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Indian Health Care Sector

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Re: Indian Health Care Sector

Postby SSridhar » 22 May 2014 07:57

No Reason to Cheer on Maternal Mortality Rate - Edit, The Hindu
On the face of it, India may appear to have made great strides in reducing the maternal mortality rate by 65 per cent, from 569 per one lakh live births in 1990 to 190 in 2013. But scratch the surface, and the real picture emerges. In 2013, India had 17 per cent (50,000) of the global maternal deaths. Together with Nigeria at 14 per cent (40,000), the two countries accounted for one-third of total global maternal deaths. The MMR of 190 last year is much higher than the government’s target of below 100 by 2012. Also, India is yet to achieve the expected average annual maternal mortality rate decline of 5.5 per cent or more during the period 1990-2013 to reach the Millennium Development Goal 5 target. With only a 4.5 per cent decline in MMR during the last 23 years, the country falls under the “making progress” category and would fail to meet the MMR target of 109 before 2015. The only silver lining is that India has been making steady progress in reducing the MMR since 1990. But for a country where an estimated 26 million deliveries take place annually, the absolute number of maternal deaths continues to be high.

Besides the medical reasons like severe bleeding and infections after childbirth and high blood pressure levels during pregnancy, one of the factors that is playing a big role in maternal mortality is the lack of skilled care “before, during and after childbirth.” {Indian women suffer from iron deficiency which causes bleeding} Maternal mortality is counted when deaths occur during pregnancy or in the first 42 days after the birth of the child, caused either directly or indirectly by pregnancy. One way of tackling this is by having more institutional deliveries. India launched a programme in 2005 to facilitate such deliveries on a larger scale than was prevalent, but the results were not encouraging: there was no corresponding decline in the number of deaths. The reason for that is not difficult to find. In 2008, more than 50 per cent of women in Uttar Pradesh and Bihar, and 41 per cent in Rajasthan, continued to deliver at home, according to a United Nations Population Fund-India report. Therefore, a greater focus on increasing the number of well-trained birth attendants should go hand in hand with promoting institutional deliveries. According to a 2008 UNICEF report, the quality of training of such attendants has been found to be “poor” in these three States that fare badly. The 2013 UNICEF report also found many other inadequacies contributing to poor outcomes when deliveries took place in health centres. Insufficient availability of health workers at primary care levels and “gaps” in the availability of equipment and supplies are some of them. The need for India to take up a more serious and multi-pronged approach to bring down the MMR cannot be overemphasised.


Some statistics (c. 2012)

Code: Select all

Andhra Pradesh   110
Karnataka        144
Kerala            60   (Best in the country)
Tamilnadu         90
Assam            328
Bihar            219
Rajasthan        255
U.P.             292
Gujarat          122
Punjab           155
Maharashtra       87
West Bengal      117

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Re: Indian Health Care Sector

Postby Prasad » 05 Jun 2014 07:11


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Re: Indian Health Care Sector

Postby manju » 05 Jun 2014 10:42

Just read on news that the reason for Munde's death was due to internal abdominal organ bleeding.

I am not privy to the details of the events and so my comments below are not about the kind of care he got in the hospital.

The are my general observations about emergency medical care in our country.

It is a known fact that for the quality of doctors and equipment that we have in India our quality in emergency systems and care sucks, including acute trauma care.

One common theme seems to be that in trauma the treatment team usually focuses on the external injury without doing a systematic system by system review and evaluation.

It is a standard operating procedure in trauma to review all systems and especially to look for internal bleeding and spine and head injuries and others which are life threatening but may not have obvious external signs to begin with. If diagnosed early some of thees can be easily treated. As in Munde's case it appears he may have had splenic rupture/bleed which if not treated is fatal. However, if diagnosed early it needs removal spleen which is not a very complicated procedure.

As a b-rakshak.. am proud to say that I have got some Emergency Docs from my university in Massa/khanland sign an mou to do a Emergency Medicine training in Karnataka thru RGHUS..

It is such a coincidence that my desi friend (another hakim) and my colleague were chatting about how to tailor the training 2 days back ( must have been about the time Munde was struck by the car). We specifically talked about trauma and how usually most doctors in India are not trained to focus on internal bleeding during accidents/trauma. Hope this will help save lives!

All we need is a major reorientation and change in attitude. As I said above we have the skills and equipement. We need to change some attitudes and tweak our priorities.

My 2 naya paisa

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Re: Indian Health Care Sector

Postby SSridhar » 12 Jun 2014 13:04

Focus on providing quality healthcare in Tamilnadu - The Hindu
After concentrating on ensuring medical treatment to all persons through its hospitals for the past several years, the health department is now focusing on offering quality healthcare through its institutions and hospitals associated with its insurance scheme.

At a meeting held on Wednesday, representatives from 700 private hospitals, officials involved in the insurance scheme and World Bank officials discussed ways to improve the quality of treatment offered under the Chief Minister’s Comprehensive Health Insurance Scheme. So far, the scheme had benefited seven lakh persons at a cost of Rs. 1,500 crore. Under the scheme, the government has earned Rs. 500 crore.

An official of the Tamil Nadu Health Systems Project, which had organised the meeting said: “We have 700 small and medium-size private hospitals empanelled with us to provide treatment under the insurance scheme. These hospitals with bed strength of around 30 to 50 and 10 to 20 doctors each depend on our support and therefore the government has a right to demand quality.”

The official said, the government would stipulate minimum standards for a hospital to remain empanelled. “The hospitals will have to toe the line as 40 to 50 per cent of their income in the middle and smaller hospitals is due to being part of the insurance scheme,” the official added.

