[op-ed snap] National Health Policy 2017: A road map for health

Context:

  1. The National Health Policy 2017 announced this week by the Centre after a nudge from the Supreme Court last year
  2. It faces the challenging task of ensuring affordable, quality medical care to every citizen

Challenges:

  1. A fifth of the world’s disease burden on India
  2. There is a growing incidence of non-communicable diseases such as diabetes
  3. There are poor financial arrangements to pay for care
  4. India brings up the rear among the BRICS countries in health sector performance

An opportunity to ensure better health through a stronger National Health Mission:

  1. Among the most glaring lacunae is the lack of capacity to use higher levels of public funding for health
  2. Rectifying this in partnership with the States is crucial if the Central government is to make the best use of the targeted government spending of 5% of GDP by 2025, up from 1.15% now
  3. A major capacity expansion to produce MBBS graduates took place between 2009 and 2015
  4. This is unlikely to meet policy goals since only 11.3% of registered allopathic doctors were working in the public sector as of 2014, and even among these, the number in rural areas was abysmally low
  5. More health professionals need to be deployed for primary care in rural areas
  6. Availability of trained doctors and nurses would help meet the new infant mortality and maternal mortality goals, and build on the gains from higher institutional deliveries, which exceeded 80% in recent years

Private sector:

  1. Contracting of health services from the private sector may be inevitable in the short term
  2. About 70% of all outpatient care and 60% of inpatient treatments are provided by it
  3. This requires accountability, both on the quality and cost of care

Way forward:

  1. No more time should be lost in forming regulatory and accreditation agencies for healthcare providers at the national and State levels as suggested by the expert group on universal health coverage of the Planning Commission more than five years ago
  2. Without such oversight, unethical commercial entities would have easy backdoor access to public funds in the form of state-backed insurance
  3. It should be mandatory for all health institutions to be accredited, and to publish the approved cost of treatments, in order to remove the prevailing asymmetry of information
  4. For the new policy to start on a firm footing, the Centre has to get robust health data
  5. Currently this is fragmented because inputs from multiple sources and sample surveys are not reconciled, and the private sector is often not in the picture
  6. To reduce high out-of-pocket spending, early deadlines should be set for public institutions to offer essential medicines and diagnostic tests free to everyone

Note4Students:

National Health Policy is an ambitious government policy that will ensure better health and health facilities. It is important to read this for both Prelims and Mains.

Health spending to be 2.5% of GDP

  1. Context: The Centre cleared the long-awaited National Health Policy 2017
  2. Background: In September 2016, the Supreme Court had directed the Centre to finalise the crucial health policy
  3. The policy: It promises to increase public health spending to 2.5% of GDP in a time-bound manner
  4. Also guarantees health care services to all Indian citizens, particularly the underprivileged
  5. Aims to move away from ‘sick care’ to ‘wellness,’ with a thrust on prevention and health promotion
  6. Private: It also looks afresh at strategic purchasing from the private sector and leveraging their strengths to achieve national health goals
  7. The government will pursue ambitious targets like reducing Under-Five Mortality to 23 by 2025 and Maternal Mortality Ratio from current levels to 100 by 2020, and Infant Mortality Rate to 28 by 2019
  8. It also seeks to reduce neonatal mortality to 16 and stillbirth rate to “single digit” by 2025
  9. It advocates a progressively incremental assurance-based approach to health care provision
  10. Not a fundamental right (criticism): It has fallen short of making health a fundamental right, a section that was removed from the final draft
  11. Previous drafts proposed to make this a fundamental right, and failure to provide health would have legal consequences
  12. Removing that makes this it empty promise, activists said
  13. Budget allocations: The promise on health spending does not square up with the past budgets of this government
  14. Money for critical programs has stagnated or gone down in real terms

Note4students:

Very important for prelims as well as mains. Important National Policies are a frequent ask in mains.

Q. Examine the main provisions of the National Child Policy and throw light on the status of its implementation. [GS-2, Mains 2016]

[pib] Know about National Health Policy, 2017

About the Policy:

  1. The Policy seeks to reach everyone in a comprehensive integrated way to move towards wellness
  2. It aims at achieving universal health coverage and delivering quality health care services to all at affordable cost
  3. This Policy looks at problems and solutions holistically with private sector as strategic partners
  4. It seeks to promote quality of care, focus is on emerging diseases and investment in promotive and preventive healthcare
  5. The policy is patient centric and quality driven. It addresses health security and make in India for drugs and devices
  6. The main objective of the National Health Policy 2017: is to achieve the highest possible level of good health and well-being, through a preventive and promotive health care orientation in all developmental policies, and to achieve universal access to good quality health care services without anyone having to face financial hardship as a consequence
  7. In order to provide access and financial protection at secondary and tertiary care levels
  8. The policy proposes free drugs, free diagnostics and free emergency care services in all public hospitals
  9. The policy envisages strategic purchase of secondary and tertiary care services as a short term measure to supplement and fill critical gaps in the health system
  10. The NHP, 2017 advocates a positive and proactive engagement with the private sector for critical gap filling towards achieving national goals
  11. The policy also advocates financial and non-incentives for encouraging the private sector participation
  12. This policy denotes important change from very selective to comprehensive primary health care package which includes geriatric health care, palliative care and rehabilitative care services
  13. It seeks to strengthen the health, surveillance system and establish registries for diseases of public health importance, by 2020
  14. The policy affirms commitment to pre-emptive care (aimed at pre-empting the occurrence of diseases) to achieve optimum levels of child and adolescent health
  15. The policy envisages school health programmes as a major focus area as also health and hygiene being made a part of the school curriculum
  16. The policy supports voluntary service in rural and under-served areas on pro-bono basis by recognized healthcare professionals under a ‘giving back to society’ initiative
  17. The policy advocates extensive deployment of digital tools for improving the efficiency and outcome of the healthcare system and proposes establishment of National Digital Health Authority (NDHA) to regulate, develop and deploy digital health across the continuum of care

Target:

  1. The policy proposes raising public health expenditure to 2.5% of the GDP in a time bound manner
  2. The policy assigns specific quantitative targets aimed at reduction of disease prevalence/incidence, for health status and programme impact, health system performance and system strengthening

The broad principles of the policy are centered on Professionalism, Integrity and Ethics, Equity, Affordability, Universality, Patient Centered & Quality of Care, Accountability and pluralism.

