November 27, 2009

Govt plans to bring back diploma docs for villages

Desperate to address manpower crunch in the rural healthcare system, the state government has apparently decided to resurrect the ‘barefoot doctors’ of the early ’80s in a new avatar through the West Bengal Rural Health Regulatory Authority Bill 2009.

Once the regulatory authority is set up, it will pave the way for insitutes that will train and issue diplomas to rural health practitioners.

During the ’80s experiment, the diploma-holding ‘doctors’ had faced stiff opposition from the medical community. The latest bill, which will be introduced in the Assembly this Winter Session, is also likely to kick up a ruckus. Congress and Trinamool are ready to oppose it. As in the ’80s, the medical community is again prepared to take on the government.

Eligible to practice in rural areas, rural health practitioners will treat patients and prescribe medicines according to a standard treatment guideline to be handed to them. They will also carry out minor surgeries and issue illness and death certificates.

Doctors have raised their voices against the move. The Medical Council of India doesn’t recognise the diploma, neither does the West Bengal Medical Council. The state health department has cited the instance of Assam, where similar legislation was enacted in 2004.

“The government had tried this in the past and failed miserably. There is no doubt that Bengal has a shortage of doctors, but creating rural health practitioners is not the solution. More medical colleges — both government and private — should be set up,” said Subir Ganguly, ex-president Indian Medical Association (Bengal chapter).

Recently, some IMA members met Trinamool MLA Aroop Biswas, a member of the Assembly’s standing committee on health, and stated their objections. Objections have been raised on the usage of the term rural health practitioner and also granting them permission to issue death certificates.

“The government claims there is a shortage of doctors. How many times have they issued advertisements through the Public Service Commission for empanelling doctors? How many doctors have been recruited in the last five or 10 years?” asked a senior IMA (Bengal) member.

“Promode Dasgupta tried this and failed. I don’t know why Buddhadeb Bhattacharjee is trying to do the same thing. We will oppose it,” said Manas Bhunia, Congress legislature party leader.

Trinamool’s newly-elected MLA from Serampore Sudipto Roy, former president of IMA (Calcutta), said the Bill discriminates between urban and rural areas. “Why should there be two sets of doctors for urban and rural areas? Government should identify the number of vacancies and fill them up,” Roy said.

Doctors said the manpower crunch can be addressed by making all MBBS passouts serve a compulsory stint in villages. They also called for campus recruitment from medical colleges.

Link: Original Article

Lifeclinic plans Any Time Health check-up stations

Lifeclinic International Inc, a US-based manufacturer of blood-pressure monitors and health stations, is in talks with a wellness provider to establish ATHs (any time health check-up centres) across the country.

“Talks are on in an advanced stage. The company plans to pilot ATHs in Andhra Pradesh with 100 installations in four months, before scaling up them to other States,” Mr James R. Evans, Chief Financial Officer of Lifeclinic, said.

The company was also in talks with non-governmental organisations to install these machines in rural areas from where the results could be transmitted to the specialist doctors for advice.

Priced in the range of Rs 1.72 lakh to Rs 12 lakhs, the machines provide quick details of weight, blood-pressure, heart rate, body mass index and blood oxygen.

Addressing a press conference here on Monday, he said the company hopes to sell 1,100 monitors in 2010. “We have registered 100 installations so far. We are in talks with pharmacy chains, hospitals and doctors to sell the machines,” he said.

“They can conduct 24 tests in five minutes, offering convenience to both patients and doctors,” Mr T. Venkateswhar Goud, President and Chief Executive Officer of Lifeclinc India, said.

He said these machines could add value to services at retail chains, banks and petrol pumps. “State Bank of Hyderabad branch at Zaheerabad (Medak district) has taken one machine on lease and found the response very encouraging,” he added.

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Nova Medical to set up day care hospital chain

Nova Medical, a company floated jointly by US investment fund GTI Group and an Indian surgeon, plans to set up a chain of day care hospitals across the country with investments from teams of local doctors.

