India Experience

 OVERVIEW OF PROGRESS ON HEALTH CARE WITH

REFERENCE TO MDGs IN SOUTH ASIA

 (5th ARM, 23-24 January 2006, Agra)

 OneWorld South Asia, New Delhi

www.oneworldsouthasia.net

Health Sector Covers

• Hospitals• Clinics• Nursing Homes• Civil Infrastructure• Doctors• Paramedical Staff• Medicines/Drugs• Equipments & Devices• Chemist Shops• Maintenance

Issues• Limited Public Resources

Plan Outlay For Health During 3rd Plan 1961-66 was only 2.6%, Reduced To 1.4% In 1997-2002

Now, Government Spending Is 0.9% of GDP • Poor quality of services through public health

infrastructure Sub centres, PHCs, CHCs, district hospitals & tertiary hospitals Doctors, paramedical staff Medicines, devices and equipments Monitoring – eg TB Poor maintenance Poor accessibility (distance) and affordability (including transportation)

Issues contd …..• Conflict of interest of different systems of medicine

Allopathy Ayurvedha Siddha Unani Homeopathy

• Disease burden Diarrhoea – leading cause of child deaths; 19.2% children below

the 3 years of age suffer from diarrhoea 35% of infants are not fully immunised – 90% in Bihar, 81% in UP TB – cases 85 lakhs; 2 lakhs die each year HIV/AIDS cases 51 lakhs Cancer – 75 lakhs diagnosed each year Cardiovascular diseases – 3.8 crores Diabetic patients – 3.3. Crores; 50,000 loose their legs Mental disorders – 6.5 to 7 crores

Disease Burden - India contd …..

Potential interventions

Pre-natal diagnostic techniques (PNDT) Act, amended in Feb 2003

• Prohibits and disclosure of sex of the foetus• Prohibits advertisements• Punishable with imprisonment and fine

• 80% provided by private sector

• of health service providers – medical, nursing, pharmacy councils, drug quality control

National rural health mission (NRHM), 2005 • Give more powers to the village councils

• Availability and accessibility of quality healthcare especially for the rural people, poor, women and children

• To cover 3,00,000 villages

• To revitalise local health traditions – ISM, AYUSH

• Success depends on alertness of civil society

• Golden triangle partnership mission to develop drugs for 13 specific diseases

• National health programmes – TB, leprosy, HIV/AIDS, etc.

• Dgroups: Pro-poor hiv/aids strategies www.dgroups.org/groups/hiv-aids

Some ICT experiences

• E-health cards – Sirsa, Haryana• Info-kiosk: n-Logue – Aravind Eye Hospital, Madurai• Telemedicine• Ek Duniya Sawal Jawab: IVRS technique – Drishtee, Haryana and Bihar; Tarahaat, UP and MP

• Phone-in radio programmes: Aravis, Gurgaon, Haryana

• Interface with governments, NGOs/CSOs and community through multi-stakeholder partnership model (MSP)

• Disease surveillance and monitoring

• Facilitate in sourcing content from the society (pull)

• Disseminate content (push) from NGOs/CSOs, Govt., to the community

• Capacity building

• Assess community needs, then develop/use suitable tools

What MSPs can do?