Health Innovation: Medical Instrument: Re-design of the conventional needle

Christopher Holden, a student of Northumbria University, UK, studying Design for industry, has re-designed the conventional needle. His design, called 'MediDome', is intended to eliminate needle stick injuries, cross contamination of blood-borne viruses such as HIV and hepatitis and the fear of needles. The design of MediDome ensures that veins would not be ruptured during intramuscular or subcutaneous injection. A soft flexible plastic is used in manufacturing MediDome, pre-filled with a measured drug dose that avoids the need for priming

 

Continue Reading: http://www.asianhhm.com/knowledge_bank/technotrends/redesign_of_the_conventional_needle.htm

Info: Mobile Health Services related links

India:

http://www.sankaranethralaya.org/tele_mobile.htm

http://news.softpedia.com/news/Ericsson-Launches-Mobile-Health-Services-in-India-87383.shtml

http://www.usaid.gov/in/our_work/activities/Health/health_mhv.htm

http://www.smilefoundationindia.org/w_e_smile_on_wheels2.htm

http://posco-india.com/website/press-room/posco-india-initiates-mobile-health-services.htm

News: http://hsprodindia.nic.in/listdetails.asp?roid=134

Indian company who can do the mobile vehicles:
http://www.hddipl.com/

News: http://www.unicef.org/infobycountry/india_40613.html

http://www.cbhi-hsprod.nic.in/sear_desc1.asp?SD=19&SI=30&ROT=1&qryAll=uttarakhand

http://www.shisindia.org/mobile-frame.html

http://www.hsprodindia.nic.in/searnum.asp?PNum=93

http://www.smilefoundationindia.org/w_e_bmms.htm



Outside India:


http://www.farberspecialty.com/Medical/medical.htm?gclid=COfZ19CP2ZQCFQZlswodCWxulw

http://www.sghs.org/body.cfm?id=303

http://www.laboit.com/medical/index.php?gclid=CKKbttmP2ZQCFQsiIgodb14alA

Mobile health vehicle Floor plans: http://tescobus.com/bus/turtletop/health_floorplans.html

Mobile Clinics for sale: http://www.mobilehealthclinicsnetwork.org/forsale.html

http://www.nhchc.org/mobilehealth.html

http://www.dodgenmobiletech.com/products.php?id=16

http://www.armormobile.com/health.htm

http://www.lifelinemobile.com/index.html

http://www.ambulanceproducer.com/mobile-health-clinic/mobile-health-care-vehicle-bus.html

News: http://www.unfpa.org/news/news.cfm?ID=595

http://www.obsinc.net/medical.php

http://www.qualityvans.com/web_pages/medical/medical_van/specialty_vehicle.html

http://www.mobilemedicalinnovations.com/

http://www.americancc.com/clinic.html#

ADI Mobile Health: www.adi-mobilehealth.com

India: Health: Innovative Ideas: Loughborough University takes mobile phone health monitoring to India

Loughborough University engineers have forged a partnership with experts in India to develop their unique mobile phone health monitoring system.
The device, which was first unveiled in 2005, uses a mobile phone to transmit a person's vital signs, including the complex electrocardiogram (ECG) heart signal, to a hospital or clinic anywhere in the world.

 

Created by Professor Bryan Woodward and Dr Fadlee Rasid from the Department of Electronic and Electrical Engineering, the system enables a doctor to observe remotely up to four different medical signals from a freely moving patient. Signals that can be transmitted include the ECG, blood pressure, oxygen saturation and blood glucose level.

Complete story: http://www.lboro.ac.uk/service/publicity/news-releases/2007/09_health_monitor.html

News: Research :India: Texas Instruments (TI) and IIT Kharagpur to collaborate on breakthrough medical technology research

Research projects to lay the foundation for a new generation of cancer diagnostics systems and health care monitoring

KOLKATA, India (April 1, 2008) – Texas Instruments Incorporated (TI) (NYSE: TXN) has signed a collaborative agreement with the School of Medical Science and Technology (SMST), Indian Institute of Technology (IIT) Kharagpur, to develop semiconductor technologies that will help improve the quality, comfort and accessibility of health care.

This is the first time that TI has partnered with any IIT in India on research projects devoted to medical electronics innovation. The announcement was made here today by Dr. Biswadip (Bobby) Mitra, managing director, Texas Instruments India, and Professor Ajoy Kumar Ray, head – SMST, IIT Kharagpur.

TI works with medical device customers across the globe to make quality health care more accessible to more people. In September 2007, the company announced that it would invest a total of $15 million to fund medical technology research at selected universities worldwide with a focus on quality, accessibility and affordability. TI's goal in supporting this research is to help develop new semiconductor technologies for personal medical devices, implantables, medical imaging, wireless healthcare systems and bio-sensor technology. The TI-IIT Kharagpur research collaboration is a part of this effort.

Read complete news: http://smandalbiomed.spaces.live.com/blog/cns!1491D6AD481654F4!231.entry

Profile: Medical Equipment and Consumables: India: Godrej Industries Limited

The medical diagnostics division of Godrej Industries was established in 1992. It used to be known as the biotechnology division, and was under Godrej Soaps Limited before coming into the fold of Godrej Industries, following the change in the company's name in 2001.   The medical diagnostics division has garnered over 2,000 satisfied customers across India. Our customer list includes prestigious institutions in urban areas as well as small ones in remote villages.

Our network consists of three regional offices, in Mumbai, Delhi and Chennai, and distributors all over India.   Visit web-site: http://godrejchemicals.com/medical_diagnostics/

Profile: Diagnsotics: USA: Home Drug Testing Kit

The FDA approved Home Drug & Alcohol Testing Kits are very accurate products. Our instant drug & alcohol testing kits provide rapid results for a very effective alcohol & drug testing solution. They have been compared with the top Home Drug & Alcohol Testing Kits in the nation by independent laboratories and found to be one of the top two with regard to accuracy and reliability. The result is that our drug test is 99.9% ACCURATE and RELIABLE.

Thank you for taking the time to view our website and consider our home drug testing kits for purchase. Click To Buy Drug Tests Online

Home drug testing kits are very EASY to use and GUARANTEED to give you results in 3 to 5 minutes, utilizing a urine or saliva sample. This can be done in the PRIVACY of your own home or business. The results stay with you.

You may want to utilize these test products to help PROTECT the health and wellness of your family members, friends, or business associates that you suspect may be using illicit drugs. As parents or other concerned individuals, should you suspect the use of recreational drugs, this kit would provide help without invasion of your privacy. Our self-help drug test kit provides substance abuse testing of BAR (barbiturates), TCA (tricyclic antidepressants), AMP (amphetamines), BZO (benzodiazepine), NIC (nicotine), Marijuana (THC, pot, cannabis), opiates (OPI, morphine, heroin), PCP, methamphetamines (M-AMP, ecstasy), cocaine (COC), and alcohol.

