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1
Kumar, Anil. "National Institute of Rural Health for India: Need of the Hour." Epidemiology International 05, no. 04 (November 20, 2020): 12–15. http://dx.doi.org/10.24321/2455.7048.202026.
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India being predominantly a rural country, striving hard to provide quality healthcare services to more than 890 million people who lives there. The importance given to rural health care by Govt. of India is visible through the implementation of dedicated submission under NHM, i.e., NRHM. However, there are still several rural health challenges, i.e., specific needs, belief/ superstition, scarcity of human resources in rural areas, lack of quality research/ coordination and collaboration between various sectors. The possible solutions to these challenges lie in strengthening research in rural health epidemiology, agricultural health, enhancing use of Information Technology & Telemedicine, designing specific clinical services, field practices, applying the biostatistics & mathematical modelling in decision making and mentoring the human resources in specific need of rural health. This article is an attempt to elucidate various rural health challenges and need for development of National Institute of Rural Health in India, to address the challenges of rural health and conduct before mentioned activities as an apex body.
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Shrivastava, Aakash. "National Programme on Climate Change and Human Health-India, 2019." Journal of Communicable Diseases 52, no. 03 (September 30, 2020): 43–48. http://dx.doi.org/10.24321/0019.5138.202029.
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Introduction: In 2015, India’s response to climate change was broadened by introducing four new missions including “Health”. National Action Plan for Climate Change and Human Health (NAPCCHH) was prepared in 2018 with objective to strengthen health care services against adverse impact of climate change on health. The Ministry of Health and Family Welfare (MoHFW) approved National Programme on Climate Change and Human Health (NPCCHH) under National Health Mission (NHM) in February 2019. The common Climate Sensitive Diseases (CSDs) are - air pollution related, heat related, water-borne, vector-borne, cardiopulmonary diseases, mental health, food-borne, nutrition related illnesses etc. Currently the three key areas of focus for NPCCHH include air pollution, heat related illnesses and creation of green and climate resilient healthcare facilities. Air Pollution and Human Health: Acute Respiratory Illnesses (ARI) surveillance in context of air pollution was started in year 2017 in Delhi. Key Strategy in coming years are to expand ARI surveillance in all polluted cities of States, developing State/District/Cities level health sector adaptation plan for air pollution and health. Heat and Human Health: Since 2015, heat related illnesses (HRI) surveillance was started from heat vulnerable States of India. Key Strategies in coming year are strengthening the surveillance, standardizing the investigation of deaths due to suspected heat stroke cases, developing State/ District/ City specific heat and health action plan, increasing public awareness and community outreach, developing measures for early warning system/ alerts and response at State, district and below district level. National Centre for Disease Control (NCDC) under MoHFW is incorporating both the green and climate resilient healthcare principles in revising Indian Public Health Service Guidelines.
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Saha, Somen, Raj Panda, and Gaurav Kumar. "Public-private partnership in health care of India: A review of governance and stewardship issues." Journal of Comprehensive Health 6, no. 1 (June 30, 2018): 02–08. http://dx.doi.org/10.53553/jch.v06i01.002.
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Indian health care is characterized by a mixed health system and different kinds of delivery structure. Mixed health systems can be defined as involving ‘centrally planned government health services that operate side-by-side with private markets for similar or complementary products and services’.1 Public health care delivery system includes teaching hospitals, secondary level hospitals (at district and subdivisional level), first-level referral hospitals (community health centres/rural hospitals), dispensaries, primary health centres, sub-centres and health posts. The private sector, both for-profit and not for profit, however, is the dominant sector and services range from 2-bed facilities to 1000+ bed hospitals.2The private provisioning of health care has grown from a mere 5 to 10 percent during India’s independence era to 82 percent of outpatient visit, 52 percent of inpatient expenditure, and 40 percent of births in institution.3 A report of the task force on Medical Education for the National Rural Health Mission in India determined that the private sector provides 58 percent of hospital buildings, 29 percent hospital beds, and 81 percent of the doctors in India.
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Faridi, Samrah Butool. "MATERNAL HEALTH SITUATION IN UTTAR PRADESH, INDIA." Era's Journal of Medical Research 9, no. 2 (December 2022): 239–42. http://dx.doi.org/10.24041/ejmr2022.37.
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Health of children and their mothers is a vital aspect of a society's longterm development. Unfortunately, around half of all mothers and over 10 million children die due to preventable causes. Data from a current National Family Health survey (NFHS) was utilized and compared with the previous data of the surveys conducted at national level. The maternal mortality ratio in India has decreased to 113 per 100,000 live births, according to a report released by the WHO. Only 51.6% women reported three or more ANC visits where anaemia is still found among 35.4% women. Although 88% of women delivered in a health facility whereas only 5 7.5 % mothers received postnatal care within two months. The Maternal Mortality Ratio (MMR) in Uttar Pradesh is remains high due to a lack of utilisation of available maternal and child health services, putting the health of mother and children at risk. Hence, to improve the health status, evidence-based policies with grass root level programme planning are required.
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PRAKASH, RAVI, and ABHISHEK KUMAR. "URBAN POVERTY AND UTILIZATION OF MATERNAL AND CHILD HEALTH CARE SERVICES IN INDIA." Journal of Biosocial Science 45, no. 4 (February 15, 2013): 433–49. http://dx.doi.org/10.1017/s0021932012000831.
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SummaryDrawing upon data from the third round of the National Family Health Survey (NFHS-3) conducted in India during 2005–06, this study compares the utilization of selected maternal and child health care services between the urban poor and non-poor in India and across selected Indian states. A wealth index was created, separately for urban areas, using Principal Component Analysis to identify the urban poor. The findings suggest that the indicators of maternal and child health care are worse among the urban poor than in their non-poor counterparts. For instance, the levels of antenatal care, safe delivery and childhood vaccinations are much lower among the urban poor than non-poor, especially in socioeconomically disadvantageous states. Among all the maternal and child health care indicators, the non-poor/poor difference is most pronounced for delivery care in the country and across the states. Other than poverty status, utilization of antenatal services by mothers increases the chances of safe delivery and child immunization at both national and sub-national levels. The poverty status of the household emerged as a significant barrier to utilization of health care services in urban India.
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Sekar, K. "(A14) Psychosocial Support Services in Disasters - Indian Experiences." Prehospital and Disaster Medicine 26, S1 (May 2011): s3—s4. http://dx.doi.org/10.1017/s1049023x11000276.
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India with 1.08 billion populations is vulnerable to earthquake (56%), floods (8%), cyclones (12%) and droughts (28%) every year. It is further compounded with refugees, riots, epidemic and endemic situations. Disaster psychosocial support and mental health services has consistently grown and standardized over the past three decades in India. The initial experiments' started in 1981 with a circus tragedy and documentation of prolonged grief reaction. In the Bhopal gas tragedy (1984) mental health services were integrated through primary care doctors. The Marathwada earthquake (1991) involved primary health care personnel in provision of mental health care to the survivors. The Orissa super cyclone (1999) saw the emergence of psychosocial support to the community using local resources like community level workers who were survivors by themselves. The feasibility study involving 40 such workers was expanded to a pilot model with 400 workers in the Gujarat earthquake (2001) and later to the level of a District model in the Gujarat riots (2002). These developments paved way for the State model when Tsunami struck the eastern coast of India affecting three States and two Union Territories in India. The experiences and experiments led to the development of standardized capacity building tools and intervention kits with level and limits of care being addressed. The Indian experiences has seen a striding change from psychiatry paradigm to public health model, to the development of a standardized psychosocial support models involving community at large. The lesson learnt has been helpful in developing the National Guidelines on Psychosocial Support and Mental Health Services by the National Disaster Management Authority of India. These service models could be adapted to the developing South East Asian countries where there is a paucity of trained professionals to attend the needs of the survivors.
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Gulia, Seema, Manju Sengar, Rajendra Badwe, and Sudeep Gupta. "National Cancer Control Programme in India: Proposal for Organization of Chemotherapy and Systemic Therapy Services." Journal of Global Oncology 3, no. 3 (June 2017): 271–74. http://dx.doi.org/10.1200/jgo.2015.001818.