The firm plans to give a small stake in each hospital to local doctors who will also practice at the centre. GTI holds a 72% stake in Nova, while Bangalore-based ortho surgeon Dr Mahesh Reddy owns the remaining 28%.

The company plans to set up 25 such hospitals across the country in the next 18-24 months, Nova’s CEO explained. The investment will be around Rs 250 crore. The parent company will bring in 70%, or Rs 7 crore, of the investment in each hospital and the remaining Rs 3 crore is expected to be brought in by the doctors.

“We will invite only reputed specialised doctors across speciality areas who are willing to practice at the centre and can invest a minimum of Rs 5 lakh and up to Rs 10 lakh. In the next 2-3 years, we may go for an initial public offering or a strategic sale for the holding company, which will create value and exit opportunity for all investors,” said Girish Rao, managing director and CEO of Nova Medical.

The company now operates one hospital in Bangalore under the proposed business model. About 30 doctors are co-investors here. Nova plans to set up two more hospitals each in New Delhi and Mumbai.

The new centres will specialise in surgeries and would aim to bring down cost of treatment for patients. “Our business model aims to bring down cost of treatment for patients by 15-20% compared to what is charged in multi-speciality hospitals,” Mr Rao added.

According to MG Bhat, a gastroenterology surgeon who is an advisor to Nova Medical, about 70% of the surgeries in the US are done through day-care centres some of which are run under a co-ownership business model.

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US Senate unveils $849 bn health care reform bill

A sweeping health care reform bill backed by President Barack Obama that promises to expand insurance coverage to 31 million more Americans at a whopping cost of $849 billion over a decade was unveiled today and is now set for a key test vote in the US Senate.

"We have travelled a long way to where we are, and (now) begins the last leg of this journey," Democratic Senate Majority Leader Harry Reid said while unveiling the 2,074-page Senate bill.

"The finish line is really in sight," Reid said as the Senate is expected to vote on the bill as early as Saturday.

Obama, who has made health care overhaul his top domestic priority, hailed the new legislation as "a critical milestone" that brought the United States "closer than ever" to a better health care system.

"From day one, our goal has been to enact legislation that offers stability and security to those who have insurance and affordable coverage to those who don't, and that lowers costs for families, businesses and governments across the country," Obama said in a statement, adding that the Senate proposal "meets those principles."

The non-partisan Congressional Budget Office has determined that the Senate bill would cut federal deficits by $130 billion over the next decade.

The proposal drafted from two separate bills approved by Senate committees now goes to the full Senate, where Republicans have vowed to try to block it.

Democrats on paper have the 60 votes needed to win on a procedural vote to formally launch the debate in the 100-member Senate. However, they must keep two independents and a handful of waverers in their own party to do so.

The House of Representatives approved its own trillion dollar version of the legislation on November 7 by a 220-215 margin after imposing tough restrictions on federal funds subsidising abortions.

The US is the world's richest but the only industrialised country that does not ensure that all of its 350 million citizens have health care coverage. It is estimated that some 36 million Americans do not have health insurance.

Officials say the legislation would require most Americans to carry health insurance and would mandate large firms to provide coverage to their workers. It also bans insurance company practices such as denying coverage on the basis of pre-existing medical conditions.

The Senate bill includes a range of tax increases and new fees. The Medicare payroll tax on individuals earning $200,000 a year and couples earning $250,000 a year would increase by half a percentage point, from the current 1.45 per cent to 1.95 per cent, CNN reported.

The bill would require individuals to purchase health insurance, with a fine for non-compliance of $95 in the first year that would escalate to $750 by 2016. Parents would be responsible for providing coverage for their children up to 18 years old, CNN said.

If the Senate manages to pass a bill, a congressional conference committee would need to merge the House and Senate proposals into a consensus version requiring final approval from each chamber before moving to Obama's desk to be signed into law.