Click To Buy Drug Tests Online

We also provide information regarding signs of drug abuse, drug side effects, marijuana effects and facts, cocaine side-effects, PCP, M-AMP (ecstasy), and opiate (morphine and heroin) effects. In addition, we have names of substance abuse treatment agencies and their contact information.

Please view the rest of our website and order your drug test kits today! TAKING A SMALL AMOUNT OF TIME NOW TO ORDER YOUR DRUG OR ALCOHOL TEST KITS COULD MAKE A SIGNIFICANT DIFFERENCE IN YOUR FUTURE! Take the time to insure good health—utilize our test kits as a preventative measure today.

 

Visit web-site: http://www.homedrugtestingkit.com/

Profile: Clinical Lab: USA: ANY LAB TEST NOW

Take Control of Your Health.

 
ANY LAB TEST NOW® is a healthcare lab testing facility that provides thousands of standard lab tests to consumers and employers in a professional, convenient and cost-effective way.

TAKE CONTROL OF YOUR HEALTH
There is an alterative in managing your health.  ANY LAB TEST NOW® offers a revolutionary healthcare testing experience by providing thousands of standard healthcare tests in a professional, convenient and cost-effective manner.

THE DIFFERENCE
At ANY LAB TEST NOW®, you don't need insurance, a physician's referral, or an appointment.  To find the location nearest you, please click here.

HISTORY
David Perlow, M.D. founded ANY LAB TEST NOW® in Atlanta, GA in 1992 in an effort to provide affordable medical laboratory testing to the general public. This type of testing is the most cost-effective way to treat and prevent disease.

FRANCHISE OPPORTUNITIES
ANY LAB TEST NOW® is one of the nation's fastest-growing franchise opportunities in the high-margin, high-growth Direct Access Testing industry. If you're interested in owning an ANY LAB TEST NOW® location, click here.

Any Lab Test Now®! - genetic testing, paternity tests, DNA test, dna paternity testing, HIV testing, hiv tests, cancer risk test, STD blood test, pre-employment drug screening, employmee drug screening, female test panels, male tests and many many more..

Visit web-site: http://www.anylabtestnow.com/

 

Profile: Clinical Lab: USA: EconoLabs

EconoLABS is a division of STAT Health Screens, LLC,
a Florida-based business dedicated to providing affordable blood tests and health screens for uninsured and underinsured consumers.Due to the large volume that we generate, we enjoy special DISCOUNT pricing from several major clinical laboratories, which we pass directly to consumers, saving them up to 60% of the customary clinical lab fees.

We service consumers at over 14,000 Patient Service Centers across the United States.

At econoLABS, we offer consumers any lab test commonly ordered by physicians - with or without a doctor's order - with savings of up to 60% off typical laboratory costs; and, a doctor's appointment is not required. Best of all, there are no physician fees, phlebotomy fees or facility fees!

Specimens are collected at collection centers near you and analyzed by the same CLIA-certified, accredited clinical laboratories used by physicians and hospitals across the United States. Within a few days, confidential results are mailed directly to you and/or FAXED to your doctor.

See why thousand of people are using our services.

 

EconoLABS works with major CLIA-Certified Clinical Laboratories and has access to thousands of their Patient Service Centers (PSA) that are staffed by certified laboratory experts and experienced, licensed Phlebotomists.

After we confirm that we have a PSC near your zip code, you can place your order online. Upon receipt of your order we will email you a Requisition Form (and map) to take to the PSA near you. The results are then sent to you via mail, email, fax and or to your physician.

Visit web-site: http://www.econolabs.com/

 

 

Rural healthcare: India: CARE to leverage ITC’s e-Choupals by M. Somasekhar

The successful e-Choupal model of ITC has provided impetus to an experiment in healthcare — a model to provide quality medical facilities to the country's rural heartland.

The Hyderabad-based CARE Group of Hospitals has launched a pilot project in Maharashtra in collaboration with ITC to test this model. The sops, offered in the recent Budget for setting up hospitals in tier II and III cities, such as a five-year tax holiday and insurance schemes are expected to prove beneficial.

The first pilot has been launched in Nagpur, where a 100-bed multi-speciality hospital has been established. This hub is electronically linked to three smaller medical centres in Yavatmal, Wardha and Amaravati. Nearly, 400 villages with a million population are brought into the network. Basically, CARE Hospitals is integrating its primary healthcare delivery model with the e-choupal network.

Typically, one e-Choupal caters to three-four villages. A choupalSagar comprises 40 such e-Choupals.CARE Hospitals has also roped in corporates to develop 'smart devices' to capture basic health information in electronic format, while leveraging the additional bandwidth available with the e-Choupals, according to Dr N. Krishna Reddy, Managing Director of the Group.

Continu reading: http://www.blonnet.com/2008/03/06/stories/2008030652111100.htm

Profile: Pathology: USA: TelePathology Consultants P.C

TelePathology Consultants, P.C. is a professional medical corporation with the mission of promoting the use of telepathology as a clinical, research and educational tool in human pathology.

Our telepathology activities in the Web are for academic purposes only and not for profit.

Telepathology allows consultations between pathologists and other physicians via the Internet and includes the study of images from gross surgical pathology specimens as well as histopathology and cytology specimens.

Please visit their web-site: http://www.telepathology.com/

Profile: Diagnostic Centre: India: Hitech Diagnostic centre, Chennai, India

Hitech Diagnostic Centre was started in the year 1986, by Dr. SP. Ganesan MBBS, DCP and Mrs. Malini Parasuraman M.Sc.,(Biochemistry) with the objective of providing quality and reliable laboratory service at an affordable cost.

The objectives have been achieved by selection of proper equipments, high quality reagents, strict internal and external quality assessment and control backed up by well qualified and dedicated professionals. As a consequence now hitech is accepted as one of the leading laboratories in the southern part of India. We are very glad that apart from the Doctors & Hospitals in Chennai more than 600 labs and hospitals in all over India uses our services.

Constant up-gradation and introduction of new tests and methods to meet the demands of the clinicians has been one of our major aims. We have introduced many new tests. Some is the first time in INDIA, and we were the first one to start full-fledged Molecular Diagnostic Centre in India in the private sector.

Some of the recent introductions are HOMOCYSTEINE, APOLIOPOPROTEINS, Lpa in Cardiac Risk Assessment, TB culture by BACTEC System, CD4/CB8 cell Monitoring in AIDS, and Specific lgE Allergen Testing by Unicap system (RAST). Again we are the first to introduce ROCHE COBAS AMPLICOR fully automated PCR system for the Diagnosis and monitoring VIRAL LOADS in HBV,HCV and HIV.