This is part of the process of helping these smaller hospitals also get accreditation.

On its part, the department had sought to break down the criteria into three parts. The National Board of Accreditation for Hospitals and Healthcare Providers (NABH) had been approached to divide the criteria into three levels: entry, progression and final stage. The advantage is that hospital administrations would have achievable goals and the process of achieving the accreditation will also be faster. This will motivate government and private hospitals to improve quality, TNHSP officials say.

According to health department officials the government hospitals in Aruppukottai and Manapparai were in the final stages of achieving accreditation.
{This would be a big achievement for government hospitals}

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Re: Indian Health Care Sector

Postby alexis » 13 Jun 2014 11:52

How effective is meningitis vaccine? The paediatrician is insisting on one but is very expensive.

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Re: Indian Health Care Sector

Postby member_28108 » 13 Jun 2014 20:07

alexis wrote:How effective is meningitis vaccine? The paediatrician is insisting on one but is very expensive.

I would recommend taking all vaccinations recommended - they prevent a host of diseases which are exactly "preventable"

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Re: Indian Health Care Sector

Postby Prem » 20 Jun 2014 04:22

http://www.firstpost.com/india/in-chenn ... 74417.html
In Chennai traffic, a 'Green Corridor' for a human heart saves patient's life


Hvovi Minocherchomi, a 21-year-old BCom student from Mumbai, suffering from swelling of the heart (dilated cardiomyopathy), was admitted to the Fortis Malar Hospital in Adyar, Chennai. According to a report in The Times of India, when a matching donor heart was found in the Government general hospital located 12 km away, a medical team transported the heart to the Fortis hospital in less than 14 minutes by creating a 'green corridor', that is, a route without any red lights.
A human heart can be preserved for up to 4 hours, but the chances of the recipient's survival are higher if transplant takes place early. The report explained that the Government hospital doctors informed their Fortis counterparts about the availability of the heart from a brain-dead patient at 5:45 am. The situation was also explained to the police.Immediately, additional commissioner of police (traffic) Karunasagar began co-ordinating the creation of the green corridor. C Kathir was selected as the ambulance driver.By afternoon, deputy commissioner Sivanandan had posted 26 officers at 12 intersections and the police were ready with the corridor, most of it along the Beach Road and Santhome High Road, two of the busiest roads in Chennai.

The report stated that the loading of the heart into the ambulance began at 6:39 pm and the ambulance left the Government hospital at 6:44 pm. "As it passed each signal - touching 100 kmph at times - a pilot radioed in the location to the control room as also the police teams along the corridor. It reached Fortis at 6:57 pm," said the report."As soon as the heart was brought, the transplant began. By 10.15 pm, the heart was beating in the patient's chest," Dr Suresh Rao, chief anesthetist at Fortis hospital, is quoted as saying in the report.The report added that the heart was harvested from a 27-year-old man who, ironically, had died in a traffic accident. Luckily, the recipient's and donor's blood group and body weight matched, making the transplant possible.Another report in The Times of India said that Hvovi had been suffering from the disease for four years. "(She) had decided to go to the US for a transplant.
The report in The Times of India added that the heart surgery was led by Dr KR Balakrishnan. "The reason behind creating a green corridor was to transport the heart as fast as possible so the outcome of the surgery would be better. The heart has a better potential when transplanted faster," he said in the report.

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Re: Indian Health Care Sector

Postby nawabs » 06 Jul 2014 13:08

Patients have become consumers and they are the losers: Dr Samiran Nundy

http://timesofindia.indiatimes.com/Home ... 875974.cms
Dr Nundy, chairman of the department of surgical gastroenterology and organ transplantation at Sir Ganga Ram Hospital and editor-in-chief of the journal, Current Medicine Research and Practice, stirred a hornet's nest with his recent editorial on corruption in healthcare in India in the British Medical Journal. The editorial exposed the widespread practice of doctors taking cuts for referrals and pre scribing unnecessary investigations and procedures for profit. Dr Nundy talks to Rema Nagarajan about the urgent need to fight this corruption to deliver trustworthy and quality healthcare to the people.

Corruption in healthcare is not new. Why did you choose to write about it now?

The corruption existed, but I guess I thought nothing could be done about it.

Most people think, why get involved when nothing will come of it. Then I saw the Australian doctor's article about his experience of widespread corruption while practicing in India. And I thought I ought to do something as, at this stage in life, I have little to lose in life, I have little to lose by sticking my neck out.

Do you think things can change?

There is tremendous hope. After my article, many senior doctors called me to say they want to join me in a movement against corruption in medi cine. To begin with, the Medical Council of India (MCI), currently an exclusive club of doctors, has to be reconstituted. Half the members must be lay people like teach ers, social workers and patient groups like the General Medical Council in Britain where, if a doctor is found to be corrupt, he is booted out by the council.

How do doctors get away by doing unnecessary procedures?

Audits of all procedures and interventions done in each department ought to be mandatory. It does not happen here. In the US and the UK surgical departments cannot get certified for training unless they have such regular audits in place. Computerization of records is very important. Doctors have to be taught how to use the electronic system so that all transactions with the patient can be recorded. Nowadays doctors only write prescriptions. Most doctors don't write patient history -what examination was done, investigations carried out, diagnosis and the modality of treatment decided upon.

That makes it easy to track the treatment.

Has the corruption and cut system become worse?