Link: Original Article

November 25, 2009

Supreme court suggests 3-year MBBS to meet rural health needs

Taking serious note of the fact that basic health facilities were not reaching the poor in rural areas, the Delhi High Court Wednesday in a notice asked the health ministry to consider whether the present course can be reduced from five years to three years.

A division bench comprising of Chief Justice Ajit Prakash Shah and Justice S.Muralidhar asked the health ministry and the Medical Council of India (MCI) to consider changing the MBBS curriculum so that basic health facilities can be reached to the rural population.

"This is a very important issue. Almost 80 percent of the rural population is devoid of the basic public health and this fact should be considered seriously," the court said while asking the ministry to file its response by Dec 9, the next date of hearing.

Asking the government to amend the present educational standards the court said: "You have to change the over-five years' MBBS course so that doctors who get trained don't fly to other countries or stick to the metro cities in the wake of good earning. Educational system should be changed to three years so that every doctor can cater to rural population."

The court was hearing a public interest petition filed by Dr. Meenakshi Gautham, a public health specialist, who contended that a person who completes his MBBS can practice modern medicine as soon as the course is completed.

These graduates, the petition said, either rush to big cities or go abroad, and therefore a large majority of people are not able to get proper medical treatment, and are forced to depend either on untrained and uncertified rural medical practitioners, or on quacks.

"The irony is that 80 percent of the common medical problems and ailments can be treated at the level of primary health care and do not require attention of a professional trained in highly academic, sophisticated, five-and a half-year long course like MBBS," advocate Prashant Bhushan said, and suggested the ministry should follow the educational model adopted by China.

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Wipro announces launch of medical gateway solution

Wipro Technologies, the global IT services business of Wipro Limited, today announced the launch of a medical gateway solution.

The solution, powered by Intel Atom processor, would enable improved care co-ordination between patients and their care providers and help overcome some of the challenges faced in traditional care delivery processes, the Bangalore-headquartered company said in a statement.

The medical gateway is an intelligent embedded platform, which enables users such as patients, doctors and other healthcare professionals to monitor, track and manage healthcare information from a remote location, it said.

"The solution enables real-time clinical review by automatically capturing vital data from multiple medical devices such as blood pressure monitors, glucose meters, pedometers and weighing scales etc. available with the patients",New York Stock Exchange-listed Wipro said.

Medical devices can connect to the gateway solution through wired and wireless technologies using both standard based and proprietary protocols, to provide real time medical data, video and image transfer from a patient to doctor and in turn from a doctor to doctor, it was stated.

This technology provides doctors the ability to evaluate patient care against quality measures for a variety of health conditions, the statement added.

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International health alliance pushes vaccine costs down

The price of a vaccine that helps babies fight off killer diseases has been forced down, thanks to a co-ordinated buying policy to meet the growing demand from developing countries, a U.N.-backed health alliance said on Wednesday.

Data from the United Nations children's fund (UNICEF) and Global Alliance for Vaccines and Immunisation (GAVI) showed average prices for the shots, which protect against five infant diseases, will have fallen by 22 percent over eight years by 2012.

"This price drop is no accident, but the result of a strategy to leverage the purchasing power of hundreds of millions of people," UNICEF Deputy Executive Director Saad Houry said in statement.

"Clearly, industry understands and responds to a market, regardless of whether that market is in poor or rich countries."

The five-in-one, or pentavalent, vaccine is given routinely to children in developed nations but price has kept them out of the reach of some poorer nations. GAVI, which buys and distributes vaccines for developing countries, said higher demand has pushed purchasing costs down.

A recent tender for the pentavalent shot showed prices for 2010 falling below $3.0 -- a drop of almost $0.50 cents per dose on the 2009 price.

"This will create approximately $55 million in savings in 2010 and enable GAVI to finance the immunisation of 6.3 million more children," it said in a statement.

By 2012 the dose will have fallen in price to $2.85. The vaccine offer protection against Hib (Haemophilus influenzae type b), diphtheria, whooping cough, tetanus and hepatitis B.