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Cancer is a major health problem in India, with an estimated incidence of 1 million cases in 2012 that is likely to double in 2035 to approximately 1.7 million. The majority of cases are diagnosed in advanced stages, and approximately two thirds of patients die as a result of their disease. The mortality-to-incidence ratio is 0.68 in India, which is far higher than that in developed countries (approximately 0.38). One of the important reasons for this discrepancy is inequitable distribution and inaccessibility of health care resources in India. One component of scarce health care resources is the low ratio of oncologists to patients with cancer (1:2,000), which leads to delivery of systemic anticancer therapy in many hospitals by health care professionals who do not have required training. Given these facts, there is a need to focus on organization of medical oncology services in terms of manpower and infrastructure to standardize the delivery of systemic anticancer therapy. Redistribution of resources can streamline the delivery of cancer care, preferably close to the patient’s home. This article describes the blueprint for organization of medical oncology services and delivery of chemotherapy and other systemic therapies to Indian patients. The model uses existing health care services in the country and is a four-tiered system of increasing sophistication: District Hospitals, Medical College Hospitals, Regional Cancer Centres, and Apex Cancer Centres. Delivery of quality care to patients with cancer through standardized protocols is crucial in improving cancer outcomes in India.
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Gopalakrishnan, S., and A. Immanuel. "Progress of health care in rural India: a critical review of National Rural Health Mission." International Journal Of Community Medicine And Public Health 5, no. 1 (December 23, 2017): 4. http://dx.doi.org/10.18203/2394-6040.ijcmph20175758.
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National rural health mission (NRHM) was initiated in the year 2005 in eleventh five year plan, with the objective of providing quality health care services to the rural population. The mission brought out salient strategies by involving various sectors and forging partnerships with various organizations to unify health and family welfare services into a single window. Though the mission strived for a sustainable health care system, it did not envisage certain challenges in implementation. The public health system in India could take off from the foundations laid by the NRHM to overcome these challenges, in order to achieve various goals of health and development and put India on the road map of healthful development. The objective of this review article is to critically evaluate the implementation of national rural health mission and highlight its success and to make recommendations on the future health care planning and implementation in achieving universal health coverage for the rural India. NRHM has been a mammoth effort by the Union Government to build the public health infrastructure of the nation. The mission deserves its credit for empowering the rural India in health care, especially in States with poor health related indicators. NRHM has been a pioneer in reiterating the need for community participation, coupled with intersectoral convergence, to bring about a paradigm shift in the indicators, which has been reasonably achieved in most of the States. Taking forward the foundations laid by the NRHM, it is essential for the forthcoming policies and plans to focus on capacity building, not only on the infrastructure and technical aspects, but also on streamlining the health workforce, which is crucial to sustaining the public health infrastructure. The public health system in India should take off from the foundations laid by the NRHM. There is an imminent need to focus on forging a sustainable public private partnership, which will deliver quality services, and not compromise on the principles and identity of the public health system of the country, in its pursuit to achieve universal health coverage and sustainable development goals.
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Singh, Ankit, Firoz Khan, and Ashish Gaur. "Utilization and comparison of family planning services through national family health survey in Uttarakhand, India." International Journal of Research in Medical Sciences 7, no. 11 (October 24, 2019): 4272. http://dx.doi.org/10.18203/2320-6012.ijrms20195001.
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Background: India was the first country to start family planning program in 1952. In the first 50 years there have been many changes in India. The family planning program name was changed from time to time. At the present scenario, its name is Reproductive and Child Health. In this study, authors evaluate utilization of family planning services with an objective to compare distribution of family planning services between the two regions of Uttarakhand: Garhwal and Kumaon.Methods: In this study, data mining was done using secondary database with the permission from International Institute for Population Sciences (IIPS) NFHS-4 data to carried out during 2015-2016 in Uttarakhand, India and estimate of the values for all the parameters of Family Planning was estimated. A statistical Z-score test was performed in the estimated of proportions in all study parameters of the family planning.Results: The study indicates that between the two divisions Garhwal has more utilization of family planning services as comparatively higher than Kumaon. Pithoragarh from the Kumaon division has more utilization proportion of family planning services in comparison to the other districts in the division, while Almora were recorded as the minimum use of family planning services. Uttarkashi in Garhwal region accounted for major proportion of utilization of family planning services, while Haridwar had minor proportions.Conclusions: Though overall utilization of family planning services of Uttarakhand is far better than other states in India but between the two divisions, Kumaon requires more attention in terms of utilizing services and awareness programmes. In fact, certain districts in Garhwal also require intervention from the Government to improve health quality. Both hilly and urban districts have different issues, which needs to be targeted to improve the health quality of the state.
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Katyal, Sonal. "Patterns of Utilization of Maternal Healthcare Services in Haryana, India." Asia Pacific Journal of Health Management 13, no. 1 (June 1, 2018): i31. http://dx.doi.org/10.24083/apjhm.v13i1.29.
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Background: Despite being a relatively smaller state, Haryana’s per capita Gross State Domestic Product (GSDP) is high. The statistical data on the status of women has a different story to share. Objective: This study analyzes the maternal healthcare situation in Haryana to examine the differential in utilization of maternal health care service i.e. antenatal care on the basis of socio economic and socio demographic indicators such as Women’s age at Birth, Birth order, Education, Residence, Religion, Wealth index and Caste. Methodology: The present study uses the third round of the National Family Health Survey (NFHS) data which is similar to the Demographic and Health Surveys (DHS). DHS collects, disseminates national data on health and population in developing countries. Findings: Indicate that economic status, husband’s education and caste have effect on the utilization of antenatal care services. Conclusion: The present study demonstrates several socio economic and demographic factors affecting the utilization of antenatal care services in Haryana. Efforts need to be taken at community and household level to improve utilization. Abbreviations: NFHS- National Family Health Survey; DHS- Demographic and Health Surveys; MDG- Millennium Development Goals; SC/ST-Scheduled caste/Scheduled tribe; WHO-World Health Organization; MOHFW- Ministry of Health and Family Welfare; ANM – Auxiliary Nurse Midwife; VIF – Variance Inflation Factor; OBC- Other Backward Classes; ANC- Antenatal Care; TBA – Trained Birth Attendant
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Prinja, Shankar, Maninder Pal Singh, Lorna Guinness, Kavitha Rajsekar, and Balram Bhargava. "Establishing reference costs for the health benefit packages under universal health coverage in India: cost of health services in India (CHSI) protocol." BMJ Open 10, no. 7 (July 2020): e035170. http://dx.doi.org/10.1136/bmjopen-2019-035170.
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IntroductionTo achieve universal health coverage, the Government of India has introduced Ayushman Bharat - Pradhan Mantri Jan Arogya Yojana (AB - PMJAY), a large tax-funded national health insurance scheme for the provision of secondary and tertiary care services in public and private hospitals. AB - PMJAY reimburses care for 1573 health benefit packages (HBPs). HBPs are designed to cover the treatment of diseases/conditions with high incidence/prevalence or which contribute to high out-of-pocket expenditure. However, there is a dearth of reference cost data against which provider payment rates can be assessed.Methods and analysisThe CHSI (Cost of Health Services in India) study will collect cost data from 13 Indian states covering 52 public and 40 private hospitals, using a mixed economic costing methodology (top-down and bottom-up), to generate unit costs for the HBPs. States will be sampled to capture economic status, development indicators and health service utilisation heterogeneity. The public sector hospitals will be chosen at secondary and tertiary care level. One tertiary facility will be selected from each state. At secondary level, three districts per state will be selected randomly from the district composite development score ranking. The private sector hospital sample will be stratified by nature of ownership (for-profit and not-for-profit), type of city (tier 1, 2 or 3) and size of the hospital (number of beds). Average costs for each HBP will be calculated across the different facility types. Multiple scenarios will be used to suggest rates which could be negotiated with the providers. Overall, the study will provide economic cost data for price setting, strategic purchasing, health technology assessment and a national cost database of India.Ethics and disseminationThe approval has been obtained from the Institutional Ethics Committee and Institutional Collaborative Committee of the Post Graduate Institute of Medical Education and Research, Chandigarh, India. The results shall be disseminated in conferences and peer-reviewed articles.
