Categories
Public Health

ICHA Mitra ….. An initiative to help our Corona Warriors

Indian Confederation for Healthcare Accreditation (ICHA) has launched the ICHA MITRA a portal to support all front line health workers during the Covid 19 epidemic.

The august fraternity of ICHA is collectively capable of addressing issues faced by Corona warriors through appropriate interventions is the main thought process behind the project.

“ICHA MITRA – From Fear to Care”   Implementation Steps

a.   An access platform has beencreated https://www.icha.in/mitra/ where presently, for one week only volunteer enrolment is being undertaken.

b. Constituent Associations are requested to disseminate the information and link  https://www.icha.in/mitra/ to their respective members to enrol as volunteers.

The aim is to generate a city wise and region wise database of volunteers / Nodal coordinators who would be able to render help to any Corona Warrior seeking help and support.

c.     All members of your Association requested to share and disseminate ICHA Mitra information on their social media through WhatsApp, Facebook, Twitter, Linkedin among others.

d.     The request for support/help received from Corona Warriors will be redirected to the respective city /area Nodal coordinator. (S)he  in turn, through a local WhatsApp group or other such means redirect to the Registered Volunteers or assign the issue to a particular volunteer on phone.

e.  The volunteer after determining the veracity of issue received will start resolving the issue on phone or escalation to appropriate levels – Regional/ State / National level. This will be done in a time bound manner with information to ICHA Team.

f.     An online briefing / training will be done to equip the volunteers and clear all doubts.

g.    The entire records and summary will be visible on a dashboard on the platform and the progress of each submission will be continuously monitored by the ICHA Team.

h.    This will be a yeoman service to our Covid warriors and build a credible connect amongst them – from fear to care and a feeling that they have support to bank upon – ICHA being “Main Hoon Na”.

Considering the situation this is a step in the right direction and hopefully, ICHA MITRA would support many health workers during this epidemic.

Categories
Wellness

Sugar is the new health threat : Findings from Credit Suisse Study

Last week I had written a piece informing people about the dangers of sugar and given them 4 reasons to cut it out of the diet. I received a lot of criticism and some feedback on the piece. I do acknowledge that I am not an endocrinologist and have not conducted any independent study on this topic.

But last week while watching a documentary on sugar consumption from New Zealand, I came across references to a report from Credit Suisse “Sugar: Consumption at Crossroads”

Findings from the Credit Suisse report is more validation of my earlier article. The truth is that the processed food industry has been using sugar in large quantities. In addition to taste, sugar is also a good preservative. And last but not the least I feel Sugar is very addictive, more addictive than cigarettes or alcohol.

Sugar is the new threat to our health

There were three findings from the report that were eye openers. These were

  1. Global Consumption- The global per capita consumption of sugar is up 46% from 48 grams a day to 70 grams a day. This is the addition of 280 calories daily. 70 grams is around 16-18 teaspoons. While this is the average, the US leads the world with 40 teaspoons a day while China has the least which is around 7 teaspoons a day. Picture an American and a Chinese. Now you would know where obesity is coming from….need I say more.
  1. Sugar link with Obesity- While medical research has not been conclusive to link Sugar with Obesity, there are indications that the link will be established soon. Today we have enough indicators putting sugars and carbohydrates as creating a greater risk for Type 2 Diabetes and Heart Attacks. While Insulin resistance is genetically determined, it is established that more than 7 teaspoons for women and more than 9 for men is way above the insulin tolerance levels. This is the amount of sugar found in a single bottle of coca-cola.
  1. Medical Practitioners Agree- While a large scale trial or study keeping a control and a trial group across many years have not been organised as yet, the surveys across medical practitioners across the glove have agreed that sugar is the causative elements for the increase in hearts diseases. The concurrence was as high as 80%. Interestingly the consumption of sugar has declined in the upper strata of the society specially among educated individuals. But sugar finds a way to sneak in through processes food.

So what does all this mean for India?

Well in India the number of deaths in India due to heart diseases stood at 15% in 1990 and now it is up to 28%. The main factor for this has been diet. While factors like hypertension are a direct result of obesity, other factors like environmental pollution and tobacco usage also contributed to this number. In other words, our sugar consumption is killing us faster than we think.