Members of the Hitech staff take part in many international workshops and conferences, presenting papers and bringing in very valuable technical knowledge, particularly in the Field of Molecular Diagnostics. We are members of professional organizations like American Association of Clinical Chemistry (AACC), International Federation of Clinical Chemistry (IFCC), American Society of Microbiology (ASM) and procedures are underway to obtain NCCLS certification.

For more information, please visit their web-site: http://www.hitechlabsindia.com/

Impact of telemedicine must be defined in developing countries

EDITORThe editorial by Edworthy shows the dangers of external commentary on what is most useful for developing countries.¹ How can we measure the comparative impact of teleconsultation in Uzbekistan or Cambodia with teleconsultation in snowbound northern Canada, telemetry in Norway supporting elderly people at home, or teleradiology avoiding long painful journeys in remote parts of the British Isles? What values do we useeconomic, social, quality adjusted life years, consumer feedback, political position, or provider satisfaction?

More importantly, how do we measure the impact of telemedicine on the health systems of developing countries? Will strengthening secondary care for a few disadvantage basic primary care or environmental health for the many? Will investment in the required rural telecommunications be at the expense of providing drinkable water? Will developing countries too be seduced by the expensive impact of technology led tertiary care for the few, while ignoring the endemic impact of modified health related behaviour? Will opportunistic global traders exploit the vulnerable?

 

Continue reading: http://www.bmj.com/cgi/content/full/324/7328/47/a

Developing Countries Find Telemedicine Forges Links to More Care and Research

By Mike Mitka

PJAMA. 1998;280:1295-1296HYSICIANS in rural America know isolation challenges their ability to keep up with the latest in medical information, techniques, and peer-to-peer consultations. But imagine how tough it is for physicians in developing countries such as Nigeria, Tanzania, and Senegal.

"One of the major impediments to the development and delivery of better health care in Africa is the inability, or at least the limited ability, of health professionals to share and collaborate on research, to participate in patient tracking through databases, to consult with colleagues and medical experts, and to track infectious and emerging diseases," said Nigeria-born Patrick Nta, MS, of Harvard Medical School in an unpublished paper he wrote earlier this year.

Nta advocates using high-tech tools such as the Internet, e-mail, telemedicine, and teleradiology to connect African physicians with each other and with colleagues around the globe.

"A continent with a very high patient-to-doctor ratio should rapidly adapt these technologies as a strategic tool to effectively improve its medical and healthcare delivery system," Nta wrote. "These tools would empower remote health clinicians by giving them access to experts worldwide and locally and would provide the tools and information to help in the diagnosis and treatment of various diseases."

 

^{Continue Reading: http://jama.ama-assn.org/cgi/content/full/280/15/1295?ijkey=34830af2810cfc1fa1b1f0d94ba9c09441aba2d1&keytype2=tf_ipsecsha}

Telemedicine: India: Article: Telemedicine in developing countries may have more impact than in developed countries

By Steven M Edworthy, associate professor of medicine and community health sciences.

University of Calgary, Calgary, Alberta, Canada T2N 4NI (sedworth@ucalgary.ca )

The advent of modern communication technology has unleashed a new wave of opportunities and threats to the delivery of health services.¹ Telemedicine, a broad umbrella term for delivery of medical care at a distance, has reached around the world, and now health professionals can communicate faster, more widely, and more directly with clients and colleagues, no matter where they are.² Telemedicine may in fact have a more profound impact on developing countries than on developed ones.

Satellite stations in Uzbekistan, wireless connections in Cambodia, and microwave transmission in Kosova have shown that the low bandwidth internet can reach into remote areas, some of them with troubled political situations and uncertain economic environments. It has been more difficult and costly to implement broad bandwidth applications in these locations. Nevertheless, with the internet come email, websites, chatlines, multimedia presentations, and occasional opportunities for synchronous communication via internet phones and videoconferencing. Each of these communication vehicles provides an opportunity for medical education and medical care, not to mention collegial support.³ Of course, they also provide the threat of mischief occurring within the health community, with breaches of security, inappropriate use of equipment, and engagement of terrorist tactics to reach political ends. For example, malicious hackers have been known to electronically deface websites. Threatening messages have been sent to health providers by opposing forces in some conflicts. Lack of systems support may lead to higher levels of virus and worm infections of electronic patient data.

Continue reading: http://www.bmj.com/cgi/content/full/323/7312/524

IT-based healthcare systems launched

Remote villages getting benefit of medical sciences through SatCom: ISRO chief

 

CHENNAI: Three important initiatives straddling technology and medicine and building an interface between the two were launched at the Indian Institute of Technology here on Saturday.

NeuroDbase, a unique customised electronic medical record system for Indian Neurologists, Neuropsychiatry Online, a joint effort by the Neurosciences India Group and IIT Madras to provide internet-based counselling to people living in rural areas and Pubmedinfo.com, a unique public portal for health related information were released by Baskara Narayana, Director, Satellite Communication, Indian Space Research Organisation. The occasion was the M.V. Arunachalam Endowment Lecture on Space Technology for Bridging the Health Divide.

Introducing NeuroDbase, E.S. Krishnamoorthy, vice-chairman and director (Neurosciences) Voluntary Health Services, said it was an EMR customised to Indian setting, enabling the collection and categorisation of neuro-psychological data. The history and physical examination of the patient, details about the investigations conducted on him/her, the neuro-ability assessment can all be recorded online.

Continue reading: http://www.hindu.com/2005/07/17/stories/2005071702321000.htm

About telemedicine by Richard Wootton.

Correspondence to: R Wootton r.wootton@pobox.com

As telecommunication technology has advanced and costs have declined over the past decade, there has been a steady growth in telemedicine. Much of this growth, however, has been in the form of feasibility studies and pilot trials. As a result there is little convincing evidence of the cost effectiveness of many applications, apart from teleradiology (box). This paper reviews recent evidence and describes clinical applications where there is early evidence that telemedicine is not only of clinical benefit but cost effective too.

What is telemedicine?

Telemedicine is an umbrella term that encompasses any medical activity involving an element of distance. In its commonly understood sense, in which a doctor-patient interaction involves telecommunication, it goes back at least to the use of ship to shore radio for giving medical advice to sea captains. A few years ago the term telemedicine began to be supplanted by the term telehealth, which was thought to be more "politically correct," but in the past year or so this too has been overtaken by even more fashionable terms such as online health and e-health.

