Category: Public Health

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Public Health

Diabetes levels drop marginally in India as per Novo Nordisk Foundation Study

Diabetes is a cause for greatest concern in India. The reason for that is many fold. But the most prominent among them is that diabetes is the foundation on which many other diseases come into play. As you know, diabetes is a condition and not a disease, and usually starts with the body’s inability to maintain the insulin level in the blood. As you know, diabetes is a condition and not a disease and usually starts with the body’s inability to maintain the sugar levels in the blood.

This could be a result of genetic makeup or also from the pancreas inability to produce insulin. But the most common co factor is stress. In 2018 Novo Nordisk had launched a diabetes impact challenge, in which they wanted to maintain a diabetes index to measure the HPA one c levels in the body.

HbA1C measures the Association of the glucose molecule with the red blood cell. As a red blood cell has a life of 120 days. This measure gives us an average of the sugar levels in the body for 120 days, and it’s a much better, and reliable measure of the sugar levels as compared to fasting, and post prandial blood sugar levels that were used earlier. In its recent finding the Novo Nordisk Foundation which produces this result figured out that from October 2019 to September 2020. The HbA1C levels have marginally dropped in India. Currently they are at 8.48 per cent. They ideally should be below 6.

By, the average HbA1C once he level was recorded at 8.48% for the year from October 2019 to 20. But this collection happened over 30 Indian cities with a vast average respondent rate of 55 years, or which of the 57% were men and 43% were women. Again you can see the testing levels among women are less and this is another area of concern.

The Indian diabetes care index which was also launched in 2018, to improve the diabetes care in the country has been providing a real time view of the average HbA1C levels in India.

According to the Novo Nordisk foundation, there are more than 77 million diabetics in the country. And the country, the total spend on diabetes is around INR 64,000 crores.

The second issue that comes up is that with COVID-19, it is clearly proven that anybody with comorbidity or with underlying conditions like diabetes, was more predisposed to, you know, to health issues. And it is clearly established that diabetes affects a lot of body parts, especially extremities like hands and feet, heart, circulatory system, and your kidneys. Your eyes, and overall suppresses your immune system.

I have written about diabetes and its implications on health, many times earlier, including these articles which you can refer to help you get a better understanding of what can be done.

What does this mean for you?

1)      Monitor-  I think 55 is a bit too late to check what your sugar levels are. The most important thing is to start monitoring it from the mid-30’s onwards. If India has risen to 71 million diabetics overnight. It is primarily because the awareness has increased. And the constant checking is possible.

2)      Detect- Get a blood sugar monitor machine. I think it’s very important, a very good investment, along with a Blood Pressure machine. I think these are solid investments that you should make, whether you have an HDTV or the latest Apple gadget. It doesn’t matter but these schedules can really save your life.

3)      Reduce Stress- Diabetes is related to stress to great extent, higher stress higher sugar levels, and higher and lower the body’s ability to deal with the sugar let’s see where is it that is causing stress for you and how you can mitigate it, you might do yoga and meditation to manage the stress, but the ultimate aim should be eliminate the source of stress.

4)      Watch out for added sugar- Last but not the least, which is sugar intake added sugar is the biggest reason why insulin intolerance is happening in the body. So, it is important to figure out if there is added sugar that you are eating which you are not aware of, which could have been causing this problem.

5)      Exercise if your medicine- Workout in the open for 150 minutes a week. This could be a simple walk or cycling or swimming.

As always, it is important for you to stay healthy. Stay safe. Own your health. You have to do it; nobody else will take care of.

Sources: https://www.biospectrumindia.com/news/79/17555/average-hba1c-level-registers-marginal-improvement-in-india.html

Categories
Digital Health Healthcare Technology Public Health

Population Health Management through Digital Tools

Dr Pallabi Roy

Does the Public Health Industry need a Digital Makeover?

Have you heard of buzzwords like ‘Tech Trends’?

Blockchain, Machine Learning, Artificial Intelligence, and the Internet of Things?

As a Healthcare Professional, you might have heard of these digital tools.

Aren’t sure about what they mean? You’re not alone!

We often ignore the technical aspects of a project.

We deal only with the core Biological Sciences.

But this approach needs some amount of tweaking. With the heavy penetration of digital tools in Healthcare, we must embrace the digital era. There is no going back to Pre COVID-19 times!

Isn’t population health management a well-known concept in the Public Health domain?

Yes, it is, but digitization is changing the face of this sector. 

Public health challenges like tuberculosis, HIV, malaria, and other communicable diseases still exist. India’s healthcare industry is going through a transitional stage. The disparity between the rich and the poor is becoming more clear. This gap creates poor health outcomes and using digital tools, we can bridge this.

Why should healthcare professionals bother about these tools?

It’s because they are going to be the harbingers of change!

The Finance Minister allocated Rs 69,000 crore for the healthcare sector. The 2020-21 Union Budget looked better than last year. This is another spectrum where digital tools can come in. FinTech can help divide funds according to the needs of our country.