I have been practicing in India since 1976. After the first 21 years in AIIMS, when I shifted to the private sector I was told that I would have to wine and dine the general practitioners (GPs) every Friday as every one got patients referred to them through the GP system. That informal system has been transformed into the cut system with the corporatization of health. Now, marketing managers work on the patients.

Patients have become consumers and they are the losers.

What can be done when majority of the people access healthcare through the private sector?

You cannot ban private practice but you need to regulate it strictly. I believe the patient has the right to choose a doctor charging Rs 100 or Rs 1,000. For instance, a person might choose to eat in the dhaba or in a fivestar, but the quality of food in both places has to be regulated.

What is the fallout of corporatization?

If you are paid more than you think you are worth, you are in big trouble. Working in the corporate sector is a nightmare. They offer crores of rupees as salary. But the small print in the contract says the salary will be reviewed in six months to see if the doctor is able to bring in the money expected. I have heard of people whose salaries went down by 30% after such reviews and some were even forced to leave because they could not deliver the profits expected. They have financial experts who ask doctors to justify the salaries they are being paid, especially if the revenue they have generated for the hospital from investigations and operations falls short of the targets set for them. There are even places where one-third of the doctor's salary is taken away for marketing and they are forced to give talks to GPs and canvass them to send patients.

Why do doctors allow such practices?

It is all very well for an established practitioner like me to pontificate. I am established and I was privileged as I came to the private sector after 21 years in AIIMS. What about young doctors who are starting out? What can they do? The corporate hospitals are the dominant employers. This is happening in top hospitals. No doctor likes this, but they have no choice.

We need to ask ourselves, what kind of a system are we offering our young doctors? Is it possible for them to stay honest in such a system?

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Re: Indian Health Care Sector

Postby manju » 06 Jul 2014 19:08

Your's truly was instrumental in sowing the seeds of this program. Am involved with the training of trainers...

MBBS Students to Take Course in Emergency Care
http://www.newindianexpress.com/cities/ ... 291760.ece
BANGALORE: The Rajiv Gandhi University of Health Sciences (RGUHS) is introducing a subject on Comprehensive Emergency Care and Life Support (ECLS) in the undergraduate medicine curriculum from the current academic year.

RGUHS Vice-Chancellor Dr K S Sriprakash told reporters here on Friday that students need to undergo training in this during their internship.

To teach them, RGUHS will organise a training programme for selected faculties of medical colleges across the state in association with the University of Utah, USA. The training will be held from June 23 to 27.

“In a first, we are training over 15 faculties from different college hospitals,” Sriprakash said. The university aims to train 24,000 faculties in emergency care and life support by 2017.
--------
MBBS students must train in emergency care
http://www.deccanherald.com/content/414 ... gency.html
From this year onwards, MBBS students will have to compulsorily undergo training in emergency medical care during their internship.

Rajiv Gandhi University of Health Sciences (RGUHS) will launch a programme on Monday on Comprehensive Emergency Care and Life Support (ECLS) titled ‘Jeeva Raksha – Saving Lives, Assuring Care’ which will be a mandatory part of the curriculum. .......................


Faculty from the University of Utah, USA : :twisted: I was one of the faculty... jingo's will be happy to know that I was in my traditional panche/veshti all thru 5 days training (this is my normal attire when In Bhaaratha..), There was no lungi dance though! will train the master trainers for this programme. About 15 doctors, including faculty from medical colleges and private hospital professionals, will take part in the training as part of the launch. The session will be spread over five days and the US faculty will visit Bangalore thrice a year over the next five years to train the master trainers who will later train students and other faculty.

The course, RGUHS officials said, combines emergency medical care and life support. It focuses on training at least 100 master trainers every year. In the first phase (the first three years), about 300 master trainers will be trained. Each group of three master trainers will in turn train about 240 interns and doctors every year at a rate of eight batches per year, including 30 trainees per batch.

The programme aims to have at least six master trainers in every district. The idea is to build a capacity to train 24,000 medical professionals per year by June 2017, Sriprakash explained. The university estimates that the course will address the needs of over 40,000 doctors and 4,000 interns in the State every year.

To begin with, the training will be conducted at the skill centre of the Bangalore Medical College and Research Centre. ............

--------------------------------------------
If you search RGUHS ECLS EMERGENCY you will get more links.
Swami Vivekananda Youth Movement (http://svym.org/) facilitated the MOU between Univ of Utah and RGUHS

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Re: Indian Health Care Sector

Postby Vriksh » 06 Jul 2014 22:30

This friday I was a witness to an accident where a young lady on a scooter clipped the back of a car while merging and lost control and fell down and hit her head quite hard. She was not wearing a helmet. I was right behind her when this happened. About a year back I had promised myself that I would take action when I see an accident. So immediately I stopped by car crossways in traffic to create a barrier to traffic in order to ensure a space to take action. Immediately got to her and tried to assess how best to help her. She seemed to be in shock and could not breathe and talk, her fingers were stiff in an unnatural way. Her eyes were not dilated in the sun which seemed to suggest that she was not in any kind of brain damage state (no idea though). After getting rid of the backpack she was wearing, my concern was whether she had a spinal fracture and whether it was wise to move her. Some police folk showed up and were more interested in calling up superiors and starting some kind of criminal investigation. People around me started pointing out that she was bleeding heavily I failed to notice this since I was concentrating on trying figure out a way to move her to hospital as damage free as possible. The crowd started insisting that she be taken to the hospital. Despite reservations I took hold of her by the shoulders and a few others help ease her into a car of a passerby. I noticed that the system we used would have definitely exacerbated any spinal injuries. A group of 4 of us in the patient car and my car took her to a near by casualty ward in less than 20 mins from time of accident. She had lost a lot of blood from her head wound most of it soaking into my clothes and the car seats (thankfully not cloth). A doc in the hospital patched the cut and took CT to see if there were internal wounds etc. She was stable within 2 hours of the accident and her husband came by that time. I washed up as best I could in the hospital and went on to my appointment. A police guy called to take my statement regarding the accident and I told as best as I recollected (in my eyes no fault of the car driver here).