The implementation of telemedicine in routine health services is being impeded by the lack of scientific evidence for its clinical and cost effectiveness. The British government has stated that, without such evidence, telemedicine will not be widely introduced.³ Policymakers have been warned against recommending investment in unevaluated technologies.⁴ Recent advances in telemedicine can therefore be considered to be shown by studies that have obtained evidence of cost effectiveness.

 

Continue reading: http://bmj.bmjjournals.com/cgi/content/full/323/7312/557

Rural Health Care: India: Article: Taking health care to rural areas

The publicly funded health infrastructure in India is in a bad shape. However, the private corporate hospitals and super speciality centres catering to the urban rich are having a field day literally. 'The rural health care sector in India, which has a ratio of one hospital bed for every 1333 citizens has become "nobody's child". With most of the medical specialists working in urban areas, villages have virtually no access to super speciality treatment close to their homes.

A recent study conducted by the Indian Institute of Public Opinion reveals that 88.8% of the rural patients in India have to travel 8 kms to access medical treatment of some sort. The remaining 11.1 percent have to travel further. Similarly, a World Bank study indicates that more than 40 percent of the Indians are forced to borrow money or sell assets when they are hospitalised. Strongly advocating the need to strengthen and expand the public health care centres, the World Bank study has recommended allocation of more resources and stepped up activities in the areas of supervisor, monitoring results and increased public accountability. It has also urged a vastly improved investment on disease surveillance, public health monitoring and information system.

Continue reading: http://www.i4donline.net/May05/satellitetech.asp

Healing by wire by ASHA KRISHNAKUMAR

The joint effort of Anna University and Apollo Hospitals to set up a telemedicine network shows the way in reaching specialised medicare to rural communities.

 

The teleconference on telemedicine, which was inaugurated by Prime Minister A.B. Vajpayee in New Delhi. Seen here is the picture of a link between Port Blair, Delhi and Chennai, taken at Sri Ramachandra Medical College and Hospital, Chennai.

WHEN Alexander Graham Bell said, "Watson, come here I want you," on March 20, 1876, he was not only making the first telephone call but holding the first telemedical consultation, without realising it though. Bell had spilt acid on himself accidentally and wanted assistance. Since this unwitting beginning, telemedicine has come a long way, with developments in communication and information technologies making healthcare accessible across distances. Yet in a paradox typical of India, most of the 620-million-strong rural population has barely any access to basic medicare.

Celebrating its silver jubilee in a novel way, the Chennai-based Anna University, with 240 engineering colleges under its fold, set up a telemedicine network linking, to begin with, 35 of its constituent colleges in Tamil Nadu to provide high-quality healthcare to their students and, more important, to the rural communities situated in the vicinity of the colleges. The project plans to use the infrastructure base of the engineering colleges to extend hi-tech medicare to people in remote areas.

A joint effort by Anna University and Apollo Hospitals (a pioneer in telemedicine), the project also has the blessings of the Tamil Nadu government. Inaugurating the programme, Chief Minister Jayalalithaa said that this facility, the first of its kind in the country, would bring secondary and tertiary medicare to over 95 per cent of the State's population when all the 240 affiliated colleges were networked. She said: "The world's largest technical university, Anna University, is to show the way to reach specialised medical care to the needy in the remote areas.''

 

Continue Reading: http://www.hinduonnet.com/thehindu/thscrip/print.pl?file=20030117007309400.htm&date=fl2001/&prd=fline&

Professor: Preserve culture, beliefs when promoting health to India's rural residents

WEST LAFAYETTE, Ind. — Improving a person's health in India, or in any country, needs to start with an understanding of culture, says a Purdue University health communication expert.

"India is certainly growing as a global center for economics, education and business, but parallel to this growth is an increasing gap in health care for India's rural residents," says Mohan Dutta, associate professor of health communication who is studying the health beliefs of low-income rural Indians. "Today's health-care technology that is used to communicate and to treat people is amazing, but there are many cultural barriers that prevent some rural groups from accessing these benefits."

Dutta is coordinating a large multi-site study that is examining health beliefs among low-income residents of India. One group being studied is the Santali people of Midnapur, West Bengal. They are low-income, and many of them are field workers.

 

Continue reading:  http://www.purdue.edu/UNS/html3month/2006/061108DuttaIndia.html

 

Profile: Telemedicine: India: Telemedicine at Amrita (AIMS)

"Where there is love, distance doesn't matter." —Amma

In January 2003, the Amrita Telemedicine facility was inaugurated from Kavaratti on the Lakshadweep Islands located 220 nautical miles off the coast of Kerala. AIMS is the first institution in Kerala to begin using telemedicine to treat patients in remote places in India, such as the Lakshadweep Islands, Port Blair on the Andaman Islands and Leh, Ladakh, thereby vastly improving the quality of healthcare for the local populations.

Telemedicine is a method by which specialist doctors can examine, investigate, monitor and treat patients in remote areas through satellite video conferencing. AIMS' telemedcine programme is made possible through its link with an ISRO [Indian Satellite Research Organisation] satellite. Telemedicine is used to transmit patients' medical images, records, output from medical devices and live two-way audio and video. With the help of these, specialist doctors can advise, online, the doctors or paramedics at the patient's end on medical care, or even guide the doctor during a surgery.

Continue reading: http://www.amritapuri.org/health/aims/telemed.php

Telemedicine: India: Article: Telemedicine in Rural India by Sanjit Bagchi

In a developing country such as India, there is huge inequality in health-care distribution. Although nearly 75% of Indians live in rural villages, more than 75% of Indian doctors are based in cities [1]. Most of the 620 million rural Indians lack access to basic health care facilities [2]. The Indian government spends just 0.9% of the country's annual gross domestic product on health, and little of this spending reaches remote rural areas [3]. The poor infrastructure of rural health centers makes it impossible to retain doctors in villages, who feel that they become professionally isolated and outdated if stationed in remote areas.

In addition, poor Indian villagers spend most of their out-of-pocket health expenses on travel to the specialty hospitals in the city and for staying in the city along with their escorts [4]. A recent study conducted by the Indian Institute of Public Opinion found that 89% of rural Indian patients have to travel about 8 km to access basic medical treatment, and the rest have to travel even farther [5].

Continue reading: http://medicine.plosjournals.org/perlserv/?request=get-document&doi=10.1371/journal.pmed.0030082&ct=1

Doc crunch brings down rural health mission

New Delhi: The multi-billion-dollar National Rural Health Mission (NRHM) was launched three years ago, but India's 650,000 villages continue to face a shortage of doctors and paramedics, says the Planning Commission.

"There is still a yawning gap between the requirement and availability of human resources in the rural health units at various levels," says an assessment report of the plan panel.