GAVI's programmes involve World Health Organisation-approved shots made by GlaxoSmithKline, Crucell, and the Indian drugmakers Shantha, owned by Sanofi-Aventis, and Panacea.

In 2006, UNICEF bought less than 50 million doses of pentavalent vaccine, it said, but this year it is projected to buy around 120 million doses -- a demand seen rising by about another 10 million doses each year until 2012.

GAVI's chief executive Julian Lob-Levyt said the price drop had come later than he had hoped but added: "This is the GAVI effect at work: encouraging and pooling growing demand from countries, attracting new manufacturers and increasing competition to drive down prices."

GAVI, which is supported by the WHO, the World Bank, UNICEF, vaccine makers and research centres and the Bill and Melinda Gates foundation, said 256 million children had now received vaccines through its programmes.

GAVI raises money by leveraging long-term aid commitments from countries through capital markets, with regular offerings of "vaccine bonds" organised by the International Finance Facility for Immunisation
Link: Original Article

A must-read for doctors

Like most of us, Jerome Groopman believes that practitioners of modern medicine are all too human and so are prone to make errors in judgment. But since the doctor’s errors can be fatal, every effort should be made to minimise them. That requires studying medical errors scientifically. This is precisely what the author does in this splendid volume

The book, he says, “is about what goes on in a doctor’s mind as he or she treats a patient.” Every physician — even the most brilliant — makes a misdiagnosis or chooses a wrong therapy. Groopman differentiates “medical mistake” from “misdiagnosis.” While the former involves prescribing a wrong dose of drug or looking at an X-ray upside down, the latter is about the way doctors think, analyse a situation, or arrive at a diagnosis taking into consideration all the factors available at that time.

A majority of medical errors, according to him, do not qualify as technical mistakes, but are attributable to flaws in the physician’s thinking. He quotes a study of one hundred cases of incorrect diagnosis where inadequate medical knowledge was identified as the reason in only four cases. The rest are all due to what he calls “cognitive-traps,” which are of three types. First is “availability,” where recent or dramatic cases come to mind and colour judgment about the case in hand. Then comes “anchoring,” or short-cut thinking, where the doctor does not consider multiple possibilities but quickly and firmly latches on to a single one. And the third is “attribution,” where stereotypes can prejudice the doctor’s thinking and lead to conclusions that do not flow from the data on hand.

“Distorted pattern recognition” can be the result of the “ecology” of the patient. (A Navajo woman with breathlessness is diagnosed as a case of pneumonia when she, in fact, was suffering from Aspirin toxicity.) “Confirmation bias” refers to selecting data which suit the already made diagnosis and ignoring the rest. “Affective error” resembles confirmation bias in selectively surveying data.

To avoid falling into these cognitive traps, Groopman has this simple but sound advice: “Even when you think you have an answer, generate a short list of alternatives.” He cites examples from each speciality to explain these cognitive errors and goes on to show that availability of time, unethical promotional activities of the pharmaceutical firms, and patterns of health coverage like insurance can ultimately influence the treatment. “Zebra-retreat” refers to doctors’ shying away from a rare diagnosis and settle for a common one. “Diagnosis momentum” refers to mental fixation of a doctor, despite incomplete evidence. (An unkempt coloured labourer who admits to taking alcohol may be conveniently branded as having alcoholic liver disease when, in fact, he may be suffering from something entirely different, for example Wilson’s disease.)

And there is a whole chapter on “uncertainty.” Based on previous studies, Groopman describes three types of uncertainty: one that results from incomplete or imperfect mastery of available knowledge; another, from the limitations in current medical knowledge; and the third, from the difficulty in distinguishing between the individual’s ignorance and the limitations of the present state of medical knowledge. The challenge of modern medicine is to make decisions “in the absence of certitude” which, according to him, forms the “core reality of practice of medicine.”