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Mojumdar, Sujoy Kumar. "Determinants of Health Service Utilization by Urban Households in India." Journal of Health Management 20, no. 2 (April 13, 2018): 105–21. http://dx.doi.org/10.1177/0972063418763642.
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In this article, an attempt has been made to examine the factors associated with the utilization of health care services among the urban households in India based on NSS case-level data of 42nd (1986–1987) and 60th round (2004–2005). The result of multivariate logistic regression analysis reveals that the education level of household head is not only an important positive predictor in the utilization of health services in general but is also found as a negative predictor to determine the utilization of public facilities in particular (National Sample Survey, 1998). It is also found that the weaker social class like scheduled caste (SC) is less likely to use curative health care facilities but the chances of using public facilities are much higher compared to non-SC households (National Sample Survey, 2006). It is found that the influence of household income for accessing health care services has been sharpened over the period. The study also reveals that the utilization of public health facilities is much higher in low-income states but the rate of improvement of public health care utilization is much higher in case of outpatient care services. The size of town has shown a significant impact on the utilization of health services. The chances of using public facilities have increased in small- and medium-sized town compared to metro cities. The level of intra-household disparities in access to health facilities with respect to age and gender has increased in urban India. Significant gender disparities are found in case of public health service utilization both for inpatient and outpatient care services in urban India.
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Tripathi, R. "Women substance use in india: An important but often overlooked aspect." European Psychiatry 64, S1 (April 2021): S818—S819. http://dx.doi.org/10.1192/j.eurpsy.2021.2163.
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IntroductionSubstance abuse has traditionally been considered as a disease of men. Women were believed to have some kind of immunity in terms of “social inoculation”. However, due to change in societal norms and beliefs, substance use is currently increasing among women also.ObjectivesTo focus on female substance use in IndiaMethodsIn India, traditional use of various substances by women during religious festivals is not unknown. Chewing tobacco is a common practice among many women across the country. Cultural use of alcohol has been known in some tribal populations but gradually the use is increasing. There is major difference in pattern of male and female substance use including initiation, progression, recovery and relapse. Women experience greater medical, physiological and psychological impairment and experience loss of control sooner than males. Teatment needs of female substance users is different and requires a gender specific comprehensive strategy which will require medical services, mental health services, services for family and child and employment opportunities.ResultsCurrently, there is no Indian policy for women substance use. However, Government of India has started a convergence program which includes National AIDS Control program (NACP), National rural health mission (NRHM) and reproductive or sexually transmitted infection (RTI/STI) to combat some aspects.Conclusions India is in great need of a policy or at least a standard operative protocol for management of female substance use disorder which may include screening for substance use disorder for all females accessing health sector, counselling, referral to addiction services, formation of a treating team and after –care.DisclosureNo significant relationships.
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Solomon, Suniti, Kartik K. Venkatesh, A. K. Srikrishnan, and Kenneth H. Mayer. "Challenges of expansion of voluntary counselling and testing in India." Sexual Health 5, no. 4 (2008): 371. http://dx.doi.org/10.1071/sh07090.
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Voluntary counselling and testing (VCT) has been recognised as an integral element of any effective HIV public health primary prevention and care program. In India, it is currently estimated that 2.0–3.1 million individuals are living with HIV. As low-cost antiretroviral therapy has increasingly become available in India, VCT could be an important link connecting individuals to treatment and care. Major barriers remain for scaling-up of VCT services, including location of VCT centres, HIV-associated stigma, and lack of perception of HIV risk. Future national expansions of VCT services must engage the Indian private sector, which is likely to remain the largest provider of healthcare for the foreseeable future, through scaling-up personnel in these facilities to provide accurate testing and culturally-relevant counselling.
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Shah, Reena, and Danièle Bélanger. "Socioeconomic correlates of utilization of maternal health services by tribal women in India." Canadian Studies in Population 38, no. 1-2 (December 31, 2011): 83. http://dx.doi.org/10.25336/p6z89v.
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Based on two waves of the National Family Health Surveys of India, this paper studies the effect of maternal characteristics on women’s likelihood of using prenatal and delivery healthcare services among two groups of tribal women. Results show that tribal women in the northeastern states of India are more likely to utilize maternal healthcare facilities compared to those in the central states of the country. Women who work are less likely to utilize healthcare services. The findings call for different strategies for the implementation of healthcare services in different tribal regions of the country.
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Banerji, Debabar. "Politics of Rural Health in India." International Journal of Health Services 35, no. 4 (October 2005): 783–96. http://dx.doi.org/10.2190/1g7y-kve3-b6yv-ane9.
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The setting up of the National Rural Health Mission is yet another political move by the present government of India to make yet another promise to the long-suffering rural populations to improve their health status. As has happened so often in the past, it is based on questionable premises. It adopts a simplistic approach to a highly complex problem. The Union Ministry of Health and Family Welfare and its advisors, because of ignorance or otherwise, have doggedly refused to learn from the many experiences of the past, either the earlier, somewhat sincere efforts to develop endogenous mechanisms to offer access to health services or the devastating impact on the painstakingly built rural health services of the imposition of prefabricated, ill-conceived, ill-formulated, technocentric vertical programs on the people of India. They also ignore some of the basic postulates of public health practice in a country such as India. That they did not substantiate the bases of some of their contentions with scientific data from health systems research reveals that they are not serious about their promise to rural populations. This is yet another instance of what Romesh Thaper called “Baba Log playing government government.”
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Kiruthika, S., and G. Raja. "Emerging Issues And Challenges Of Public Health Infrastructure Of Covid-19 In India." International Review of Business and Economics 4, no. 2 (2020): 260–64. http://dx.doi.org/10.56902/irbe.2020.4.2.37.
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Today Indian health care system is in pathetic condition, its needs radical reforms to deal with new emerging challenges and issues. COVID-19 is spreading really fast around the world. The Indian government facing the problem of lack of resources and infrastructure facilities, there are insufficient number of beds, rooms, ventilators and medicines. Public health is the practice of preventing disease and promoting good health within groups of people, from small communities to entire countries. The countries concentration has been focused on the crucial need for a strong public health infrastructure to protect community health. The current study describes the situation of the outbreak of this pandemic in India. The study also discusses the availability of public health infrastructure facilities in virus infected peoples. Public health organizations at the federal, state, tribal, local are taking steps to increase effectiveness and efficiency through its National Public Health Improvement Initiative (NPHLL), the centers for disease control and prevention supports improvements in 74 state, local and territorial health departments systems, practices, and essential services. COVID pandemic has considerably undermined the accessibility and availability of essential health services. A good health infrastructure also guarantees a country of strong and healthy way to living as well as happy life.
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YADAV, AWDHESH, and RANJANA KESARWANI. "EFFECT OF INDIVIDUAL AND COMMUNITY FACTORS ON MATERNAL HEALTH CARE SERVICE USE IN INDIA: A MULTILEVEL APPROACH." Journal of Biosocial Science 48, no. 1 (March 5, 2015): 1–19. http://dx.doi.org/10.1017/s0021932015000048.
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SummaryThis study aimed to assess empirically the influence of individual and community (neighbourhood) factors on the use of maternal health care services in India through three outcomes: utilization of full antenatal care (ANC) services, safe delivery and utilization of postnatal care services. Data were from the third round of the National Family Health Survey (2005–06). The study sample constituted ever-married women aged 15–49 from 29 Indian states. Multilevel logistic regression analysis was performed for the three outcomes of interest accounting for individual- and community-level factors associated with the use of maternal health care services. A substantial amount of variation was observed at the community level. About 45%, 51% and 62% of the total variance in the use of full ANC, safe delivery and postnatal care, respectively, could be attributed to differences across the community. There was significant variation in the use of maternal health care services at the individual level, with socioeconomic status and mother's education being the most prominent factors associated with the use of maternal health care services. At the community level, urban residence and poverty concentration were found to be significantly associated with maternal health care service use. The results suggest that an increased focus on community-level interventions could lead to an increase in the utilization of maternal health care services in India.
