Previously, most research focused on the impact of one or two lifestyle choices on hypertension, heart failure, and other diseases. Here are 2 studies which assess the impact of a cluster of modifiable lifestyle choices on the onset of hypertension and heart failure.
1) The risk of the onset of hypertension was prevented or delayed by 78 percent if study participants:
* Kept their body mass index under 25 (within a normal weight range)
* Exercised vigorously daily
* Maintained a diet designed to stop hypertension
* Drank alcohol moderately
* Used a non-narcotic analgesic less than once a week. Non-narcotic analgesics include pain relief medications, such as acetaminophen, or Tylenol
* And took recommended doses of a folic acid supplement
2) A 21 percent lifetime risk of heart failure was reduced to 10 percent if male participants followed four of the following lifestyle recommendations:
To overcome the acute shortage and uneven distribution of human resources in public health delivery system, the Ministry of Health & Family Welfare aims at overhauling the current regulatory framework. Toward this end, it is proposed to set up a National Council for Human Resources in Health as an overarching regulatory body to achieve the objective of enhancing the supply of skilled personnel in the health sector.
http://www.mohfw.nic.in/nchrc-health.htm
Here is the draft report for initiating Positive changes in our medical education system.
Some of the ideas mentioned are revolutionary scrapping multiple levels of control and having a standardised post graduation level exam) whereas some are half-assed (like the umpteen administrative functions concentrated in a select few).
The general public is invited to go through the report of the Task Force and the draft bill and sent their comments / observations on the suggested provisions by the 15th October, 2009.
In 2007, the ethical landscape surrounding medical male circumcision (MC) suddenly lurched and shifted when the World Health Organization and UNAIDS declared unequivocally that the `efficacy of male circumcision in reducing female to male transmission of HIV has been proven beyond reasonable doubt.The male foreskin has been shown to have a high number of cells that were targeted by the HIV virus
Interestingly, evidence that MC had medical benefits has been mounting for more than 20 years. Not only does the procedure reduce the risk of HIV infection, it also has been shown to prevent urinary tract infections, sexually transmitted diseases, and penile and prostate cancers.
Researchers have even found that MC reduces the risk of cervical cancer in current female partners . In spite of that growing list of medical benefits, the issue has hovered just below the radar screen until several large randomised controlled studies from Africa showed that circumcision offered a 60% to 70% protective effect against the heterosexual acquisition of HIV. The evidence was so compelling that three of the studies were stopped early, on the recommendation of Data Safety and Monitoring Boards
The Government of India has been reluctant to approach an issue that promises to be controversial among conservative Hindus. MC is considered a marker of religious identity since Muslims routinely circumcise their male children, and Hindus do not. It has been suggested that at times, circumcision status may even have been used to identify people`s religious affiliation during communal riots. Popular wisdom holds that even the mention of MC in some communities will trigger sectarian violence. Predictably, some opponents have argued that the greater good of society must be protected by withholding information about MC from the population.
This is a joke, surely?
They wont tell the benefits of circumcision because they want to use it to identify Muslims?
The benefits of circumcision include:
• Decrease in physical problems involving a tight foreskin [Ohjimi et al., 1995].
• Lower incidence of inflammation of the head of the penis [Escala & Rickwood, 1989; Fakjian et al., 1990; Edwards, 1996].
• Reduced urinary tract infections.
• Fewer problems with erections, especially at puberty.
• Decrease in certain sexually transmitted infections (STIs) such as HIV, HPV, genital herpes, syphilis and other micro-organisms in men and their partner(s).
• Almost complete elimination of invasive penile cancer.
• Decrease in urological problems generally.
Other proofs of advantages of circumcision
Removal of the foreskin of the penis (male circumcision, MC, C) is known to significantly reduce female-to-male HIV transmission through sex, which then decreases male-to-female transmission. Three recent randomized controlled studies from Africa have shown that circumcision offers a 60% to 70% protective effect against heterosexual acquisition of HIV. The protective effect of circumcision against HIV, known since the 1980s, has been confirmed by more than 30 studies before these three famous randomized controlled trials, which are the criterion standard of clinical research.
In a developing country such as India, where an optimal level of health service is a dream to many, there are far too few health workers in training and the number of training institutions is far too few. To understand the gravity of the situation, ther r r re are more than 365,000 doctors, 264,000 nurses and 350,000 allied health professionals which includes Multipurpose Health Workers, Village Health Guide, etc. Whereas, proper training facilities exist only at a few institutions like National Institute of Health and Family Welfare (NIHFW), State Health and Family Welfare Training Centers. With a limited number of available training institutions, it is nearly impossible to train large numbers of medical officers and paramedical workers. Nearly 47 Health and Family Training Centers (HFWTC's) and seven Central Training Institutes (CTIS) provide health and family welfare training to all categories of health functionaries in the country. These long-duration training programs attract a limited number of clients, and hence most of the institutions also organize in-house short-term training programs which has less than the desired impact on their functionaries.