In case this happens again I want to be better prepared and help fellow citizens in the absence of a strong state infrastructure under Indian conditions. Any pointers?

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Re: Indian Health Care Sector

Postby Sudip » 07 Jul 2014 08:15

I am an indian citizen living in US. Last year i joined a volunteer fire department here where I was supposed to take a 4 month long extensive course for EMT (Emergency Medical Technician) from a community college. This is the basic qualification needed for running ambulance services etc. It was a pretty hard and intense challenging course for me (I am engineering background) with practical and written tests and also clinical experience in hospital emergency ward. From your description of the circumstance, the responders should have maintained c spine immobilization, instant bleeding control to prevent her from going in shock etc.

I googled if such training is available in india and it seems like it isnt (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3299154/)

If you want to prepare yourself for such scenarios, you can look up how to use c-spine (there are many youtube videos)

If its road accidents, it would also help to know the mechanism of bleeding control to prevent person from going into shock (pressure dressing, using torniquets etc) and long bone, joints immobilization in case of fractures. Give primacy to ABCs (Airway-Breathing-Circulation) to save lives..

maybe you could buy some c spines, splints online somewhere and keep it as part of an emergency first aid kit in your car.

I can give you more resources if you are interested.

I salute your decision to come ahead and be a good samaritan even if others just prefer to stand and watch. with more people like you, India will change.

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Re: Indian Health Care Sector

Postby manju » 07 Jul 2014 18:31

Vriskh, well done. You saved her life

There is some data now (as per my Emergency Medicien Colleague) that the spinal immobilization is over done. If the injury/accident is not severe enough to cause neurological damage (from spine fracture) it is unlikely a little movement will do more damage. Nevertheless, you still need to be careful with the spine. If there is no hard board to immobilize spine.. stabilizing the next with "Neck Collar" should help.

Other things
- keep the patient flat, especially if bleeding.
- If there is obvious bleeding from any part of body apply compression/pressure with cloth/bandage.

For Docs:
- Do not be distracted by small cuts or wounds to the limbs (especially if there are no obvious fractures). However, you need to put a bandage to cover it so the family does not feel that you are missing the obvious..
- Always look for intra abdominal bleeding and for chest wall bleeding.

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Re: Indian Health Care Sector

Postby manju » 07 Jul 2014 18:36

I will make a statement that will sound as if I am biased against women.

I have noticed, in general more women than men do not have much insight into their ability to read the situation and control the bike in traffic. Sometimes, I am shocked the way they zoom thru non chalantly thru the traffic.

Unlike, the old days the current day scooter are very powerful and can go up to 60-70 kms/hr. However, they are very unstable compared to a regular bike (with gear). I have 150 cc automatic scooter (no gear) and I am shit scare to go beyond 50/hr in traffic. However, if I am on geared bike I fell I have good control even beyond 60kmh

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Re: Indian Health Care Sector

Postby SSridhar » 12 Jul 2014 06:16

4 new vaccines for immunisation scheme to cost ₹3,500 cr more - Business Line
The Government’s outgo on its vaccination scheme is likely to go up by as much as three times, with the introduction of four new vaccines in the Universal Immunisation Programme (UIP), said Ajay Khera, Deputy Commissioner, Ministry of Health and Family Welfare.

Currently, routine immunisation requires about ₹1,000 crore annually, and with the introduction of four vaccines into the UIP — rotavirus, rubella and polio (injectable) and an adult vaccine against Japanese encephalitis — will require an additional ₹3,500 crore, Khera told BusinessLine.

However, this additional cost would mean cost-saving in the long-term in healthcare expenditure. For example, about 80,000 children die from rotavirus infection, which causes severe diarrhoea among young children, every year, besides over 8 lakh hospitalisations. This can be prevented by large-scale Pulse Polio-like vaccination scheme in the country.

An additional ₹1,000 crore also goes into the Pulse Polio campaign. However, the Pulse Polio campaign would be phased out gradually, since the country has received polio-free status. India is now introducing injectable polio vaccine (IPV) into the UIP as a risk-mitigation effort to prevent re-infection.


Khera said the country is likely to start the IPV regime by the third quarter of this fiscal. By mid-2016 the country would be able to shift entirely to IPV.

Cold chain capacity

The Ministry has already started preparing to introduce four new vaccines, which would require at least six months since this would be on a large scale.

For this purpose, the Government would have to review cold chain capacity across the country, since these vaccines would need to be stored in cold chains to retain efficacy, besides sensitising and preparing healthcare workers in anganwadis, establishing new operating guidelines and mobilising communities to raise awareness about these new vaccines.

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Re: Indian Health Care Sector

Postby Vriksh » 13 Jul 2014 17:17

Apart from reaching her to the hospital fast I don't think we did anything extraordinary. This sort of help is available throughout India whenever you are injured. The one thing that could have been available is a foldable stretcher with straps and a first aid kit to stop bleeding.

