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Public Health

Now an easier way of avoiding UTI for Women

One in two women in India have been or will be affected by UTI (Urinary Tract Infection) in their lifetime. One of the main reasons for this are unhygienic public toilets in India. As it is easier for the bacteria to reach the bladder in women, UTI affects women more than men.

In men with enlarged prostate glands and those affected by diabetes, UTI has been observed as well. Symptoms of UTI range from burning sensation in the lower part of the bladder and specifically while passing urine. It also manifests itself as pain, swelling, and fever. While mostly transient, UTI can spread and cause infection in the kidneys. That makes it a serious condition especially in the case of senior citizens.

A lot of emphasis in the management of UTI goes with prevention including awareness about cleanliness in public restrooms and overall sense of hygiene. Also exercise and drinking enough water can result in lowering the chances of contracting UTI.

Medically UTI is managed with Anti Biotics, with both broad-spectrum and narrow-spectrum antibiotics used to treat the condition. Cephalosporins and Quinolones are the medicines that are the treatment of choice. But the ultimate defense against UTI is prevention. While public campaigns like Swacch Bharat are taking shape the improve the public health and sanitation, these have been concerted efforts from the private sector to raise awareness and reduce instances of infection.

Bangalore based startup Pee Easy is one of the players that has recently launched a product to help women and men to overcome the challenges of UTI. They have used food grade paper to create a contraption that can help women and men to pass urine standing up. This would really help reduce the chances of infection. Pee Easy has been set up with vending machines across malls, hospitals and airports and also available at pharmacies.

Such devices are also useful in medical departments like gynecology, orthopedics, urology, oncology and HIV, pathology (for easier collection of a urine sample (under testing)), and post-surgery. In addition to women, senior citizens can really help in reduction of infections.

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Public Health

The real cost of obesity in India

India has always been a land of plenty. Historically it was a land that controlled almost 25-30% of global GDP. It is no surprise then that ancient texts write about obesity in uncertain terms. As a matter of fact practices like Yoga developed in India as a holistic system for physical and mental wellbeing.

During the colonial rule India suffered and so did the health of its citizens. Obesity was replaced with starvation. The Bengal famine during 1943 was the epitome of what all was wrong with the colonial rule and administration. The situation continued after independence, the PDS and rationing system ensured that food was available but in limits.

But 1991 changed all that. With global liberalisation India was an active market to many of the food companies. Nestle, Unilever, General Mills, among others introduced many of their global successes in the country. The net result combined with the growing purchasing power of the middle class has resulted in an epidemic that affects 5% of the population today. It also lays the foundation for systemic conditions like Diabetes and circulatory conditions like cardiovascular diseases.

According to reports from the Indian Heart Association India carries almost 60 % of the cardiovascular disease burden of the world. In terms of obesity again India sees more instances of abdominal obesity. During research on 22 different SNPs near to MC4-R gene, scientists have identified an SNP (single nucleotide polymorphism) named rs12970134 to be mostly associated with waist circumference. In this study, more than two thousand individuals of Indian origin participated and the aforementioned SNP is highly prevalent in this group. Also, obesity seems to affect women more than men in India. According to research done by CADI Research, Obesity among women seems to go higher with increasing BMI.

So what’s the real economic cost of obesity?

  1. For starters, I think it is not necessary for people to spend to consume more if they are already obese. Consumption of food should be “means to an end” and not the other way around.
  2. Obesity forms the basis of the other two lifestyle diseases killing India- Hypertension, and Diabetes. Just last week a very serious colleague from my office had a stroke, his condition was exasperated due to diabetes and obesity.
  3. Studies in India estimate that, for a low-income Indian family with an adult with diabetes, as much as 20 percent of family income may be devoted to diabetes care. For families with a diabetic child, up to 35 percent of income is spent on diabetes care.
  4. If you have Diabetes for five years you would have spent around Rs 1,50,000 on diabetes treatment only. After 10 years you would have spent Rs 4,00,000 and after 20 years you would have spent Rs 15,00,000. The increase in cost with time is due to the increase in complications.
  5. To add this the direct cost of diabetes is around Rs 1,00,000 which includes the cost of direct consultation with doctors and the numerous tests that have to be performed.
  6. Then there is the opportunity cost. Is it estimated that a loss of Rs 50,000 per annum per individual due to sick leaves?