 Note4Students:

Its importance has already been highlighted in the news-card covering the policy.

PIB

[pib] Know about Swachhta Pakhwada

  1. The Ministry of Women & Child Development celebrated Swachhta Pakhwada between 1st to 15th March, 2017 through the country along with the International Women’s Day
  2. The Secretary WCD, Ms. Leena Nair said that the women and children have a pivotal role to play in the Swachhta Mission

Theme:

  1. The theme of the Swachhta Pakhwada observed by the WCD Ministry was to spread swachhta awareness and implementation across the country with a focus on role of women and children in taking a leadership role for community led sanitation initiatives
  2. It has been realized that lack of sanitation and hygiene has a far reaching impact on women and children’s health and safety, dignity, education and livelihood, Ms. Leena Nair explained

Objective:

  1. The Secretary WCD said that the main objective of the Swachhta Pakhwada has been ‘cleanliness, inside out’
  2. To sensitize and ensure good health and hygiene by providing women and children with awareness on clean and safe environment, personal health, hygiene and good practices including hand washing on cleanliness, in order to create safe, healthy, clean and green environment

Note4Students:

Important information for Prelims.

PIB

Union cabinet approves National Health Policy

  1. The policy had been pending for the last two years
  2. The National Health Policy: It proposes to provide “assured health services to all” in the country
  3. Expanding Primary Health Centres: In a major shift, the policy increases the gambit of sectors covered in the Primary Health Centre (PHC)-level and envisages a comprehensive approach
  4. For example, till now, PHCs were only for immunisation, anti-natal check ups and others
  5. But what is a major policy shift is that now it will also include screening of non-communicable diseases and a whole lot of other aspects
  6. There will also be a bigger focus on upgrading district hospitals
  7. For the first time, there will be an implementation framework in place
  8. Background on draft policy: The proposed National Health Policy, which has been pending for the past two years, aims to provide assured health services to people as an “entitlement”
  9. The Cabinet note, which had been given earlier had not talked about making health a “fundamental right” as it will have “legal consequences” but proposed assured health services
  10. The draft also addressed the issues of universal health coverage, reducing maternal and infant mortality rate, as well as making drugs and diagnostics available free at least in the public healthcare system of the country
  11. It suggests the Centre must amend laws to align them with the current healthcare scenario

Note4students:

Very important for mains as well as prelims. Every year there is a question in mains on one of the National Policies. Keep track- the finalised version of policy is yet to be made public.

[op-ed snap] Not so accessible after all

Context:

  1. 2015-16 was a landmark year that led to the passing of the Rights of Persons with Disabilities Bill, 2016
  2. From only seven recognised disabilities in the previous archaic Act of 1995 to 21 disabilities now, the new law is a true game changer that provides provisions that will benefit many
  3. This isn’t just a piece of legislation that is the politically correct thing to say
  4. It is the real deal which takes into account real issues like accessibility to infrastructure, technology and information

Accessible India Campaign:

  1. The Accessible India Campaign (Sugamya Bharat Abhiyan) was launched by the Department of Empowerment of Persons with Disabilities (DEPwD) in 2015, and it was welcomed for its spirit and intention
  2. The campaign has a heavy focus on not just accessibility to physical infrastructure, but also on Information and Communication Technologies

Rights of Persons with Disabilities Bill, 2016:

  1. As per the Rights of Persons with Disabilities Act, 2016: “The appropriate Government shall take steps to ensure that all their public documents are in accessible formats
  2. The Accessible India Campaign itself has a separate objective and its own targets on enhancing the proportion of accessible and usable public documents
  3. From all the other provisions laid out in the law and the campaign, this needs a special mention since more often than not, people with disabilities miss out on information to do with their own lives because of lack of accessibility

Attitudinal barriers:

  1. Recently, the DEPwD drafted the rules of the new law which have now been made available to the public for comments
  2. The 74-page-long comprehensive document will be scrutinised by many, but not by those whose lives these rules directly impact
  3. It’s ironic that the rules, a public document on the department’s website, are not published in an accessible format to those whose roar made this happen

Note4Students:

Formulating an ambitious campaign is a wonderful idea, but what about the barriers within the walls of the system? Publishing the rules of the Accessible India Campaign without making them accessible is just ironic in a tragic way. Make note of the details for Prelims. The points here can also be used in a Mains answer.

[pib] Know about SAATHIYA

  1. Ministry of Health and Family Welfare launched the SAATHIYA Resource Kit including ‘Saathiya Salah’ Mobile App for adolescents, as part of the Rashtriya Kishor Swasthya Karyakram (RKSK) program
  2. One of the key interventions under the programme is introduction of the Peer Educators (Saathiyas) who act as a catalyst for generating demand for the adolescent health services and imparting age appropriate knowledge on key adolescent health issues to their peer groups
  3. RKSK identifies six strategic priorities for adolescents i.e. nutrition, sexual and reproductive health (SRH), non-communicable diseases (NCDs), substance misuse, injuries and violence (including gender-based violence) and mental health
  4. Fact check: India is home to 253 million adolescents which is largest in the world in terms of absolute numbers

Note4Students:

Important for prelims. Note the key points highlighted above.