Is there a place I can get this and keep it in the car. I looked online in India and could not find a good foldable stretcher with straps and a way to keep the neck stable

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Re: Indian Health Care Sector

Postby SSridhar » 31 Jul 2014 08:49

A need to turn the corner on child health - Mathuram Santhosham, The Hindu
At 400 million, India is home to the world’s largest child population. More than 50 per cent of the children are malnourished and almost 50 per cent of them do not attend school. That’s the state of our country, soon to have the world’s largest young population.

Under-five mortality

In 2012, almost 14 lakh Indian children under the age of five died due to preventable diseases including pneumonia, diarrhoea and measles. Let’s put this into perspective by doing a comparison with the number of children who died just two decades back.

In 1990, 28.5 lakh children in India died before reaching their fifth birthday. Despite the decline in child mortality, a large number of children are still dying, the death of each individual child being more than just a number. India continues to be responsible for the highest number of child deaths in the world, amounting to 21 per cent of the total global burden of child mortality.

The official estimate of the country’s under-five mortality rate is 56 per 1000 live births, as of 2012. This shows that India is far behind from achieving its millennium development goal of 42 per 1000 live births by 2015. India’s Under five Mortality Rate compares poorly with that of countries in its own neighbourhood; Bangladesh (41) and Nepal (42). It is also worth noting that both have already achieved their respective MDG 4s, unlike India.

Though the World Health Organization (WHO) believes that India has been effectively reducing its infant and maternal mortality figures, thanks largely to the many successful programmes that have been initiated by the Government of India such as the National Rural Health Mission (NRHM), the results have not been satisfactory, especially when it comes to infant and maternal deaths.

The current scenario tells us that a lot needs to be achieved in the next one and a half year. Luckily, the subject has been able to attract the attention of the new government. On July 3, 2014, the Bharatiya Janata Party (BJP) government decided to introduce rotavirus vaccine, rubella vaccine and Inactivated Poliovirus Vaccine (IPV) into India’s Universal Immunisation Programme (UIP), making the vaccines available to all children.

In addition, Japanese Encephalitis vaccines will be introduced in 179 endemic districts across nine States. The government aims to reach 27 million Indian children under the Universal Immunisation Programme targeting, and protecting the largest birth cohort in the world against ten potentially devastating diseases. India reported half of the global polio cases until the year 2009. Thanks to the aggressive polio campaign in the country, India has now become a polio-free country. But the fight against polio is still not over, and as the world moves to eradicate polio once and for all, high levels of safe and effective vaccination with both Oral Polio Vaccine (OPV) and IPV are needed. IPV is a critical part of the strategy to protect against any future risk of outbreak and, as recently reported in The Lancet, a study from Christian Medical College (CMC), Vellore showed that IPV also helps boost the effectiveness of OPV vaccine. Adding IPV to the UIP can contribute greatly to the success of this programme and goal of global eradication.

A bird’s eye view into rotavirus may give us a clear perspective of why the government needed to introduce the vaccine immediately. Diarrhoea alone kills more children across the world than AIDS, malaria and measles combined. It is the second leading cause of child mortality worldwide and India alone accounts for a fourth of global child diarrhoeal deaths.

Rotavirus is the leading cause (>40%) of moderate to severe diarrhoea. As per the 2012 demographic and child mortality data, rotavirus kills more than 50,000 children each year in India. Up to a million more are hospitalised. Dr. Vinod Paul of All India Institute of Medical Sciences (AIIMS) points out that even with improved sanitation, rotavirus will continue to cause diarrhoea as it did in all the developed countries prior to vaccination.

Rotavirus causes rapidly progressing diarrhoea which can quickly lead to severe dehydration and death, especially if children do not receive the appropriate care such as Oral Rehydration Solution (ORS) and/or intravenous hydration. Therefore, it is essential to introduce a vaccine to save lives and prevent serious disease. Globally, more than 55 countries already use the rotavirus vaccine as part of their immunisation programme.

Economic implications

The rotavirus vaccine has economic implications as well. With up to one million rotavirus hospitalisations each year, many Indian families are pushed below the poverty line because of this illness. According to estimates, the average cost of hospitalisation for each episode of rotavirus diarrhoea is approximately Rs.3,000, which is equivalent to 7.6 per cent of an average Indian family’s total annual expenditure. Billions of rupees are spent on health care-related costs and the impact on GDP adds up as children do not grow up to contribute to India’s economy.

It is really a historic moment for India to be turning the corner on child health. So much progress has been made on the polio front and we are at the cusp of eradicating the disease. Emphasis is being placed on ensuring that children grow up to lead healthy and productive lives. As a leader vaccine producer, India is poised to move forward as a world leader. Now is the time to make the most out of the government’s decision and do what is needed to make the policy a reality and achieve what has long been missed for India’s children and the nation. As the leading economic power in the region, India has a moral obligation to ensure that every one of its children has access to life saving interventions like vaccines.

(Mathuram Santhosham is a scientist and the recipient of the 2014 Albert B. Sabin Gold Medal Award.)

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Re: Indian Health Care Sector

Postby Prasad » 02 Sep 2014 11:40

The cost for vaccinating a 6 month old kid apparently costs Rs 7,000 in India. Does the govt give free vaccines for people? MMR, Polio(this one is, we all know), HepB etc?

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Re: Indian Health Care Sector

Postby Aditya_V » 02 Sep 2014 13:57

Prasad wrote:The cost for vaccinating a 6 month old kid apparently costs Rs 7,000 in India. Does the govt give free vaccines for people? MMR, Polio(this one is, we all know), HepB etc?


I think govt provides Pentaxim and Polio free of cost, at least these costs are affordable thanks to generics, but some vaccines like Roto Virus etc Govt does not provide. If left the Western Govts and MNC, millions of Indians would have died due to cost of Massa medecines.

