Healthcare in India
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Healthcare in India
Selection of Articles, Opinions, Discussions and News on Healthcare in India from all over the web covering Healthcare Policy, Healthcare Reform, News, Events, #HealthIT , Edipdemics, Chronic Diseases, #mHealth, #hcsmin ,
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Indian Clinical Trial Reforms Take Shape as Report Condemns HPV Vaccine Trials

Indian Clinical Trial Reforms Take Shape as Report Condemns HPV Vaccine Trials | Healthcare in India | Scoop.it

As questions continue to be raised over the policies governing clinical trials in India, new regulations and amendments to the country's pharmaceutical laws are now coming to light.


Specifically, India’s CDSCO (Central Drugs Standards Control Organization) is looking to crack down on unauthorized trials and is now calling for sponsors to reveal payments made to CROs and trial investigators.


A recent announcement by CDSCO says that information in respect of the payments made by the sponsor to the investigator for the conduct [of the] clinical trial should be made available


Formal and legal agreements between sponsors, CROs (contract research organizations) and investigators should be decided prior to the start of the trial and define the relationship in terms of financial support, honorariums, fees and other payments, the order says.


Source and Further reading: http://www.outsourcing-pharma.com/Clinical-Development/Indian-Clinical-Trial-Reforms-Take-Shape-as-Report-Condemns-HPV-Vaccine-Trials

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Lifestyle diseases to cost India $6 trillion, study estimates

Lifestyle diseases to cost India $6 trillion, study estimates | Healthcare in India | Scoop.it

 India's march towards being an economically stable nation is threatened not just by global financial issues. Poor health indicators pose an equally big threat.


The Harvard School of Public Health has, in a study on economic losses due to non-communicable diseases (NCDs), estimated that the economic burden of these ailments for India will be close to $6.2 trillion for the period 2012-30, a figure that is equivalent to nearly nine times the total health expenditure during the previous 19 years of $710 billion.


NCDs, chiefly cardiovascular diseases (including heart disease and stroke), diabetes, cancer and chronic respiratory diseases, are defined as diseases of long duration and generally slow progression. They are the major cause of adult mortality and illness worldwide.


The Harvard report, which is based on WHO projections of the mortality trajectory associated with NCDs, says ischemic heart disease is going to be the single most costly non-communicable disease in India (causing an output loss of about $1.21 trillion over 2012-30), followed by chronic obstructive pulmonary disease (COPD).


China, the report adds, is estimated to face output losses of $27.8 trillion for 2012-30 - which is more than 12 times the total health expenditure during the previous 19 years of $2.2 trillion. "The economic impact of NCDs is estimated higher in China than in India mainly because of China's higher income and older population," said David E Bloom, the lead researcher.


According to Dr K Srinath Reddy, president of the Public Health Foundation of India, NCDs can impact the economy in multiple ways. "Most of the non-communicable diseases, for example diabetes or heart disease, affect the person in the productive years. They cause reduced productivity and early retirement. Also, they put immense pressure on public health expenditure as in most cases the treatment costs are higher compared to communicable diseases," he said.


Reddy added that the increasing burden of NCDs could rob India of the 'demographic dividend' it is projected to reap on account of a predominantly young population. A recent report published by IRIS Knowledge Foundation in collaboration with UN-HABITAT states that by 2020, India is set to become the world's youngest country with 64% of its population in the working age group.

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Innovation in training programmes can transform the medical education in India in no time

Innovation in training programmes can transform the medical education in India in no time | Healthcare in India | Scoop.it
Young doctors across India have kicked off a “Save the Doctor’ campaign to demand for more post-graduate seats in medical colleges to make up for the acute shortage of specialists.


Has medical education changed much since you were a student? What are the changes you would like to see?
Unfortunately, the curriculum in India has not changed since I was a medical student 40 years ago.  Today, medical students across developed world follow problem-based education where in they get hands-on training from the day they join a medical college.  We are very far off from the innovation.  As a result, the quality of doctors who are graduating today in India has not improved significantly compared to 40 years ago.
 
What is the biggest shortcoming in India?
The greatest short coming in medical education system here is the acute shortage of post-graduate seats.  In the US, they have 19,000 undergraduate (UG) seats and 32,000 post-graduate (PG) seats.  Even in the UK, the ratio of UG to PG  seats is almost double.  In India, we have 47,688 UG seats 14,500 PG seats in clinical subjects.  This has resulted in nearly two lakh students spending two to five years in coaching classes to mug up multiple choice questions to get one of those rare PG seats.   If the trend continues, bright student, especially from working class and poor families, will not join medical college. 
Till the shortage of medical specialists is met, maternal mortality and infant mortality across the country cannot come down.  Also, hospitals won’t come up in Tier-2 and Tier-3 cities since these hospitals will not have anaesthetists, gynaecologists, radiologists and paediatricians.
 