So essentially we have a interesting situation, where we spend money to consume and then spend again on healthcare services.

So how can we change this around

  1. Get aware of the disease burden. If overweight then start, looking at dedicating 1 hour per day on exercises. Something as simple as walking daily is a good start.
  2. Lose the habits, drinking, smoking, junk food is again adding to the costs.
  3. Get regular tests done, this avoids surprises and helps you plan to cover for the disease burden. At a minimum, you should get HB1ac test done quarterly.
  4. Pick up Yoga, I have been practicing Yoga for the last 5 years and have immensely benefited from the practice

The cost of healthcare is only going to go up. Just remember that steps taken today can reduce the cost tomorrow, whether to act or not is totally upto you.

Sources

  1. https://cadiresearch.org/topic/obesity/global-obesity/obesity-in-india
  2. https://edition.cnn.com/interactive/2017/10/health/i-on-india-childhood-obesity/
  3. https://timesofindia.indiatimes.com/life-style/health-fitness/health-news/What-is-the-cost-of-diabetes-care/articleshow/49843288.cms

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Public Health Uncategorized

National Health Blue Print 2019

Niti Aayog in July 2019 has finally released the digital health blueprint policy for India. The focus of the digital health blueprint is in line 2017 National health policy which focuses on long with a strong emphasis on the care continuum. National health policy also plays a lot of emphasis on the Triple Aims that include

1)Accessibility

2) Affordability

3) Quality of care

National Digital Health blueprint truly recognises that there is no one entity or organisation that can solve the Healthcare problems of India it calls the blueprint for the entire Healthcare system this is a strong departure from the traditional ideology that the government is the sole provider of healthcare for all citizens.

National health blueprint focuses on three major components

  1. Digital health infrastructure number
  2. Digital data
  3. Standards and regulations

Meeting key healthcare objectives

The key objectives of the national digital health blueprint include establishing the core data model for storing and using healthcare data that would be generated from this ecosystem. Standards for the infrastructure required for its seamless integration using standards for all the components of the ecosystem.

The other interesting aspect is creating a system of Personal Health Records, based on international standards, and easily accessible to the citizens and to the service providers, based on citizen-consent.

There is also a provision for declassifying data for usage for analytics and doing population health management. In addition to these, there is guidance on governance, leveraging information systems already in place.

Finally, the 4 building blocks of the policy are

  1. Identification- Identifying the citizen and ensuring that his corresponding health data is mapped to his id. This is possible through Personal health identifier and through the health registries
  2. Citizen in the center- All access and control of the data lie with the citizen. This is enforced through consent manager, Anonymizer and Privacy Operations Center.
  3. Interoperability- Data should be available through health information exchange and National Health Informatics Standards.
  4. Access – Governed by Mobile First and a Digital Web portal strategy

I would encourage you to download the blue print report and study the implications of the report for your self. Looking forward to your comments.

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Public Health

Healthcare in union budget 2019

I was shocked to see only a passing mention of the healthcare sector in the healthcare budget 2019. For years healthcare as a sector has been neglected and though there are efforts by the government, it is clearly not enough to revive the stagnating rural health system in India.

The finance minister made a passing reference to the sector, stating that according to the vision presented in the interim budget, “a healthy society would remain an area of attention for the government, which she attributed to factors like Ayushman Bharat and well-nourished children and women.” This was during her Union Budget 2019 presentation yesterday in the Parliament while addressing the healthcare budget 2019.

The healthcare budget 2019 spend sees a 15% rise in terms of allocation to the finances to the ministry of health and family welfare. In 2019-2020 the ministry would have access to INR 62659 crores to spend on the health and welfare of the nation.

Also, the budget to the National Rural Health Mission has increased by 7 % to INR 27,039 Crores in the healthcare budget 2019. Also, there has been a marginal increase to the National Urban Health Mission to INR 950 Crores.