As of December 2007, for example, only 5,910 specialist doctors were available at community health centres across the country, against the requirement for 21,490, the report said.

"Though there is an improvement over the 3,550 specialists that these community health centres had prior to the launch of NRHM, the pace of implementation needs to be accelerated," said a senior official in the plan panel.

The plan panel will shortly review the flagship rural health scheme, which was launched April 12, 2005, to provide effective healthcare facilities to the rural population.
 

Continue Reading: http://news.in.msn.com/national/article.aspx?cp-documentid=1459336

Rural Health Care: India: Article: Predator Quacks from aarogya.com web site by Cliff Samuel

Sometimes, patients are incapacitated for life and at other times even have to pay with their lives. Much of it goes unreported since most deaths occur some time after the patient has been under the treatment of the quack and especially if he dies at home. Only if it is a glaring instance of foul play, where a seriously ill patient dies almost immediately after the administration of some drug at the clinic, that people begin to cast aspersions on the credibility of the "doctor". And that is when the so-called doctor if he happens to be a quack, panics and usually spills the beans especially when up against police pressure to speak the truth.

While a vast majority of our doctors can't resist the lure of lucre and seek greener pastures of practice overseas or in towns and cities here in India, the rural folk are left to choose from many such pretenders. These men know virtually nothing about medical science or for that matter about human anatomy and physiology. They have usually been old fashioned "compounders" who had worked with some doctor or the other, or for that matter, aspiring students of medicine, or even dropouts of medical colleges. Some of them have pursued short-term correspondence courses in some alternative system of medicine or the other offered by universities that are not even recognized and start practicing, when they prescribe even allopathic drugs to unsuspecting patients who approach them like the proverbial lamb being led to the slaughter!

Continue Reading: http://www.aarogya.com/Healthresources/Rural/quack.asp

Rural Health care: India: Article: Clinical Research in a Rural Setting from aarogya.com web site

The red scorpion (mesobuthus tamulus) is common in rural India, especially in the coastal areas where about 10 - 12 cases are seen every month in primary health centers. Red scorpion venom contains a potent cardiotoxin which when given to guinea pigs and mice causes pulmonary edema and death. Despite the use of digoxin , diuretics, aminophylline and medical phlebotomy, Dr P.M. Mundle in 1961 drew attention to high fatality (23/78) due to scorpion-sting. In 1973 Dr H.S.Bawaskar, M. D., a physician, took interest in this problem and did a meticulous study of the clinical and electrocardiographics features of envenomation.

Continue Reading: http://www.aarogya.com/Healthresources/Rural/bawaskar/index.asp

Rural health information from aarogya.com web site

Large masses of the Indian poor continue to fight a hopeless and constantly losing battle for survival and health even fifty years after India's independence. The war begins even before birth, as malnourishment of the mother reduces life chances, while the fetus is still in the womb. Only the most sturdy survive subsequent onslaughts of unsafe and unhygienic birth practices, unclean water, poor nutrition, sub-human habitats and degraded and unsanitary environments. With little or no access to health care, the grim battle continues into adulthood, until precarious survival once again spawns a fresh cycle of birth and struggle.

 

Continue reading the links on the left side of this URL:   http://www.aarogya.com/Healthresources/Rural/index.asp

 

 

 

What’s More Important in Medicine: Diagnostics, Therapeutics or Prognosis?

What's More Important in Medicine: Diagnostics, Therapeutics or Prognosis?

Posted by Ogan Gurel MD MPhil at 5 February 2007, 10:50 PM and is filed under Theranostics,Practice of Medicine,Bioinformatics,Abbott,GE Healthcare,RADIOLOGY,CMT,Diagnostics

What is more important: diagnostics, therapeutics or prognosis? While all are important, we will in this column see how past history has addressed this question and also how recent events (such as the GE acquisition of Abbott Diagnostics) shed light on this fundamental issue.

It is all too easy to take modern medicine for granted, to not delve too deeply into its assumptions and to regard it as having "simply just appeared". However, considering the historical origins of Western medicine, reference is made to Hippocrates who is often called the "father of Western medicine". This is not entirely true.

Medical Models

In ancient Greek times, there were two schools of thought in medicine: the Knidian, which focused on diagnosis, and the Hippocratic (or Koan) school, which focused on patient care and prognosis rather than diagnosis. With the limited knowledge and techniques available then, the Hippocratic approach – with its emphasis on passive treatment and more generalized diagnosis – was more successful. Therefore, we have been handed down the "legend" of Hippocrates as founder of our current medical culture.

Our focus on treatment

Of course, today's medical practice focuses on diagnosis and, above all, specialized and aggressive treatment (both of which were hallmarks of the Knidian method). A story comes to mind. Back in 1993 during the first World Trade Center bombing, I was at the Columbia University College of Physicians & Surgeons. It was a frightening time for the entire city.

As with many other large buildings and public centers, the medical center was in a virtual lockdown. The chief of security sent out a notice stating something to the effect of: "We are instituting these measures to protect the safety and security at our treatment centers." While his emphasis on treatment facilities was simply an oversight, a radiologist friend of mine couldn't help but cheekily point out whether it meant that diagnostic centers were to be left as open targets. While we were not often in a joking mood during those days, it did point out how deeply ingrained our focus on treatment has become.

Read further in
http://blog.aesisgroup.com/2007/02/05/whats-more-important-in-medicine-diagnostics-therapeutics-or-prognosis.aspx?results=1#SurveyResultsChart

--
Col. S. Rajaraman
Director ( Strategy and Planning)

Sneha Diagnostics

Delayed by a year, telemedicine project will now be extended across the state

Mumbai, June 29 Project planned with ISRO should have started in June last year; now, initial phase will connect via satellite premier medical colleges and hospitals to patients at eight or nine district hospitals

Two years after it was first proposed to link the city's premier KEM hospital with four district hospitals, the telemedicine project planned with the Indian Space Research Organisation (ISRO) is now being extended to centres across the state.

In a month's time, the initial phase of the project will connect via satellite premier medical colleges to patients at eight or nine district hospitals.

 

"The King Edward Memorial (KEM) hospital project is now being extended and will start functioning soon. Almost 15 hospitals have already been connected. KEM hospital, JJ hospital, and medical colleges in the Pune, Aurangabad and Nagpur will be offering expert advice to the district hospitals," said Dr Prakash Doke, director of health services, Maharastra.

