india experience overview of progress on health care with reference to mdgs in south asia (5 th arm,...
TRANSCRIPT
India Experience
OVERVIEW OF PROGRESS ON HEALTH CARE WITH
REFERENCE TO MDGs IN SOUTH ASIA
(5th ARM, 23-24 January 2006, Agra)
OneWorld South Asia, New Delhiwww.oneworldsouthasia.net
Health Sector Covers
• Hospitals
• Clinics
• Nursing Homes
• Civil Infrastructure
• Doctors
• Paramedical Staff
• Medicines/Drugs
• Equipments & Devices
• Chemist Shops
• Maintenance
Issues• Limited Public Resources
Plan Outlay For Health During 3rd Plan 1961-66 was only 2.6%, Reduced To 1.4% In 1997-2002
Now, Government Spending Is 0.9% of GDP
• Poor quality of services through public health infrastructure
Sub centres, PHCs, CHCs, district hospitals &
tertiary hospitals Doctors, paramedical staff Medicines, devices and equipments Monitoring – eg TB Poor maintenance Poor accessibility (distance) and affordability
(including transportation)
Issues contd …..
• Conflict of interest of different systems of medicine Allopathy Ayurvedha Siddha Unani Homeopathy
• Disease burden Diarrhoea – leading cause of child deaths; 19.2% children below
the 3 years of age suffer from diarrhoea 35% of infants are not fully immunised – 90% in Bihar, 81% in UP TB – cases 85 lakhs; 2 lakhs die each year HIV/AIDS cases 51 lakhs Cancer – 75 lakhs diagnosed each year Cardiovascular diseases – 3.8 crores Diabetic patients – 3.3. Crores; 50,000 loose their legs Mental disorders – 6.5 to 7 crores
Disease Burden - India contd …..
Potential interventions
Pre-natal diagnostic techniques (PNDT) Act, amended in Feb 2003
• Prohibits and disclosure of sex of the foetus
• Prohibits advertisements
• Punishable with imprisonment and fine
• 80% provided by private sector
• of health service providers – medical, nursing, pharmacy councils, drug quality control
National rural health mission (NRHM), 2005
• Give more powers to the village councils
• Availability and accessibility of quality healthcare especially for the rural people, poor, women and children
• To cover 3,00,000 villages
• To revitalise local health traditions – ISM, AYUSH
• Success depends on alertness of civil society
• Golden triangle partnership mission to develop drugs for 13 specific diseases
• National health programmes – TB, leprosy, HIV/AIDS, etc.
• Dgroups: Pro-poor hiv/aids strategies www.dgroups.org/groups/hiv-aids
Some ICT experiences
• E-health cards – Sirsa, Haryana
• Info-kiosk: n-Logue – Aravind Eye Hospital, Madurai• Telemedicine• Ek Duniya Sawal Jawab: IVRS technique – Drishtee, Haryana and Bihar; Tarahaat, UP and MP
• Phone-in radio programmes: Aravis, Gurgaon, Haryana
• Interface with governments, NGOs/CSOs and community through multi-stakeholder partnership model (MSP)
• Disease surveillance and monitoring
• Facilitate in sourcing content from the society (pull)
• Disseminate content (push) from NGOs/CSOs, Govt., to the community
• Capacity building
• Assess community needs, then develop/use suitable tools
What MSPs can do?