Where does all this leave us? Well not very well I am afraid.

The Primary Health Care (PHC) system is crying out for reform with only 20% fulfilling the minimum criteria for Indian Public Health Standards. Almost 5 % of the PHCs are without doctors and almost 60% have only 1 doctor servicing the population. We had discussed the importance of rural health in the overall healthcare reforms in India in an article in 2017.

In analyzing the election manifestos of political parties, from 2014 elections, we realised that healthcare is not an election issue. The report would be available in a months time, but on initial analysis, health occupies about 2-6 % of the manifesto.

Keep tuned to read more on this in our follow up stories.

But today the question to you is, what would an ideal healthcare budget look like if we had to provide access to quality healthcare to a billion plus people? We would like to hear your thoughts on the same.

References

Categories
Public Health

Air pollution linked to high risk of oral cancer: Study

You may be wrong if you still believe that oral cancer is only caused by smoking, tobacco use, liquor and betel nut. Because a recent study in Taiwan says that air pollution too could lead to a high risk of oral cancer.
The study, published in the Journal of Investigative Medicine, has literally turned the tables on the conventional wisdom we still adhere to when it comes to the causes of oral cancer. Its findings are not what we have believed all along.
It says higher levels of air pollution may also be responsible for the cancer of the lips, tongue, cheeks, mouth and palate. Which means, the air around us is more harmful that we assume with risks more dangerous than only respiratory problems.

Before diving into the study, it’s good to have a look at some numbers –

  • As per the WHO, air pollution causes an estimated 4.2 million premature deaths worldwide per year
  • It also says that, nearly half of around 6,57,000 patients of oral cancer who’re diagnosed annually across the globe with die

Details of the study
The study clearly links higher levels of air pollution to a greater risk of oral cancer. And if it’s to be believed, this calls for more safety measures on part of us in dealing with air pollutant. As per the study, apart from the conventional list of causes, oral cancer may also be caused by the heightened levels of fine particulate matter (PM2.5) and ozone (but to a lesser extent).
We have reasons to believe the findings of the study because it has used a large sample size, and it’s also the first in the world to link oral cancer with PM2.5. The findings may appear to some an attempt to create panic, but they are not an isolated case as there is a growing evidence linking the adverse effects of higher levels of air pollution on human health.
While it’s widely known that PM2.5 is harmful to respiratory and cardiovascular health, our exposures to heavy metals and emissions from petrochemical plants can also lead to the development of the disease. When analysed in this light, we can easily see how air pollution can harm us more than we think.

Some of key things that can be corroborated form the study may include –

  • There is no safe level of air pollution when it comes to our overall health
  • High air pollution is more dangerous can causing a greater risk of the lungs, asthma and dementia
  • The study has collected data from 66 air quality monitoring stations, analysed the health records of more than 4,80,000 men aged 40, and found a 11,617 cases of mouth cancer
  • The study clearly establishes how people who’re exposed to the highest levels of PM2.5 have a greater risk of oral cancer
  • The study has also found that men exposed to higher level of air pollution are 43% more likely to develop oral cancer than those exposed to average level of pollution
  • The study also observed exposure of men to higher ozone levels and found in them a greater risk of developing oral cancer

Clearly, air pollution is now a big menace, something we can’t afford paying lip service to. The time has come when drastic measures needed from governments across the world to reduce emissions and curb carbon in the atmosphere. Only this can lead to a safer world where a quality life can be lived.

Reference Links:

  1. https://timesofindia.indiatimes.com/life-style/health-fitness/health-news/air-pollution-linked-to-high-risk-of-oral-cancer-study/articleshow/66164807.cms
  2. https://swachhindia.ndtv.com/air-pollution-journal-of-investigative-medicine-oral-cancer-particulate-matter-26472/

Author Bio:
Irshad Alam is a writer with experience in oral care. He shares information about dental health and treatments. You can benefit form his posts to boost your understanding of things related to dental health. He also advises on teeth braces price, but you must consult only a dentist for more knowledge in this regard.