What is the way forward?
The government should equalise UG and PG seats. This does not require any regulatory changes.  Medical Council of India (MCI) after assessing acute shortage of PG seats changed the norms for creating more PG seats.  All that we now require is to implement those policies across the country in all medical colleges.  Without spending even one rupee, government will straightaway get 40,000 PG seats.  If this is accomplished, within two to three years we will have enough medical specialists to run secondary medical care facilities in Tier-2 and Tier-3 cities, which is required to reduce maternal mortality and infant mortality.
 
How can we meet the unmet demand of doctors in the rural areas?
Unless the cities get saturated with medical specialists, doctors will not go to Tier-2 and Tier-3 cities, leave alone rural india.  Only when doctors do not have opportunity to practice in cities, they will decide to go to next level of Tier-2 or Tier-3 cities.  No regulation can push the doctors away to rural areas unless there is surplus skilled manpower.
 

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Why is India’s healthcare system in such a sorry state?

Why is India’s healthcare system in such a sorry state? | Healthcare in India | Scoop.it

R Srinivasan’s credible government document on healthcare in India titled ‘Health Care in India – Vision 2020’ draft published in 2004, sub-titled ‘Issues and Prospects’, has suggested four criteria that make a just healthcare system 


1. Universal access, access to an adequate level, and access without excessive burden.

2. Fair distribution of financial costs for access and fair distribution of burden in rationing care and capacity and a 
constant search for improvement to a more just system.

3. Training providers for competence empathy and accountability, pursuit of quality care and cost effective use of the results of relevant research.

4. Special attention to vulnerable groups such as children, women, the disabled and the aged.
 
Srinivasan's  draft is dated; but the criteria are relevant even today as India’s healthcare system remains in a very sordid state.


A recent study by IMS Institute of Health Informatics (19 July, 2013) has revealed that 72 percent of the rural Indian population has access to just one-third of the country’s available hospital beds while 28 percent of urban Indians have access to 66 percent of the total beds. The study also notes that those living in remote pockets have to travel more than five kilometres to access an in-patient facility, 63 percent of the time.


Evidently, the country’s historical spend on healthcare, apart from immunization programmes, has not been enough. WHO statistics show the total expenditure on health is 4.4 percent of the GDP, for a population of 1.27 billion. As a result of a low healthcare spend and lack of special attention towards this sector and absence of concrete regulatory policies, India’s healthcare system is in shambles.


Here is a picture of the current healthcare scenario:
 
Universal Access and Financial Costs: The IMS study noted that long waiting time and absence of diagnostic equipment at public facilities has caused an increasing number of patients to rely on private healthcare facilities.  Quality of treatment is also a reason why patients switch to private centres. However, this shift from public to private care is posing an affordability challenge to poor patients.
 
Training and distribution of Health workforce: Statistically speaking, Indian cities have four times the number of doctors and three times more nurses than in rural areas. Meanwhile, almost 80 percent of the medical colleges are located in South and West India. The direct impact is a dearth of trained professionals practicing in rural India.






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India to curb technology import for universal healthcare

India to curb technology import for universal healthcare | Healthcare in India | Scoop.it

There is a need in India to curb the import of medical equipment and focus on indigenous healthcare technology to make procedures and services affordable for all, a report released Monday said.


"About 75% of the medical devices in India are imported, so there is a need to promote indigenous medical technology in low-resource settings to drive down the cost of healthcare," read the report, "Universal Health Cover for India 2013".


The report has been released by the Federation of Indian Chambers of Commerce and Industry (FICCI) in collaboration with Ernst and Young, a leading professional services organisation, during FICCI Heal 2013.


"The government of India does not provide enough funds to support local innovation. Our government has not been able to take cognisance of the situation like in China and Brazil," said G.S.K. Velu, co-chair of FICCI health services committee.


The report also highlights the need to look after reimbursement mechanisms of the government.


"When we talk about the reimbursement rates, there is a need for the government to focus on patients' safety and award incentive models for hospitals that work to provide good healthcare services," Murli Nair of Ernst and Young said.


The industry leaders also reiterated the need for bringing public-private partnership into play, to achieve universal healthcare.

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Sickle-cell research centre soon

A full-fledged sickle-cell anaemia homoeopathy research unit will soon be opened in Sambalpur.

"Sickle-cell anaemia cases keep pouring in from western part of the state. After repeated demand for a research unit, we decided to have a modern facility in Sambalpur," said director general, Central Council for Research in Homoeopathy (CCRH), Dr R K Manchanda, while addressing a seminar here on Friday.

Sambalpur earlier had a small research laboratory from 1985 to 2005.

"This modern unit will definitely help people, suffering from the disorder, get better treatment," said former principal-cum-superintendent of Abhin Chandra Homoeopathic (ACH) Medical College and Hospital Niranjan Mohanty.

There are two other homoeopathy research centres in the state.

The Regional Research Institute for Homoeopathy (RRI-H) in Puri, which was set up in April 1980, carries regular clinical tests of various homoeopathy drugs.

The drug probing unit on the ACH premises in the capital is an extended facility of RRI-H.