Distance education is a relatively new concept which not only has the ability to train a large number of health care workers in a short time in a cost effective way but can also attend to skills of health care without diluting the quality.Distance teaching-learning often involves a multi-media approach to design, develop and implement independent learning programs through self-instructional materials, both in print and electronic media forms. Distance study allows self pacing for convenience and also facilitates learners having control over their learning. The various media used for distance education delivery include among others, print materials, audio and video programs, radio and television programs, tutoring and counseling, field visits, laboratory practicals, extended contact programs, and teleconferencing.
The following issues need to be addressed and considered for successful application of distance education programs for health professions:
1. Since health sciences deal with life and death and are therefore are more skill-oriented (rather than more knowledge-based), it is felt that providing basic beginning or early training in the field of health may not be feasible through distance learning. Being an innovative and flexible system, and having the ability to respond to emerging training and educational needs, distance education is more appropriate for inservice training of health personnel.
2. The academic programs have been confined to a limited area of health education and training. In order to meet the diversified and emerging needs of health workers, the programs and courses have to go beyond medical graduates to include a wide variety of need-based functional areas ranging from simple awareness programs to more complicated skill-oriented courses on epidemiology and health economics.
3. Application of sophisticated communication technology has to be done cautiously, keeping in view clients needs, cost, media behavior and infrastructure and facilities at the receiving end. In the developing countries including India, audio and television programs seem to be more feasible and promising. Furthermore, multi-media packages need to include a large amount of hands-on and field experience.
4. An issue to be deliberated is the provision of student support services for health workers and professionals. While compulsory counseling and extended contact increase the effectiveness of programs, these on the other hand pose problems to both providers as well as the receivers of health education. More practical-oriented courses need to have compulsory built-in face-to-face components; and work centers or practice centers at grassroots level with required instructional provisions would be more feasible than regular study centers.
In conclusion, it is worth noting that distance education has tremendous potential for providing education and training programs to different categories of medical and paramedical personnel as a means of helping achieve the goals of HFA. In addition to the national agencies such as the Ministry of Human Resources Development, the Ministry of Health & Family Welfare and Indira Gandhi National Open University, international agencies such as WHO and UNICEF need to play increasingly prominent roles in facilitating the achievement of national and institutional targets. Proper use of ISRO provided satellite communication facilities can make distance education courses an important aspect of ongoing medical education.
Chandigarh: In a bid to increase accessibility of the rural people for getting better healthcare, the Chandigarh Administration has started a Mobile Medical Unit (MMU) to provide healthcare services at the door steps of the rural people.
MMU not only facilitates access to basic services of healthcare, but also provides essential knowledge and information on the kind of services under the umbrella of National Rural Health Mission (NRHM).
The Unit, a hospital on wheel under the flagship programme of NHRM, has been pressed into service in the union territory (UT) as joint venture with the Guru Granth Sahib Sewa Society.
A team consisting of eye specialist, gynaecologist and dentist will provide specialist services from within the van. Two doctors of Health Department along with RCH staff will provide primary health care facilities including MCH and immunisation services.
Initially, 10 villages have been identified which will be visited by the team fortnightly.
Information, education and communication (IEC) material on health education including personal hygiene, proper nutrition, hazards of tobacco consumption would be displayed and health awareness about various ongoing national programmes will be imparted.
RAKSHA (Registered society for knowledge and health activities) is a Rajasthan based non-profit organization working for democratization of knowledge and health. It is headed by 1)Dr.Neelesh Bhandari, a Armed forces Medical College passout, a pathologist, post graduate in Human Rights and a medical multimedia consultant. Dr.Neelesh has more than ten years of experience in public health administration, of which about Eight years is in Rajasthan Public service commission. 2) Dr. Preeti Lodha, a psychiatrist and health rights activist with more than ten years of experience in public health administration, of which about Eight years is in Rajasthan Public service commission. Additionally, Dr. Preeti has previous experience of One year as a Project Manager in Operation Veerni. ( A maternal and child health project run by Apollo Rajdadiji Hospital, Jodhpur with international assistance).
The Swasthya Beema Yogana is an ambitious programme meant to provide cashless health care services to the poor in Rajasthan and India.
-Health Raksha Campaign, Rajasthan-
The main aims of the Project-
1) Creating New multimedia/video content for public awareness 2) Displaying multimedia content at important rural junctions using Audio-visual equipment and via local cable and news channels.Permanent IEC Boards ( 4 feet by 2 feet) to be erected at more than one thousand sites. 3) Explaining the benefits of the scheme to Doctors and health workers. 4) Screening BPL families and referring appropriate cases to public hospitals. 5) Collect data on baseline health status and scheme usage trends amongst the BPL families.
