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India won’t meet National Health Policy 2017 targets: Ex-health secretary




New Delhi, April 15: Health has never been a national priority and it is one reason why we have the highest number of women dying during childbirth and under-five mortality rates, former Union Health Secretary K. Sujatha Rao wrote in her recently-published book “Do We Care? Indias Health System”.

Drawing on two decades of work in public health, Rao favours increasing the health budget, greater use of technology and providing leadership and good governance for better healthcare. In an email interview with IndiaSpend, Rao said that with the level of under-funding for health and crowding in of ambitious targets, India will not meet the National Health Policy 2017 targets. Excerpts:

Q: Public health spending is 1.16 per cent of GDP while the World Health Organisation (WHO) recommends spending five per cent of GDP. National Health Policy 2017 talks about increasing the spending to 2.5 per cent by 2025 but we haven’t met the 2010 target of two per cent of GDP. Why does India’s public health funding remain low?

A: Public health spend is low for three reasons: First, lack of political will and the absence of political philosophy that places an individual’s health, well-being and education as being central to the development process. Our mindset is still wired to fly-overs and fast trains. Second, the absence of accompanying reforms in the direction of decentralisation, flexibility and greater accountability to enable quicker absorption of funds and utilisation. Thirdly, on the macro-level, we are not collecting enough taxes and have competing demands and liabilities that have constricted space for increasing resources for health.

Q: Most of the health targets mentioned in National Health Policy 2017 are the same as in 2002, which were supposed to be met in 2010. Most targets have been repackaged with new deadlines. What went wrong, and how do we ensure that we meet the 2017 targets?

A: We will not meet these targets either… not with the level of funding proposed and the crowding in of too many ambitious targets, indicating an absence of prioritisation. I see no shift in strategy that could accelerate the process for achieving the targets within the time-frame suggested. Our public health systems are too weak to fulfil the many demands being placed on it.

Q: How important is it to regulate the private consultation system that caters to 75 per cent of the country’s health needs, as a 2016 Brookings India report showed?

A: Since the 1980s, with the gradual emergence of the economic crisis, India had no option but to allow the entry of the commercialised private sector. The structural adjustment following the IMF loan in 1993 accelerated the process due to severe budget cuts.

Health, unlike other sectors, is fraught with market failures such as the asymmetry of information. These characteristics put limitations on the ability of markets to arbitrate equitably necessitating state intervention. Regulations are critical to protect patient interests and ensure that patient vulnerability is not exploited by the provider… or, as we now see, by the hospital managements.

Q: Talking about the cut in health budgets in the 12th Plan (2015-17), you have said: “…reduced public spending on health and pushing of public-private partnership (PPP) is a dangerous cocktail”. Yet, the National Health Policy 2017 talks about partnerships with the private sector to “address specific gaps in public services”. Should India focus on strengthening the public sector than on PPPs?

A: PPPs work when the risk is shared. They fail when it is a one-sided game with all benefits taken by one partner and all risks borne by one. PPPs in the health sector seem to be more like the latter case.

Secondly, purchasing of health services is based on a contract that is a legal document. So, when you have restricted budgets and contractual obligations, spending priorities get dictated by the legal commitments and not what is in the immediate interest of the people.

Thirdly, the “gap” is more a huge hole. Private sector is the dominant provider. So, if there has to be a real PPP based on a level playing field, the public sector has to be strengthened.

Q: You have mentioned the lack of public discourse and involvement on health in demanding accountability from policy makers. What are the factors responsible for it, and how do we change it?

A: Lack of understanding or perhaps a belief that illness is our fault. Besides, in a very poor country still struggling for basics, health is not a priority — access to water, food and basic incomes to survive are.

By Swagata Yadavar (IANS/Indiaspend) 


Lap-band surgery may lower chronic knee pain



chronic knee pain

New York, March 20: Obese people who have a band surgically strapped around their stomach to restrict food intake not only lose weight but will also suffer less from arthritic knee pain, a new study suggests.

According to researchers, the pain proceeds from the deterioration and related inflammation in knee joints caused in part by the extra weight they bear.

While the pain relief seen with lap-band surgery applied to all patients with osteoarthritic knees, researchers found that it was most helpful in the young men and women who lost the most weight.

“Our study shows that extremely obese people seeking relief from their knee pain should consider lap-band surgery earlier because the benefits from it being successful — although significant for all ages — decrease with age,” said co-author Jonathan Samuels, Associate Professor at NYU School of Medicine.

For the study, published in the journal Seminars in Arthritis and Rheumatism, researchers examined 120 patients who underwent lap-band surgery between 2002 and 2015.