What can we do ?

Here are three steps that I want all my readers to take immediately

  1. Educate yourself- There is enough literature available on the net and as well on research sites. Spend some time reading this and take charge of your health.
  2. Watch Documentaries- There are enough documentaries on channels like Discovery and Amazon Prime. This gives you a sense of the research and though process on this issue across the globe.
  3. Read Nutrition Facts- At the back of all food articles in India, there is a table that indicates the amount of sugar that have been added to the product. Read that carefully. Remember WHO prescribes only 9 teaspoons per male per day and 7 per female. Anything above that is very dangerous.

In conclusion, take charge of your health. If you don’t no one else will. As always comments and suggestions are welcome.

Categories
Wellness

4 reasons to cut out the sugar from your diet.

There is something more addictive than cigarettes and alcohol in your diet and you probably don’t even know about it. Its SUGAR.

Surprise Surprise!!!!!

Sugar is probably the greatest threat to your health today and you are probably not even aware of it…..:)

And I am not talking about the sugar you add to your tea or coffee, but also the sugar that is in processed food like Ketchup, Mayonnaise, and even in healthy food like cornflakes.

Yes Cornflakes,

A research article in Times of India showed the results of some research done on popular Corn Flakes and Muesli brands. The brands included Kellogg, Bagrry’s, and Good earth. The research found these brands have more than double the sugar prescribed. According to the European Regulation on Health and Nutritional Claims (ERHNC), “sugar content higher than 12.5 gm per 100 gm is considered to be high’. All variants in the study were found to be exceptionally high’ in sugar. And not even a single product had printed the sugar content on its packet. ” For more on cornflakes please read this article we wrote earlier on the website.

I have personally started experiencing the addiction and control that sugar has on you. Since the lockdown, to counter the drop in energies while working from home, I had been regularly consuming Cornflakes and Musli, little realizing that it spiked my sugar levels leading to mood swings, headaches (migraine in my case) and a general feeling of low spirits. I was consuming a packet of cream biscuits regularly and I gained around 10 kilograms during this time. All this happened while I was still working out and aware of my consumption.

Cornflakes is another seemingly harmless presence in our diet but is actually dangerous to health

It took me until the end of June to figure out what was going. Since July 2020 I have cut out on any sugar in the diet. I drink Black coffee or green tea. I have swapped out sweets and biscuits with fruit. I know these are early days but I already see an effect on my energy, moods and overall general wellbeing.

So why is sugar so dangerous? Here are some of the reasons from my experience as a doctor and some research that has been publicly released globally.

  1. Sugar is a dumb substance. It has no nutritional value. Any sugar that you need can be made by the body from fruits and dairy products. These are naturally occurring sugars and give you fiber, vitamins, and proteins in addition to the sugar.
  2. Weight gain is an apparent downside to sugar. Sugar disruption the Leptin cycle in the body. Leptin is a hormone that regulates the hunger cycles in the body, any disruption in the Leptin cycle can cause weight gain and hunger pangs. There has been some study on this topic, please read here for more details.
  3. Insulin resistance is another reaction to high sugar diets. There is a myth in India that sugar causes diabetes. While sugar does not cause diabetes, but high levels of sugar in the bloodstream leads insulin coming out to regulate sugar, and this causes insulin to be less effective over a period of time leading to prediabetic conditions.
  4. Last but not the least sugars are also linked to higher triglycerides level in the body leading to heart attacks.

So what I can recommend you is to cut the added sugar from the diet. Also, please don’t switch to Honey or Jaggery as the effect is the same. Like the rules for smoking cessation or alcohol cut out, you need to brutally cut out the sugar, otherwise it will creep back in one spoon at a time.

Please also keep the following in mind

  1. Exercise daily, if you can’t take out 30-40 minutes for exercise you are doomed and will be experiencing high medical costs after 45
  2. Eat only homemade food.
  3. Check the added sugar quantity before buying anything from the market
  4. Load your diet with fruits and vegetables.

Wishing you all a safe reading and better health this year.