PIB

Stents prices heavily slashed

  1. Price control: In a major relief to lakhs of cardiac patients, the government cut prices of life—saving coronary stents by up to 85 per cent by capping them at Rs 7,260 for bare metal ones and Rs 29,600 for drug eluting variety
  2. Why price control? National Pharmaceutical Pricing Authority (NPPA) notification- It was found that huge unethical mark—ups are charged at each stage in the supply chain of coronary stents resulting in irrational, restrictive and exorbitant prices in a failed market system driven by information asymmetry between patients and doctors, pushing patients to financial misery
  3. Under such extraordinary circumstances, there is an urgent necessity, in public interest, to fix ceiling price of coronary stents to bring respite to the patients
  4. Earlier steps: The government had included coronary stents in the national list of essential medicines (NLEM), 2015, in July 2016 and in the first Schedule of the Drug Prices Control Order (DPCO), 2013, in December 2016

Note4students:

Know more about stents issue here + here. Do check the given links for details on the issue and the basics on stents and medical device regulation in India. It is very important for prelims.

Immunisation advisory body to be moved out of Health Ministry

  1. National Technical Advisory Group on Immunisation (NTAGI), the secretariat of the country’s apex immunisation advisory body is being ‘transitioned’ out to the Health Ministry
  2. It is considered as a loss of face for Bill and Melinda Gates Foundation (BMGF)
  3. The Ministry, however, clarified that it would continue to collaborate with the Gates Foundation on immunisation policy and the National Health Mission
  4. Planned: The transitioning of the NTAGI Secretariat to NIHFW is a planned activity and is part of the health system strengthening efforts by the Government
  5. There is no financial link of NTAGI with BMGF or any other organisation as the body consists of independent experts
  6. As far as technical support by ITSU, it is functioning till February 28, 2017 and the project will continue to support the immunisation programme in techno-managerial capacity beyond this date
  7. The contours of this support are being finalised with the Public Health Foundation of India (PHFI) and BMGF
  8. It is ‘inaccurate and misleading’ to suggest that all health-related collaboration with the Gates Foundation with the National Health Mission (NHM) has been stopped
  9. BMGF clarifies: The Foundation maintained that it did not play any role on policy decision making pertaining to immunisation, which is the sole prerogative of the Indian government
  10. Criticism of BMGF: Last year, the Gates Foundation has drawn criticism globally for “dangerously skewing” development agenda in the Global South
  11. A study by Global Justice Now maintained that as of 2014, the BMGF trust had investments in several multinational pharmaceutical companies like Dow Chemicals, GlaxoSmithKline, Novartis and Pfizer and went on to argue that the Gates Foundation’s recommendations to developing countries result in profits for the Foundation itself

 

[op-ed snap] Shot in the arm

Context:

  1. The highest attainable standards of health in terms of physical, mental and social well-being is not only a fundamental right of every human being, but also a prerequisite for the economic and social development of a nation

Children’s health:

  1. The highest possible physical and mental development can only be attained by investing in the initial five years of a person’s life as this ensures survival with improved cognition
  2. The Ministry of Health & Family Welfare (MoHFW) is therefore working towards ensuring the most productive life for a person by specifically focussing on the initial five years of life

Progress in public health:

  1. India should take pride in its progress in public health
  2. Life expectancy has increased from 63.5 to 67.9 during the last decade
  3. Through 2009 to 2015, the maternal mortality rate has decreased from 212 deaths per 100,000 live births to 167 deaths and infant mortality rate has decreased from 50 to 37 deaths per 1,000 live births
  4. We have also eradicated polio and eliminated maternal and neonatal tetanus

Child death and disability:

  1. Every year, 2.6 crore children are born in India; nearly 11.4 lakh die before their fifth birthday, many from preventable causes
  2. A powerful weapon against deadly childhood diseases is immunization
  3. To ensure that every child has access to immunisation, MoHFW launched Mission Indradhanush (MI) in 2014

Mission Indradhanush:

  1. MI is a special drive to vaccinate all unvaccinated and partially vaccinated children, protecting them against 10 life-threatening diseases, including diphtheria, whooping cough, tetanus, polio and measles, among others
  2. During MI drives, pregnant women are administered the tetanus vaccine, ORS packets and zinc tablets are distributed for use in the event of severe diarrhoea or dehydration and vitamin A doses are administered to boost child immunity
  3. MI is one of the largest immunisation programmes in the world
  4. Since the launch of MI, full immunisation coverage has increased by 5% to 7%
  5. The goal of MI is to achieve more than 90% full immunisation coverage among children in the country by 2020
  6. Set to enter its fourth phase, MI will initially cover 67 districts across the eight north-eastern states, some of the most remote and inaccessible districts in the country

Universal Immunisation Programme:

  1. The government has strategically introduced several new vaccines in the Universal Immunisation Programme (UIP)
  2. The pentavalent vaccine, which protects against five diseases, was introduced throughout the country in 2015
  3. Rotavirus vaccine, which protects against rotavirus diarrhoea, has been introduced in four states so far
  4. Inactivated polio vaccine, which protects against polio, was introduced in 2015 and expanded across all states by the middle of 2016
  5. In the coming weeks, two new vaccines will be introduced into the UIP —
  • measles-rubella (MR) vaccine, for protection against measles as well as congenital birth defects caused by rubella
  • pneumococcal conjugate vaccine (PCV) to protect against pneumonia

Role of health workers:

  1. Trainings offered to frontline workers are facilitating a higher number of institutional deliveries and increase in newborn care, in addition to immunization
  2. As health workers reach out to people in previously unaccessed and remote areas, MI has created an interface to connect populations with a wide range of health services and strengthened health systems in these areas

Conclusion:

  1. Immunisation helps the country invest in human capital, contributing to future economic growth and reducing the economic burdens of hospitalisation and treatment costs
  2. Further, the lessons learned from the special immunisation campaign contributed to strengthening other public health services, including deworming and diarrhoea control

Note4Students:

The life of every child is precious. Our governments should be committed to investing in India’s children, towards enabling a secure and progressive future. The information given in the op-ed is important for both Prelims and Mains.