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India may join global forum to safeguard drug exports

India may join global forum to safeguard drug exports | Healthcare in India | Scoop.it

India is considering joining a global forum that prescribes standards for medicine manufacturing to safeguard its drug exports to the member countries. Called the Pharmaceutical Inspection Convention and Pharmaceutical Inspection Co-operation Scheme (PIC/S), it currently comprises 43 drug importing countries.


The move assumes significance in the backdrop of Indian drugmaker Ranbaxy being recently penalised $500 million (aboutRs3,350 crore) by the US government for shoddy manufacturing practices. The United States and the European Union are among the key members.


Under an agreement, drug regulators of member countries ensure compliance with standards rather than individual manufacturers. PV Appaji, director general of India's Pharmaceuticals Export Promotion Council (Pharmaexcil), said the country's drug exports could suffer in the medium to long term if India does not join the league. "It is going to impact our export growth as more and more countries are now looking for PIC/S compliance. India should join the league at the earliest."


Sudhanshu Pandey, joint secretary at the commerce ministry, said while joining the forum will help exports grow, there were broader issues. "As there is the requirement that the whole pharma industry, including non-exporters, be compliant with the standards, the issue needs to studied more carefully." He said the commerce ministry held talks with officials of Drug Controller General of India (DGCI) and the health ministry is examining the likely impact of joining the forum.

The Indian pharma industry, which currently has the largest number of US Food and Drug Administration-approved manufacturing facilities outside the United States, does not want to risk losing out on drug exports and prefers the country join the forum quickly. The industry saw its exports growing to $14.5 billion (Rs79,500 crore) during 2012-13, up from $13.2 billion (Rs 63,500 crore) a year ago. "With the US and the EU already a part of this (forum), other countries are joining too," said a spokesperson of drugmaker Dr Reddy's Laboratories.


It could, howeer, hurt companies that are today just about meeting the minimum required standards, the spokesperson said. "Membership would probably become important in the coming years if not so immediately," said Arun Sawhney, chief executive and managing director of Ranbaxy Laboratories. "The Indian regulator should work towards making India a member of PIC/S within the agreed timeframe."


Joining the forum will also help the Indian pharma industry improve quality standards, said Ganadhish Kamat, Lupin's executive vice president-quality assurance. It will "help boost exports and strengthen India's credentials as amongst the best quality manufacturers of pharmaceuticals globally."

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The mHealth Case in India

The mHealth Case in India | Healthcare in India | Scoop.it
The mHealth Case in India

This paper presents the opportunities for mHealth adoption in rural and urban markets, and explores the role that telcos can play in the delivery of mHealth services in India. 

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Tata power's mobile medical vans in Dharavi

MUMBAI: Tata Power, India's largest integrated power player has once again taken a step forward to provide primary, preventive and referral healthcare services to people around its area of operation. The mobile medical van services were inaugurated at Dharavi receiving station recently by Varsha Gaikwad, minister for women and child Development, government of Maharashtra, Eknath Gaikwad, member of Parliament, and Vishnu Gaikwad, corporator, MCGM in the presence of Ashok Sethi, chief-COM and other senior leaders of Tata Power.

 

The van will provide treatment for basic illnesses like cough, cold, fever, infections, malaria, dengue, typhoid and hepatitis. Complicated cases will be referred to the nearest hospitals. While the services will include curative medicine, there will be a focus on preventive medicine and maternal child health as well.
 

Speaking on the initiative S Padmanabhan, executive director - operations, Tata Power said, "At Tata Power, it's our endeavour to improve the quality of life by providing adequate medical amenities for those who find primary health care expensive and unaffordable."

 

"The mobile medical van is a unique initiative which will be carried out in Mumbai as part of the "Health at Doorstep" initiative. The main aim is to encourage higher quality PHC and promote health seeking behaviour as well," added Vijay Chourey, Head- Transmission.

 

Speaking on the occasion Eknath Gaikwad said- "We are happy with Tata Power's resolve to make Chembur clean and green." ""We appreciate TATA Power's efforts towards community on employment, education, and empowerment and would like the company to partner with the Govt of Maharashtra as well." said Varsha Gaikwad, minister for women and child development.

 

The mobile medical van will provide services in Mahul, Ambada, Gavanpada, Prabuddha Nagar, Ayodhya Nagar, Bharat Nagar, Rahul Nagar, Prayag Nagar, Vishnu Nagar, Vashi Gaon and Jijamata Nagar in Chembur, Mankhurd East and West, Thakarbapa Colony- Kurla East, Dharavi- around 90ft road up to Sion, Wadala and Parel, Tembhipada- Bhandup, Borivali East, Dahisar East and Mira Road East.

 

While 700 million people live in rural India in 6,36,000 villages, only 23,000 PHCs are available. 66% of rural population does not have access to critical medicines and 31% of rural Indians travel more than 30 Kms to seek health care. Also the PHCs are short of trained medical personnel. India has 6 doctors per 1000 people and majority of them are present in the areas where medical care is expensive. The mobile medical van will promote higher quality PHC as compared to currently available options across such as local self-proclaimed practitioners and home based therapies. By providing regular and concentrated healthcare facilities, the Mobile Medical program will promote health seeking behavior.

