Saturday, 24 October 2015

The Prime Focus on Health: Questioning Actions, Charting Challenges and Demanding an Answer ~ Is the answer - Voice, Visibility or Ability?


From the Desk of Bipin Batra, MBBS, DNB ~CEO & Executive Director NBE & Sagar Galwankar, MBBS, DNB~CEO of INDUSEM

Introduction:
The Social Media and Print Media are all buzzing with some Editorial Article in a Journal questioning the Governance in India as regards the health care policy.
India is being subjected to a Media Trial with serious questions being raised about its Health Policy actions and alarming deductions predicting India’s Health Care doom as against the predicted Health Care Boom by the whole investment world.

Let’s look at some of the actions in the Health Policy, Public Health and Global Diplomacy arena with respect to India.
I answer because India is in Question:

India is openly committed to a People Centered Health Model with simultaneous and equal investments in Research, Education, Treatment, Public Health and Global Health with a progressive vision.
Research:

The massive expansion of the Translational Research Program lead by Department of Biotechnology (DBT) with focus on finding solutions to diseases at a Nano-Molecular level will make India as a Biotech Leader in Asia.

The installation of Progressive and Aggressive Leadership at the Helm of Indian Council of Medical Research (ICMR) and DBT reinforces the commitment of the Government to solve the TB / Communicable and Non Communicable Disease Crisis.


The Directors and Secretaries at both above departments bring years of successful program development and implementation at their earlier positions. Their experience and capabilities can now be escalated at National and International Level.
ICMR and DBT are developing Live Surveillance and Study Systems at Molecular, Genetic and Patient Care Levels at multiple locations to gather data and act on the findings to derive fast track solutions.
Increasing funding and encouraging research at Medical Students, Teaching Faculty and Private Hospital Level is a Major area of Expansion for ICMR and DBT.



Education:

Increasing the number of seats across Medical Colleges, Spear Heading the creation of AYUSH Ministry and focusing on the growth of Traditional Medicine as well as increasing number of Allopathic Graduates is a major game changing strategy by the government.
Reformatting the Medical Council of India (MCI) and bringing in intense coordination between the National Board of Examinations and MCI to bridge the difference in number of Under Graduate Medicine Seats and Post Graduate Medicine Seats will be a major accomplishment whose results will be robustly visible in coming years.

The biggest feather in the cap is the National Roll out of the Specialty Training Programs in Emergency Medicine across NBE Recognized and MCI Recognized Hospitals across India. The First Programs started in the Home State of PMO when he was CM of Gujarat and today they are across the Nation.
Until 72 Hours ago commitments were made to develop More AIIIMS and Similar Institutions across States in India with a vision that every state will have an Apex Institution for Super Specialty and Complex Health Problems.


Building on the earlier vision to develop Trauma Centers in India there was no Training on Trauma Surgery in India and now the Government with the help of the Academic Community has rolled out Subspecialty training in Trauma Surgery and Critical Care.


Additionally Post Graduate Training in Family Medicine has been a Prime Focus to create Specialist Primary Care Doctors across India.


Treatment:

We must admit that India is the Epicenter of Economical Generic Medication Manufacturing and Global Supply of the same.

Development of National Treatment Algorithms for DM, HTN and HIV, TB and Malaria as well as Faster Diagnostic Technologies and infrastructure development for rare and common diseases are the prime agenda of Indian’s Health Security.
As a part of India’s Commitment to the Global Health Security Mission, India in partnership with WHO, UN and USA Governments is implementing various multi-level strategy to address Prevention, Diagnosis, Response and Policy of Major Infectious Disease Threats and Challenges.

As a part of the Quality and Patient Safety Mission the NABH and NBE have formalized a Maiden Partnership to augment dual certification for Quality and Educational Accreditation. This has started with Accreditation EM Departments for PG Training as well as for Patient Safety and Quality Care. This will be expanded to the whole facilities and soon all the Educations Institutions will follow.

 

Rural Health Care:
Efforts are on and strategies are being made to use the Rural Health System as a training and education gateway by creating Post Graduate Training Programs at Rural Health Centers with National Procedural Skill Training Centers for Specialty and Sub Specialty HealthCare at Major Institutes in Every State of the Country.
Private-Public Sector partnerships to Operate Primary Health Care Centers and incorporating Ambulatory / Mobile Health Care Delivery Models are also being developed across major States.

Multi-Level-Multi-Fork Strategy:

Involving Private Hospitals, Governmental Hospitals, and Hospitals under NABH, NBE, MCI and Health Facilities under the purview of Directorate of Health Services of States, Interacting with National and International Health Agencies, Working closely with Bio-Pharma Industry and Commercialization of Innovation with a focus on India’s Health Security is the Interlaced Model the Government is working on.

Various Acts/ Policies and Laws are being Modified, Amended and being worked on as India moves ahead with its Progressive Health Agenda.
The Existing PNDCT act is being fortified to crack down on Female Feticide with greater vigilance being instituted. Additionally experts group are working on amendments to validate the use of Ultrasound in Emergency and Trauma under the purview of the PNDCT Act.

Experts are working on putting together the Bhartiya Emergency Medicine for All Act (BHEMAA) which will be a Historical Move to ensure Emergency Care to every citizen of India.


The Clinical Establishment Act is being implemented with great care and will show results in coming years.


Funds are bring allotted and States are being encouraged to ensure Ambulance Services for all Emergency patients. This is a step towards having an EMS Service for the whole nation.


A universal Emergency Number is also being issued.


International Investments are flowing into states with Uttar Pradesh Being the First State to have Massive Foreign Direct Investment in HealthCare in year 2014. This is called the SVADESH Program lead by Investors from Silicon Valley, USA.


The government is not basking on its success of a Healthy Kumbh Mela at Nashik or the eradication or polio or its Disaster Response system which not only is successful in India but also helped neighbors during environmental crisis, instead it is moving ahead with changes which are progressive.


The Health Care Models in Gujarat are complimented by similar models in Rajasthan Chhattisgarh and Many States.

Flagship Projects:

The Swach Bharat Abhiyan is a massive SEffort for Public Health &Cultural Transformation where efforts are being made to establish civil sense and responsibility.
The same applies to organ donation, and various other programs where massive media marketing is being used to instill Championed Cause for various initiatives.

Summary:

There are endless such initiatives which can be listed.

The Government is focused on building relations with Nations to speed the Economy. Health is a Silent but Vibrant Part of this Wealth Story which will not only progress India but also Position it as a Stable Player in Peace and Security.
India has a population of 125 Crores and hence problems are many. Governmental Health Care is available for all but Utilized more than 70 %. Rest use Fee Based Corporate Care.

Just because Health has not been in the news does not mean India's Health Story is doomed.
The results of Health Interventions in the Populations take time to be visible.

I still am open to specifics as we continue to be critical of the definition of Visibility, Voice and Viability as well as question the sheer existence of Ability.


I think Remembering Sustainability is equally important!

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