Ultrasound devices to be mapped

  1. What: The Ministry of Health and Family Welfare (MoFW) has decided that all ultrasound machines in States will be mapped
  2. Why: In an attempt to identify unauthorised and unregistered diagnostic centres in the country
  3. While regularising the diagnostic facilities is the main aim, curbing sex determination tests and female foeticide is another important aspect of the move
  4. It will help reduce the thousands of unregistered sonography centres that have mushroomed over the years
  5. The first intimation to carry out the exercise had come from the SC in 2013
  6. Unregulated machines and centres are misused for carrying out illegal sex determination tests
  7. Since they are not registered, they don’t follow the rules of submitting Form F for every case, which is mandatory under the Pre-Conception and Pre-Natal Diagnostic Techniques Act
  8. Form F is a document to be filled by radiologists carrying out ultrasound tests on any pregnant woman
  9. This is where couples looking for identifying the sex of their baby head to

Back2basics:

Pre-Conception and Pre-Natal Diagnostic Techniques (PCPNDT) Act, 1994 is an Act of the Parliament of India enacted to stop female foeticides and arrest the declining sex ratio in India. The act banned prenatal sex determination.

Choosing hospital over home

  1. What: The maternal health programme Janani Suraksha Yojana (JSY)
  2. It is a govt programme aimed at increasing institutional deliveries. It has changed the health-seeking behaviour of Indian women
  3. It aimed to promote institutional delivery — instead of delivering babies at home — to improve India’s infant and maternal mortality rates
  4. Under JSY, pregnant women choosing to deliver at the hospital and the health worker who motivated her to take the decision get cash incentives
  5. It led to a 22% increase in women delivering in government hospitals between 2004 and 2014
  6. The scheme also is attributed for increasing the probability of a woman being hospitalised
  7. The increase, however marginal, is a cause of celebration as women in rural India are known to delay seeking health interventions
  8. The percentage of women reporting sick has also increased and it could be a result of other health insurance schemes like Rashtriya Swasthya Bima Yojana (RSBY)
  9. However, the quality of care remains a concern

Note4students:

Importance of this news is because of the health schemes JSY and RSBY mentioned. Also important is the purpose of the schemes – to induce a behavioral change in rural areas. Having facilities would be pointless if people do not use them.

Back2basics:

On JSY –

1. JSY is a safe motherhood intervention under the National Rural Health Mission (NRHM).

2. It has identified ASHA, the accredited social health activist as an effective link between the Govt and the poor pregnant women in 10 low performing states.

3. In other eligible states and UTs, wherever, Anganwadi workers and TBAs or ASHA  like activist has been engaged in this purpose are involved.

On RSBY – RSBY was launched in early 2008 and was initially designed to target only the Below Poverty Line (BPL) households, but has been expanded to cover other defined categories of unorganised workers. These include – street vendors, MNREGA workers etc. The objective is to reduce out of pocket (OOP) expenditure on health and increase access to health care. OOP is the most inefficient and least accountable way of spending on health.

[pib] Brush your facts regarding National Health Mission (NHM)

  1. National Health Mission (NHM): has 2 Sub-Missions, viz. the National Rural Health Mission (NRHM) and the National Urban Health Mission (NUHM)
  2. While NRHM was launched in April 2005, launch of NUHM was approved by the Cabinet on 1st May 2013
  3. 3 main programmatic components: Health System Strengthening in rural and urban areas, (RMNCH+A) interventions and control of Communicable and Non-Communicable Diseases.
  4. RMNCH+A: Reproductive-Maternal-Neonatal-Child and Adolescent Health

[pib] What is Family Planning 2020?

  1. Family Planning 2020 (FP2020) is a global partnership that supports the rights of women and girls to decide, freely, and for themselves, whether, when, and how many children they want to have.
  2. FP2020 is an outcome of the 2012 London Summit on Family Planning
  3. India is a signatory to FP2020
  4. FP2020 is based on the principle that all women, no matter where they live should have access to lifesaving contraceptives
  5. What are the steps taken by India?
  6. Introducing New Contraceptive Choices: The current basket of choice has been expanded to include new contraceptives viz. Injectable contraceptive, Centchroman and Progrsterone Only Pills (POP)
  7. Refurbishing Contraceptive Packaging: The packaging for Condoms, OCPs and ECPs has now been improved and redesigned so as to increase the demand for these commodities.

Note: These schemes and international commitments can be used as healthy points to differentiate your answers in Mains. FP2020’s focus is on family planning and these are unique initiatives by GOI around contraceptives and its promotion

HIV community rejects AIDS Bill in current form

  1. What: The HIV community rejected the long awaited HIV/AIDS Bill in its current form
  2. It demanded removal of the phrase “as far as possible” from the proposed legislation
  3. The current version of the HIV Bill has shocked the HIV community as it dilutes rights to access treatment
  4. The Bill was approved by the Cabinet in Oct and was expected to guarantee the rights of India’s 2.4 million HIV positive community
  5. Problems with current version of Bill: The Bill has been amended to state that governments are required to focus on prevention — and not on treatment — that too, as far as possible
  6. The public health legislation is first on the list of legislative business of the RS with Health Minister J.P. Nadda set to move the Bill

[pib] What is Pradhan Mantri Surakshit Matritva Abhiyan?