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Startups making medical devices to boost demand in Tier-1 & Tier-2 cities

Startups making medical devices to boost demand in Tier-1 & Tier-2 cities | Healthcare in India | Scoop.it

Indian startups making medical devices have innovated to slash costs and spawn demand in Tier-1 and Tier-2 cities. This has drawn interest from bigger multinational rivals - operating mostly in metros with overcrowded markets - who are keen to get a piece of the action. The Indian medical device market, currently about $4.5-5 billion, is pegged to grow to about $14 billion in 2020, according to a report by accounting firm PricewaterhouseCoopers and industry body Ficci.


Metros and Tier-1 cities contribute to about 50% of the total market, with the rest of India making up the rest. But most of the growth will occur in smaller towns and cities.


Also, India imports almost 65% of its medical devices, which are too expensive for small nursing homes coming up in Tier-2 and Tier-3 cities.


Startups, such as Mysore-based Skanray Technologies, have taken advantage of such gaps in medical treatment and brought out products that are dirt-cheap but effective. For instance, Skanray's USB-based ECG unit called Cardiskan converts laptops, or personal computers, into a 12-channel electrocardiogram system. As a result, rural diagnostic centres can now offer ECGs for as little as 15, compared with 100 earlier.


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Sex ratio in India showing improvement

Sex ratio in India showing improvement | Healthcare in India | Scoop.it
In what could be termed as a good news, Indian Health has revealed that male-female sex ratio in India is showing signs of improvement.

Indian Health Minister Ghulam Nabi Azad Wednesday said male-female sex ratio in India is showing signs of improvement.


“As per the census, sex ratio has increased from 933 females per thousand males in 2001 to 943 females per thousand males in 2011,” Azad told Lok Sabha, lower house of Indian parliament today.


He said Indian government has been exhorting on the States and Union Territory governments to pay utmost attention for effective implementation of the provisions of the Pre-Conception & Pre-Natal Diagnostic Technique (Prohibition of Sex Selection) Act (PC&PNDT Act), 1994.


He said he has urged the officials and bureaucrats to establish mechanism for monitoring and to take deterrent follow up action for effective implementation of the PC & PNDT Act. “The Indian government has provided funds to the States & union territories for implementation of the Act.”

‘Multiple-strategy devised for better sex ratio’

The Indian health minister said government has adopted a multi-pronged strategy devising schemes, programmes and awareness generation/advocacy measures to build a positive environment for the girl child through gender sensitive policies, provisions and legislation.


“The Government has intensified effective implementation of the Act and amended various provisions of the rules relating to sealing, seizure and confiscation of unregistered machines and punishment against unregistered clinics,” he said.


He said regulation of use of portable ultrasound equipment only within the registered premises has been notified. “Restriction on medical practitioners to conduct ultrasonography at maximum of two ultrasound facilities within a district has been placed. Registration fees have been enhanced. Rules have been amended to provide for advance intimation in change in employees, place, address or equipment”.


“Religious leaders, women achievers etc have been involved in the campaign against skewed child sex ratio and discrimination of the girl child,” Azad added.

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IMA to move SC against PCPNDT Act provisions

The Indian Medical Association (Pune branch) will file a writ petition in the Supreme Court challenging certain rules in the sections of the Pre-Conception and Pre-Natal Diagnostic Techniques (PCPNDT) Act.


Doctors with IMA are upset about being pulled up for technical lapses and incorrect filling of forms.


They have also protested about the rule under which no sooner is the chargesheet framed against a doctor under the Act, his/her name is sent to the Maharashtra Medical Council (MMC). The council can take stern action like suspension or cancellation of the doctors' registration.


Dr Jayant Navrange, in charge of the medico legal cell of the IMA, said all doctors supported the move by the state to implement the PCPNDT Act and were against sex determination of the foetus. "However, there are certain rules in the sections of the Act that are being challenged," he said.


For instance, not filling Form F properly is regarded as an offence related to sex determination. Form F under the PCPNDT Act records the medical history of a pregnant woman. Navrange said while doctors were filling the forms as per the rules, some lapses occur inadvertently, such as spelling mistakes. These technical errors should not amount to an offence like sex determination, the petition states.


"Doctors condemn the practice of illegal sex selection, but being pulled up for technical errors and chargesheeted is not fair," said Dr Vaijayanti Patwardhan, in charge of the Garima cell of the IMA. Doctors have unanimously agreed to file the writ petition seeking changes in some rules of the Act, she said.

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With ToucHb & uChek mobile tech, Biosense aims to boost healthcare

With ToucHb & uChek mobile tech, Biosense aims to boost healthcare | Healthcare in India | Scoop.it

Health care systems in India are often poorly managed and need a big boost. Whether it is urban or rural, public or private health care, there are a lot of challenges like lack of technology, affordability, implementation among others. However, these problems also give birth to solutions, like a team of doctors, engineers and product designers who seems to do their bit to improve healthcare access via technology.