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Re: Indian Health Care Sector

Postby govardhanks » 02 Sep 2014 16:46

Modi-Japan and sickle cell anemia(SCA)-

No. of people affected in India- 300,000 children are born every year with this disease.
Traditional treatment- Not effective
Stem cell therapy- Found effective but still under trials(since 2011).
Gene therapy- May be in future.

Short story- Modi seems to have sought help of iPS fame Nobel Laureate S Yamanaka, Yamanaka has insisted he would like Indian scientists to conduct research at the institute.

Stem cell therapy NIH report-
Thirty patients, ages 16 to 65, with severe sickle cell disease enrolled in the study between 2004 and 2013. The patients first underwent a less toxic regimen to kill off some of their marrow cells. They then underwent a stem cell transplant, receiving cells donated by a healthy brother or sister.
The team found that the stem cell transplant reversed the disease in 26 of 30 patients (87%). The patients had normal hemoglobin, fewer hospitalizations, and lower use of narcotics to treat pain from the disease. The patients didn’t experience graft-versus-host disease—in which donor cells attack the recipient—after a median follow up of 3.4 years. Fifteen patients successfully stopped immunosuppression medications a year after the transplant. The treatment was unsuccessful in 4 patients, and some complications, such as infections, occurred.

Courtesy NIH - http://www.nih.gov/researchmatters/july2014/07142014sickle.htm

Ref-
http://icmr.nic.in/ijmr/2013/september/0901.pdf
http://www.thehealthsite.com/news/modi-proposes-india-japan-tie-to-beat-sickle-cell-anaemia/
http://newsroom.ucla.edu/releases/ucla-stem-cell-gene-therapy-for-246937
http://www.sciencedaily.com/releases/2013/07/130701135032.htm
http://www.hopkinsmedicine.org/news/media/releases/correcting_sickle_cell_disease_with_stem_cells

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Re: Indian Health Care Sector

Postby panduranghari » 03 Sep 2014 17:30

Prasad wrote:The cost for vaccinating a 6 month old kid apparently costs Rs 7,000 in India. Does the govt give free vaccines for people? MMR, Polio(this one is, we all know), HepB etc?


Vaccines is the most efficient way for doctors in India to make money. GOI should be able to step in and make the costs uniform all over the country. This is essential as some doctors charge ridiculous amounts just because they can.

This is a good suggestion for MyGov.in. Some one could please do the honours, for some reason I cannot register though I have tried.

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Re: Indian Health Care Sector

Postby Varoon Shekhar » 23 Sep 2014 17:49

Canada based forum readers would be familiar with the recent news of a few Indian made generic medicines being investigated, and the controversy around why Health Canada allowed certain drugs from India, that the US FDA banned. Question is, why is the US FDA, and the US FDA alone, spotting all these supposed anomalies and irregularities in pharmaceutical research and production in India? Why aren't the officials from France, Australia, Africa, Eastern Europe and Russia, South America as well as Canada, also not detecting these alleged defects and deficiencies? The drug agencies of all these countries can't all be corrupt or inept.

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Re: Indian Health Care Sector

Postby vivek_v » 24 Sep 2014 11:04

Prasad wrote:The cost for vaccinating a 6 month old kid apparently costs Rs 7,000 in India. Does the govt give free vaccines for people? MMR, Polio(this one is, we all know), HepB etc?


To the best of my knowledge there are two types of vaccines in India which are

a) Normal syringe type a.k.a painful type. These cost only Rs:1000 in any place. These Vaccines are also normally associated with some minor fever and other minor side effects associated with Vaccinations.

b) Painless type of Vaccines. These cost around Rs:7000 and are expensive. Absolutely no side effects, plus they vaccinate against multiple conditions.

Nowadays due to better financial status and people having only one kid prefer the Painless type and hence Vaccines looks costly. Actually for my kid it costed around Rs: 21,000 in Painless vaccines till now and is the normal rate across all hospitals, give or take a few hundred rupees.


Varoon Shekhar wrote:Canada based forum readers would be familiar with the recent news of a few Indian made generic medicines being investigated, and the controversy around why Health Canada allowed certain drugs from India, that the US FDA banned. Question is, why is the US FDA, and the US FDA alone, spotting all these supposed anomalies and irregularities in pharmaceutical research and production in India? Why aren't the officials from France, Australia, Africa, Eastern Europe and Russia, South America as well as Canada, also not detecting these alleged defects and deficiencies? The drug agencies of all these countries can't all be corrupt or inept.


US FDA from my personal experience (consumer wearable healthcare devices) is generally more strict and a lot more through.

Right from Documentation, Clinical trials, Independent lab Testing, Production, Reporting, Storage, Transport and Tracking they tend to have a few more clauses and test cases than what CE (Europe) would specify for a similar device. There is no conspiracy theory against any country, US FDA is lot more strict, that's all.

Edit:

I see a lot of grief on people saying India does not do enough R&D or products. Would like to say that an Indian Team which we named after God of medicine as "Danvantri" is among top 10 in an $10 Million (from a initial of 300+ teams) X-Prize Health sciences competition named "Tricorder X-Prize". Please do check the links below :) ,

Tricorder X-Prize link:

http://tricorder.xprize.org/teams/danvantri

Actual R&D design product link:

http://www.amibolt.com/vitalsfit/

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Re: Indian Health Care Sector

Postby Sanjay » 25 Sep 2014 00:08

Anyone see this:

http://www.thehindu.com/news/national/p ... 423712.ece

Is Infant mortality now 29/1000 ? If so this a huge achievement !