80% of our fund allocation can elevate health promotion and disease prevention. Using digital tools, we can deliver these healthcare services to the rural parts of India. The public health workforce is working hard and adopting these measures. How can you leverage these tools for research and evidence-based treatment protocols?

Technology has made it easier to reach out. This holds true not only for remote areas but also for an international ecosystem. Doctors can use this approachable network as a reference. Digital tools are facilitating knowledge and implementation, in new-age India.

The Government of India has come up with training and guidelines for telemedicine. Tele-Consultations in specializations like Ophthalmology, Radiology, Mental Healthcare, and Obstetrics-Gynaecology have created waves. ASHA workers (Accredited Social Health Activists) are warming up to digital tools. These include virtual training and EMRs (Electronic Medical Records). We are observing a gradual improvement in primary levels of population health management.

Mother and Child Care programs are improving since e-governance is possible. There are online registries that get updated every week by these healthcare facilitators.

We use them for tracking data like child mortality rates and cases of tuberculosis. Cases of COVID-19 are being monitored through similar means.

National Digital Health Mission has an agenda that we cannot sideline. Our government is centralizing healthcare. This gives us time to catch up with tech trends. It gives us time to understand these digital tools and make the most of them in our clinical practices.

Which are some digital tools that you have used for population health management?

About the Author

Dr Pallabi Roy is a dentist and works as a marketing professional, podcaster and an influencer in the area of digital health. She can be reached on Linkedin- https://in.linkedin.com/in/pallabiroy27

Categories
Public Health

Closing the Oxygen Gap in Covid19

Oxygen is essential. It is a key treatment for a wide range of diseases that affect all parts of the population—but it’s often overlooked in health system planning for a number of reasons. It is both a medicine and a device, has complex delivery infrastructure, requires proper training for health workers and sustainable maintenance plans for oxygen equipment, and should be supported by sufficient budget.

While medical oxygen remains an essential commodity for improving a variety of health outcomes, the COVID-19 pandemic has spotlighted its importance as the first line treatment for COVID-19 patients struggling to breathe.  However, many countries, including India, face a gap in access to medical oxygen, leaving many health facilities in these communities unequipped to meet the level of patient demand.  

The COVID-19 pandemic has spotlighted the role of medical oxygen as a lifesaving therapy for patients struggling to breathe. It also pushed to the surface the long-existing issue of oxygen access gap, as it created an overwhelming demand for oxygen technologies and supplies across many health facilities in LMICs.

Closing this gap will require an integrated set of solutions and investment in strengthening the oxygen delivery systems, including resilient oxygen markets—from demand planning to financing to supply and distribution systems. PATH the Chicago based Not for Profit organisation has been working in India for many years. In the past they have worked on areas like providing contraception to remote areas of the country by tying up with India Posts, you can read that story here- Link.

Now they have launched the “Markets Matter: Closing the Oxygen Gap” initiative, this campaign puts a spotlight on the role that efficient markets play in scaling up #OxygenAccess. Now is the time to add your voice and help close the oxygen gap!

We have a chance to move some of the solutions forward now to ensure a rapid response to the pandemic, as well as build a sustained platform for the future. Now is the time to use our voices to elevate these important messages about the need to prioritize oxygen access amidst the COVID-19 pandemic – and beyond.  

You can get involved as well, please download the campaign material from this link and share it within your network. Looking forward to all your support.

Categories
Public Health

On-time delivery: Ensuring reliable reproductive choice in India

Dr. Sudhir Maknikar

PATH has helped leverage the India Post—the world’s largest postal service—into a full-fledged distribution system delivering access to contraceptives for thousands of people in the state of Odisha.

In India, health systems face many obstacles when moving family planning commodities from state warehouses to towns and villages where health care providers and patients need them most. A lack of reliable transportation and other essentials triggers delays in delivery, severely impacting access to contraceptives. Lack of access—often triggered by failures in the supply chain—is a principal barrier to contraceptive use in the country.

PATH’s India office is working with state health systems, governments, and partners to address the gaps that prevent access to family planning commodities such as condoms, oral contraceptive pills, injectable contraceptives, and intrauterine devices (IUDs). With support from the Bill & Melinda Gates Foundation, the family planning supply chain strengthening project provides technical support to eight states in India to improve delivery of contraceptives.

Leveraging the India Post to meet supply chain challenges

A vehicle designated by India Post to transport contraceptives to towns and villages in Odisha, on India’s east coast. Photo: PATH

In Odisha, on India’s east coast, the state’s health system relied for many years on the services of a state-owned vehicle with a government driver to transport family planning commodities to district warehouses. With only one vehicle for a large state, it took at least three months to deliver shipments to all of Odisha. When a given district ran out of supplies—as was frequently the case—there was no chance for replenishment until the next quarter. Especially for women depending on the state-supplied contraceptives, this distribution system jeopardized their access to and choice in family planning.

