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Healthcare Technology Public Health

GE Healthcare launches infant warmer in India

India has an infant mortality rate of 42 per 1,000 live births. This has come down since 2011 when we stood at 44 infant deaths per 1,000 live births.

Almost 35 % of the 2.5 crore infants are born with either Jaundice or respiratory ailments, mostly lack of oxygen. And most of these infants end up with disability or chronic conditions because there is a lack of basic infrastructure.

A lot of this can be prevented by using a simple infant warmer. Despite the lack of sophisticated equipment a basic infant warmer can do wonders.

GE Healthcare recently launched a basic infant warmer something if priced right could help prevent infant mortality and other complications. Today almost 15,000 infant warmers are sold in the country and the requirement is far greater than that.

Now what GE Healthcare has to work on is the following

1) Work on the pricing- A made in India and made for India product would require the right price. I think the earlier version launched in 2010 was priced at $200. Now this model works without a constant supply of electricity. I think we need to bring the pricing around the $150- $ 100 mark and that would make it very attractive for many of the smaller healthcare centers in rural India.

2) Work on distribution- Again a big problem in India, distribution lines are stretched thin and I am wondering what kind of partnerships GE would need to extend their reach.

I will imagine that this product would be exported to Africa and Latin America from India and that would make a vey interesting proposition for GE and the Indian healthcare industry overall.

Great product and congratulations to the GE Healthcare team….

 

 

 

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Public Health

Why urbanization is affecting the disease pattern in India?

Urbanization is the next shift in the history of human civilization.

If experts are to be believed more than 60 % of the human population would be living in mega cities by 2050. This would call for massive investments in process, technology, infrastructure and people. It would also call for a re-look at how healthcare is being delivered today.

One of the key factors that has changed due to urbanization in India is the disease pattern.

For a country that for long relying on Agriculture, the disease pattern was mostly consisted of  acute communicable diseases. Malaria, Cholera and Typhoid for long haunted India. The tropical climate, the heat waves, the lack of proper sanitation in the hinterland was the main elements contributing to this situation.

But not anymore.

India today is plagued by typical urban diseases like TB, Hypertension and Diabetes. These are a direct result in the change in our life style without a change in the diet.

Let me give you an example. A good friend of mine is very fond of ghee. He used to tell me how his grandfather used to consume a few kilos of ghee every month, in the form of ladoos, on Rotis and sometimes even raw. He lived to the ripe old age of 94. So genetically there was nothing wrong with the diet. But what he neglected was the fact that his grandfather was a farmer and he used to walk 10 kilometers daily. That was the distance between his field and home. His grandfather did not even posses a cycle leave alone a car and worked daily from 5 in the morning till 5 in the evening in the fields. His work also involved crouching for hours, lifting hay sacks, plugging fields and manually harvesting the crops.

My friend has a different life. Wakes up at 8 in the morning and hits the gym for 30 minutes. He then gets into his car and drives to work. At work his only exercise is hitting the key board a few million times in the day.

Needless to say my friend in diabetic and has been recently told to stay off ghee for his own well being.

Technology and urbanization are good, but also require a change in diet. We need to change the diet in order to counter the changes due to urbanization. The lack of this awareness is causing a change in the disease pattern.

In the next post I will discuss the implications that urbanization has on diseases like malaria and dengue…

 

 

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Public Health

Why Polio is making a comeback in the world ?

Recently one of the biggest successes in the public health scenario in India has been the pulse polio program.

poilo-300x240From Amitabh Bachchan to Shah Rukh Khan big names got behind this program and we marveled at our own intelligence. Often I would see schools children and NCC cadets carrying the vials to give two drops to infants. The program also found a mention in masala movies like Dabangg, where the protagonist Robinhood Pandey inquires why the heroines’s brother was struck by polio and that 2 drops could have saved him. A great example of how a public health program found its way into modern pop culture.

But recently a news report from Syria brought the focus back on the dangers of celebrating too early.

Polio is back and with a bang. Not in India but Syria.

A recent report from the WHO states that polio is back. For more on that read this NPR article.

One of the dangers of conflicts as they are happening in that part of the world is that normal processes are thrown out of gear. So what was a routine administration of 2 drops, has become as complicated as open heart surgery. Aid workers have been prevented from doing their job not only in Syria, but also in places like Pakistan, Somalia and Afghanistan.The net result is that cases are showing up in places like Italy which has received a fair share of immigrants from Syria. Also swamps in Israel and Egypt are showing strains of the virus.

Egyptian authorities not withstanding their own issues in the country, have gone on a war path to solve this problem. For more on their effort please see the embedded video.

We in India have to take care of the following

1) Not remove focus from the program just because of the initial successes. The battle has just begun and the war is far from over.

2) Monitor the situation in Syria, Afghanistan and Pakistan to ensure that there is no spread to India

3) Combine the current efforts on polio with anganwadi workers and other infant schemes so that we have more standardization across the public health schemes.