To patients, Groopman offers a very practical advice: expect from your doctors and demand of them, 3-Cs — communication, critical reasoning, and compassion. Note that he does not include academic brilliance! A medical practitioner who is able to deliver on these three counts is unlikely to err in his judgment. This book is a must-read for doctors who would like to re-evaluate their medical decisions, critically and constantly.

Link: Original Article

Goodbye MCI? Bill on health education watchdog NCHRH ready

The draft Bill to set up the National Council for Human Resource in Health (NCHRH) -- the overarching regulatory body for the health sector, that would replace the existing Medical, Dental, Nursing and Pharma Councils of India -- is now ready.

Moving swiftly to establish the NCHRH as a way to cleanse the already tainted medical education system in the country, the health ministry has finalized the draft Bill and opened it for public scrutiny. States have also been sent the Bill for their comments following which it will be taken to the law ministry and the Cabinet.

A 12-member task force set up to form the NCHRH under the chairmanship of the Union health secretary in June, in its report to the ministry, said that while India was one of the fastest growing economies in the world, it was also one of the weakest performers in health. The estimated density of health workers is 20% lesser that the WHO norm of 2.5 workers (doctors, nurses and midwifes) per 1,000 population.

According to the task force, there are important distortions in the production of health workers in India. It said that while there has been an increase in the number of medical colleges in the last decade, it has been due to increase in private medical colleges in the southern states.

"Private medical colleges also place a heavy burden of fee on students and their admission procedures are not transparent. The curricula of the medical schools are not designed for producing social physicians. Rather the training they provide is better suited to the problems of urban India and for employment in corporate hospitals," the task force report said.

This is why the ministry is going all out to set up the NCHRH, the idea of which was first floated by President Pratibha Patil.

The Bill says that the chairman of NCHRH should have at least 10 years experience in medical and health education or leadership of non-medical academic institutions imparting education in disciplines such as law, management and public administration.

The committee to chose the chairman will include the cabinet secretary, principal secretary to PM, Union health secretary and two other technical experts.

The Council will meet at least once every three months and will, among other things, give permission to establish new institutions or new courses of study, recognition or approval of courses, recognition of qualifications, recognition and disqualification of foreign degrees, prescribe standards of professional conduct and etiquette.

The single regulatory body will oversee the regulation of seven departments related to medicine, nursing, dentistry, rehabilitation and physiotherapy, pharmacy, public health/hospital management and allied health sciences.

According to the draft Bill, the Council will consist of the chairperson and four full-time members appointed by the Central government. They will hold office for three years. Every state will have separate bodies constituted by the Council for each department.

The Council will maintain a national register of human resources in health which will contain names of all persons who are enrolled by the Board.

The Council will also conduct a national level exit exam for super-speciality postgraduate students. The Council will be be an autonomous body independent of government controls.

Link: Original Article

Docs told not to accept gifts from drug cos

The global association of doctors World Medical Association (WMA) has asked physicians to refrain from taking gifts, including hard cash from drugmakers, as an incentive to promote their medicines to the patients. It is part of a resolution passed by WMA outlining the guidelines for doctors to follow while dealing with pharma companies.

The advisory issued during a recent WMA meeting in Delhi comes at a time when the domestic pharma companies and medical bodies are in the process of finalising a detailed marketing code of conduct to curb the practice of pharma companies paying doctors to prescribe their medicines. The Indian government had recently asked the drug industry to self regulate so that the interests of the patients are not compromised.

The Rs 36,000-crore Indian drug retail market is fiercely competitive, with the largest player having a meagre 5% market share. Globally, drugmakers are not allowed to advertise their prescription drugs, or medicines that can only be bought on a doctors prescription. As a result, the success of a medicine largely depends on the recommendation of doctors.

The WMA guidelines has asked doctors to refrain from taking expensive personal gifts designed to influence clinical practice, payments in cash or cash equivalents from companies, payment to cover travelling expenses or room for conference or compensation for their time, and declare financial support they get from companies.