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Zodpey, Sanjay, Himanshu Negandhi, and Ritika Tiwari. "Human Resources for Health in India: Strategic Options for Transforming Health Systems Towards Improving Health Service Delivery and Public Health." Journal of Health Management 23, no. 1 (February 27, 2021): 31–46. http://dx.doi.org/10.1177/0972063421995005.
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Introduction: The health workforce is the channel for delivering health interventions to populations. A critical mass of health professionals is necessary to manage a health system and is often a crucial limiting factor in the delivery of quality health services. India’s current situation, juxtaposed with its medium-term and long-term HRH (human resources for health) requirements, necessitates reassessing the policy levers that are available at the national level. Objective: To suggest strategic options to recommend India’s way forward to meet challenges related to health service delivery and public health with an HRH focus. Methodology: We reviewed and compared studies from different countries which focused on strengthening HRH at the national level. A two-step approach towards identifying and selecting HRH strategic options was adopted: desk review and discussions. A list of strategic options for reforming the current state of HRH in India was developed on the basis of lessons learnt from the review. These options were then scored and plotted on a grid (for innovation, disruption, difficulty of implementation, budget for implementation, importance and time period for implementation) in discussion with experts. Result: Based on the lessons learnt, eight strategic options were suggested for India: instituting a national HRH body; developing partnership models for the public sector and the private sector; setting benchmark HRH ratios; allocating at least 2.5% of the GDP to health; allocating at least 25% of all development assistance for health to HRH; halving the current levels of disparity in health worker distribution between urban and rural areas; evaluating HRH support through the National Health Mission (NHM); and maintaining a live register of HRH. Conclusion: The research is timely as India moves towards the implementation of the Sustainable Development Goals (SDGs) with a particular focus on universal health coverage (UHC) and Ayushman Bharat Yojana. The suggested strategic options for the way forward shall help India in dealing with the current health crisis to emerge with a strong public health system.
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Mohanasundari, SK, and A. Padmaja. "National Health Mission (NHM) and India Newborn Action Plan (INAP) Services in Newborn Health-An Overview." International Journal of Advances in Nursing Management 7, no. 4 (2019): 366. http://dx.doi.org/10.5958/2454-2652.2019.00086.6.
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P, Suganya, Bharathwaj V. V, and Sindhu R. "Trend Analysis of Vital Statistics in India - A Key to Improve Quality of Health Care Services and Infrastructure." International Journal of Research and Review 8, no. 11 (November 12, 2021): 217–26. http://dx.doi.org/10.52403/ijrr.20211129.
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Aim: The aim of this study is to assess the trends of vital statistics in India for improving the quality of health care services and infrastructure. Materials and Methods: This study was carried out to improve the quality of health care services and infrastructure by analysing the trends of vital statistics in India. The data regarding vital statistics which includes birth rate, death rate, infant mortality rate, neonatal mortality rate and total fertility rate were obtained from the year 2011-2017 using electronic sources such as sample registration system, National health profile and NITI Aayog. Results: The death rate found to be increased in various states and union territories of India. Over all the states and union territories in India Chhattisgarh, Madhya Pradesh, Odisha, Assam, Puducherry, Punjab and Uttar Pradesh has the highest death rate whereas the Nagaland, Chandigarh and Delhi has the lowest death rate. The rural areas of India have the highest number of mortality rate when compared to urban areas. Conclusion: The government of India should pay more attention to the health care services and increase the health care expenditure of the public from the Gross Domestic Product (GDP) for the beneficiaries of people. Keywords: Trend analysis, Vital statistics, India, Gross Domestic Product, Health care services, Infrastructure.
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Bhatia, Ridhi, and Udita Taneja. "Factors Affecting Indian Consumers’ Intention to Use eHealth Services." Journal of Health Management 21, no. 2 (May 22, 2019): 258–78. http://dx.doi.org/10.1177/0972063419835119.
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Purpose: This study focuses on the degree of acceptance of different categories of eHealth among the Indian consumers and the factors that determine acceptance and intention to use these services. The factors included for the study are as follows: demographic factors, use of information and communication technology (ICT) and the status of healthcare. Design/methodology/approach: Data were collected through personal interviews from a sample of 125 respondents living in urban and semi-urban villages in the National Capital Territory (NCT) of Delhi of India. Quota sampling method was used so that the impact of demographic factors on eHealth services could be analysed. Findings: From this study, we can conclude that the key factors that need to be considered include age, location, computer literacy and healthcare status in terms of healthcare need, accessibility and satisfaction. Practical implications: The results of this study will help in determining the customer segment and size of the market for eHealth. The government can also use the findings of this study to improve the quality of healthcare for its people by ensuring better utilization of eHealth services. Originality/value: eHealth services are an emerging solution to address the issues of healthcare accessibility, affordability and financial viability in developing countries like India. This study contributes to the limited existing literature on exploring the consumers’ intention to use eHealth services in India and the factors that will determine this intention.
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Banerji, Debabar. "The World Health Organization and Public Health Research and Practice in Tuberculosis in India." International Journal of Health Services 42, no. 2 (April 2012): 341–57. http://dx.doi.org/10.2190/hs.42.2.k.
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Two major research studies carried out in India fundamentally affected tuberculosis treatment practices worldwide. One study demonstrated that home treatment of the disease is as efficacious as sanatorium treatment. The other showed that BCG vaccination is of little protective value from a public health viewpoint. India had brought together an interdisciplinary team at the National Tuberculosis Institute (NTI) with a mandate to formulate a nationally applicable, socially acceptable, and epidemiologically sound National Tuberculosis Programme (NTP). Work at the NTI laid the foundation for developing an operational research approach to dealing with tuberculosis as a public health problem. The starting point for this was not operational research as enunciated by experts in this field; rather, the NTI achieved operational research by starting from the people. This approach was enthusiastically welcomed by the World Health Organization's Expert Committee on Tuberculosis of 1964. The NTP was designed to “sink or sail with the general health services of the country.” The program was dealt a major blow when, starting in 1967, a virtual hysteria was worked up to mobilize most of the health services for imposing birth control on the people. Another blow to the general health services occurred when the WHO joined the rich countries in instituting a number of vertical programs called “Global Initiatives.” An ill-conceived, ill-designed, and ill-managed Global Programme for Tuberculosis was one outcome. The WHO has shown rank public health incompetence in taking a very casual approach to operational research and has been downright quixotic in its thinking on controlling tuberculosis worldwide.
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Dey, Joyashri, Chathapuram Ramanathan, and Subhabrata Dutta. "Issues and Concerns of Women’s Health in India: A Case Study of Cachar, Assam." International Journal of Community and Social Development 2, no. 3 (September 2020): 327–43. http://dx.doi.org/10.1177/2516602620957781.
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This article discusses women patients’ level of awareness of health services and health-seeking behaviour. Further, it analyses their perceptions and experiences of services received under the National Rural Health Mission (NRHM). By employing a survey method, data were collected through 200 women patients from eight Block Primary Health Centres located in Cachar district. The analysis showed mixed experiences of receiving health services. Women in rural areas experience difficulties in accessing health services and low literacy levels, low awareness of services and low economic status, which further contribute to reduced access. Through the NRHM, Accredited Social Health Activist and Auxiliary Nurse Midwives were able to connect well with the community and advance women’s health. Women’s experiences at health centres warrant systematic improvements in service delivery. Additionally, these findings have implications for improving health policies, programmes and services for women in similar rural areas beyond India.
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Sharma, Nandini, A. Venkat Raman, Sunita Dhaked, and Pawan Kumar. "Human Resource Challenges in Indian Public Health Services." South Asian Journal of Human Resources Management 3, no. 2 (December 2016): 173–90. http://dx.doi.org/10.1177/2322093716677414.
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The quality, accessibility and viability of health services depend primarily on the performance of those who deliver them. Given the strong correlation between the quality of health services and job satisfaction of the health personnel, this study evaluates the problems faced by primary health care providers in India. This cross-sectional study was conducted among middle-level primary care providers operating in the National Capital Region of Delhi, to assess their perception of various issues and challenges related to human resources for health (HRH). They identified gaps in human resource (HR) staffing, training, performance appraisal and compensation, including delays in recruitment, lack of probationary training and failure to link appraisal and compensation to performance. This study contributes to the limited literature on HRH from a broader policy reform perspective, underpinned by stakeholder perspective.