The journey of Biosense started during the team's medical posting. They felt and experienced the problem of anaemia up close at a tribal village, that was nearly 20 kilometres away from the nearest Primary Health Centre (PHC). A large population amongst the women was anaemic but due to inaccessibility and lack of roads, it was difficult for villagers to visit PHC to get their blood samples tested.

 

This left the team of Biosense with the feeling that such fields need affordable, portable, easy to use (for the health worker) devices, which can enable affordable screening, regular monitoring and effective control. This lesd to the team developing such a device and the concept took the name of Biosense Technologies later on, according to company's official webpage.

Till date, the startup has launched two products, one mobile gadget, which lets one measure haemoglobin and the other lets the user analyse urine samples via smartphones. The first one is for health workers while the second product is consumer centric.

Biosense's first product is a portable gadget called ToucHb-a battery operated device that screens anaemia. The device measures the count without the prick of a needle. It is a hand-held needle-free battery operated haemoglobin estimation device that gives instant readings.

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Portable digital kit CareMother allows community health workers ensure the safety of pregnant mothers

Portable digital kit CareMother allows community health workers ensure the safety of pregnant mothers | Healthcare in India | Scoop.it

In an attempt to curb the mortality rate of mothers in rural parts of the country, five youths have developed a portable digital kit called CareMother, which will enable community health workers to visit the homes of pregnant women to conduct tests. 

The 3kg kit consists of digital sensors to test the woman’s blood pressure, blood sugar, urine sugar and protein levels, apart from the heart rate of the foetus and fundal height, among other things, all at a cost of Rs100. The results of these tests can then be uploaded on a web portal through a cell phone app. 

“With this kit, all pregnancies can be monitored on the web portal by a doctor sitting at a hospital. The doctor can send out SMS alerts in case the results show anomalies,” said Shantanu Pathak, one of the five who developed the kit. 

Rural parts of India usually lack medical facilities, leading to complex pregnancies going unnoticed. A UN report released last year revealed that there is one maternal death every 10 minutes in our country. The report put India close to sub-Saharan countries, with over 212 mothers dying per one lakh live births.

Another team member, Vaibhav Tidke, said, “It took us around six months to minimise all the medical components available in the market to put into the kit. For example, the weighing scales available in the market weighed not less than 3kg. We brought that down to 600g using lightweight polymer.”


Once fully charged, the kit can work for a month. The students spent Rs20,000 to develop this kit. The cost could be brought down if the kit is manufactured commercially. 

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Conclave to discuss reforms in medical education

Conclave to discuss reforms in medical education | Healthcare in India | Scoop.it

Issued related to reforms in medical education system of the country will be discussed at a two-day conclave of representatives from various students organisations in the field from September 8 here. 

Though India has progressed in other arenas, medical education has failed to keep pace with global standards as well as advancements in medicine and technology, which has affected Indian medical students when it comes to competing with international medical students, said Pratap A Naidu, executive president of Medical Students Association of India (MSAI). 

MSAI is organising the India International Medical Conclave on Dept8-9 which is likely to be also attended by representatives of medical student associations from NepalBangladeshMalaysia and the US. 

"This is perhaps for the very first time that medical students as main stakeholders are coming together with other stakeholders at a platform to discuss the crucial issue of reforms in medical education," Naidu said. 

According to Dr Narendra Saini, General Secretary, Indian Medical Association (IMA), "Some of the skills that need to be incorporated into medical education include communication skills, clinical skills, and information system and data management. 

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Medical education in India at crossroads

Medical education in India at crossroads | Healthcare in India | Scoop.it

The recent Supreme Court judgment, albeit a split verdict, has thrown more issues to ponder. The question of whether the Supreme Court rightly held that MCI has no mandate to intervene in admission process or otherwise is a matter of legal debate. Although the health ministry may file a review petition against the judgment, it is time for the government to go back to drawing table to clear the medical education mess.


Apart from legal aspects, the Supreme Court in its recent judgment also considered the practical aspects of holding single National Entrance Test for admission into medical courses. By endorsing arguments of the states and private institutions on the possible increase of urban-rural divide and disparity in educational standards of states, the Supreme Court seems to have ignored the ground realities and the greedy manipulations of private institutions.


If we look at the context of the case, the petitioners only sought relief on the ground that the students had to appear in multiple examinations and wanted to have only one single examination for admission in medical courses. By making invalid the single entrance examination, the top court brought the issue back to square one, giving undue advantage to private institutions. Besides the issue of admission process, the government has to seriously look at the aspect of fee structure and capitation fees charged by private institutions.

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India is the place to be, say home-bound doctors

India is the place to be, say home-bound doctors | Healthcare in India | Scoop.it

After technology sector, it's the health sector in Bangalore that is witnessing a reverse brain drain. Across fields-nephrology, general medicine, pathology, orthopaedics and oncology among others, doctors are returning to India in general and Bangalore in particular.