  1. Aim: To provide fixed-day assured, comprehensive and quality antenatal care universally to all pregnant women on the 9th of every month
  2. A package of antenatal care services would be provided to pregnant women in their 2nd / 3rd trimesters
  3. Support from private sector doctors to supplement the efforts of the government
  4. IMP: Identification and follow-up of high risk pregnancies and red stickers would be added on to the Mother and Child Protection cards of women with high risk pregnancies
  5. OBGY specialists / Radiologist/ Physicians working in the private sector are encouraged to volunteer for the campaign. Just encouraged. No coercion.

Way ahead for regulation of medical devices

  1. According to the World Health Organisation, the methodology used for medicines cannot be replicated with medical devices when it comes to ‘essentiality
  2. Moreover, coronary stents is a category and not products, just like antibiotics/vaccines are also a category of medicines, which have different drug molecules within them, which can be essential
  3. Way ahead: Singular focus on capping prices of stents will not help improve access to medical devices for patients, as it will not impact the overall procedure cost and will limit the introduction of innovative products
  4. More clarity and a comprehensive, consultative multi-stakeholder approach that involves contributions from all stakeholders is the need of the hour

Health Ministry’s notice on reducing coronary stent price

  1. News: Health Ministry issued a notification adding coronary stents to 2015 National List of Essential Medicines (NLEM)
  2. Aim: To bring down prices of stents
  3. Concern: The medical device industry- the price control mechanism would not bode well in creating a conducive environment for FDI in the country
  4. Confederation of Indian Industry (CII): The decision is contradictory to its recent efforts to press forward with legislation that would create separate and appropriate laws for medical devices
  5. Devices v/s drugs: Given the clear distinction between medical devices and drug formulations, the methodology for price control of drug formulations cannot be applied to devices
  6. Medical devices in India are regulated under the Drugs & Cosmetics Act
  7. Background: In response to the government’s call, CII members have already submitted their proposal of voluntary price reduction to the Ministry of Health
  8. This has enabled access of ‘value stent’ at CGHS prices below Rs. 25,000 to all patients

Bar coding of drugs to come soon

  1. News: An integrated approach would be undertaken to ensure that sub-standard medicines are weeded out
  2. To be implemented by the Drug Controller General of India (DCGI) along with the Union Health Ministry
  3. Bar coding for medicines, training for drug manufacturers and an integrated approach toward zero tolerance for sub-standard medicines to be followed
  4. Aim: Drugs to be made available to the common man with 100% potency and that aren’t sub-standard
  5. Background: Circulation of sub-standard medicines in the market has come down from 10% in 2002 to 4-4.5% currently
  6. Though India has a barcode system in place for exported medicines, no system is there for domestically produced and imported medicines

Aizawl has highest incidence of cancer in men: Report

  1. Context: According to latest cancer data, Aizawl has the highest incidence of cancer in men while Arunachal Pradesh has highest number of cancer in women
  2. The data was released by the Indian Council of Medical Research (ICMR) collected under Population-Based Cancer Registry (PBCR) programme
  3. Cause: High usage of tobacco in daily life of North eastern states
  4. Top five cancer in men: Lung, Stomach, Prostate, Oesophagus , Brain
  5. In women: Breast, Cervix, Ovary, Thyroid, Mouth
  6. In case of stomach cancer, Chennai has highest incidences than Aizawl

Govt sacks some foreign-funded consultants

  1. Context: India is firing dozens of foreign-funded health experts working inside the government
  2. It is seen as part of a broader clampdown to reduce the influence of NGOs on policy
  3. Impact: Signature programmes to combat HIV/ AIDS and tuberculosis may suffer
  4. Magnitude: Of the nearly 140 people who run India’s HIV/AIDS programme, 112 are consultants seconded from foreign organisations

Govt plans pharma zones to reduce API imports

  1. Context: Govt is considering setting up specified pharmaceutical zones
  2. Aim: To boost domestic manufacture of active pharmaceutical ingredients (APIs)
  3. Why? To reduce the country’s dependence on China for the raw material that is used to produce drugs
  4. Dependence: India has a heavy dependence on China for APIs, importing 90-100% APIs for more than 10 types of drugs
  5. Some of these are crucial drugs such as antibiotics and anti-diabetic medicines

What are APIs?

  1. What? API is the ingredient in a pharmaceutical drug that is biologically active
  2. Any drug is composed of two components- first is the actual API, which is the central ingredient
  3. The second is known as an excipient & refers to the substance inside the drug or tablet
  4. API is the chemically active substance, which is meant to produce the desired effect in the body

Norms for clinical trials eased

  1. News: Health Ministry has amended the Drug and Cosmetics Act (D&C Act)
  2. Context: This exempt clinical trials conducted at academic institutions from taking the hitherto mandatory permission from Drug Controller General of India (DCGI)
  3. Aim: To speed up innovation and research in India
  4. Move is a setback for those working towards a safer, more transparent clinical trials regime
  5. Background: Clinical trials came under SC scrutiny in 2013, after at least 370 deaths were attributed to Serious Adverse Events (SEAs) during
    such trials
  6. In 2013, SC ruled that no new clinical trials be permitted until the regulatory mechanism was reformed
  7. Relevance: Amendment to the D&C Act follows recommendations by the Professor Ranjit Roy Choudhury Committee

Health Ministry launches GIS-enabled HMIS application, self-printing of e-CGHS Card

  1. News: Two major Digital initiatives to provide easy access to health services to the public, GIS-enabled HMIS application and the self-printing of e-CGHS card
  2. Context: To strengthening public health systems and providing user-friendly health services in the country
  3. About: GIS-enabled HMIS (Health Management Information System) services will provide comprehensive data on a GIS platform on 1.6 lakh
    Govt Health facilities
  4. HMIS is a web-based monitoring system, to monitor health programmes and provide key inputs for policy formulation and interventions
  5. Self-printing of the E-CGHS (Central Government Health Scheme) card, provide ease and access to all beneficiaries such as the pensioners who may find it difficult to go to the CGHS centres for renewal
PIB