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Ganesan, L., and R. Senthamizh Veena. "A STUDY ON INTER-STATE DISPARITIES IN PUBLIC HEALTH EXPENDITURE AND ITS EFFECTIVENESS ON HEALTH STATUS IN INDIA." International Journal of Research -GRANTHAALAYAH 6, no. 2 (February 28, 2018): 54–64. http://dx.doi.org/10.29121/granthaalayah.v6.i2.2018.1542.
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Public health services play an important role in the health status of the people and Health Expenditure by the Government occupies crucial part in influencing the health outcome in the country. The healthcare finances are influenced by the respective State's budgetary allocation which leads to inter-state disparity in health services and health status in India. This has implications on providing Universal Health Coverage, which aims at ensuring equitable health services to people at all levels in the country (National Health Portal, GoI). The researcher has selected 15 major states based on the level of population (which accounts for about 90 percent of the total population in India) to analyse the inter-state disparities in health sector. Alongside, this study focuses on the performance of public health sector of the selected states through a comparative analysis of various parameters depicting health expenditure, availability of health services, their utilization and health outcomes. With vast variation in the availability, affordability and utilisation of health services across different states, it is found that the economic conditions, health finance, infrastructure and effectiveness of health services at the state level have direct bearing on the health status of the people in the respective states. Therefore, it is essential to take necessary corrective measures that target the disparity, to achieve better and equitable health services for all, leading to Universal Health Coverage which is the real inclusiveness.
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Ali, Balhasan, Paramita Debnath, and Tarique Anwar. "Inequalities in utilisation of maternal health services in urban India: Evidences from national family health survey-4." Clinical Epidemiology and Global Health 10 (April 2021): 100672. http://dx.doi.org/10.1016/j.cegh.2020.11.005.
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White, Jeffrey D., Barry R. O’Keefe, Jitendra Sharma, Ghazala Javed, Vid Nukala, Aniruddha Ganguly, Ikhlas A. Khan, et al. "India-United States Dialogue on Traditional Medicine: Toward Collaborative Research and Generation of an Evidence Base." Journal of Global Oncology, no. 4 (December 2018): 1–10. http://dx.doi.org/10.1200/jgo.17.00099.
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Therapies originating from traditional medical systems are widely used by patients in both India and the United States. The first India-US Workshop on Traditional Medicine was held in New Delhi, India, on March 3 and 4, 2016, as a collaboration between the Ministry of Ayurveda, Yoga and Naturopathy, Unani, Siddha, and Homoeopathy (AYUSH) of the Government of India, the US National Cancer Institute (NCI), National Institutes of Health, and the Office of Global Affairs, US Department of Health and Human Services. It was attended by Indian and US policymakers, scientists, academics, and medical practitioners from various disciplines. The workshop provided an opportunity to open a dialogue between AYUSH and NCI to identify promising research results and potential topics for Indo-US collaboration. Recommendations that emerged from the workshop underlined the importance of applying rational and scientific approaches for drug development; standardizing traditional medicine products and procedures to ensure reliability and reproducibility; promotion of collaboration between Indian traditional medicine practitioners and researchers and US researchers; greater integration of evidence-based traditional medicine practices with mainstream medical practices in India; and development of training programs between AYUSH and NCI to facilitate crosstraining. Several positive developments took place after the thought-provoking deliberations.
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Dawa, Natasha, Thelma Narayan, and Jai Prakash Narain. "Managing Health at District Level: A Framework for Enhancing Programme Implementation in India." Journal of Health Management 23, no. 1 (March 2021): 119–28. http://dx.doi.org/10.1177/0972063421994991.
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COVID-19 pandemic has brought to the fore the need for a strong health system for the social protection of people and to improve health programme implementation in the coming years. India has made great progress in health over the past 50 years; however, despite the progress made, it is faced with several challenges. While infectious diseases remain an unfinished agenda, chronic non-communicable diseases (NCDs) are rising and are now the leading cause of mortality in the country. This is further compounded by the prevailing inequalities in access to quality health care among population groups including those living in remote rural areas. To achieve Universal Health Coverage and Sustainable Development Goals by 2030, India in 2017 revised its National Health Policy and committed itself to attain the highest possible level of good health and well-being, through preventive and promotive health interventions. While policies are enunciated and plans are formulated, the implementation at ground level is at best tardy and lack lustre As an administrative unit for programme implementation, a district has a key role to play in implementing national programmes and in delivery of basic health services to the people. They are strategically placed to plan, organise and lead efforts meant to deliver primary health care services through better management of existing resources and by fully engaging all relevant stakeholders in contributing towards achievement of national health goals and in responding to a public health emergency such as Covid-19. Planning and managing health problems need an improved and responsive health governance. Strategic planning, monitoring and evaluation require integration and coordination of various health programmes including dealing with health crises, fostering inter-sectoral involvement and engagement of the community as a key actor. Efforts are needed to ensure that services reach the most vulnerable and marginalised sections of the society. Adequate governance support at district level through a whole-of-society approach is essential to bridge the health inequities and ensure equitable access to health services.
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Saiyed, Saiyedali Ahmedmiya. "Determinants of National Gross Domestic Product among Disaggregated Development Expenditure Schemes: An Experience of Indian Economy during 1990-91 to 2004-05." Journal of Global Economy 8, no. 3 (October 8, 2012): 225–31. http://dx.doi.org/10.1956/jge.v8i3.261.
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This paper is a study which examines what are the determinants of National Gross Domestic Product. In India various disaggregated development expenditure schemes undertaken during period of 1990-91 to 2004-05 have a significant influence on determination of National Gross Domestic Product. Here association between cross-sectional disaggregated development expenditure schemes and year-wise number of National Gross Domestic Product in India is estimated by a Multivariate Regression Model Analysis. Cross-sectional analysis shows significant association between year-wise number of gross domestic product and disaggregated development expenditure schemes in terms of Agriculture and Allied Activities, Rural Development, Irrigation and Flood Control, Energy, Industries and Minerals, Transport, Education, Health Including Medical, and Others Services, included together jointly in the model, have positive influence on the determination of Gross Domestic Product in the Indian economy.
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Rajpal, Sunil, William Joe, Malavika A. Subramanyam, Rajan Sankar, Smriti Sharma, Alok Kumar, Rockli Kim, and S. V. Subramanian. "Utilization of Integrated Child Development Services in India: Programmatic Insights from National Family Health Survey, 2016." International Journal of Environmental Research and Public Health 17, no. 9 (May 4, 2020): 3197. http://dx.doi.org/10.3390/ijerph17093197.
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The Integrated Child Development Services (ICDS) program launched in India in 1975 is one of the world’s largest flagship programs that aims to improve early childhood care and development via a range of healthcare, nutrition and early education services. The key to success of ICDS is in finding solutions to the historical challenges of geographic and socioeconomic inequalities in access to various services under this umbrella scheme. Using birth history data from the National Family Health Survey (Demographic and Health Survey), 2015–2016, this study presents (a) socioeconomic patterning in service uptake across rural and urban India, and (b) continuum in service utilization at three points (i.e., by mothers during pregnancy, by mothers while breastfeeding and by children aged 0–72 months) in India. We used an intersectional approach and ran a series multilevel logistic regression (random effects) models to understand patterning in utilization among mothers across socioeconomic groups. We also computed the area under the receiver operating characteristic curve (ROC-AUC) based on a logistic regression model to examine concordance between service utilization across three different points. The service utilization (any service) by mothers during pregnancy was about 20 percentage points higher for rural areas (60.5 percent; 95% CI: 60.3; 30.7) than urban areas (38.8 percent; 95% CI: 38.4; 39.1). We also found a lower uptake of services related to health and nutrition education during pregnancy (41.9 percent in rural) and early childcare (preschool) (42.4 percent). One in every two mother–child pairs did not avail any benefits from ICDS in urban areas. Estimates from random effects model revealed higher odds of utilization among schedule caste mothers from middle-class households in rural households. AUC estimates suggested a high concordance between service utilization by mothers and their children (AUC: 0.79 in rural; 0.84 in urban) implying a higher likelihood of continuum if service utilization commences at pregnancy.