On an average big medical hospital chains in the city each get 8 to 10 applications every month from Indian doctors in the US, the UK, Canada, Australia and Singapore. "I interview one doctor a week. And in the last six months I have got 12 applications for jobs from doctors abroad. They are all in their 30s," says Dr H Sudarshan Ballal, medical director, Manipal Hospitals.


The scene is no different at Sparsh Hospital on Narayana Health City campus where chief orthopaedic and hospital head Dr Sharan Patil scrutinizes at least 10 applications every month from doctors in the UK, Australia and the US.

"There is no bigger canvas to paint yourself than in medicine. Two decades ago when doctors left India, the opportunities were few. Today opportunities outweigh frustrations. After the training, they want to return," says Dr Patil, who himself spent five years in the UK before returning to the city to become a doctor-entrepreneur.


Ten of the 40 orthopaedicians at Sparsh are those who have returned from abroad. "I began to feel I was making no difference in my job and decided to leave Australia. I find it more satisfying here. But it is good to study and train abroad for some time," says Dr A Thomas, spine surgeon, who practised for five years at St George Hospital, University of South Wales.


Hospital honchos are seeing the trend only in the past five years. In many hospital chains of Bangalore, the entrepreneurs are doctors themselves who left practice in the dream country where they were and came back home.

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Mothers' milk bank to bridge nutrition deficiencies

Mothers' milk bank to bridge nutrition deficiencies | Healthcare in India | Scoop.it

Human milk banks are growing in Pune. After Deenanath Mangeshkar Hospital which has had the facility since the last two years, Pimpri Chinchwad's first human milk bank is going to be launched at D Y Patil Medical College and Hospital on Saturday.


A milk bank caters to infants who do not get the milk from the mothers due premature birth or when the mother dies during childbirth.

As the incidence of low-birth weight babies and preterm babies is very high in India, it is imperative for the survival of these babies that constant and adequate supply of milk is guaranteed to them. A milk bank can perform a virtual function in such scenario. It acts as the most cost effective strategy for overall improvement in neonatal care, say experts.

"The human milk bank gives parents the choice of donated breast milk when the mother's own milk is not available. The facility is created to provide families with the option of donor mothers' milk when needed and to see that babies exclusively receive breast milk from birth to six months of age," said senior paediatrician Sharad Agarkhedkar, head of the paediatrics department at D Y Patil Medical College and Hospital, Pimpri.

Milk banking includes collecting, screening, processing, pasteurising, storing and prescribing donated human milk by lactating mothers to the babies who are not able to breastfeed immediately after birth. Milk is distributed according to the requirement.

Extremely preterm and low birth weight babies, all babies separated from their mothers due to complications or illness in mothers, mothers who have adopted the newborn and abandoned neonate or neonate from orphanage admitted in neonatal care unit or paediatric ward can benefit from this facility, Agarkhedkar added.

Mothers with surplus milk without any infection like HIV, hepatitis B, hepatitis C, syphilis, and tuberculosis can donate.

Breastmilk is expressed with the help of electronic breast pumps in clean containers. "The procedure is painless and safe. There is no spilling and no chances of infection. The breast milk if stored in a tightly sealed container at room temperature is safe for 4-6 hours and can be stored in a refrigerator for a week and in deep freezer at -20 degree centigrade for 6 months," Agarkhedkar said.

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Genetic labs, counselling centres under health department's lens

Genetic labs, counselling centres under health department's lens | Healthcare in India | Scoop.it

The absence of adequate checks on genetic labs and genetic counseling centres functioning in the state has prompted the health department to inspect them for possible misuse of sex determination technology.

Sonography centres have to submit form 'F' which gives details of a pregnant woman undergoing an ultrasound scan. Similarly, genetic counseling centres must maintain form 'D' while genetic laboratories need to fill form E.

However, 'health officials have been lax in inspecting the records at these centres', states the letter issued by the state health department to civil surgeons and civic health officials in the city on August 3.

Health authorities said the genetic labs have Pre-implantation Genetic Diagnosis (PGD) facilities, which allows testing of the embryo before implantation and hence the daily monitoring of their functioning is crucial.

state health official, on the condition of anonymity, said, "The fact is that there has been no monitoring of genetic labs and genetic counseling centres functioning in Maharashtra. So, we have ordered civil surgeons in rural areas and civic health officials in cities to carry out inspection of such labs and centres and report to us every day."

Asaram Khade, a consultant to the state government on Pre Conception and Pre-Natal Diagnostics Techniques (PCPNDT) Act, said, "We have started consolidating the exact number of genetic labs and genetic counselling centres functioning in the state. We have issued orders to civil surgeon and municipal corporation health officials to inspect these centres and report to us about the same in the format prescribed.

Like inspection of form F, officials have been told to report to us the daily scrutiny of form D meant for genetic counseling centres and form E for genetic labs."