Kayakalp awards felicitate Public Health Facilities

  1. Context: Felicitation ceremony of Kayakalp awardees for their work in maintaining high standards of sanitation and hygiene in public health facilities
  2. Objectives of Kayakalp awards scheme:
  • To promote cleanliness, hygiene and infection control practices in public health care facilities
  • To incentivize and recognize such public healthcare facilities that show exemplary performance in adhering to standard protocols of cleanliness and infection control
  • To inculcate a culture of ongoing assessment and peer review of performance related to hygiene, cleanliness and sanitation
  • To create and share sustainable practices related to improved cleanliness in public health facilities linked to positive health outcomes
PIB

PPP for district hospitals: NITI

  1. Context: Recent presentation on the outcomes in the health sector by NITI Aayog
  2. Govt is in process of developing a framework for PPP in district hospitals
  3. Why? To improve the service levels of district hospitals
  4. Also, India is on track to meet 12th Plan targets in total fertility rate and under-five mortality by 2017

Health Ministry launches project Clean Street Food

  1. Aim: To raise the safety standards of foods sold on streets across the capital city of New Delhi
  2. Training: To 20,000 roadside vendors on aspects of health and hygiene, in the first phase
  3. Partnership: Food Safety and Standards Authority of India(FSSAI) with Ministry of Skill Development & Entrepreneurship
  4. Under Recognition of: Prior Learning (RPL) category of Govt’s flagship skills training scheme- Pradhan Mantri Kaushal Vikas Yojana (PMKVY)
  5. Significance: Project shall upgrade the skills of the street food vendors and also contribute to preventive and promotive health
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Rotavirus vaccine by month-end

  1. News: Indian Council of Medical Research will launch the rotavirus vaccine through the national immunisation programme soon
  2. Background: In Mar, 2015, India launched its first indigenously developed Rotavirus vaccine “Rotavac”
  3. It will be initially provided to all children in AP, Haryana, Odisha and HP and later expanded across the country
  4. Impact: It is expected to bring down the large number of infant deaths due to the Rotavirus diarrhoea in India and across the globe

A New Health Protection Scheme announced

  1. Context: A serious illness of family member(s) causes severe stress on the financial condition of poor and economically weak families, shaking the foundation of their economic security
  2. To help families: Govt will launch a new health protection scheme which will provide health cover up-to rupees 1 lakh per family
  3. For Senior citizens: an additional top-up package up to Rs.30,000 will be provided
  4. Another initiative: 3,000 stores under Prime Minister’s Jan Aushadhi Yojana will be opened during 2016-17
  5. This will reinvigorate the supply of generic drugs
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Birth Companions allowed during Delivery in Public Health facilities

  1. News: Health Ministry has allowed birth companions during delivery in public health facilities
  2. Objective: To reduce Maternal Mortality Ratio and Infant Mortality Rate
  3. Importance: It signifies India’s commitment under SDGs
  4. The WHO promotes labor companionship as a core element of care for improving maternal and infant health
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Know about Birth companions

  1. Birth companions are women who have experienced the process of labour and provide continuous one – to – one support to other women experiencing labour and child birth
  2. Birth companions provide emotional support, advice regarding coping techniques, comfort measures to pregnant women
  3. Benefits: It is a low cost intervention that has proved to be beneficial to the women in labour
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What is Jaundice?

  1. Context: Jaundice is a term used to describe the yellowing of the skin and the whites of the eyes
  2. Caused by: A build-up of a substance called bilirubin in the blood and body’s tissues
  3. Types: Pre-hepatic jaundice, intra-hepatic jaundice, post-hepatic jaundice
  4. Who’s at risk? Intra-hepatic and post-hepatic jaundice are more common in middle-aged and elderly people than in the young
  5. Pre-hepatic jaundice can affect people of all ages, including children

Health Minister urges Himachal Govt to take necessary steps to check Jaundice

  1. Context: Health and Family Welfare Minister expressed concern over the situation arising out of outbreak of jaundice in Shimla, Himachal Pradesh
  2. News: Minister urged the state government to take all necessary steps to handle the situation while assuring full support from the Centre in this regard
  3. Relevance: Union Health Ministry sanctions Rs 70 lakh for Indian Council of Medical Research(ICMR) study on Jaundice in Shimla
  4. Aim: To conduct a study so that reoccurrence of this situation can be avoided
  5. Experts’ advise: Sanitation and cleanliness in affected areas need to be improved and contamination of water needed to be checked
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Learn more about Arogya Fair?

  1. Aim: To showcase and promote the strengths, efficacy and affordability of the AYUSH systems of medicines
  2. The Fair also offered useful information related to AYUSH through information centers setup by Ministry of AYUSH
  3. The live yoga demonstrations by the Center for Research and Yoga & Naturopathy attracted large no of visitors
  4. Various endangered herbal and medicinal plants were showcased at the Herbarium & Museum by Center Council for Research in Ayurvedic Sciences

4-day National Arogya Fair-2016 at Dehradun concludes successfully

The 8 Free Government (AYUSH) clinics served more than 1000 patients in four days

  1. The Arogya Fair was organized by the Ministry of Ayurveda, Yoga & Naturopathy, Unani, Siddha, Sowa Rigpa & Homoeopathy (AYUSH)
  2. Thousands of visitors benefited from the information gathered about AYUSH Systems in 4 days
  3. The Fair attracted immense participation from all stakeholders, residents, practitioners, academicians, corporates, institutes, university heads and students
  4. Themes – Immune system, Homeopathy in Women’s disorders, Treatment in Ayurveda, Yog se Arogya and
    Non-Communicable Diseases management in Siddha System
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What are parasitic worms?