All were surveyed for what they remembered about their knee pain immediately before surgery, a year after their procedure, and for as long as 14 years later.

The main purpose of the survey was to find out why some extremely obese people showed more knee pain relief from lap-band surgery than others.

According to the survey results, men and women in their 40s experienced post-surgical knee pain reductions after one year of between 50 and 60 percent; while those in their 50s, one year later, had pain reductions between 30 and 40 percent; and those in their 60s, had reductions between 20 percent and 30 percent.

Pain relief persisted for a decade in all patients monitored.

People with BMIs in the upper 40s were just as likely to report decreased knee pain as people with BMIs in the lower 40s if they lost proportionally the same amount of total body weight.


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Healthy office spaces promote healthy lifestyles




New Delhi, March 20: Managed and serviced co-working spaces go an extra step to promote a healthy lifestyle. Studies have shown that employees who work in a healthy environment usually enjoy good well-being, increased productivity and a positive outlook towards the company.

Creating a perfect office set-up and turning it into an ideal workplace environment usually involves astronomical costs. From paying office rent to office furnishings, insurances, equipment and money invested in health and hygiene, the cost is mostly high.

Puneet Chandra, Founder & CEO of Skootr, a managed office solution provider, lists the five musts for creating the ideal office space.

* Maintaining hygiene: None of the healthy measures taken into consideration will be effective if the workstation itself is host to illnesses and lacks basic sanitation. There are numerous people who get satisfaction from a clean environment. An absolutely clean and a hygienic toilet with the smell of fresh lemon is on everyone’s wish list. A hygienic washroom boosts the morale of office employees and helps in increasing their productivity.

* Seeding plants: Numerous scientific studies have established the advantages — both physical and psychological — of having plants inside the office. Moreover, with pollution levels rising above the danger zone, seeding indoor plants in an office will contribute towards fresher air and a cleaner environment. It is also highly cost-effective compared to indoor air purifiers: A significant aspect for any cost-conscious business owner.

* Pantry services: Clean, healthy and hygienic food leads to happy and efficient employees. Hence, pantry services form an important ingredient of a healthy work environment. Industry experts say 70 percent to 90 percent of healthcare spending can be saved by excluding unhealthy lifestyle choices, one of the major reasons for chronic lifestyle diseases. Co-working and managed office space providers are opting for pantry service wherein snacking becomes a healthy break-time instead of employees depending on junk food from roadside shops and street food vendors.

* Bright interiors, comfortable furniture: A specially-designed office ensures innovation among employees. According to psychoanalysts, mental and physical health is majorly dependent on the physical work environment. Hence, managed and co-working spaces these days prefer bright coloured furniture along with peppy interiors. Such colours make employees more productive and help them stay active throughout the day. Comfortable ergonomic furniture has also proven to alleviate stress in employees, hence promoting a positive work environment. Interactive work desks are also a new concept offered by co-working office providers, which not only encourages interaction but can also change height and position according to the comfort postures of employees.

* Gyms for strong work life: Various studies have claimed a solid connection between the amount of time people spend in sitting and thereafter the increased chances of diabetes, obesity, cancer and cardiovascular diseases. Hence, co-working and managed office spaces are providing office gyms for employees to maintain energy, enthusiasm and positivity — while helping an individual become healthier and fitter.


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World Sleep Day: Over 60% Indians feel sleep is not a priority, finds Survey



world sleep day

New Delhi, March 16: Over 60 per cent of Indians feel exercise is the top factor impacting health and well-being more than sleep, finds a survey that highlighted the need for good sleep for better health.

The survey, led by Philips India, showed that 19 per cent of Indian adults account overlapping work hours with normal sleep time (shift work sleep disorder) as a key barrier to sleep.

According to another 32 per cent, technology is a major sleep distractor.

While 45 per cent adults have tried mediation to initiate and maintain good sleep, 24 per cent reported having tried specialised bedding.

“Sleep disorder is a much more serious issue than what most people understand, especially given their direct correlation with other serious conditions like cardiovascular disease, diabetes, stroke etc,” Harish R, Head (Sleep and Respiratory Care) at Philips, said in a statement.

“In a country where snoring is traditionally associated with sound sleep, it is extremely challenging to make people aware that it is a sign of a serious sleep disorder,” he added.

The findings will provide directions to raise awareness and innovate interventions to ensure an important but oft-neglected aspect of health and wellbeing: sleep health.

The survey was based on Philips annual global survey conducted with over 15,000 adults across 13 countries — India, the US, the UK, Germany, Poland, France, China, Australia, Colombia, Argentina, Mexico, Brazil and Japan.


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