The results that we have achieved against polio are spectacular but the real victory is keeping polio out for ever…..

 

 

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Healthcare Delivery Public Health

How can we tackle the issue of Breast cancer in India ?

 

In my last post I wrote about the looming challenge that breast cancer poses for the Indian women. If you have not read that piece please click here for the link.

To find answers to these questions i started looking at the various components of the Healthcare ecosystem to see what they were doing to tackle the issue.

As always I start with the Government.

The Government in India has achieved several significant milestones in the healthcare space. They eradicated small pox in the 70’s and finally eradicated polio recently. Currently the Govt is on a war footing to tackle Measles. But when it comes to breast cancer the government has done little. With around 130,000 cases per year the number is far lower than the ones from other diseases like Tuberculosis and hence the general lack of interest in that area.

Most of the Government efforts have gone around providing diagnostic equipment and helping set up radiotherapy centers. India today has 300 full fledged radiotherapy centers. While the WHO guidance is to have one center per  million people. In addition the state governments do run campaigns and have one off events. There has been a lot of talk on the Public – Private partnerships, but nothing has come out of it. Currently certain state governments have been more active. One such example is Punjab which has shown more interest in cancer detection.

The Healthcare Insurance industry in India has not been active in this area either. With many corporate programs, the Insurance firms have a great opportunity to create products just for women but till now there has been nothing concrete that has been done.

But the Medical Devices industry has been active and are on the fore front of the work against breast cancer.

According to Rekha R the marketing manager for Oncology, Philips Healthcare, medical devices firms have been active in this area. The Philips Healthcare strategy is based on three key fronts.  On the first leg they have the Philips Innovation Center (PIC) that works on technology to reduce the exposure to radiotherapy. As the only way to detect the condition is to use self examination followed by a mammogram, the PIC tends to work with technology like Microdose Mammography. In pursuit of this facet Philips acquired the Swedish firm Sectra that has the technology to reduce scatter and reduce the scan time.

The second pillar rests on generating this awareness among general practitioners and other specialists. They are made aware that there is technology can reduce risk which scanning for cancer and they should recommend patients to be aware of the technology available for preventive screening.

The third pillar is around educating women. In the end self examination is the first step and there is no way that any steps can be taken against breast cancer without the women becoming aware of the self examination methods and their need to do the same.

Also Philips invests a lot of effort in continuing medical education for  doctors and also hold technical webinars for them. there are also programs called ‘Catch them young ‘ which trains freshly graduated doctors.

In the next issue of this series I will talk about a unique program called Asha Jyoti and also reflect on the work done by the Pharmaceutical sector in this area.

 

As always comments and suggestions are welcome.

 

Categories
Healthcare Delivery Public Health

Why breast cancer could be a big looming challenge for India ?

Cancer.

The very word strikes terror in the hearts of patients and physicians alike.

But often we consider cancer as a problem of the west and one that does not really affect India. Except for tobacco related cancer, there is hardly any public outreach program either from the Government or the private health sector.

India has almost 3-4 million cancer patients. The number could be much higher as the detection mechanisms in India are almost not present. 70% of these cancer patients come in at stage 3 or 4 where the prognosis is very bad.  Almost a million cancer are detected annually and the number of cancer patients in India could be around 7 million in the next couple of years.

Women though less prone to tobacco related cancer are more prone to Cervical and breast cancer. These two types account for almost 80 % of cancers in women. Every year almost 130,000 cases of breast cancer are detected in India and according to the Indian Medical Association the situation will get worse.

Rural women are more affected as the cancer is detected at a much later stage. The increase in awareness and education has also resulted in the rise of the cases from 54,000 ten years ago to 130,000 today. Almost 30,000 women would die due the breast cancer every year, which is a sad statistic as breast cancer is not terminal. If detected at early stages can be dealt with effectively. Incidentally October was breast cancer awareness month and a series of events were held in India to take stock of the situation. Overall there were some key reasons why the situation was getting worse in India.

Some of the reasons for increase in the cases detected include

1) Awareness and education

2) Late marriages and pregnancies

3) Use of contraceptives

4) Hormonal imbalances

5) Stress and change in life style

 

Not surprisingly Bangalore has emerged as the breast cancer capital of India. Bangalore has an incidence of 36.6 per lakh cases. Thiruvanathapuram and Chennai follow closely and these figures are also an indication of higher awareness in these cities.

The real challenge is to get women to take charge of their lives and get serious about screening. High risk categories are advised to undergo screening once every 2 years especially after the age of 38. Those in high risk include women who have an incidence of breast cancer in their family.

A good example in news was the extreme step taken by actress Angelina Jolie who got her breasts removed once she realized that she was in the high risk category. Her mother it seems had been diagnosed with breast cancer and she had a 80 % chance of developing the condition herself.

So what can we do as a nation?

In the next part of this series I will discuss what can the various parts of the healthcare ecosystem do to combat breast cancer in India.

As always views, suggestions and comments are welcome.