  1. India has the highest burden of parasitic worms in the world
  2. Parasitic worms in children interfere with nutrient uptake
  3. This can contribute to anaemia, malnourishment, and impaired mental and physical development
  4. According to Children in India report, 48% of children under the age of 5 years are stunted and 19.8% are wasted
  5. This indicating that half of the country’s children are malnourished

Health Ministry launches National Deworming initiative

National Deworming initiative to benefit more than 27 crore children in 536 districts of the country

  1. The Union Health Minister stated that India shall be in the forefront of the war against Neglected Tropical Diseases
  2. The Ministry had first launched National Deworming Day (NDD) in 2015 which was implemented in 11 States/UTs, targeting children aged 1 to 19 years
  3. The National Deworming Day will mobilize health personnel, state governments and other stakeholders
  4. To prioritize investment in control of Soil Transmitted Helminth (STH) infections—one of the most common infections
  5. It aims to create mass awareness about the most effective and low-cost STH treatment— administering Albendazole tablets
  6. Deworming has been shown to reduce absenteeism in schools, improve health, nutritional, and learning outcomes
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Healthcare service providers want tax sops in Budget

Healthcare Federation of India (Nathealth), which represents hospitals, medical equipment manufacturers, and insurance companies, has few demands from upcoming budget.

  1. Patient treatment service is currently exempted from service tax and this should continue under GST regime (which would put various sectors under purview of service tax) for at least 10 years.
  2. Increase in tax holidays for establishment of healthcare facilities in non-metros from 5 to 10 years and rise in tax exemption limits on preventive health check-up.
  3. Increase depreciation rate applicable on medical and pathological equipment and medical devices from 15 to 30 per cent and extend tax incentives to hospitals with 50 beds.
  4. This initiative will extend benefits to smaller facilities and will encourage healthcare facilities in Tier-II and -III cities.
  5. Creation of funds to boost medical innovation and healthcare infrastructure in India.

On Good Governance Day, Health Minister announces 4 new IT-based initiatives

  1. A major IT initiative, Kilkari is an audio-based mobile service that delivers weekly audio messages to families about pregnancy, childbirth and child care.
  2. A new mobile-based application, Mobile Academy, has been developed through which about 9000,000 ASHAs will be trained using mobile services.
  3. By making the Revised National TB Control Programme (RNTCP) more patient-centric.
  4. Under dedicated toll free number initiative, callers can give a missed call to get complete support for diagnosis, treatment and support on national toll free number.
  5. ‘M-Cessation’ will be an IT-enabled tool to help tobacco users to quit tobacco.
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Mainstreaming of AYUSH is one of the strategies in NHM

National Policy on Indian Systems of Medicine & Homoeopathy, 2002, envisages integration of AYUSH with the Health Care Delivery System.

  1. This seeks to provide affordable and quality health care in order to improve the existing health care delivery system.
  2. The engagement of AYUSH Doctors/Paramedics and their training is supported by the Department of Health & Family Welfare.
  3. The support for AYUSH infrastructure, equipment/furniture and medicines are provided by Ministry of AYUSH under shared responsibilities.
  4. Medical Council of India (MCI) and IMA have consulted on issue of permitting the medical practitioner.
  5. Under the AYUSH system of medicine to practice allopathy treatment in a limited way.
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Let’s know more about Stillbirth rate?

  1. The birth of an infant that has died in the womb (strictly, after having survived through at least first 28 weeks of pregnancy).
  2. State health officials attribute this to socio-cultural factors and misconceptions and taboos in society, especially in rural areas.
  3. It is mainly because women face many difficulties relating to accessibility, affordability and quality issues when utilising healthcare facilities during pregnancy in rural areas.

Karnataka has highest stillbirth rate

According to the Sample Registration Survey (SRS) 2013 Karnataka has the highest stillbirth rate in India. That is, 12 deaths per 1,000 births.

  1. The survey notes that Karnataka’s perinatal mortality rate stands at 30 per 1,000 live births.
  2. This is higher than the country’s average of 26 per 1,000 births.
  3. Stillbirths and perinatal mortality are the only two health indicators where Karnataka fares badly.
  4. Higher number of stillbirths also grossly indicates the low pre-natal and natal care for pregnant women in primary health centres.

The comprehensive healthcare alternative

Rescuing Maternal and Child Health-only systems, which have become under-resourced and have built a very high-cost but low-performance culture, will be a challenging task.

  1. Given the rising burden of non-communicable diseases, there is an increasing demand to build health systems that can address concerns.
  2. Indian government has chosen to stay focussed on Maternal and Child Health (MCH). But is the most effective way to deliver on the MCH goals to build an MCH-only health system, or does it need a completely different approach?
  3. At the community level,need of Clinic-based obstetric and emergency care on offer, and, within a reasonable travel distance, hospital-based emergency care.
  4. Indian government has recently mooted the concept of a health and wellness centre (HWC) that is intended to be more comprehensive health care.
  5. If HWCs (the erstwhile sub-centres) are able to address all of the necessary MCH conditions, then it becomes possible for the next level centre to provide a much broader range of care upon referral by the HWC.
  6. Clearly, building such a system to serve only MCH needs will not be cost-effective nor will it keep all of the necessary personnel gainfully employed.Having a much wider range of conditions would be the only sustainable way to address this concern.
  7. Building such a broad-based system will need a substantial investment for which political commitment desired.
  8. Fact that the Indian (MCH-focussed) health system is currently able to cope only with conditions that account for fewer than 25 per cent of the Years of Life Lost (YLL).
  9. The difficulty that health systems in India, designed as MCH-only systems,become chronically under-resourced and have now built a very high- cost but low-performance culture.
  10. For various good reasons, 68 countries, including low income and middle income countries, have chosen to use health-specific taxation such as mandatory payroll deduction.
  11. For countries such as India and China, which also have a large informal sector, since mandatory payroll deduction is not an available option for a large segment of the population, the direct sale of healthcare packages or insurance becomes additionally necessary.
  12. Bihar and Himachal Pradesh states,continues to battle with high levels of IMR and MMR and a high level of poverty. Tamil Nadu and Kerala have brought those rates under control.
  13. Building comprehensive healthcare systems which reflect the realities of each State will not only yield strong benefits on problems such as IMR and MMR but will also, over time, help build health systems that respond to a much a wider set of concerns.