 

Continue Reading :

http://www.expressindia.com/latest-news/Delayed-by-a-year-telemedicine-project-will-now-be-extended-across-the-state/329092/#

 

 

 

From Bhore Committee to National Rural Health Mission:

Sir Joseph Bhore Committee or Health Survey and Development Committee ¹ was constituted in 1946. It was guided by lofty principals as 'nobody should be denied access to health services for his inability to pay' and that the focus should be on rural areas. Following the acceptance of report of Bhore Committee by rulers of newly independent country, a start was made in 1952 to setup primary health centers to provide integrated promotive, preventive, curative and rehabilitative services to entire rural population, as an integral component of wider Community Development Programme. In 1952, India was the first country to launch a national programme emphasizing family planning to stabilize the population at a level consistent with the requirement of national economy. The convulsive political changes that took place in the 1970s impelled the Central Government to implement the vision of Sokhey Committee ² of having one Community Health Worker for every 1000 people to entrust 'people health on people's hand'. India has come quite close to Alma Ata Declaration on Primary Health Care made by all countries of the world in 1978 ³ . The Declaration included commitment of governments to consider health as fundamental right; giving primacy to expressed health needs of people; community health reliance and community involvement; Intersectoral action in health; integration of health services; coverage of entire population; choice of appropriate technology; effective use of traditional system of medicine; and use of only essential drugs. In 1982, Government made a major move in health politics by coming up very sharply against the health work done in the country in last 35 years.

 

Continue Reading: http://www.ispub.com/ostia/index.php?xmlFilePath=journals/ijh/vol7n1/bhore.xml

It Works: Rural Health-Care Tech

CAMBRIDGE, Mass. -- Vikram Kumar is hardly your typical tech chief executive. He shares a two-bedroom apartment with a sister and a nephew and gets around town by bicycle or in a 20-year-old Mercedes Benz.

The 28-year-old MIT graduate works days as a pathology resident at Brigham and Women's Hospital across the Charles River in Boston and only turns his energies at night to his business: improving rural health care in the developing world with handheld computer technology.

With degrees in medicine and engineering, Kumar could have plenty of lucrative opportunities. Instead, he's opted for a venture with dicey moneymaking prospects. The chief customers of Dimagi, his two-year-old startup, are nonprofit health agencies in developing countries.

With software co-developed by Dimagi, nurses in India manage information collected in the field on more than 70,000 patients. And in rural South Africa, outreach workers use software that Dimagi helped develop to distribute HIV test results in remote settings while ensuring confidentiality.

The handful of regular Dimagi employees do not take salaries, while earnings from Dimagi's contracts with public and private health-care organizations are invested in new projects for the developing world.

Kumar believes delivering high tech to low-tech corners of the globe isn't just socially transformative but also carries potential for huge financial gains for companies like his because health problems are so great in emerging markets.

 

Continue Reading: http://www.wired.com/medtech/health/news/2004/10/65449

Wikipedia article on Indian Health Care

Central government role

Critics say that the national policy lacks specific measures to achieve broad stated goals. Particular problems include the failure to integrate health services with wider economic and social development, the lack of nutritional support and sanitation, and the poor participatory involvement at the local level.

Central government efforts at influencing public health have focused on the five-year plans, on coordinated planning with the states, and on sponsoring major health programs. Government expenditures are jointly shared by the central and state governments. Goals and strategies are set through central-state government consultations of the Central Council of Health and Family Welfare. Central government efforts are administered by the Ministry of Health and Family Welfare, which provides both administrative and technical services and manages medical education. States provide public services and health education.

The 1983 National Health Policy is committed to providing health services to all by 2000. In 1983 health care expenditures varied greatly among the states and union territories, from Rs 13 per capita in Bihar to Rs 60 per capita in Himachal Pradesh, and Indian per capita expenditure was low when compared with other Asian countries outside of South Asia. Although government health care spending progressively grew throughout the 1980s, such spending as a percentage of the gross national product (GNP) remained fairly constant. In the meantime, health care spending as a share of total government spending decreased. During the same period, private-sector spending on health care was about 1.5 times as much as government spending.

 

Continue Reading: http://en.wikipedia.org/wiki/Healthcare_in_India

The Institute of Rural Health Studies

The IRHS runs clinics in two villages in the rural semi-arid tropics of Andhra Pradesh: Dokur and Kotakadra. These villages are located in Mahbubnagar district. The area endures monsoons from July to September and has no rain for the remainder of the year.

The majority of IRHS patients in the Mahbubnagar district are landless laborers, who survive on less than a dollar a day and owe far more in debts to money lenders. Malnutrition, a lack of health education and demanding physical labour cause villagers to be particularly vulnerable to health problems.

Each week hundreds of patients travel from all over the district to receive medical attention at our clinics. Experienced paramedics, healthcare workers and volunteer doctors staff the clinics. As the only reliable healthcare provider within a great distance, they a treat a large variety of illnesses and medical conditions.

Aside from serving patients at our village clinics, the IRHS also refers patients to government and private hospitals in Hyderabad, if they are in need of more sophisticated treatment than can be offered in the clinics or the district hospital. The IRHS follows each patient's case closely, to ensure that they receive appropriate healthcare, and provides support to patients and their families.

The IRHS is able to provide its patients with medicines either inexpensively or free of charge. Drugs are purchased from Locost, a non-profit drug trust, or are sourced locally. The IRHS gives free medicine to all children under 12.

 

Visit their web-site : http://www.ruralhealthindia.org/

BIOMEDICAL EQUIPMENT SYSTEMS FOR RURAL, HEALTH CARE

Biomedical equipment technology can be of significant help in bringing health care to large rural populafions. Of the possible technology alternatives, providing an equipment package to the health worker to take to the doimestic site is most appropriate. Equipment choice must give priority to preventive care especially for the mother anid the child. Besides the general equipment design features of ruggedness, low weight and others, there are for each type, special design requirements making each equipment quite different from conventional forms. Further R&D is neededfor optimization.

 I. INTRODUCTION

Meeting good health standard requirement for all citizens is a major goal for India with its very large population residing mostly in semi urban and rural areas. Primary health care, a term which in India implies first level general health care not restricted to emergencies alone, helps in reducing the need for cost intensive secondary and tertiary care. The requirements are multifaceted and traditional methods of health care delivery are not adequate. Ne:w concepts are being evolved and suitable biomedical technology can have a multiplier effect on all the efforts being put in by health personnel. Based upon the experiences gained during field trials of technology in health care programmes carried out as a joint endeavour of the Department of Electronics, Ministry of Headth and the Centre for Biomedical Engineering of the Indian Institute of Technology and All Jndia Iinstitute of Medical sciences it is now possible to consider several options to achieving the goals and also pr 10 j ect some thoughts on the needs of equipment systems to support

 

Continue Reading:  http://ieeexplore.ieee.org/iel2/1028/12827/00593836.pdf?isNumber=

India Rural health care: views

I read with great interest that India has launched a new National Rural Health Mission. I think the government has to be complimented for the mission approach to the health sector. However, a few words of caution.