Broadly, the project would consist of
1) Four vehicles, armed with Audio-visual equipment ( Television and CD player) to be leased for One year. 2) Each vehicle manned by one driver, one paramedical staff and one Technician, ie 3 personnel.( Total Twelve employees in four vehicles). Supervision over Four vehicles by Two doctors ( Dr.Neelesh Bhandari,Pathologist and Dr.Preeti Lodha, Psychiatrist). 3) Each vehicle entrusted with carrying out IEC activities in Six ( or seven) Districts.( Total 25 districts) 4) Each vehicle makes a minimum of twenty (20) visits per month.( Total approx. One thousand visits over 25 districts in one year) These visits would be prefixed in consultation with local authorities and would consist of rural junctions with high BPL population/attendees ( like Tehsil offices, hospitals, panchayat bhawan, Bus stops, subordinate courts etc.) 5) Dr.Neelesh Bhandari and Dr.Preeti Lodha to make regular monthly visits to various district hospitals, CHCs etc. to give multimedia presentations on the Scheme to the medical and paramedical staff. These visits shall coincide with monthly block/CHC meetings and achieve the dual purpose of training and sensitization of health workers and Doctors. All District hospitals and medical staff at CHCs in all 25 districts to be covered over one year.
Creating New Multimedia
1) For this campaign original video content shall be produced . Promotional content shot in TV studios ( Surya Cine vision, Mumbai and MEdRC, Hyderabad), Interviews with BPL families and officials on site, health education videos and other such content shall be produced. RAKSHA expects to produce original video content of Tens of hours over One year. All intellectual property rights to the multimedia content will be equally shared between RAKSHA and Controlling agency / ICICI Lombard.All the content shall be branded and provided to local cable channels, TV stations and also published on our youtube channel on medical education. 2) Each visit shall be recorded via Still photographs which shall be posted on a dedicated Flickr channel created for this purpose.Copies of photographs shall be distributed to all the local newspapers. Close to five thousand photographs ( Five photographs per visit X approx. 1000 visits) shall be published on the internet. 3) All the events shall be chronicled ( updated every three days) on a new blogspot/wordpress blog created for this purpose. Such extensive self publication via youtube, blogs and Flickr.com shall also assist in Remote Monitoring of the campaign by state and central authorities at ICICI Lombard.
During each visitby the mobile team, the activities carried out would include
1) Set up the TV and the CD player 2) Give short talks on the Bima Yojana to the gathering 3) Distribute pamphlets and other brochures. 4) Provide OTC medication only to BPL families. This will be done primarily to attract the Target audience.The seriously ill amongst these families to be referred to nearby hospitals with instructions to avail the Bima Yojana. Data regarding total number of patients seen and referred to be conveyed monthly to ICICI Lombard.
This is the skeleton sketch of the proposed Project to conduct IEC and other Promotional activities in the state of Rajasthan over one year. Initially, the four vehicles shall concentrate on the four districts of Jhalawad, Rajsamand, Barmer and Bikaner ( as recommended by you). Later, all the remaining districts shall be covered in equal proportions during the year. RAKSHA shall operate locally in conjunction with public health authorities and local NGOs like Bharat Vikas Parishad., Manav sewa sansthan and others.RAKSHA shall strive to create new partnerships with national and international organizations by using United Nations platforms like solution exchange.to furthur extend the reach of this campaign.
Copies of all the multimedia content along with analysis of before-after data accumulated over the year shall be handed over to Controlling agency / ICICI Lombard at the end of the year. Kindly email me for receiving a detailed project report. If approved, RAKSHA can initiate the project from the First of January, 2009.
Chief Mentor- RAKSHA Registered society for knowledge and health activities. c/o Suncity Hospital and Research Center, Paota, Jodhpur 342006 Phone- 02912701970
Proper Health management requires the monitoring of the health status of the population, the provision of services as to the coverage and utility, drugs stocks and consumption patterns, equipment status and availability, Finances, personnel on a regular basis.India has a large population living in widespread far flung areas. Because of this, Data collection and streamlining of public health services has always been a very tough task.
The Government of India has launched the Health Management Information System (HMIS) portal to convert local health data into real time useful information, management indicators and trends which could be displayed graphically in the reports.The new system envisages enhancing the information flow at various levels and providing useful and timely inputs for programme development, monitoring and midcourse interventions in the policies.
The HMIS portal captures data to be collected as per the revised HMIS formats on a web-based system at the District level so that the primary data can be easily aggregated and the information and reports flow quickly to the state head quarters and the Ministry.
The application has been developed by the Ministry in technical collaboration with iBILT Technologies who will also be providing maintenance and support to the application for the next five years.
The portal will be generating unique intelligence reports using the advanced SAS Data Warehousing platform and explore and establish new linkages and advanced analysis for policy initiatives.
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