Narrowly focussed health systems on the other hand risk falling short not only on their goals but also make it difficult, if not impossible, to build broader health systems for the future.

Cabinet approves setting up of National Resource Facility for Bio-medical Research (NARF)

Setting up of a National Resource Facility for Bio-medical Research (NARF) at Genome Valley in Hyderabad by the Indian Council for Medical Research (ICMR).

  1. Institution will be first of its kind for quality laboratory animals for basic and applied biomedical research in country.
  2. It will be developed as a world-class facility for breeding and housing of animals.
  3. Such as primates, cabines and other specialized models such as transgenic and knockout rodents required for testing of various R&D products.
  4. Facility will create, develop and provide access to a range of laboratory animals and technological resources for advancement of biomedical research in country.
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What does Maternal and Neonatal mortality actually mean?

  1. A neonatal death is defined as a death during the first 28 days of life (0-27 days).
  2. 56% of under-5 child mortality in India is from neonatal mortality.
  3. Maternal death is the death of a woman while pregnant or within 42 days of termination of pregnancy.
  4. India accounts for the maximum no. of maternal and neonatal deaths in the world.
  5. Literacy and social issues are major factors that have led to high maternal deaths.

Nutrition bureau axed, anti-poverty schemes starved

The National Nutrition Monitoring Bureau (NNMB) has been shut down by the Union Health Ministry.

  1. Reason to shut down, as bureau was running in project mode and Government programmes that run in a project mode for this long are not sustainable.
  2. NNMB provides a good understanding of what people eat and what, therefore, can be culturally accepted nutritional interventions.
  3. NNMB plays a very important role in projecting data in terms of what people are eating.
  4. The data gathered by the NNMB informs the policy intervention to address under-nutrition.

National Nutrition Monitoring Bureau, has a mandate to generate data on the nutritional status of socially vulnerable groups, established in 1972 by Indian Council of Medical Research (ICMR).

WHO cautions against slashing health spending

Health sector ‘should not be seen as a black hole of expenditures’, says WHO director general Margaret Chan

  1. India is confronted with rising disease burden, worsening pollution and growing shortage of clean drinking water and sanitation.
  2. In this year’s Union budget, Rs.33,152 crore allocated for health and family welfare for fiscal 2016.
  3. India spends about 1.2% of its GDP on public health.
  4. It missed the United Nations Millennium Development Goals targets for infant mortality, under-five mortality and maternal mortality.
  5. Many of India’s health challenges are linked to the poor state of sanitation. It tops the world in open defecation.

India has the highest number of people living below poverty line of $1.6 per day, according to the World Bank.

Expert team conducts rapid assessment to declare India Yaws-free

  1. Yaws is a chronic infectious skin disease caused by treponema pallidum subspecies pertenue.
  2. It affects the skin, bone and cartilage and if left untreated, can lead to deformities of the nose and leg bones.
  3. In India the disease was eliminated in Sep, 2006, but field assessment are being conducted to ensure that it has been fully eradicated.
  4. This disease was found more in tribal pockets and hence, elimination has been one of the success stories for public health.

Blood banks can borrow blood units from one another

This decision is expected to sort out the issue of shortage.

  1. Union Ministry of Health & Family Welfare made a major modification in the National Blood Policy (NBP), 2002.
  2. The Ministry took this decision as part of reforms to the handling of blood units in the country.
  3. It will increase the availability of essential life saving medicines like immunoglobulins, human albumin and clotting factors which are all derived from plasma.
  4. Reduce the country’s dependence on import of these products.

National Blood Policy aims to ensure easily accessible and adequate supply of safe and quality blood and blood components procured from a voluntary non-remunerated blood donor in well equipped premises, which is stored and transported under optimum conditions.

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National Health Profile highlights poor doctor-patient ratio

The National Health Profile 2015 is prepared by the Central Bureau for Health Intelligence.

  1. The new official data shows, every govt. hospital serves an estimated 61,000 people in India, with one bed for every 1833 people.
  2. There is a steady increase in out-of-pocket private expenditure on health, with the cost of medicines and hospitalisation accounting for the largest share of the household expenditure.
  3. India spends less of its GDP on health than some of the world’s poorest countries.
  4. The Centre’s share of total public expenditure on health has fallen over the last two years.
  5. Non-communicable diseases are on the rise with cardiovascular diseases accounting for a quarter of deaths from non-communicable diseases and cancer accounting for 6%.

[Discuss] Health as a Fundamental Right

Should India make health a fundamental right? Impediments and Opportunities.


 

We go back to time and start the discussion with this –

The draft National Health Policy 2015 (NPH) released by the National Democratic Alliance (NDA) government on 31 December 2014 seems to have its heart in the right place.

The idea of making health a fundamental right is an old, comfortable, feel-good debate. So let’s consider its broad contours. The case in favour can be summed up as follows: the right to health is a natural corollary of the right to life and, therefore, denying someone healthcare is like denying a living human being the right to live out her natural life span.

What is the case against?

India celebrated 1st National Deworming Day

  1. The first national deworming day was celebrated on 10 Feb, 2015.
  2. Agency – Ministry of Health and Family Welfare.
  3. It aims to protect more than 24 crore children in the ages of 1-19 years from intestinal worms by providing Albendazole tablets.
  4. India is now targeting intestinal worms among the children to achieve the status of being “Worm-free”
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