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Arora, RamandeepSingh, Vatsna Rathore, Ankit Taluja, PuneetRana Arora, Poonam Bagai, Gauri Kapoor, and Rachna Seth. "Delivery of services to childhood cancer survivors in India: A national survey." Indian Journal of Medical and Paediatric Oncology 41, no. 5 (2020): 707. http://dx.doi.org/10.4103/ijmpo.ijmpo_6_20.
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Simpson, Hope, K. N. Panicker, Leyanna Susan George, Jorge Cano, Melanie J. Newport, Gail Davey, and Kebede Deribe. "Developing consensus of evidence to target case finding surveys for podoconiosis: a potentially forgotten disease in India." Transactions of The Royal Society of Tropical Medicine and Hygiene 114, no. 12 (November 9, 2020): 908–15. http://dx.doi.org/10.1093/trstmh/traa064.
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Abstract Background Podoconiosis is a non-infectious geochemical lymphoedema of the lower legs associated with a significant burden of morbidity. There are historical reports of podoconiosis in India, but its current endemicity status is uncertain. In this investigation we aimed to prioritise the selection of districts for pilot mapping of podoconiosis in India. Methods Through a consultative workshop bringing together expert opinion on podoconiosis with public health and NTDs in India, we developed a framework for the prioritisation of pilot areas. The four criteria for prioritisation were predicted environmental suitability for podoconiosis, higher relative poverty, occurrence of lymphoedema cases detected by the state health authorities and absence of morbidity management and disability prevention (MMDP) services provided by the National Programme for Elimination of Lymphatic Filariasis. Results Environmental suitability for podoconiosis in India was predicted to be widespread, particularly in the mountainous east and hilly southwest of the country. Most of the districts with higher levels of poverty were in the central east and central west. Of 286 districts delineated by state representatives, lymphoedema was known to the health system in 189 districts and not recorded in 80. Information on MMDP services was unavailable for many districts, but 169 were known not to provide such services. We identified 35 districts across the country as high priority for mapping based on these criteria. Conclusions Our results indicate widespread presence of conditions associated with podoconiosis in India, including areas with known lymphoedema cases and without MMDP services. This work is intended to support a rational approach to surveying for an unrecognised, geographically focal, chronic disease in India, with a view to scaling up to inform a national strategy if required.
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BRIJNATH, BIANCA R. "The legislative and political contexts surrounding dementia care in India." Ageing and Society 28, no. 7 (October 2008): 913–34. http://dx.doi.org/10.1017/s0144686x08007368.
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ABSTRACTCurrently there is no specific policy on dementia care in India. Rather, the responsibility for care for people with dementia is not clearly articulated and formal care services straddle mental health and aged care. The result is that much care is placed upon individual families. This paper critically reviews Indian legislative and policy documents on this field of care, namely, the Mental Health Act 1987, the National Mental Health Programme, the National Policy on Older Persons and the Senior Citizen's Act 2007. The invisibility of dementia care in public policy translates into the absence of adequate treatment facilities and mental health staff, and leaves informal care-giving unsupported. This gap is replicated in mental health and dementia-care research and literature in India, with little being known about how family carers respond to the experiences of care-giving, manage the stigma, and access support. As India, like other middle-income and low-income countries, is experiencing an increase in its older population, more research is needed to develop the epidemiological, medical and anthropological understanding of ageing, dementia and care. This knowledge is vital to understanding the cultural context of the disease and must also be incorporated into public health policy if there is to be effective management of the rising need for personal care.
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Rout, Sarit Kumar, and Sandeep Mahapatra. "Has the Public Health System Provided Adequate Financial Risk Protection for Child Birth Conditions – Evidences From an Eastern Indian State." International Journal of Health Policy and Management 8, no. 3 (November 24, 2018): 145–49. http://dx.doi.org/10.15171/ijhpm.2018.111.
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Over the years, national and sub-national governments have introduced several initiatives to improve access to maternal and child health services in India. However, financial barriers have posed major constraints. Based upon the data of National Family Health Survey (NFHS) round 4 for Odisha state, our paper examines the out-of-pocket expenditure (OOPE) borne by households for accessing maternal and child healthcare services in a low resource setting of India. We have interpreted results of NFHS-4 by drawing inferences from literature for understanding the rising OOPE in the public health system. Findings suggests that OOPE is considerably high for maternal and child health conditions in Odisha and ranks fifth, despite the coverage of 72% women under Janani Suraksha Yojana (JSY), a condition cash transfer scheme with majority utilizing the public health system. The high OOPE on child delivery raises numerous pertinent questions about the effectiveness of the public health delivery system, and thus requires financial protection in the interest of the population that accesses public health systems in the state.
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B., Swarna Priya, Kalepu Srinath, Anagha Jammalamadaka, and Anurita Hindodi. "Advancement of existing healthcare setting through tele-medicine: the challenges faced in India." International Journal Of Community Medicine And Public Health 8, no. 1 (December 25, 2020): 502. http://dx.doi.org/10.18203/2394-6040.ijcmph20205743.
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Telemedicine is the mixed structure of tele-communication technologies and quality health care making it feasible for general populace to obtain superlative healthcare. Starting from video chat for medical services in 2000 to e-Sanjeevani OPD 2020, Indian healthcare reform has come a long way in achieving sustainable healthcare in which, the setting up of the National Telemedicine Taskforce by the Health Ministry of India, in 2005, played a huge role for various projects like the ICMR-AROGYASREE, NeHA and VRCs. Despite the lack of awareness among common public on Tele-medicine, it has a lot of benefits on existing health care settings which makes it to thrive and progress within a decade. Health systems and polices have a critical role in determining the manner in which health services are delivered, utilized and affect health outcomes. This article in brief discusses on the changes and advancement of traditional healthcare system, realizing the pace of timeline in bringing Tele-medicine into practice. As, international telemedicine initiatives are attaining quality healthcare, this article also describes the challenges of telemedicine in Indian healthcare settings.
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Kaur, Harleen, Deepti Chalia, and Raj Manchanda. "Homeopathy in Public Health in India." Homeopathy 108, no. 02 (February 8, 2019): 076–87. http://dx.doi.org/10.1055/s-0038-1673710.
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Background Based on a pluralistic approach to health care, India offers a range of medical treatment modalities to its population. In that context, the government of India aims at providing its people with wider access to homeopathy. This article provides insight into the infrastructural support put in place by the government to meet that aim. Data and Methods A literature review was carried out of recent surveys and articles to assess the morbidity trends in India and the treatment modalities being sought by patients. Extensive attempts were made to identify and access all data sources that could contribute to understanding the situation of homeopathy in public health in India. These efforts included analysis of secondary data about government wellness centres, as also a case study of one such centre. Results In India, homeopathy is well represented in public health, being a close second among the AYUSH (Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy) services. Homeopathy wellness centres comprise 31% of the total for AYUSH. Seven out of 10 diseases recognised as a national health burden are in the category of most commonly reported diseases at the homeopathy wellness centres. Academic homeopathy institutes comprise 35.8% of AYUSH colleges, the total student intakes of which are 13,658 and 32,256 respectively. Homeopathy practitioners are 37% of the AYUSH total. Homeopathy units comprise 1/19th of the number of allopathy units, yet the annual patient footfall in the former is 1/5th of the latter. Conclusion Homeopathy services, wherever available, are being used fully and thus sharing the patient load in the government-run wellness centres. There is the potential for more homeopathic practitioners to contribute importantly to health care delivery in India.
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Sharmila Mallik. "Family Adoption Program, A Way Forward to Community Based Medical Education…. Challenges Ahead." Journal of Comprehensive Health 10, no. 1 (June 30, 2022): 1–3. http://dx.doi.org/10.53553/jch.v10i01.001.
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Medical education in India is based predominantly on hospital environments and specialist services covering a narrow spectrum of health problems, with especially dependent on technology. A significant reorientation is needed in medical education, to allow students to understand people in their social contexts in a more holistic way, rather than seeing them merely as parts of a biological machine.1 National Medical Commission (NMC) in their recent notification included Family Adoption Program (FAP) in the undergraduate curriculum to provide a learning opportunity towards community-based health care to Indian Medical Graduates.2 The NMC documented its vision as “to provide for medical education system that improves access to quality and affordable medical education, ensures availability of adequate and high-quality medical professionals in all parts of the country; that promotes equitable and universal health care that encourages community health perspective and makes services of medical professionals accessible to all citizens; that promotes national health goal.”
