continuing other primary health care services during the pandemic

Despite ongoing COVID-19 pandemic antenatal care and new born care have not been affected in PHCs managed by Karuna trust. Deliveries and C-section have been conducted at PHCs and maternity homes with adequate precautions.

9. IT Innovations

In addition to preparing our Primary Health Care centres (PHCs) and field staff to handle their specific roles in dealing with the COVID-19 Pandemic, Karuna Trust is working with our technology partners to innovate solutions that will enhance our abilities to deal with the Pandemic. Some of the innovations are:

a. EMR (COVID-19 Symptom tracker) – Cerner

Karuna Trust uses an Electronic Medical Records (EMR) solution to track and manage the functioning of our PHCs. Working with our technology partner Cerner, we have enhanced the EMR to incorporate COVID-19 suspected patient data. This allows for the tracking of this data over an extended period by multiple healthcare providers. The platform now provides a tool to track, as well as effectively manage suspected COVID-19 patients. The EMR implementation has two parts:

A. At the registration: The staff in charge of registration uses the COVID-19 triage questionnaire to separate the patients into two categories:
1. COVID suspected cases: These patients will be marked as red by the symptom tracker and be serviced in a separate high priority queue.
2. General Patients: These are other than COVID suspected cases. These patients will get serviced by ANMs (Auxiliary Nurse Midwife) and receive appropriate treatment or be directed to a physician if required.

B. At the physician: Physician will prioritize the red signalled patients. He or She, will check the patient with the help of COVID-19 symptom tracker, and determine their risk category, and will take further actions based on their risk category.

    b. Covid19 Emergency Supply Chain Management – Logistimo

We have enhanced our medical supply chain management and tracking solution from Logistimo, to incorporate a separate panel for tracking Covid19 emergency supplies, including PPE. The app now helps us know the current status of medicine and PPE stocks of PHCs, and alert us to shortages before they occur, and to where potential stocks are available. A pharmacist at PHCs will update the stock details in a simple mobile app periodically, it will help us to maintain proper supply of all essential medicines and equipment required for COVID-19 preparedness and first-level management.

10. Training, capacity building and Safety of Health Staff and PPE

1. Training of staff:

All the PHC staff are regularly trained on various COVID related topics such as personal protection, infection control, communication strategies for general public, early warning signs, testing, triaging and emergency management. To fight the COVID-19 pandemic it is of immense importance that everyone who is fighting this disease should be updated with the latest relevant knowledge. Including doctors, nurse, pharmacist, lab technician, ANM, ASHA, health worker, ambulance drivers, Group D worker.

2. Safety of Health Staff and PPE

Safety of health staff is of prime importance for Karuna Trust, we have facilitated the supply of all essentials PPE and drugs for the management of COVID 19. We acknowledge our donors who have supported for the immediate response of COVID-19 at health centres by facilitating the procurement of personal protective equipment. ACT grants supported Karuna Trust with N95 masks for all healthcare workers

11. Covid19 Collaboration

11.1 COVID-19 Action Collaborative (#COVIDActionCollab – ACT)

It has come together in response to the COVID-19 pandemic, consisting of expertise in Public health, Medicine, Technology, Sociology, Behavioural science, Financing, Humanitarian emergencies, Procurement and Supply, Designers, and the likes. The Collaborative has developed and promoted the COVID Action Collab framework to support stakeholders to collaborate, coordinate, and integrate COVID-19 Response. Karuna Trust is part of this collaborative and working proactively with the team.

11.2 Global COVID-19 Collaboration

A Global knowledge sharing platform has been created for mutual learning, case presentation, assessing the global scenario of Covid-19 involving experts in infectious disease and public health across the globe, Karuna Trust is a member of the collaboration.

11.3 Covid19 PHC Action Group:

Karuna Trust is a part of this action group that includes various International and National public health experts together formed as a PHC action Group for Covid-19 to facilitate improved preparedness in PHC/community settings, especially in rural areas


Karuna Trust, with support from donors and partners has established a designated covid health centre in Gonikoppa, Kodagu District, Karnatka, India. It is a free, 24*7, 30 bedded facility with 1 ICU bed, 8 HDU beds and 21 general beds with oxygen support. This centre has dedicated team of doctors, nurses and other staff. Patients receive quality care, all essential medicines, ygeinically cooked food all at no cost. Ambulance services are avilable for pick up and drop, referral to higher centres if required. This effort has been greatly appreciated by the local citizens and media. Work is in progress for establishing similar centres is Yemalur, Gumballi, Adugodi and Thavrekere health centres too.

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Gallery and media reports:

III. COVID-19 Status in Karuna Trust Managed Karnataka PHCs as on 30th Apr 2021