The Indian Medical Association (IMA), representing doctors in the country, and the domestic drugmakers associations say they agree with the WMA resolution in-principle. IMA secretary general Dharam Prakash said: “Once you take a gift or travel at somebody’s expense, you would be obliged to return the favour, which means promoting a company’s brand. The resolution should curtail the practice of drugmakers to unethically promote their drugs.”

“In many areas, the WMA statement is similar to our code of conduct for marketing practices. This is a good step in the right direction,” said Tapan Ray, director general at the Organisation of Pharmaceutical Producers of India, a group that represents the interests of large drugmakers in the country.

Most doctors in the country accept gifts and incentives in various forms to promote a particular company’s products. Industry experts such as CM Gulati, a veteran with medical regulations, feels the resolution will be ineffective and it is an attempt by the medical fraternity and industry bodies to prevent the government from regulating the drugmakers marketing practice.

“Both the doctor and industry are interested parties who benefit from the current practice, the consumers interest is not represented. The industry bodies are toothless and can’t take any punitive action, so the question of self-regulation is a hogwash,” he says.

Link: Original Article

Now, entrance test for courses in Indian medicine

An independent entrance test for degree courses in Ayurveda, Homeopathy and Unani; annual assessments and gradation of colleges and 14 new diploma courses on specialisation in Ayurveda, are some of the key changes that are in the offing on a country-wide basis for studies in traditional Indian medicine.

President of the Central Council of Indian Medicine (CCIM) Raghunandan Sharma told TOI in an exclusive interview here on Saturday: "The move to have a separate entrance test was finalised on Friday at a meeting of representatives from the council and the Union health ministry's department of Ayurveda, Yoga & Naturopathy, Unani, Siddha and Homeopathy (AYUSH)." The CCIM is the apex regulatory body for education in traditional Indian medicine.

According to Sharma, the need to ensure timely completion of the annual admission process for degree courses in Indian medicine has spurred to decision for entrance test. "Medical (MBBS) and dental (BDS) courses often consume a major portion of the admission period for health sciences," he said.

As a consequence, the colleges offering studies in Indian medicine end up running against the October 31 cut-off date set by the Supreme Court for completion of admissions, he added. "Also, they (colleges) have to be content with the leftover of the aspirants for health science seats," he said.

In Maharashtra, the MHT-CET, a combined entrance test for health sciences, engineering and pharmacy courses, forms the basis for admissions to all health sciences and allied courses like MBBS, BDS, Ayurveda, Homeopathy, Unani, Nursing, Physiotherapy, Occupational Therapy, etc.

Sharma said, "We are now writing to all the state governments to formulate independent entrance test scheme for courses in Indian medicine with a view to introduce the test from academic year 2010-11."

The CCIM has consistently hit the headlines in the last two years for adopting a carrot-and-stick policy towards making the colleges overcome a slew of deficiencies regarding basic infrastructure and academic standards. "We have been constantly emphasising on a no-comprise policy for quality education and have gone to the extent of shutting down 107 colleges last year (2008-09) across the country. Measures like this spurred an improvement as we now have only 78 colleges shut down this year (2009-10) and 35 of these are border-line cases," he said.

Sharma said, "Starting this year, we have decided to follow a time-bound schedule for assessment of colleges on different parameters concerning infrastructure and academic standards. The assessments will begin from December-January and will be completed by April with our recommendation to the government for admissions at the assessed colleges. This will lead to timely commencement of admissions in July."

He said, "The CCIM will implement the gradation scheme that envisages A' grade for colleges meeting more than 90 per cent of the overall performance parameters and B' and C' grades for colleges meeting upto 90 per cent and upto 80 per cent parameters, respectively."

Those colleges graded in C' category will be given three years time to upgrade themselves to B' category while those graded B' will be given two years time to upgrade to A' category, he said. "The fee structure at these colleges will also be linked with the grade they score," he added.