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Mobile-based healthcare services have huge scope in India: veteran venture capitalist Vinod Khosla

Mobile-based healthcare services have huge scope in India: veteran venture capitalist Vinod Khosla | Healthcare in India | Scoop.it

Entrepreneurs working in mobile-based healthcare services have huge opportunities in India, according to Silicon Valley-based veteran VC investor Vinod Khosla.Speaking at Khosla Labs IGNITE 2013, the venture capitalist said the startup ecosystem in India is up for a huge growth, and five years down the line, the country will start seeing many growth stories.


“I am amazed by the activities happening in the mobile space in India. It is growing fast and has a huge potential. With the mobile-based healthcare services, we can slash the cost of healthcare by 90 per cent while at the same proving better quality services,” he said.


Khosla noted that internet is another vertical that is creating a revolution in the country. According to him, startups operating in traditional IT-related areas such as machine learning and data mining can also script success stories in the country.


“Almost all innovations will come only from the startup world. There is a tremendous scope for entrepreneurship in India. As Walmart changed the retail sector and YouTube changed the media space, new startups can revolutionise many verticals,” he said. “The world is ripe for innovation. If you have skills, expertise and idea, do start now,” he urged the people gathered at the event.


Asked about Khosla Ventures’ investment strategy, the veteran investor said it is looking for three things: the team, market and willingness to take risk. “I am looking to invest in companies which can create an impact in the society. The RoI is secondary for us. We have made at least 100 investments, but have never calculated the rate of return.”

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FDA India gets serious about enforcing rules on drugs and food

FDA India gets serious about enforcing rules on drugs and food | Healthcare in India | Scoop.it

NAGPUR: The Food and Drugs Administration (FDA) seems to be getting more serious in enforcing laws related to sale of medicines as well as all eatables. It is also implementing the ban on gutka, kharra, mawa, scented pan masalas and processed betel or supari vigorously.

 

Mahesh Zagade, FDA commissioner who was on a tour of the region, told reporters that FDA was extremely serious on the issue of presence of pharmacists in every medicine shop. "The situation is slightly better in Vidarbha. In Maharashtra, however, 30-40% of the medicine shops are run like kirana stores with no pharmacists. It is a serious lapse and shops with no pharmacist will be closed and their licences cancelled," he said.

  

Zagade said increased drug resistance in many diseases like tuberculosis that are mass killers can also be attributed to disbursement of medicines across the counter without prescription and bills. In the west, pharmacists have the power to return prescriptions that prescribe irrational combination or are not according to body parameters of patient like weight and age. FDA would also be taking stringent action on shop owners who sell medicines without bills. Substandard drugs make their way into the market through this channel, he said.

 

Zagade stated the state had introduced a system to recall drugs found substandard through a regular sampling process. FDA inspectors picked about 6-7,000 drugs from across the state and found 700 of them were of bad quality. "Information on these medicines will now be available online and they will be recalled from market," he said.

 

Another major step towards curbing illegal trade practices was implementation of Drug Price Control Order (DPCO). Until now there was a big cartel of companies and druggists and chemists association. The two used to sign a MOU and prevent entry of new companies or wholesalers and the companies increased the price of medicine which was borne by patients, Zagade added.

He said the ban on gutka and similar addictive items aimed at preventing cancers of mouth, digestive track etc. Research by Government Dental College in Nagpur and Tata Memorial Hospital has shown how scented and processed items also gradually kill. Talking about the Food Safety and Standard Act (FSSA), the commissioner stated that the act was now very powerful. Food safety officers would now have more powers of compounding fines as well as making case for compensation to consumers, he said.

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Healthcare woes: India has 1 govt hospital bed for 879 people

Healthcare woes: India has 1 govt hospital bed for 879 people | Healthcare in India | Scoop.it

India has one government hospital bed for 879 people on average, a ratio that starts looking nearly 10 times as bad in a state like Bihar, but improves dramatically in Manipur.


Andhra Pradesh, where every tenth Indian student of medicine studies, has a government hospital bed for every 2,230 people. 

The estimates for January 1, 2013 were given to Lok Sabha by Health Minister Ghulam Nabi Azad Friday. As per the goals of the 12th Plan, India needs another 5,96,589 hospital beds to reach the target of 500 beds per 10,00,000 people. 


This goal is far below the world average of 30 hospital beds per 10,000 population, but above the World Health Organisation recommendation of 1.9 beds per 1,000 population.


The report of the high level expert group of the Planning Commission headed by Dr K S Reddy which was released in 2011 noted that of the 1.37 million hospital beds available in the country, 8,33,000 were in the private sector. India spends a little over 4 per cent of its GDP on healthcare, but the bulk of it comprises pocket expenditure.


Azad said that public health is a state subject. Under the National Rural Health Mission, the central government provides financial support to states to strengthen their health systems including new constructions and upgradation of public health facilities based on the requirement. Central government has decided to open eight new AIIMSes, and to upgrade 19 medical colleges and institutions to provide tertiery healthcare services that would add about 11,390 additional beds.

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Britain's health service turns to India for help

Britain's health service turns to India for help | Healthcare in India | Scoop.it

Britain's cash-strapped National Health Service(NHS) is planning to strike up a series of healthcare deals in India, including inviting Indian doctors to treat patients in UK, in a bid to boost its coffers.