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Re: Indian Health Care Sector

Postby panduranghari » 25 Sep 2014 12:56

Tweets by Kanchan Gupta

Decontrolling prices of cardiac and diabetes drugs (just before PM's US visit; coincidental?) is not good news. 1.d


Order enforced in June to control prices of cardiac and diabetes drugs quietly annulled. Seems huge pressure mounted by big pharmas. 2.d


India faces steep rise in cardiac issues and diabetes. Pharmas want to reap whirlwind profits. Hence huge pressure to remove controls. 3.d


Strangely and silently crucial clause allowing Govt to add drugs to price control list has been removed. That also nullifies June order. 4.d


Instead of bunk, here is a story which media should go to town with. Millions impacted by decontrolling cardiac and diabetes drugs. 5.d


What is intriguing is that cardiac and diabetes drugs were put on control list in June. What changed between June and September? 6.d


Did MNC pharmas put pressure to nullify June order? If yes, why did Govt cancel order? Is there a US link to this? 7.d


Direct impact: Anti-asthma, anti-cancer, anti-HIV, anti-TB and anti-malarial drugs and vaccines will now be beyond price control. 8.d



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Re: Indian Health Care Sector

Postby Sanjay » 25 Sep 2014 21:14

I have been reading and re-reading that Hindu article and looking for other data. But if it is the case that India did reduce its IMR to 29, that is a near miracle - does anyone have any insight ?

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Re: Indian Health Care Sector

Postby Rahul M » 29 Sep 2014 21:52

x-post

I have same question.
Prasad wrote:Forget turdesai.

Whats the reason for increasing the prices of heart, diabetes, cancer related drugs recently?



someone with links to pharma (sunilupa ?) please weigh in.

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Re: Indian Health Care Sector

Postby Rahul Mehta » 02 Oct 2014 07:09

from NaMo policy thread

abhijitm wrote:^ yes I agree about cancer drugs. Its so confusing why they did that? Cancer is so common these day. Its like we are sitting on a time bomb. I have a cousin and a friend, both under 40, diagnosed with cancer in last 12 months. I have one death by cancer in my social circle in last 6 months. Four women in my social circle have had breast cancer. And its not that I know 100s of people. Like any middleclass working person I know very limited number of people. Its really alarming. The trauma, frustration. And then the treatment makes you pay through the nose.


The rise in cancer is because refusal of MPs across parties to print law-drafts to decrease use of chemical pesticides etc in agriculture.

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Re: Indian Health Care Sector

Postby Kamal_raj » 06 Oct 2014 02:58

'In 1976 I discovered Ebola, now I fear an unimaginable tragedy

http://www.theguardian.com/world/2014/o ... t-outbreak

Will our health care sector cope with this? I hope things are under control in Africa.

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Re: Indian Health Care Sector

Postby Varoon Shekhar » 06 Oct 2014 03:39

Some Indian pharma companies-Sun/Ranbaxy, Apotex, IPCA, GVK, Wockhardt and one or two others, have received some adverse publicity recently, because they, or a few of their products, did not match the standards of the US FDA. European and Canadian drug agencies are now scrutinising the Indian companies more, and have started sanctioning certain units from India. Will other countries follow suit?

Can anyone post any links or articles which portray Indian generic drugs in a good light? There must be many good news items about Indian pharmaceuticals. There is of course that great success of Cipla with AIDS medications in Africa.

But what about the rest? Where are the positive news stories about Indian generics throughout the world, and within India itself? Since India accounts for a significant portion of all generic medicines worldwide, common sense alone tells you that a majority of the products would be satisfactory, if not better.

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Re: Indian Health Care Sector

Postby panduranghari » 06 Oct 2014 18:27

^ I know a guy in UQ who buys Indian drugs from India and sells them in Africa. He is doing well. As local African doctors dont mind where the drugs are coming for, as there are drugs which are not exorbitant. I believe many Americans do the same when they visit India or they travel to Cuba for buying generics.

However, the drug companies - GSK specifically - has used the might of the British government to prevent access of cheap generics to Africa. And they tried the same in China. But were caught and now they are facing execution. They wanted Chinese government to stop using Indian drugs as a state policy.

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Re: Indian Health Care Sector

Postby Kamal_raj » 07 Oct 2014 20:46

Suspected Ebola case causes panic in Manipur

http://www.thehindu.com/sci-tech/health ... 475140.ece

I am increasingly concerned about ebola. There has been a case in Spain where the nurse got the virus in spite of using protective clothing. Spanish authorities are investigating how this occurred?

I hope the current health mister and the government both local and centra are taking this very seriously because there is no way to stop this if it gets to Mumbai or kolkotta or any of our mega cities.

Nigeria needs to be watched closely as there are many Indians there and they will start coming back and in turn spread the disease in India.

Regds

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Re: Indian Health Care Sector

Postby sunilUpa » 08 Oct 2014 05:04

Rahul M wrote:x-post

I have same question.
Prasad wrote:Forget turdesai.

Whats the reason for increasing the prices of heart, diabetes, cancer related drugs recently?



someone with links to pharma (sunilupa ?) please weigh in.


Sorry saw this just now.

AFAIK, there is no increase in prices of the above. The Generics are still available at very low cost in India.

Price control is wrong way to provide affordable medicine to the needy. Govt. should subsidize it by providing insurance. Why on earth pharma companies should sell something under loss?

By the same logiv why there is no price control on food and housing?