Sharma said, "The gradation scheme will come into force over the next six months considering the time that needs to be given to the state governments and the colleges to understand and appreciate the scheme in a proper perspective."

The Indian medicine education faces a high level of about 30 to 35 pc shortage of qualified teachers. Asked how the CCIM proposes to tackle this problem, Sharma said, "The thrust has been on sanctioning greater number of post-graduate (PG) colleges in Indian medicine. We sanctioned 20 PG colleges this year. At the same time, the retirement age for teachers, which varies from 55 to 60 years in different states, has set at a uniform age of 65. These measures will help bring down the teachers shortage by 15 per cent."

From 2010-11, the CCIM will also introduce 14 new diploma courses on specialisation in Ayuurveda like panchakarma, child care, diet, etc, he said. The council has further recommended to the government to incude private unaided colleges in the centrally-sponsored scheme for upgradation of colleges. "Till recently, the scheme was applicable to only government-run colleges and now the grant-in-aid colleges. We have proposed its extension to the private colleges too."

Link: Original Article

November 24, 2009

PM Gordon Brown to curb entry of professionals, doctors to UK

Prime Minister Gordon Brown today pledged to curb the entry of doctors and other professionals from outside Europe into the UK in a new crackdown on immigration, a move likely to adversely impact thousands of Indians.

Signalling a major shift in the Labour government's immigration policy, the Prime Minister vowed to "stem rising tide of migration". He said his government plans to restrict the points based system for determining which migrants can work in Britain.

"One of the reasons that immigration will fall is the tightening of the new points system and it will continue to tighten over the next few months," Brown told the Daily Mail in an interview ahead of a major speech on immigration today.

Link: Original Article

India has the largest number of stunted children: UNICEF

Underlining the dismal state of health and nutrition in Indian children, a UNICEF report says that the country has a whopping 61 million stunted children, the largest in any country. In other words, 3 out of 10 stunted children are from India distantly followed by China that has 12 million children.

Stunted growth is a consequence of long-term poor nutrition in early childhood. Stunting is associated with developmental problems and is often impossible to correct. A child who is stunted is likely to experience a lifetime of poor health and underachievement, a growing concern in India that is demographically a young nation. Astoundingly more than 90% of the developing world's stunted children live in Africa and Asia.

The findings of the `Tracking progress on child and maternal nutrition' also point out that undernutrition contributes to more than a third of all deaths in children under five. Undernutrition is often invisible until it is severe, and children who appear healthy may be at grave risk of serious and even permanent damage to their health and development.

Linking malnutrition to gender equality, the UNICEF report also says that children's health suffers not just due to poor hygienic conditions and lack of nutritional food but also because the mother herself is suffering from anaemia and malnutrition during adolescence and child-bearing. "They become trapped in an intergenerational cycle of ill-health and poverty,'' says the report.

Of all the proven interventions, exclusive breastfeeding for the first six months together with nutritionally adequate foods from six months can have a significant impact on child survival and stunting, potentially reducing the under five child mortality by 19% in developing countries. The report includes data showing that 16 developing countries successfully increased their exclusive breastfeeding rates by 20%, in periods ranging from 7 to 12 years.

Link: Original Article

School health clinics prove ineffective

Despite endeavours by health department towards good health of schoolchildren studying in government schools, it is sad that due to lack of cooperation from government schools, the school health programme has been rendered largely ineffective.

School health clinics were formed long back. Under related programmes, thorough check-up of students studying in government schools was planned. These check-ups comprise physical check-up that includes dental, eye, and skin examination. In case of primary school, it is mandatory for the school health clinic doctors to do the check-up done twice a year while for secondary schools, it is required once a year.

A health department official said there was lack of cooperation from schools as ground-work including issuance of cards to students with regard to their check-up was yet to be completed. Moreover, instructions given to teachers with respect to children’s health have not been conveyed to the latter.

A teacher from a government school said it was very difficult for teachers to complete the work pertaining to schoolchildren’s health as they were overburdened with duties relating to mid-day meals and other work. Teaching work was suffering, the teacher said.