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Dhaka, Rohit, Ramesh Verma, Ginni Agrawal, and Gopal Kumar. "Ayushman Bharat Yojana: a memorable health initiative for Indians." International Journal Of Community Medicine And Public Health 5, no. 8 (July 23, 2018): 3152. http://dx.doi.org/10.18203/2394-6040.ijcmph20183043.
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India in a state of epidemiological health transition i.e shifting from communicable to non-communicable diseases. The annually 3.2% Indians falling below the poverty line and three forth Indians spending their entire income on health care and purchasing drugs. The government of India announced a Ayushman Bharat Yojana- National Health Protection Scheme (AB-NHPM) in the year 2018. The aim of this programme is to providing a service to create a healthy, capable and content new India and two goals are to creating a network of health and wellness infrastructure across the nation to deliver comprehensive primary healthcare services and to provide health insurance cover to at least 40% of India's population which is deprived of secondary and tertiary care services. This Yojana will be implemented through Health and Wellness Centres that are to be developed in the primary health centre or sub-centre in the village and that will provide preventive, promotive, and curative care for non-communicable diseases, dental, mental, geriatric care, palliative care, etc. These centres would be equipped with basic medical tests for hypertension, diabetic and cancer and they are connected to the district hospital for advanced tele-medical consultations. The government has aims to set up 1,50,000 health and wellness centres across the country by the year 2022.
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Chatterjee, S., M. N. Toshniwal, P. Bhide, K. S. Sachdeva, R. Rao, Y. V. Laurence, N. Kitson, et al. "Costs of TB services in India (No 1)." International Journal of Tuberculosis and Lung Disease 25, no. 12 (December 1, 2021): 1013–18. http://dx.doi.org/10.5588/ijtld.21.0105.
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BACKGROUND: There is a dearth of economic analysis required to support increased investment in TB in India. This study estimates the costs of TB services from a health systems´ perspective to facilitate the efficient allocation of resources by India´s National Tuberculosis Elimination Programme.METHODS: Data were collected from a multi-stage, stratified random sample of 20 facilities delivering TB services in two purposively selected states in India as per Global Health Cost Consortium standards and using Value TB Data Collection Tool. Unit costs were estimated using the top-down (TD) and bottom-up (BU) methodology and are reported in 2018 US dollars.RESULTS: Cost of delivering 50 types of TB services and four interventions varied according to costing method. Key services included sputum smear microscopy, Xpert® MTB/RIF and X-ray with an average BU costs of respectively US$2.45, US$17.36 and US$2.85. Average BU cost for bacille Calmette-Guérin vaccination, passive case-finding, TB prevention in children under 5 years using isoniazid and first-line drug treatment in new pulmonary and extrapulmonary TB cases was respectively US$0.76, US$1.62, US$2.41, US$103 and US$98.CONCLUSION: The unit cost of TB services and outputs are now available to support investment decisions, as diagnosis algorithms are reviewed and prevention or treatment for TB are expanded or updated in India.
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Hans, Gagan, and Pratap Sharan. "Community-Based Mental Health Services in India: Current Status and Roadmap for the Future." Consortium Psychiatricum 2, no. 3 (November 5, 2021): 63–71. http://dx.doi.org/10.17816/cp92.
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An estimated 197.3 million people have mental disorders in India, and majority of the population have either no or limited access to mental health services. Thus, the country has a huge burden of mental disorders, and there is a significant treatment gap. Public mental health measures have become a developmental priority so that sustainable gains may be made in this regard. The National Mental Health Program (NMHP) was launched in 1982 as a major step forward for mental health services in India, but it has only been able to partially achieve the desired mental health outcomes. Despite efforts to energize and scale up the program from time to time, progress with development of community-based mental health services and achievement of the desired outcomes in India has been slow. Public health measures, along with integration of mental health services in primary healthcare systems, offer the most sustainable and effective model given the limited mental health resources. The main barriers to this integration include already overburdened primary health centres (PHCs), which face the following challenges: limited staff; multiple tasks; a high patient load; multiple, concurrent programs; lack of training, supervision, and referral services; and non-availability of psychotropic medications in the primary healthcare system. Thus, there is an urgent need for a fresh look at implementation of the NMHP, with a focus on achieving sustainable improvements in a timely manner.
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Al Dahdah, Marine, and Rajiv K. Mishra. "Smart Cards for All: Digitalisation of Universal Health Coverage in India." Science, Technology and Society 25, no. 3 (April 26, 2020): 426–43. http://dx.doi.org/10.1177/0971721820912920.
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In less than ten years, India has launched colossal biometric databases. One among them is related to the first ‘free’ health coverage scheme offered by the government of India: the Rashtriya Swasthya Bima Yojna (RSBY). Based on a public–private partnership between government and private companies, RSBY national scheme was launched in 2008, as a first step towards universal health coverage in a country where households endorse 70% of health expenses. The first phase of RSBY offers to cover ₹30,000 ($600) of inpatient expenses per year for five members of a below poverty line household and is now piloted in several Indian States to include outpatient expenses and above poverty line families too. RSBY relies exclusively on a centralised digital artefact to function, made visible by the ‘RSBY Smart Card’, a chip enabled plastic card containing personal data of individual and their family counting and conditioning the granting of health services to them; thus, no smart card means no health coverage. Till date 120 million Indians have been registered in the RSBY database. This article analyses how health accessibility is crafted under the RSBY scheme by questioning two central dimensions of this data-driven digital health scheme: the smart card technology and the public–private partnership, whereas RSBY scheme promises health coverage for all, its digital infrastructures may complicate access to health services, and reveal new patterns of exclusion of individuals. Thus, we will detail how smartcards technologies and private providers condition access to health care in India.
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Shirisha, P., Girija Vaidyanathan, and V. R. Muraleedharan. "Are the Poor Catching Up with the Rich in Utilising Reproductive, Maternal, New Born and Child Health Services: An Application of Delivery Channels Framework in Indian Context." Journal of Health Management 24, no. 1 (February 17, 2022): 87–104. http://dx.doi.org/10.1177/09720634221079071.
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The article is aimed to assess trends in wealth-related inequalities in coverage of reproductive, maternal, neonatal and child health (RMNCH) interventions using delivery channels framework in Indian context, at national level as well as at state level—Tamil Nadu (TN) and Chhattisgarh (CG)—a better off and poorer state, respectively. We used National Family Health Survey—3rd (2005–2006) and 4th (2015–2016) to study the trends and differentials of inequalities in the RMNCH coverage. We have used two summary indices—absolute inequalities using the slope index of inequality (SII) and relative inequalities using the concentration index (CIX). Culturally driven interventions had pro-poor inequalities in TN, CG and in India, but the coverage has improved significantly for the women from wealthier households recently. Environmental interventions were highly inequal in distribution, particularly for the ‘use of clean fuels’. Inequalities in the coverage of health facilities-based interventions has reduced in TN, CG and overall India, but more so in TN. The inequalities in coverage of community-based interventions have reduced over the period of ten years in TN, CG as well as at national level. Adopting RMNCH delivery channel framework could be useful for assessing and monitoring the progress of public health programmes. Policy makers can gain insights from the success of coverage of various interventions and determine specific implementation strategies to reduce inequalities in the coverage and its effectiveness.
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Babu, Cimil. "ASHA - World’s Largest All-female Frontline Community Health Worker: Features and Challenges." Indian Journal of Holistic Nursing 12, no. 3 (September 20, 2021): 16–20. http://dx.doi.org/10.24321/2348.2133.202111.