In response, PATH analyzed several distribution systems that could supplement the existing one. The choice quickly become obvious: India Post, the world’s biggest postal network. With more than 155,000 offices across the country, it has been connecting the subcontinent for 242 years. In January, the state government used India Post to ship its first-ever consignment of family planning supplies from a warehouse in Odisha to depots in five districts.

An illustration of the flow of family planning commodities through India Post. Photo: PATH

The government of Odisha now uses India Post’s express parcel services to transport small quantities of commodities like IUDs, injectable contraceptives, and tubal rings. Larger shipments of condoms, emergency contraceptive pills, and pregnancy testing kits are still supplied through the state-owned transport.

This powerful intervention has strengthened the supply chain and distribution network for contraceptives throughout Odisha. Overall costs are lower, delivery times are faster, and there are no restrictions on the quantities that can be transported. Since the partnership between India Post and the state government began, the state’s health system has been more successful in meeting the urgent demand for contraceptives.

A boon during the COVID-19 crisis

In Odisha, the India Post and state government staff prepare a consignment of family planning commodities for delivery by India Post. Photo: PATH

Until the COVID-19 outbreak in India, the government of Odisha used both its own distribution system and India Post to supply contraceptives to the districts. But the nationwide lockdown closed borders and restricted the movement of vehicles. Soon, districts sounded the alarm: they were running out of contraceptives.

This is when the India Post proved invaluable. Classified as essential, postal services remained functional throughout the lockdown. Since March, the Odisha government has relied on India Post vehicles to dispatch more than 115 consignments of family planning commodities to about 28 districts, charting a 100 percent rate of on-time arrivals.

The project has also demonstrated the huge potential of India Post as a delivery method for other essential medical commodities. PATH is discussing with the governments of other Indian states how to leverage India Post for distribution of family planning commodities and expand it to strengthen the supply chain across the public health spectrum. The success of this intervention has proven, yet again, that innovative approaches can tackle critical health challenges and improve lives.

Dr. Sudhir Maknikar is Director, Family health at PATH’s India Country Program.

Categories
Public Health

A healthy start for newborns in India

Every baby deserves access to lifesaving human milk and essential newborn care services.

By Isha Jain

A health worker pooling the donor human milk at Jay Prakash Hospital in Bhopal, India. Photo: Jay Prakash Hospital.

Nandini Kumari’s son arrived early. Because of his low birth weight, he was quickly shifted to the neonatal intensive care unit (NICU). The stay in the NICU and the feeding challenges that followed were hard on Nandini and her son. In an all too common story, what could have been a time of joy became a time of great distress.

India is home to roughly 18 percent of the world’s population, but about 33 percent of the world’s preterm births. The high prevalence of preterm births contributes to another alarming statistic—in India, newborns account for more than half all deaths of children under age five.

Though these statistics are grave, WHO estimates that nearly 71 percent of all prematurity-related deaths could be avoided with cost-effective interventions—breastfeeding and human milk banking, kangaroo care with skin to skin contact, and infection detection and treatment. With support from Philips India CSR, PATH is working with government partners in India to expand access to these critical interventions by scaling them across facilities and states.

Lifesaving human milk

With technical support from PATH, the states of Uttar Pradesh and Madhya Pradesh established their first comprehensive lactation management centers, and the states of Maharashtra and Rajasthan each upgraded their lactation centers into regional reference centers that now provide training and accreditation to others.

These achievements ultimately mean better access to lifesaving human milk for newborns in each state—especially preterm deliveries like Nandini’s son.

A mother expressing milk for her own baby at King George Medical University in Lucknow, India. Photo: King George Medical University.

To address the feeding challenges they faced, doctors prescribed donated, pasteurized human milk for Nandini’s son and provided counseling regarding its use. The donated milk helped him gain weight and prevented additional complications, while Nandini received lactation counselling and learned to express her own milk.

“Every hospital should offer this support for mothers and babies,” Nandini says. “I am really thankful to the mothers who have donated milk so other babies can benefit.”

Counselling support given to mothers by health workers at King George Medical University in Lucknow, India. Photo: King George Medical University

Pushing past the pandemic
The COVID-19 pandemic has disrupted the delivery of essential newborn nutrition and care services in India. Outpatient hospital services have been suspended. Hospital stays shortened. Staff headcounts reduced and more.

All these changes have made it difficult for mothers and families to get the feeding support they need. PATH is working with health facilities across India to help bridge these new gaps and provide lactation support to mothers and newborns. We’re supporting the government as they develop guidance for health workers, sharing best practices for newborn nutrition and care, and providing technical support as lactation management centers adapt to the new normal.

“From March to June of this year, PATH helped the health facilities to provide counselling and breastfeeding support to more than 10,000 mothers and their families,” says Ruchika Sachdeva, Deputy Director of PATH’s MNCHN portfolio in India. “Despite the pandemic’s challenges, we are working to ensure a healthy start for newborns.”

Isha Jain is Communications Officer with PATH’s India Country Program.