Notably, during the pulse polio campaign, employees of the health department had made a complaint to the civil surgeon that school authorities had not allowed health employees to administer polio drops to children studying in their schools. Authorities in such schools are said to have feared that parents of students might object to the idea. Health department identified 15 such schools in posh areas.

Dr Manu Vij, incharge of the school health programme, said it was true that most of the schools did not cooperate with the health department staff that had visited schools to examine children. He added that if schools cooperated with them, a lot of improvement could be effected in the school health clinic programme results.

Link: Original Article

November 07, 2009

Postage stamp in name of Apollo Hospitals released

Union Communication and IT Minister A Raja today released a postage stamp in the name of Apollo Hospitals and said the group has made important contributions towards the healthcare services in the country.

"The Apollo Hospitals is contributing its best to health services especially to the people of Tamil Nadu," Raja said.

Speaking on the occasion, Tamil Nadu Deputy Chief Minister M K Stalin said "The uniqueness of Apollo Hospitals is that it has good doctors, better equipment and offered world class treatment.

Link: Original Article

Comics take medical science to kids

When Sanjana Ramesh (13) was diagnosed with Type 1 diabetes six months ago, she was only told the name of the condition and to take insulin regularly. "When I asked the doctor what was happening to me, she told me You are becoming too sweet.' I don't know if they thought I was too stupid to understand my medical condition or if they were worried about scaring me. I tried searching for information on the internet and in medical books, but those details were too heavy for me to grasp," Sanjana says.

Every day doctors diagnose children like Sanjana with medical conditions they don't understand. But the launch of Medikidz in the country could change a scenario where parents and paediatricians feel that children are too young to understand medical concepts or that they are better off not knowing. Medikidz presents medical conditions, their prevention and treatment through the adventures of five superheroes - Pump, Chi, Skinderella, Gastro, Axon and his pet robot Abacus. For example, the book on asthma shows the super heroes passing through the food pipe of a giant human model and experiencing spasms of the respiratory tract. Another one on diabetes shows a visit to an insulin factory called pancreas.

"Medikidz has done a great job by coming up with a product to empower ill children and their parents with the information they need, so they can get better medical care, in partnership with their doctor. Information therapy can be powerful medicine. Ideally, every clinic, hospital, pharmacy and diagnostic center should have a patient education resource center, where people can find information on their health problem," says Dr Aniruddha Malpani, medical director of the Health Education Library for People in Mumbai, which provides free materials for patient education.

Dr Kim Chilman Blair and Dr Kate Hersov from New Zealand created Medikidz to empower children with medical information that will help them take charge of their health. So far the team has created 42 titles of around 30 pages each. "We want to cover 300 topics, including the most common and the rarest conditions. The books won't answer all your questions, but they will start a dialogue on the subject and a thirst to learn more about it. We tasted success when a child with epilepsy told us that he could tell other children why he had to take anti-convulsion pills every day that he didn't have to hide his condition from his friends anymore," Dr Kim says. They are working on A(H1NI1) flu, attention deficit hyperactivity disorder and autism now.

Medikidz has also published brochures explaining how MRI and CT scans, ultrasounds, X-rays and bone scans work and what the equipment does, so children are not nervous when they enter the machines. More titles are on the way. Siddhartha Jegannathan, director India, Medikidz, says, "We want the brochures in all diagnostic labs and hospitals that conduct these tests, so that children can read them before they take the tests. This way they'll be less nervous and there will be no need for sedation." The current series is targeted at children aged 10 to 15 years. A new series for children of five to 10 years will be out in six months.

Medikidz is in discussion with Philips Healthcare for funding their book on sleep apnea. Vice-president and business head of Philips Healthcare India Anjan Bose says, "We find that when information on medical conditions are provided in booklets, they are just left on the table, but this novel way of reaching the message to the people will help people go for check ups on time because they will know the complications that could arise out of neglecting such a condition."

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