The funding for the health sector is proposed to be more than doubled. In ordinary circumstances one would welcome this, but we need to look at the absorptive capacity of the system. Within the existing resources at .9 percent of the GDP, there are massive savings at all levels; the entire allocation is hardly ever spent. Apart from the capacity to absorb, one will also have to look into the quality of spending; the relationship between the inputs and outputs and outcomes.

The country has a wonderful resource pool of qualified health professionals. However, the country specialises in putting round pegs in square holes. A few people in key places in the mission have any idea about the real issues in the health sector. On the other hand most professionals in the know, who understand the health sector remain on the fringes. There has to be a lateral entry at the senior level so that people who have the knowledge as well as the passion for the subject are in places where they can influence policy and implementation.

Another major issue is the total lack of ownership of the people for whom most funds are proposed to be spent. 70% of the people live in the villages, yet they have no say whatsoever in the health services they are provided with. Can we not think of making part of the payment to the village level health workers and the PHC staff through the village Panchayats or the village health committees.

Continue Reading: http://www.bmj.com/cgi/eletters/330/7503/1330-b

Health care is paradox in India

EDITOR—The National Rural Health Mission is an ambitious yet sincere effort of India's health ministry.¹ It is reassuring to note the commitment to raise the annual spending on health care to more than 2% of gross domestic product, which had fallen to 0.9% in the past few years.

India is a land of striking inequalities. More than 70% of its population lives in rural areas, where only 20% of the total hospital beds are located. Yet India is proudly announcing that it is ready to cater to "health tourists" from the developed world. The advances in health care are accessible to only a very small percentage of Indians. With the influx of medical tourists the healthcare inequality is bound to widen.

Corporate hospitals are well known for "poaching" doctors from government and teaching institutions, luring them with huge sums of money, which often paralyses the government's healthcare infrastructure.

How can a country allow its doctors, who were educated at the people's expense, to cater for affluent patients from developed countries when more than 1300 people die every single day from a completely curable disease such as tuberculosis?

Most medical education in India is government sponsored, but no mechanisms are in place to ensure that the beneficiaries of this subsidised education pay back the people who have contributed to their education.

Continue Reading: http://www.bmj.com/cgi/content/full/330/7503/1330-b

India launches national rural health mission

The Indian government announced a plan to increase staffing levels and improve the infrastructure in rural hospitals last week. It also intends to use village women to track the health needs of their own communities.

The health ministry has ear-marked 67bn rupees (£0.8bn; $1.5bn; 1.2bn) this year (2005-6) for the National Rural Health Mission, dubbing it a fresh effort to correct "striking inequalities" between urban and rural health services in India. But health activists have said that the plan would require more funding and complementary changes to India's medical education system for it to work.

The mission will raise a cadre of 250 000 women volunteers designated as accredited social health activists over the next three years, virtually one from every village or cluster of villages, across 18 states with weak rural health infrastructure.

The activists would be trained to advise village populations about sanitation, hygiene, contraception, and immunisation; to provide primary medical care for diarrhoea, minor injuries, and fevers; and to escort patients to medical centres.

 

Continue Reading: http://www.bmj.com/cgi/content/full/330/7497/920-a

New wireless networking system brings eye care to thousands in India

BERKELEY – Thousands of residents of rural villages in India are receiving quality eye care thanks to a collaborative effort between an Indian hospital network and the researchers at the University of California, Berkeley, and at Intel Corporation who have developed a new technology for low-cost rural connectivity.

 

This new technology, based on "Wi-Fi" wireless networks, allows eye specialists at Aravind Eye Hospital at Theni in the southern India state of Tamil Nadu to interview and examine patients in five remote clinics via a high-quality video conference.

Just 17 months old, the pilot project has proved so successful that the partners are announcing this week that it will be expanded in the state to include five hospitals that will be linked to 50 clinics that are expected to serve half a million patients each year.

"The information technology revolution holds tremendous potential for addressing problems in developing countries," said Eric Brewer, a UC Berkeley professor of computer science and director of the Intel Research Berkeley lab who initiated efforts to develop the technology. "Historically, though, most projects have been either too expensive or too technologically complex to be used in poor, rural areas. What we've done here is develop a simple, inexpensive software and hardware system that can provide villages with a high-bandwidth connection to computer

Continue Reading: http://berkeley.edu/news/media/releases/2006/06/06_telemedicine.shtml

Enabling Eye Care in Rural India Research at Intel

At an eye care clinic in Bodinayakannur, a rural village in South India, a 64-year-old man and a computer technician sit in front of a PC screen, consulting with a doctor in a hospital in Theni, 9 miles away. "Everyone said to get a checkup here," says the man. "They said I could talk straight to a doctor through the TV."

After asking the man a few questions, the technician describes his history and symptoms to the doctor, who instructs her to give him two prescription medications and have him visit the hospital for an exam. Then the technician gives the man a microphone so he can speak directly to the doctor. "For the last week, my eyes have been itching," he says. "There has been swelling and watering." The doctor responds: "The redness in your eyes is because of infection. You need to apply drops for five days, six times. After three days, come to Theni. Since you have diabetes, we want to examine you. Okay?" He agrees.

The consultation only took minutes, but it saved the patient a day's time, and the wages he would forfeit if he'd had to walk the 9 miles to the hospital. "If I had to go to Theni, I would have put it off," he says. "Because the clinic was here, I came right away."

 

Continue Reading: http://www.intel.com/research/eyecareindia.htm

 

 

Profile: Vaatsalya Healthcare, Bangalore, India

Our vision is to transform the quality of life in India by bringing affordable, efficient and friendly healthcare within the reach of the common man.

With passion, commitment and leadership, Vaatsalya is the new face of healthcare in India.
Vaatsalya Healthcare: While 70% of India is living in semi-urban and rural areas, 80% of our healthcare facilities are located in urban/metro areas. Vaatsalya is bridging this gap by building and managing hospitals/clinics in semi-urban and rural areas and bringing healthcare services where it is needed most. We have hospitals in Hubli, Gadag and Karwar (North Karntaka) and are expanding to other locations soon

Vaatsalya is the sanskrit word which means "nurture" or "paternal love".

True to our name, our logo also reflects the idea of different colored petals coming together to create a unique flower. We and our partners might bring in different and complementary strengths but we all of it will create a unique flower like offering.

Mission
We will redefine healthcare in India by creating the largest primary and secondary care healthcare network in the country, with special focus on preventive care. We believe that with the right combination of passion, commitment and leadership, we will bring in a sweeping change in the existing healthcare system.