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Re: Indian Health Care Sector

Postby sunilUpa » 08 Oct 2014 05:14

Varoon Shekhar wrote:Some Indian pharma companies-Sun/Ranbaxy, Apotex, IPCA, GVK, Wockhardt and one or two others, have received some adverse publicity recently, because they, or a few of their products, did not match the standards of the US FDA. European and Canadian drug agencies are now scrutinising the Indian companies more, and have started sanctioning certain units from India. Will other countries follow suit?

Can anyone post any links or articles which portray Indian generic drugs in a good light? There must be many good news items about Indian pharmaceuticals. There is of course that great success of Cipla with AIDS medications in Africa.

But what about the rest? Where are the positive news stories about Indian generics throughout the world, and within India itself? Since India accounts for a significant portion of all generic medicines worldwide, common sense alone tells you that a majority of the products would be satisfactory, if not better.


Some Indian companies have cut corners and have been penalized heavily. Most of the transgressions have to do with data manipulation a.k.a passing the failing batches by testing them again and again or failing to do proper investigations. This is mostly due to 90's style management still prevalent in Indian pharma companies where no bad news is tolerated. Dr.Reddys is a rare exception.

There is also major push in the US to bring manufacturing sector back to the US.

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Re: Indian Health Care Sector

Postby Rahul Mehta » 08 Oct 2014 14:46

sunilUpa wrote:AFAIK, there is no increase in prices of the above. The Generics are still available at very low cost in India.

Price control is wrong way to provide affordable medicine to the needy. Govt. should subsidize it by providing insurance. Why on earth pharma companies should sell something under loss?

By the same logiv why there is no price control on food and housing?


Has the prices non generics increased after removal of price cap? Any idea on highest increases? The rumor mill says that some medicine's price went from Rs 9000 to Rs 100,000 . I asked local pharma people around me. They didnt know , as they didnt deal with such high end medicines.

The price cap on foreign medicines makes sense, because property rights and fairness dont exist outside borders. eg USA looted Iraqi oil and its all fair in international politics. So if a foreign medicine company gets looted, it is always fair. Rest is OSF.

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Re: Indian Health Care Sector

Postby member_28108 » 08 Oct 2014 15:52

No I haven't seen an increase. Price dynamics of generics is such that if one were to do that no one will buy those.

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Re: Indian Health Care Sector

Postby sunilUpa » 09 Oct 2014 02:35

What is foreign medicine? If you mean those which are patented, why on earth those companies should sell them at a loss when they have monopoly?

Indian generic market is cut throat. When I was working India, my boss was very happy if I could cut the cost of some generics by 1 paisa...no that's not typo

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Re: Indian Health Care Sector

Postby member_28797 » 09 Oct 2014 03:22

sunilUpa wrote:What is foreign medicine? If you mean those which are patented, why on earth those companies should sell them at a loss when they have monopoly?

Indian generic market is cut throat. When I was working India, my boss was very happy if I could cut the cost of some generics by 1 paisa...no that's not typo


Such ancedotal stories are found everywhere why should anyone trust it?

This forum is filled more with conspiracy theories than facts... and this is supposed to one of the more factual Indian forums out there :roll:

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Re: Indian Health Care Sector

Postby sunilUpa » 10 Oct 2014 09:39

narendranaik wrote:
sunilUpa wrote:What is foreign medicine? If you mean those which are patented, why on earth those companies should sell them at a loss when they have monopoly?

Indian generic market is cut throat. When I was working India, my boss was very happy if I could cut the cost of some generics by 1 paisa...no that's not typo


Such ancedotal stories are found everywhere why should anyone trust it?

This forum is filled more with conspiracy theories than facts... and this is supposed to one of the more factual Indian forums out there :roll:


? Sorry I don't follow you. You mean why you should trust me?

I didn't address you or asked for your opinion.

ever worked in Indian generic industry? 1 Paisa per pill is huge savings when cost of production is 25 paisa.

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Re: Indian Health Care Sector

Postby panduranghari » 10 Oct 2014 12:19

sunilUpa wrote:What is foreign medicine? If you mean those which are patented, why on earth those companies should sell them at a loss when they have monopoly?

Indian generic market is cut throat. When I was working India, my boss was very happy if I could cut the cost of some generics by 1 paisa...no that's not typo


Is there any indigenous R&D to produce new meds within India?

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Re: Indian Health Care Sector

Postby SSridhar » 18 Oct 2014 08:33

“Very, very high” risk of Ebola in India: U.S. expert - Narayan Lakshman, The Hindu
An infectious diseases and public health systems expert at Harvard Medical School has warned that the risk of India seeing an Ebola patient is “very, very high.”

He predicted that India may well have “at least a few cases before the calendar year is over.”

“As long as the outbreak continues in West Africa, the chances that someone will end up in India and then develop symptoms are very high,” Ashish Jha, Professor of International Health at Harvard’s School of Public Health and Director of Harvard Global Health Institute, told The-Hindu in an exclusive email interview.

‘India not prepared’

Professor Jha also noted that in terms of preparedness to deal with a potential epidemic, “the bottom line is that India is probably not as prepared as it should be.”

He said that when the first case crops up, it would likely be at a public hospital in some mid-size or large city, where there may be serious questions about whether the institution had provided sufficient training to manage someone, even temporarily, until substantial expertise could be brought in.

Further, Professor Jha said, he would want to know whether the hospitals had “proper protective equipment they need to care for [an] Ebola patient,” adding that he “worried” about whether hospitals across the country, even those designated as regional centres of excellence in each State, were “really getting the training they need to be safe and effective.



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