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India accounts for the second-highest number of maternal deaths all over the world. India has shown a remarkable decline in MMR (Maternal Mortality Ratio) during the last two decades. According to the SRS (Sample Registration System), MMR dropped from more than 556 per 100,000 in 1990 to 113 in 2018 and the proportion of deliveries attended by skilled health personnel has increased from 58% in the 1990s to 81% in 2019. In the year 2005, the Government of India launched the National Rural Health Mission (NRHM) with the purpose of improving the existing health facilities provided to the community with a special focus on the poor and vulnerable states and societies. NRHM identified ASHA (Accredited Social Health Activist), a voluntary community health worker, to provide services to the community on incentives. ASHA workers are the female health workers who have hailed from the same community where they serve. An ASHA worker acts as a link person between the health system and the community. At present, ASHA services are utilised in a number of programmes including maternal and child health, Various studies have extensively documented about ASHAs dissatisfaction with their pay and workload. ASHA services are widely accepted by societies, especially the poor, but issues like sexual harassment, violence, unsafe working conditions, and cast discrimination were also reported.ASHA programme plays a critical role in implementing Government health programmes, especially on MCH. Therefore keeping the ASHA updated and motivated is very important for performing her duties efficiently and effectively.
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Ngangbam, Sapana, and Archana K. Roy. "Determinants of Health-seeking Behaviour in Northeast India." Journal of Health Management 21, no. 2 (May 22, 2019): 234–57. http://dx.doi.org/10.1177/0972063419835118.
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India’s northeast region comprises eight states, which, together, is home to 3.8 per cent of the country’s population. The quality of healthcare and manpower availability remains a cause for concern in the region, affecting the overall health-seeking behaviour of the people. This study attempts to understand the determinants of utilization of healthcare services in Northeast India. Healthcare and morbidity data for this study are based on a Northeast India sample from the National Sample Survey Organization’s (NSSO’s) health consumption data (2014). Probit, multinomial and mixed conditional logit models were employed in the study. In Northeast India, uneducated, higher-aged, Schedule Castes/Schedule Tribes (SCs/STs), Muslims, rural people and district people are served less by medical institutions and because of poor road connectivity they either remain untreated or seek care at underequipped primary healthcare services, while their counterparts utilize private facilities mostly for outpatient care and either public hospital or private facilities for inpatient care. There is also a tendency to substitute alternative healthcare when the cost of an inpatient healthcare service rises. To protect the interest of marginalized people and achieve the target of accessible, affordable and quality healthcare, the government needs to strengthen the primary healthcare in rural areas and improve the quality of healthcare in urban areas without increasing the cost of treatment.
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Samal, Janmejaya. "Role and effectiveness of AYUSH doctors in providing maternal health services under National Health Mission in rural India." Journal of Indian System of Medicine 8, no. 4 (2020): 246. http://dx.doi.org/10.4103/jism.jism_88_20.
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Kapanee, A., P. Sudhir, and L. Suman. "Bridging the treatment gap in India: Online training of psychologists in basic mental health services." European Psychiatry 64, S1 (April 2021): S832—S833. http://dx.doi.org/10.1192/j.eurpsy.2021.2199.
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IntroductionThe National Mental Health Survey of India 2015-16 (Gururaj et al., 2016) indicated a large treatment gap of 70-92% for mental disorders and a paucity of mental health specialists in the country. In order to address this treatment gap and develop human resources, the National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, India, with impetus from the Ministry of Health and Family Welfare, Govt. of India, launched the online course of Diploma in Community Mental Health for Psychologists.ObjectivesThe course was designed with the objective of training individuals with a Master’s Degree in Psychology, in providing first-level psychological care in the community.MethodsThe course is a 3-month online programme comprising of approximately 25 hours of self-paced e-learning and 11 hours of live real-time interactive discussion via video conference. The course comprises of 6 modules, with an assessment at the completion of each module. Pre- and Post-Assessment is conducted to evaluate competencies achieved.ResultsOn successful completion of the course, trainees are expected to have achieved competencies to: Screen for and identify mental health problems in adults and children, and understand factors influencing them; Understand management options; Conduct interview-based functional developmental assessment for intellectual deficits; Conduct first-level brief psychosocial interventions; Make appropriate referrals to Mental Health Professionals and other health professionals.ConclusionsThis digitally-driven online course is a viable option for development of human resources on a large scale, in a resource-scarce (i.e. of mental health specialists) country such as India.DisclosureNo significant relationships.
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Kumar, Santosh, Rajesh Garg, Haroon Ali Siddiqui, and Rupali Roy. "Health services rendered through Accredited Social Health Activists to rural Uttar Pradesh, India: community’s perception." International Journal Of Community Medicine And Public Health 4, no. 3 (February 22, 2017): 662. http://dx.doi.org/10.18203/2394-6040.ijcmph20170736.
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Background: To reduce infant and maternal mortality in India, the Government of India (GOI), under its flagship program, National Rural Health Mission (NRHM), in 2005, introduced a new village based health functionary named Accredited Social Health Activist (ASHA) to act as a bridge between rural population and health care delivery system. To a large extent the actualization of the goals of NRHM depends on the functional efficacy of ASHA as a grass root health activist.Methods: The Study was conducted in a Chiraigaon Block of District Varanasi, Uttar Pradesh., India from October 2008 to September 2009. A total of 270 beneficiaries comprising of mothers, who have delivered during the study period or within last six months since initiation of the study were enrolled and interviewed. Apart from that, 20 Multi Purpose Health Workers- Female (MPHW-F), 30 elected village Heads and five Medical officers were interviewed independently to know their opinions about work performance of ASHA.Results: This study revealed that 80 % of beneficiaries availed Ante Natal Care (ANC) check up. A total of 97% of the beneficiaries had received 100 tablets of Iron Folic Acid (IFA), 72% of the beneficiaries were counseled for nutrition during pregnancy and the child immunization coverage was more than 80%. About 75% of multi purpose Health Worker-Female (MPHW-F), 83 % of the village heads and 80% of the Medical Officers were of the opinion that the maternal and child health (MCH) services have improved after ASHAs introduction. Conclusions: Overall, ASHA’s impact in the form of counseling on health services utilization by beneficiaries was observed to be statistically significant.
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Paul, Sohini. "Are the Poor Catching Up with the Rich in Utilising Maternal Health Care Services? Evidence from India." Journal of Health Management 23, no. 3 (September 2021): 470–81. http://dx.doi.org/10.1177/09720634211035212.
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India launched the National Rural Health Mission (NRHM) in 2005 to improve maternal and child health by providing good quality health services to all, especially deprived sections of society, to reduce inequality in access to health services. With the backdrop of NRHM, we analysed the extent to which the utilisation of maternal health care services (MHCSs) in the three stages of the continuum of care—antenatal care (ANC), care during child delivery and postnatal care (PNC)—–has improved among the poor vis-à-vis the rich in India, and the corresponding narrowing down in inequality in the period 2006–2016. Data from the 3rd round of the National Family Health Survey (NFHS) in 2005–2006, capturing the pre-NRHM period and the 4th round of NFHS 2015–2016, capturing the post-NRHM era ten years after the implementation of the flagship programme, are used for the analysis. We estimated absolute as well as relative measures of inequality, absolute gap and coverage ratio between the poor and rich, slope index of inequality and concentration index. Our findings show that maternal health care coverage increased significantly among the poor for all components of MHCSs. Even so, the extent of utilisation of services remains significantly lower among the poor in 2015–2016 compared to the coverage among the rich in 2005–2006. Although inequality declined at the national level over the decade, it still persists. High equity has been achieved in using skilled birth attendance during child delivery and institutional delivery during 2015–2016, however, inequality continues to be higher for ANC indicators including consumption of iron and folic acid supplements for at least 100 days, receipt of four or more antenatal check-ups and comprehensive health check-ups at least once during antenatal visits and receipt of first check-up in the first trimester.
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Chadda, R. K. "Six decades of community psychiatry in India." International Psychiatry 9, no. 2 (May 2012): 45–47. http://dx.doi.org/10.1192/s1749367600003106.
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The community psychiatry movement started in India in the early 1950s. It has gone through different phases of development, beginning with family care of people who are mentally ill in the campus of the mental hospitals, followed by satellite clinics and a national mental health programme. Other initiatives have included the camp approach, initiatives by non-government organisations and the media, and mental health services for disaster-affected populations. The paper traces the development of community psychiatry in India over the past six decades.