Patricia Hewitt, Labour's former health secretary and current chair of UK India Business Council (UKIBC), claimed that between 10 and 20 NHS trusts are holding talks with Indian providers and "half a dozen to a dozen" should reach an agreement by 2015.


The proposals centre around NHS doctors being flown to India to treat patients in a bid to raise cash for British hospitals and less expensive Indian doctors coming to the UK to perform operations.


Hewitt said that it would take time before trusts saw significant revenue from India, but added that the income could help them close the NHS' funding gap, which is projected to be as large as 30 billion pounds by 2020.


"Our ambition is to get as many (NHS trusts, health companies and charities) there as we can. I would certainly hope by 2015 we will be able to say- here is what they are doing and selling and here are the benefits that are accruing both to Britain and to India," Hewitt told the Health Service Journal (HSJ).


India's healthcare market is set to be worth 110 billion pounds by 2017 and the British government is keen to encourage British businesses and NHS trusts to gain a foothold in the sub-continent.


One of the key areas where British expertise is sought is in India's growing primary care sector, which many NHS experts are already helping to develop.


While the British government denied suggestions this could mean patients being flown out from Britain to India for cheaper treatment, health campaigners have warned against such a move.

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Form 'F' for ultrasound scans becomes simpler

The modified version of Form 'F' - the mandatory record which captures detailed information like the name, address, previous children with their sex, previous obstetric history related to the pregnant woman undergoing ultrasound scan - will be rolled out across the country soon.


The modified version of Form 'F' is divided into four sections, simpler to understand and is expected to reduce the ambiguity which doctors face while filing the existing form, experts said.


The Central Supervisory Board (CSB) chaired by Union health minister Ghulam Nabi Azadhas approved the new format prepared by the 12-member experts' committee set up last July to examine the existing format and lay down necessary parameters.


The board reviews and monitors implementation of the Pre-Natal Diagnostic Techniques (Prohibition of Sex Selection) Act, 1994 and advises the Centre on policy matters.


"The board has approved the modified version of Form 'F' prepared by its sub-committee set up for simplification and rationalisation. The Union health and family welfare ministry will issue a notification in the next few days. The application of the new format will come into effect across the country soon after," said senior gynaecologist Sanjay Gupte, a member of the Central Supervisory Board (CSB). Gupte is also one of the members of the sub-committee set up to suggest modifications in the existing format of the form.


"The new format of Form 'F' was approved in the 21st meeting of the board which was held in Delhi on July 23. The notification will be out in the next few days," said Rajeev Yeravadekar, one of the members of CSB.


Contrary to the existing form which contains columns of all types, invasive (for example amniocentesis) as well as non-invasive (for example sonography) diagnostic tests and procedures and gives rise to ambiguity at various points, the modified version is more sorted out. It has separate sections for invasive and non-invasive test and the doctor has to fill only sections which are applicable, the experts said.


For example, if the doctor has conducted sonography or imaging scan and not invasive tests like amniocentesis (the sampling of amniotic fluid during pregnancy) or chorionic villus sampling (sampling of placental tissue to diagnose genetic abnormalities), then he is supposed to fill only section B which is for performing non-invasive diagnostic procedures/tests only.


If the doctor has conducted an invasive test then he is to fill section C which is for performing invasive procedures/tests only and leave section B blank since it is meant for non-invasive tests.


Only section A and section D have to compulsorily filled by doctors. Section A records information like name and complete address of genetic clinic/ultrasound clinic/imaging centre, registration number under PCPNDT Act, patient's name, age, total number of living children, postal address, referral doctor's name.


"In this section, we have added a few more necessary parameters which are conspicuously absent in the existing format of Form 'F' like age of each living son in years and months and age of each living daughter in years and months. This can help the inspecting officials with enough index of suspicion for probing the case further if there is doubt of sex determination," Gupte said.

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Health care in India skewed towards urban residents: Study

The provision of health care services in India is skewed towards urban residents who constitute about one-third of the country’s population, a new study says.

 

Urban residents, who make up 28 percent of India’s population, have access to 66 percent of the country’s available hospital beds, according to the study by IMS Institute for Healthcare Informatics released here Friday.

 

The study also shows that the distribution of healthcare providers including doctors, nurses and pharmacists is highly concentrated in urban areas and the private sector.

 

The physical reach of any health care facility is a challenge in rural areas, particularly for patients with chronic ailments. Patients in rural areas must travel more than five km to access an in-patient facility 63 percent of the time, the study found.

 

Patients in rural areas face difficulty in accessing transportation options and loss of earning as a result of travel time to reach facilities for treatment, it says.

 

Private health care facilities are being used by an increasing proportion of patients due to gaps in quality and availability of public facilities.

Availability of doctors is a key reason for selecting private facility outpatient treatment.

 

The study goes on to say that the cost of treatment at private health care facilities is between two and nine times higher than at public facilities, thus leading to debt burden on the poor.

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