Categories
Public Health Uncategorized

Why India needs to stengthen its primary helthcare system

While COVID rages on globally and across India a more spirited debate ranges in my mind. Was there a way to anticipate and proactively move on infectious and non infectious conditions in India?

One thing that COVID has exposed is the gross unpreparedness of the Indian healthcare system to deal with pandemics. But it also exposed how little we knew about the situation on the ground. Data available is inadequate and most of the data especially from the villages and districts is not captured.

At the front line for the fight against disease and other illnesses is the Indian Primary Care system. This system is mostly run by ASHA (Accredited Social Health Activists) If something is coming our way, they are the first to know. And while they have been around since the recommendations of the Bhore Committee recommendations were given in 1943, it is easy to see how they are ill-prepared to deal with anything.

This is some data that I have been able to ascertain from public sources.

Number of ASHA Workers 9,00,000
Number of primary health centers 25,000
Average Salaries of ASHA Workers INR 2,000/PM
Average costs incurred by ASHA WOrkers INR 800/PM

So this is the on-ground scenario. These workers have to fill multiple forms for child care, maternal care among others, and then they have made 10-15 home visits per day. There are key reasons why ASHA workers are important.

  1. They are local to an area, they understand the local customs and traditions
  2. They have the trust of the community, communitites in rural India do not like to discuss their health with strangers
  3. While are part timers, going from home to home makes them the best eyes and ears for the healthcare system

But given their situation and low pay, would it be interesting to see what we can do to help their situation. The government is spending close to INR 5000 Crore on the Ayushman Bharat Program. Next year the outlay is close to 10,000 Crore. But at a fraction of this cost, we can increase the pay for the ASHA workers and get much better coverage to prevent patients from getting hospitalized.

In the coming days, I would be focusing on how we can strengthen the primary care system and improve the overall effectiveness of the ASHA workers while providing them better remuneration for their tasks.

We did this video to talk about the challenges of the primary healthcare system. Below is the recording for the same.

As always we look forward to your comments and suggestions on the same.

References

https://thelogicalindian.com/story-feed/awareness/asha-workers-rural-healthcare/?infinitescroll=1

Categories
Healthcare Delivery

Why patient experience would be the key in the post covid world?

In January 30 2020, India recorded its first case for Corona Virus popularly known as Covid19. Since then India has seen a series of lockdowns and as we inch towards somewhat of a partial recovery, the question around the state of our healthcare system has become centre stage again.

Since the 1940’s where the Bhore committee gave its recommendations for developing the healthcare structure in India, as a nation we have been playing catch up with demand far exceeding the supply in terms of doctors, diagnostic equipment, hospital beds and medicines.

In addition the wellness programs have been struggling and preventive measures have not been very successful. In this context the corner stone of the healthcare system in India has become the hospital.

What determines a successful healthcare intervention is patient experience. Today with the advent of telehealth and the guidelines given by Medical Council of India, it becomes even more important for hospitals to focus on patient experience and add to the growth of the industry.

What is Patient Experience?

Private hospitals have long tracked patient satisfaction ratings, but they didn’t always carry great significance. While all hospitals want happy patients, most hospitals have been historically plagued with the “doctor knows best” mentality — a mentality where clinical outcomes outweigh “touchy-feely” indicators such as patient satisfaction or overall patient experience.

However, in recent years, some leading institutions in India have begun to focus more heavily on providing an outstanding patient experience. Drivers for this include growing consumerism and transparency for healthcare services and increased interest from both consumers and providers in patient-centred care.

Why Patient Experience is important to Hospitals?

Healthcare consumers increasingly view their experience with a provider as a key consideration for determining if they’ll return to or recommend the provider, largely because it remains one of the few ways consumers can differentiate providers. Over the past few decades, clinical outcomes have improved dramatically, and patients no longer view favourable outcomes as a key differentiator as these are expected. What remains is the patient’s overall experience, which encompasses everything from customer service to patient-centeredness and care coordination among providers.  Also given the growth of Tele Health, it would become even more important for hospitals to focus on patient experience in order to create a favourable experience and create the hook that would bring patients and others in the community back to the hospital.

We are working on a report on understanding the current digital levers to manage patient experience. We will be releasing the report soon.