Values

When we started our journey, the single most important guiding principle was - "Can i bring my parents to this hospital?" or "Will i recommend this hospital to my children?" is the fundamental basis of Vaatsalya's approach to hospitals. We dont want to create just another hospital, but create hospitals which we, our team and our families will be proud of.

We also believe in utmost integrity, with our patients, suppliers and the community.

Please visit their web-site to know more: http://www.vaatsalya.com/

Visit their blog: http://vaatsalya.com/blogs/

Comprehensive Rural Health Project, Jamkhed

The Comprehensive Rural Health Project, Jamkhed, has been working among the rural poor and marginalized for over 37 years. By partnering with village communities and expanding upon local knowledge and resources the project aims to effectively meet the immediate and long term needs of these groups, especially women. With values of compassion, justice, respect and trust, CRHP works to empower people, families and communities, regardless of caste, race or religion, through integrated efforts in health and development. Dr. Raj Arole (Founder and Director) Dr. Shobha Arole (Associate Director)

We envision communities where families are healthy and enjoy fulfilling lives. The full human rights of every individual, especially women and children, are protected and uncompromised. We believe that all people are made in the image of God and endowed with talents and abilities. We are called to facilitate and empower the poor and marginalized and enable them to achieve their full potential through a value-based approach with equity and justice

Health is a universal human right. Eliminating injustices which deny all people access to this right underlies the very essence of our work and our approach. Using the combined talents and energy of our staff and the families we work with, we strive to develop communities through a grassroots movement. By mobilizing and building the capacity of communities all can achieve access to health care and freedom from poverty, hunger and violence.   Visit their web-site to know more :http://www.jamkhed.org/

Rural India needs large dose of health-care

Health-care in the country has improved quite dramatically, but remains urban-centric. Time, the Government focused more on Rural India.

 

Even as medical facilities in India are going hi-tech and its professionals global, Rural India seems to be languishing. There is a continuing flight of doctors and paramedical staff from the country, seeking greener pastures abroad.

With the income levels in the metros and towns soaring in the last decade, the demand for superior medical facilities has made health industry a lucrative business.

Doctors and medical professionals are now being increasingly attracted to these pockets of affluence. The advent of telemedicine and health tourism is reinforcing this trend of increasing returns for the health industry.

There is a great difference between medical facilities available in Western countries and that in India. But there is a common thread — Indian medical professionals.

In several developed countries, Indians constitute a substantial percentage of medical professionals. Reports are that close to 38 per cent of practising doctors and dentists in the US are of Indian origin.

The sheer profusion of qualified Indian doctors in the UK has sparked apprehensions among British medical professionals. A growing number of Indian nurses, pharmacists and other paramedical staff are going abroad every year.

Continue Reading: http://www.thehindubusinessline.com/2006/09/08/stories/2006090800261100.htm

 

Much health care in rural India comes from unqualified practitioners

Public and private healthcare facilities that purport to serve poor people in rural parts of India are increasingly catching the attention of researchers. A survey conducted by US researchers in Udaipur, Rajasthan, now provides hard data showing the nature of the availability of health care in rural India.

The researchers, Dr Abhijit Banerjee and Dr Esther Duflo from the Massachusetts Institute of Technology and Dr Angus Deaton from Princeton University, all working under the aegis of the institute's Poverty Action Lab, found widespread symptoms of disease among the people surveyed.

Given the state of the public facilities, the main sources of health care are private practitioners and traditional faith healers (bhopas). However, such practitioners are largely untrained and unregulated, said Dr Banerjee. His team found that 41% of those in the private sector who called themselves doctors said they had no medical degree, 18% had no medical or paramedical training at all, and 17% had not even graduated from high school. In 68% of visits to private clinics or practices patients were given an injection and in 12% patients were given a drip, compared with 32% and 6% in public facilities. Only 4% of visits to private facilities led to a laboratory test for diagnosis.

The study also showed that on average 45% of medical or paramedical personnel were absent from government run sub-centres (serving a practice population of about 3600) and 36% were absent from the larger primary health centres (serving 48 000). The sub-centres were closed 56% of the time during their regular opening hours, at unpredictable times, discouraging people from walking an average of 1.4 miles from their village.

"The situation does not seem specific to Udaipur: these results are similar to absenteeism rates found in nationally representative surveys in India and Bangladesh," the researchers said.

Continue Reading: http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=404528

India: The Crisis in Rural Health Care

Rural health care in India faces a crisis unmatched by any other sector of the economy. To mention just one dramatic fact, rural medical practitioners (RMPs), who provide 80% of outpatient care, have no formal qualifications for it. They sometimes lack even a high school diploma.

In 2005, the central government launched the National Rural Health Mission (NRHM) under which it proposed to increase public expenditure on health as a proportion of the GDP to 3% from 1%. But increased expenditure without appropriate policy reform is unlikely to suffice. Experience to-date inspires little confidence in the ability of the government to turn the expenditures into effective service.

Rural India consists of approximately 638,000 villages inhabited by more than 740 million individuals. A network of government-owned and -operated sub-centres, primary health centres (PHCs) and community health centres (CHCs) is designed to deliver primary health care to rural folks.

Sub-centre is the first contact point between the community and the primary health care system. It employs one male and one female health worker, with the latter being an auxiliary nurse midwife (ANM). It is responsible for tasks relating to maternal and child health, nutrition, immunisation, diarrhoea control and communicable diseases.

Current norms require one sub-centre per 5,000 persons, one PHC per 30,000 people and one CHC per 120,000 people in the plains. Smaller populations qualify for each of these centres in the tribal and hilly areas. Each PHC serves as a referral unit to six sub-centres and each CHC to four PHCs. A PHC has four to six beds and performs curative, preventive and family welfare services.

Each CHC has four specialists — one each of physician, surgeon, gynaecologist and paediatrician — supported by 21 paramedical and other staff members. It has 30 indoor beds, one operation theatre, X-ray and labour rooms and laboratory facilities. It provides emergency obstetrics care and specialist consultation.

Despite this elaborate network of facilities, only 20% of those seeking outpatient services and 45% of those seeking indoor treatment avail of public services. While the dilapidated state of infrastructure and poor supply of drugs and equipment are partly to blame, the primary culprit is the rampant employee absenteeism. Nation-wide average absentee rate is 40%.

The employees are paid by the state, with the local officials having no authority over them. Not surprisingly, many medical officers visit the PHCs infrequently and run parallel private practice in the nearby town. ANMs are frequently unavailable for childbirths even if the mother is willing to come to the PHC. Though PHCs are supposed to be free, most of them informally charge a fee. Under these circumstances, even many among the poor have concluded in favour of private services.

Continue Reading: http://www.brookings.edu/opinions/2008/0124_health_care_panagariya.aspx